35 results on '"diagnostic tools"'
Search Results
2. CRISPR applications in cancer diagnosis and treatment.
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Wang, Mingxia, Chen, Menghui, Wu, Xia, Huang, Xinbo, and Yu, Bo
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Cancer remains a significant global health challenge, necessitating the exploration of novel and more precise therapeutic options beyond conventional treatments. In this regard, clustered regularly interspaced short palindromic repeats (CRISPR) systems have emerged as highly promising tools for clinical gene editing applications. The CRISPR family encompasses diverse CRISPR-associated (Cas) proteins that possess the ability to recognize specific target sequences. The initial CRISPR system consisted of the Cas9 protein and a single-guide RNA, which guide Cas9 to the desired target sequence, facilitating precise double-stranded cleavage. In addition to the traditional cis-cleavage activity, the more recently discovered Cas12 and Cas13 proteins exhibit trans-cleavage activity, which expands their potential applications in cancer diagnosis. In this review, we provide an overview of the functional characteristics of Cas9, Cas12, and Cas13. Furthermore, we highlight the latest advancements and applications of these CRISPR systems in cancer gene therapy and molecular diagnosis. We also emphasize the importance of understanding the strengths and limitations of each CRISPR system to maximize their clinical utility. By providing a comprehensive overview of the current state of CRISPR technology in cancer research, we aim to inspire further exploration and innovation in this rapidly evolving field. [ABSTRACT FROM AUTHOR]
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- 2023
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3. Factors associated with the utilization of diagnostic tools among countries with different income levels during the COVID-19 pandemic
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Zhou, Shuduo, Feng, Xiangning, Hu, Yunxuan, Yang, Jian, Chen, Ying, Bastow, Jon, Zheng, Zhi-Jie, and Xu, Ming
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- 2023
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4. Association of neutrophil to lymphocyte ratio with preterm necrotizing enterocolitis: a retrospective case-control study.
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Mu, Yuju and Wang, Hua
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Background: There have been few studies on the relationship between the neutrophil to lymphocyte ratio (NLR) and necrotizing enterocolitis (NEC). We conducted a retrospective case-control study to investigate this relationship in preterm neonates.Methods: A total of 199 preterm neonates diagnosed with NEC between January 2018 and January 2020 were included in this study. For each preterm infant with NEC that was admitted to the neonatal intensive care unit (NICU), controls were preterm neonates (matched for gestation and year of birth) who were not diagnosed with NEC. Exclusion criteria were post-maturity, small or large for gestational age (week of pregnancy), congenital major anomalies, and cyanotic congenital heart disease. Univariate and multivariate logistic regression analyses were used to identify the association between NLR and preterm NEC.Results: This study included 93 preterm neonates with NEC and 106 matched controls. There were no significant differences in gestational age (GA), birth weight (BW), age, sex, vaginal delivery (VD), chorioamnionitis (CA), and gestational diabetes mellitus (GDM) between the groups. Compared with the control group, the lower and higher NLR levels in the NEC group were statistically different. Following univariate analysis, NLR was a risk factor for NEC (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.00-1.90; P = 0.042), and according to multivariate analysis, risk factors for NEC were NLR ≥ 3.20 and NLR < 1.60, within 1 week before NEC diagnosis. Thus, NLR values of ≥ 1.60 and < 3.20 were determined as the predictive cut-off values for protecting preterm infants from NEC (Model I: OR, 0.20; 95% CI, 0.10-0.40; P < 0.001) and (Model II: OR, 0.10; 95% CI, 0.00-0.40; P < 0.001].Conclusions: NLR ≥ 1.60 and NLR < 3.20 were associated with a decreased risk of NEC in preterm infants. [ABSTRACT FROM AUTHOR]- Published
- 2022
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5. High diagnostic performance of independent alpha-synuclein seed amplification assays for detection of early Parkinson’s disease
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Christina D. Orrú, Claudio Soto, Samantha J. Hutten, Simone Giaisi, Un Jung Kang, Byron Caughey, Andrew G. Hughson, David Erick Lafontant, Jennifer Mollon, Bradley R. Groveman, Bret Holguin, Luis Concha-Marambio, Kalpana Merchant, Chelsea Caspell-Garcia, Roland G. Heym, Christopher S. Coffey, Carly M. Farris, and Marco J. Russo
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Oncology ,medicine.medical_specialty ,Neurology ,Parkinson's disease ,Diagnostic tools ,Synucleinopathy ,Pathology and Forensic Medicine ,Alpha-synuclein ,Cellular and Molecular Neuroscience ,chemistry.chemical_compound ,PMCA ,Internal medicine ,medicine ,RC346-429 ,Synucleinopathies ,Reproducibility ,business.industry ,Research ,Seed amplification assay ,RT-QuIC ,medicine.disease ,chemistry ,Clinical diagnosis ,Cohort ,Parkinson’s disease ,Neurology. Diseases of the nervous system ,Neurology (clinical) ,business - Abstract
Alpha-synuclein seed amplification assays (αSyn-SAAs) are promising diagnostic tools for Parkinson’s disease (PD) and related synucleinopathies. They enable detection of seeding-competent alpha-synuclein aggregates in living patients and have shown high diagnostic accuracy in several PD and other synucleinopathy patient cohorts. However, there has been confusion about αSyn-SAAs for their methodology, nomenclature, and relative accuracies when performed by various laboratories. We compared αSyn-SAA results obtained from three independent laboratories to evaluate reproducibility across methodological variations. We utilized the Parkinson’s Progression Markers Initiative (PPMI) cohort, with DATSCAN data available for comparison, since clinical diagnosis of early de novo PD is critical for neuroprotective trials, which often use dopamine transporter imaging to enrich their cohorts. Blinded cerebrospinal fluid (CSF) samples for a randomly selected subset of PPMI subjects (30 PD, 30 HC, and 20 SWEDD), from both baseline and year 3 collections for the PD and HC groups (140 total CSF samples) were analyzed in parallel by each lab according to their own established and optimized αSyn-SAA protocols. The αSyn-SAA results were remarkably similar across laboratories, displaying high diagnostic performance (sensitivity ranging from 86 to 96% and specificity from 93 to 100%). The assays were also concordant for samples with results that differed from clinical diagnosis, including 2 PD patients determined to be clinically inconsistent with PD at later time points. All three assays also detected 2 SWEDD subjects as αSyn-SAA positive who later developed PD with abnormal DAT-SPECT. These multi-laboratory results confirm the reproducibility and value of αSyn-SAA as diagnostic tools, illustrate reproducibility of the assay in expert hands, and suggest that αSyn-SAA has potential to provide earlier diagnosis with comparable or superior accuracy to existing methods. Supplementary Information The online version contains supplementary material available at 10.1186/s40478-021-01282-8.
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- 2021
6. Tuberculosis screening costs and cost-effectiveness in high-risk groups: a systematic review
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Alice Zwerling, H. Alsdurf, B. Empringham, and Cecily Miller
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Cost effectiveness ,Tuberculosis in HIV-infected ,Cost-Benefit Analysis ,Population ,Psychological intervention ,Infectious and parasitic diseases ,RC109-216 ,Disease ,Tuberculosis screening ,Diagnostic tools ,Variable cost ,03 medical and health sciences ,0302 clinical medicine ,Risk groups ,Environmental health ,Medicine ,Tuberculosis ,Humans ,Mass Screening ,030212 general & internal medicine ,education ,education.field_of_study ,Tuberculosis control ,business.industry ,030503 health policy & services ,Research ,Economic evaluation ,3. Good health ,Infectious Diseases ,Systematic review ,Cost-effectiveness ,Quality-Adjusted Life Years ,0305 other medical science ,business ,Delivery of Health Care - Abstract
Background Systematic screening for active tuberculosis (TB) is a strategy which requires the health system to seek out individuals, rather than waiting for individuals to self-present with symptoms (i.e., passive case finding). Our review aimed to summarize the current economic evidence and understand the costs and cost-effectiveness of systematic screening approaches among high-risk groups and settings. Methods We conducted a systematic review on economic evaluations of screening for TB disease targeting persons with clinical and/or structural risk factors, such as persons living with HIV (PLHIV) or persons experiencing homelessness. We searched three databases for studies published between January 1, 2010 and February 1, 2020. Studies were included if they reported cost and a key outcome measure. Owing to considerable heterogeneity in settings and type of screening strategy, we synthesized data descriptively. Results A total of 27 articles were included in our review; 19/27 (70%) took place in high TB burden countries. Seventeen studies took place among persons with clinical risk factors, including 14 among PLHIV, while 13 studies were among persons with structural risk factors. Nine studies reported incremental cost-effectiveness ratios (ICERs) ranging from US$51 to $1980 per disability-adjusted life year (DALY) averted. Screening was most cost-effective among PLHIV. Among persons with clinical and structural risk factors there was limited evidence, but screening was generally not shown to be cost-effective. Conclusions Studies showed that screening is most likely to be cost-effective in a high TB prevalence population. Our review highlights that to reach the “missing millions” TB programmes should focus on simple, cheaper initial screening tools (i.e., symptom screen and CXR) followed by molecular diagnostic tools (i.e., Xpert®) among the highest risk groups in the local setting (i.e., PLHIV, urban slums). Programmatic costs greatly impact cost-effectiveness thus future research should provide both fixed and variable costs of screening interventions to improve comparability.
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- 2021
7. Lipidomic risk score independently and cost-effectively predicts risk of future type 2 diabetes: results from diverse cohorts.
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Mamtani, Manju, Kulkarni, Hemant, Wong, Gerard, Weir, Jacquelyn M., Barlow, Christopher K., Dyer, Thomas D., Almasy, Laura, Mahaney, Michael C., Comuzzie, Anthony G., Glahn, David C., Magliano, Dianna J., Zimmet, Paul, Shaw, Jonathan, Williams-Blangero, Sarah, Duggirala, Ravindranath, Blangero, John, Meikle, Peter J., and Curran, Joanne E.
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BLOOD lipids , *BIOMARKERS , *TYPE 2 diabetes risk factors , *TYPE 2 diabetes diagnosis , *LIQUID chromatography , *ELECTROSPRAY ionization mass spectrometry - Abstract
Background: Detection of type 2 diabetes (T2D) is routinely based on the presence of dysglycemia. Although disturbed lipid metabolism is a hallmark of T2D, the potential of plasma lipidomics as a biomarker of future T2D is unknown. Our objective was to develop and validate a plasma lipidomic risk score (LRS) as a biomarker of future type 2 diabetes and to evaluate its cost-effectiveness for T2D screening. Methods: Plasma LRS, based on significantly associated lipid species from an array of 319 lipid species, was developed in a cohort of initially T2D-free individuals from the San Antonio Family Heart Study (SAFHS). The LRS derived from SAFHS as well as its recalibrated version were validated in an independent cohort from Australia - the AusDiab cohort. The participants were T2D-free at baseline and followed for 9197 person-years in the SAFHS cohort (n = 771) and 5930 person-years in the AusDiab cohort (n = 644). Statistically and clinically improved T2D prediction was evaluated with established statistical parameters in both cohorts. Modeling studies were conducted to determine whether the use of LRS would be cost-effective for T2D screening. The main outcome measures included accuracy and incremental value of the LRS over routinely used clinical predictors of T2D risk; validation of these results in an independent cohort and cost-effectiveness of including LRS in screening/intervention programs for T2D. Results: The LRS was based on plasma concentration of dihydroceramide 18:0, lysoalkylphosphatidylcholine 22:1 and triacyglycerol 16:0/18:0/18:1. The score predicted future T2D independently of prediabetes with an accuracy of 76 %. Even in the subset of initially euglycemic individuals, the LRS improved T2D prediction. In the AusDiab cohort, the LRS continued to predict T2D significantly and independently. When combined with risk-stratification methods currently used in clinical practice, the LRS significantly improved the model fit (p < 0.001), information content (p < 0.001), discrimination (p < 0.001) and reclassification (p < 0.001) in both cohorts. Modeling studies demonstrated that LRS-based risk-stratification combined with metformin supplementation for high-risk individuals was the most cost-effective strategy for T2D prevention. Conclusions: Considering the novelty, incremental value and cost-effectiveness of LRS it should be used for risk-stratification of future T2D. [ABSTRACT FROM AUTHOR]
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- 2016
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8. High prevalence of asymptomatic malaria infections: a cross-sectional study in rural areas in six departments in Haiti.
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Elbadry, Maha A., Al-Khedery, Basima, Tagliamonte, Massimiliano S., Yowell, Charles A., Raccurt, Christian P., Existe, Alexandre, Boncy, Jacques, Weppelmann, Thomas A., De Rochars, Valery E. M. Beau, Lemoine, Jean F., Okech, Bernard A., and Dame, John B.
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MALARIA , *PUBLIC health , *TECHNOLOGICAL innovations , *PLASMODIUM falciparum , *PROTOZOAN diseases - Abstract
Background: Public health measures are poised for transition from malaria control to malaria elimination on the island of Hispaniola. Assessment of the reservoir of asymptomatic infections from which acute malaria cases may derive is critical to plan and evaluate elimination efforts. Current field technology is ill suited for detecting submicroscopic infections, thus highly sensitive survey methods capable of detecting virtually all infections are needed. In this study the prevalence of infection with Plasmodium falciparum was determined in patients seeking medical care primarily for non-febrile conditions in six departments in Haiti using a newly designed qRT-PCR-based assay. Methods: Three different methods of parasite detection were compared to assess their utility in approximating the prevalence of P. falciparum infections in the population: malaria rapid diagnostic test (RDT) designed to detect histidinerich protein 2 (HRP2), thick smear microscopy, and a quantitative reverse transcription polymerase chain reaction (qRTPCR) assay based upon the small sub-unit ribosomal RNA. The limit of detection of the qRT-PCR assay utilized was 0.0003 parasite/μL of blood. Venous blood was obtained from a total of 563 subjects from six departments in Haiti, all of whom were seeking medical attention without complaints consistent with malaria. Each subject was questioned for knowledge and behaviour using demographic and epidemiological survey to identify risk factors for disease transmission. Results: Among the 563 samples tested, ten and 16 were found positive for malaria by RDT and microscopy, respectively. Using the qRT-PCR test to assess the infection status of these subjects, an additional 92 were identified for a total of 108. Based upon the qRT-PCR assay results, a wide variation in prevalence of infection in asymptomatic subjects was seen between geographic locations ranging from 4-41 %. The prevalence of infection was highest in the Grand Anse, Nord and Sud-Est Departments, and demographic data from questionnaires provide evidence for focal disease transmission. Conclusions: The qRT-PCR assay is sufficiently sensitive to identify an unexpectedly large number of asymptomatic, submicroscopic infections. Identifying and clearing these infections presents a significant challenge to both control and elimination efforts, but the qRT-PCR assay offers a reliable method to identify them. [ABSTRACT FROM AUTHOR]
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- 2015
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9. Epidemiology and genotyping of Anaplasma marginale and co-infection with piroplasms and other Anaplasmataceae in cattle and buffaloes from Egypt
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AL-Hosary, Amira, Răileanu, Cristian, Tauchmann, Oliver, Fischer, Susanne, Nijhof, Ard M., and Silaghi, Cornelia
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- 2020
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10. Next-generation-sequencing-based identification of familial hypercholesterolemia-related mutations in subjects with increased LDL–C levels in a latvian population.
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Radovica-Spalvina, Ilze, Latkovskis, Gustavs, Silamikelis, Ivars, Fridmanis, Davids, Elbere, Ilze, Ventins, Karlis, Ozola, Guna, Erglis, Andrejs, and Klovins, Janis
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GENETIC mutation , *HYPERCHOLESTEREMIA , *LOW density lipoproteins , *GENETIC disorders , *CORONARY heart disease risk factors , *GENE amplification , *GENETICS - Abstract
Background: Familial hypercholesterolemia (FH) is one of the commonest monogenic disorders, predominantly inherited as an autosomal dominant trait. When untreated, it results in early coronary heart disease. The vast majority of FH remains undiagnosed in Latvia. The identification and early treatment of affected individuals remain a challenge worldwide. Most cases of FH are caused by mutations in one of four genes, APOB, LDLR, PCSK9, or LDLRAP1. The spectrum of disease-causing variants is very diverse and the variation detection panels usually used in its diagnosis cover only a minority of the disease-causing gene variants. However, DNA-based tests may provide an FH diagnosis for FH patients with no physical symptoms and with no known family history of the disease. Here, we evaluate the use of targeted next-generation sequencing (NGS) to identify cases of FH in a cohort of patients with coronary artery disease (CAD) and individuals with abnormal low-density lipoprotein-cholesterol (LDL–C) levels. Methods: We used targeted amplification of the coding regions of LDLR, APOB, PCSK9, and LDLRAP1, followed by NGS, in 42 CAD patients (LDL–C, 4.1–7.2 mmol/L) and 50 individuals from a population-based cohort (LDL–C, 5.1–9.7 mmol/L). Results: In total, 22 synonymous and 31 nonsynonymous variants, eight variants in close proximity (10 bp) to intron-exon boundaries, and 50 other variants were found. We identified four pathogenic mutations (p.(Arg3527Gln) in APOB, and p.(Gly20Arg), p.(Arg350*), and c.1706–10G > A in LDLR) in seven patients (7.6 %). Three possible pathogenic variants were also found in four patients. Conclusion: NGS-based methods can be used to detect FH in high-risk individuals when they do not meet the defined clinical criteria. [ABSTRACT FROM AUTHOR]
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- 2015
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11. Diagnostic accuracy of cardiac MRI, FDG-PET, and myocardial biopsy for the diagnosis of cardiac sarcoidosis: a protocol for a systematic review and meta-analysis
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Dominik Roth, Marialena Trivella, Nikolaos P E Kadoglou, Harald Herkner, Mariska M.G. Leeflang, and René Spijker
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Protocol (science) ,medicine.medical_specialty ,lcsh:R5-920 ,Myocardial biopsy ,business.industry ,Indirect comparison ,Diagnostic accuracy ,Cardiac sarcoidosis ,030204 cardiovascular system & hematology ,Diagnostic tools ,Sarcoidosis, Cardiac ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Diagnostic test accuracy ,Systematic review (diagnostic) ,0302 clinical medicine ,Meta-analysis ,medicine ,Protocol ,Fatal disease ,Bayesian meta-analysis ,Radiology ,business ,lcsh:Medicine (General) - Abstract
BackgroundCS constitutes a rare but potentially underdiagnosed and fatal disease. Its diagnosis remains difficult owing to the infrequent and indistinguishable symptoms and the lack of formal diagnostic criteria dependent upon the diagnostic techniques used. Early diagnosis and treatment, however, may help to counter its poor prognosis.We aim to characterize and compare the diagnostic accuracy of cardiac MRI, FDG-PET and myocardial biopsy for the diagnosis of cardiac sarcoidosis and to advance and compare methods for complex diagnostic test accuracy reviews and meta-analysis.MethodsFollowing a systematic review on DTA studies on the aforementioned topic, a four-part approach to meta-analysis will be used: (1) direct comparison of index tests with clinical reference standard, (2) indirect comparison of index tests with clinical reference standard, (3) addition of an alternative test to that indirect comparison (4) and Bayesian meta-analysis using results of part 3 as informative prior for comparisons analogous to part 1 and 2.DiscussionThe most widely recognized diagnostic algorithm for cardiac sarcoidosis is considered out of date, as it precedes the introduction of imaging techniques in diagnostic pathways. These novel imaging techniques, like CMR and FDG-PET scan, have emerged as promising diagnostic tools which may fill the current diagnostic gap. Thus, a systematic review and evaluation of CS diagnosis are much needed. Such an attempt is anticipated to alter the current diagnostic guidelines for CS by shedding more light on the role of sophisticated imaging techniques on prompt CS therapy and follow-up.Trial registrationPROSPERO,CRD42019047126
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- 2020
12. Paradigm shift in the diagnosis of peste des petits ruminants: scoping review
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Richard Kock, Steven Odongo, Edson Kinimi, Gerald Misinzo, and Serge Muyldermans
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Nanopore ,040301 veterinary sciences ,Loop-mediated isothermal amplification ,Recombinase Polymerase Amplification ,Review ,Biology ,Diagnostic tools ,Peste-des-petits-ruminants virus ,0403 veterinary science ,03 medical and health sciences ,Peste des petits ruminants ,Peste-des-Petits-Ruminants ,Animals ,Diagnostics ,030304 developmental biology ,0303 health sciences ,lcsh:Veterinary medicine ,General Veterinary ,Animal health ,04 agricultural and veterinary sciences ,General Medicine ,Ruminants ,Virology ,Reverse transcriptase ,Reverse transcription polymerase chain reaction ,lcsh:SF600-1100 ,Nanobodies - Abstract
Peste des petits ruminants virus causes a highly contagious disease, which poses enormous economic losses in domestic animals and threatens the conservation of wild herbivores. Diagnosis remains a cornerstone to the Peste des petits ruminants Global Control and Eradication Strategy, an initiative of the World Organisation for Animal Health and the Food and Agriculture Organisation. The present review presents the peste des petits ruminants diagnostic landscape, including the practicality of commercially available diagnostic tools, prototype tests and opportunities for new technologies. The most common peste des petits ruminants diagnostic tools include; agar gel immunodiffusion, counter-immunoelectrophoresis, enzyme-linked immunosorbent assays, reverse transcription polymerase chain reaction either gel-based or real-time, reverse transcription loop-mediated isothermal amplification, reverse transcription recombinase polymerase amplification assays, immunochromatographic lateral flow devices, luciferase immunoprecipitation system and pseudotype-based assays. These tests vary in their technical demands, but all require a laboratory with exception of immunochromatographic lateral flow and possibly reverse transcription loop-mediated isothermal amplification and reverse transcription recombinase polymerase amplification assays. Thus, we are proposing an efficient integration of diagnostic tests for rapid and correct identification of peste des petits ruminants in endemic zones and to rapidly confirm outbreaks. Deployment of pen-side tests will improve diagnostic capacity in extremely remote settings and susceptible wildlife ecosystems, where transportation of clinical samples in the optimum cold chain is unreliable.
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- 2020
13. Large-scale implementation of electronic Integrated Management of Childhood Illness (eIMCI) at the primary care level in Burkina Faso: a qualitative study on health worker perception of its medical content, usability and impact on antibiotic prescription and resistance
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Bessat, Cécile, Zonon, Noël Adannou, and D’Acremont, Valérie
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- 2019
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14. Diagnostic performance of salivary urea nitrogen dipstick to detect and monitor acute kidney disease in patients with malaria
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Calice-Silva, Viviane, Sacomboio, Euclides, Raimann, Jochen G., Evans, Rhys, dos Santos Sebastião, Cruz, Tchivango, Adelino Tchilanda, Kotanko, Peter, Levin, Nathan, and Pecoits-Filho, Roberto
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- 2018
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15. Dementia and immigrant groups: a qualitative study of challenges related to identifying, assessing, and diagnosing dementia
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Sagbakken, Mette, Spilker, Ragnhild Storstein, and Nielsen, T. Rune
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- 2018
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16. Arbovirus circulation among febrile patients at the greater Accra Regional Hospital, Ghana
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Simon Kofi Manu, Joseph H.K. Bonney, Deborah Pratt, Eudosia Esinam Agbosu, Farida Njelba Abdulai, Prince Osei Frimpong, and Theophilus Korku Adiku
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0301 basic medicine ,Male ,viruses ,Suspected dengue ,lcsh:Medicine ,Diagnostic tools ,medicine.disease_cause ,Antibodies, Viral ,Ghana ,Dengue fever ,Serology ,Dengue ,0302 clinical medicine ,030212 general & internal medicine ,Chikungunya ,Child ,lcsh:QH301-705.5 ,Cross Infection ,Coinfection ,virus diseases ,General Medicine ,Middle Aged ,Polymerase chain reaction ,Research Note ,Child, Preschool ,Differential diagnosis ,Female ,Chikungunya virus ,Adult ,medicine.medical_specialty ,Adolescent ,Ns1 antigen ,Arbovirus ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Young Adult ,Internal medicine ,parasitic diseases ,medicine ,Humans ,lcsh:Science (General) ,Aged ,business.industry ,lcsh:R ,Dengue Virus ,medicine.disease ,Regional hospital ,030104 developmental biology ,Cross-Sectional Studies ,lcsh:Biology (General) ,Chikungunya Fever ,business ,Arboviruses ,lcsh:Q1-390 - Abstract
Objective Arboviruses, Dengue and Chikungunya have become major international public health concerns due to their epidemics and introduction in new areas. In Ghana, little is known is about Dengue and Chikungunya viruses though the country has been listed as part of the 34 countries in which the viruses are endemic. This has been attributed partly to the lack of diagnostic tools for these viruses in several health facilities and institutions across the country. The purpose of this study was to detect and characterize these viral pathogens among febrile patients in Accra Ghana. Results This hospital-based cross-sectional study enrolled 260 suspected Dengue and/or Chikungunya febrile patients who submitted their clinical specimens of serum. Out of the total number tested with both molecular and serological tools, Chikungunya and Dengue specific total antibodies were detected from 72 (27.69%) and 180 (69.23%) respectively. None of the participants tested positive for Dengue and Chikungunya by reverse transcription-polymerase chain reaction (RT-PCR) and with the Dengue-specific NS1 antigen strip kits. Our findings suggested that Dengue and Chikungunya viruses may be circulating but are being missed among febrile patients. Differential diagnosis work-up in febrile patients should be made to include Dengue and Chikungunya infections.
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- 2019
17. Application of fungal fluorescent staining in oral candidiasis: diagnostic analysis of 228 specimens
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Yilin Yao, Lan Wu, Hong Sun, Linjun Shi, and Chunye Zhang
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Microbiology (medical) ,Adult ,Male ,Pathology ,medicine.medical_specialty ,Biopsy ,lcsh:QR1-502 ,Fungal culture ,Biology ,Diagnostic tools ,Microbiology ,Sensitivity and Specificity ,lcsh:Microbiology ,Fluorescence ,03 medical and health sciences ,Diagnostic analysis ,Candidiasis, Oral ,Predictive Value of Tests ,medicine ,Humans ,Aged ,Fluorescent Dyes ,0303 health sciences ,Mouth ,medicine.diagnostic_test ,Staining and Labeling ,030306 microbiology ,Periodic acid-Schiff reagent staining ,Gold standard (test) ,Middle Aged ,Periodic Acid-Schiff Reaction ,Predictive value ,Staining ,Parasitology ,Oral candidiasis ,Microscopy, Fluorescence ,Fluorescent staining ,Female ,Fungal fluorescent staining ,Research Article - Abstract
Background Several conventional methods, including fungal culture and periodic acid-Schiff (PAS) reagent staining, have been used to diagnose oral candidiasis. The aim of this study was to evaluate the efficacy of a novel method, fungal fluorescent staining, in relation to conventional protocols in the diagnosis of oral candidiasis. Methods We collected 106 oral swabs and 122 oral biopsy tissues from patients highly suspected with oral candidiasis. We applied fungal culture and periodic acid-Schiff reagent staining as the gold standard diagnostic tools. The efficacy of these methods in determining the presence of Candida was compared with that of fluorescent staining. Results In the majority of specimens subjected to fluorescent staining, fungal organisms were distinguished by blue fluorescence surrounding their tubular or annular shapes. The sensitivity, specificity, Youden index, positive predictive value and negative predictive value of the fluorescent staining method were 82.7, 93.5, 76.7, 96.8 and 69.1% in oral swabs and 90.0, 92.9, 82.9, 96.0 and 82.9% in oral biopsy tissues, respectively. Conclusions Fungal fluorescent staining represents a rapid method for detection of Candida, supporting its potential utility as an effective early diagnostic tool for oral candidiasis.
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- 2019
18. Large-scale implementation of electronic Integrated Management of Childhood Illness (eIMCI) at the primary care level in Burkina Faso : a qualitative study on health worker perception of its medical content, usability and impact on antibiotic prescription and resistance
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Valérie D'Acremont, Cécile Bessat, and Noël Adannou Zonon
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Male ,Antimicrobial resistance ,0302 clinical medicine ,Health facility ,Health care ,Medicine ,030212 general & internal medicine ,Child ,Qualitative Research ,media_common ,Integrated Management of Childhood Illness ,lcsh:Public aspects of medicine ,Bacterial Infections ,Middle Aged ,Primary care ,Computerized decision support system ,Anti-Bacterial Agents ,Virus Diseases ,Computers, Handheld ,Antibiotic use ,Female ,Algorithms ,Integrated management of childhood illness ,Research Article ,Tablets ,Adult ,medicine.medical_specialty ,Fever ,Attitude of Health Personnel ,media_common.quotation_subject ,030209 endocrinology & metabolism ,Clinician perception ,Interviews as Topic ,Electronic clinical algorithms ,03 medical and health sciences ,Nursing ,Burkina Faso ,Drug Resistance, Bacterial ,Humans ,Quality (business) ,Diagnostic tools ,Primary Health Care ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Consumer Behavior ,Decision Support Systems, Clinical ,Triage ,Drug Utilization ,Health Facilities ,Low-resource countries ,Biostatistics ,business ,Qualitative research ,Anti-Bacterial Agents/administration & dosage ,Anti-Bacterial Agents/therapeutic use ,Bacterial Infections/drug therapy ,Bacterial Infections/microbiology ,Burkina Faso/epidemiology ,Computers, Handheld/standards ,Decision Support Systems, Clinical/organization & administration ,Decision Support Systems, Clinical/standards ,Fever/drug therapy ,Fever/microbiology ,Primary Health Care/organization & administration ,Primary Health Care/standards ,Virus Diseases/drug therapy ,Virus Diseases/microbiology - Abstract
Background Electronic clinical decision algorithms (eCDAs) that guide clinicians during patient management are being deployed in resource-limited settings to improve the quality of care and rational use of medicines (especially antimicrobials). Little is known on how local clinicians perceive the use and impact of these tools in their daily practice. This study investigates clinician insights on an eIMCI tool. Specifically, we report their views on its medical content, assess their knowledge on microbes, antimicrobials and the development of resistance. Methods This qualitative study was conducted in the frame of a large-scale implementation in Burkina Faso of an eIMCI tool developed by the Swiss NGO Terre des hommes. Twelve in-depth interviews and 2 focus-group discussions were conducted including 21 health workers from 10 primary care facilities. Emerging themes were identified using qualitative data analysis software. Results eIMCI users expressed a high level of satisfaction, slowness of the tablet was perceived as the major inconvenience limiting uptake. Several frequent illnesses were identified as missing in the algorithm along with guidance for fever without focus. When asked about existing types of microbes, 9 and 4 out of 21 participants could mention bacteria and virus respectively; only 5 correctly answered that antibiotics had no action on viral disease and 6 mentioned the risk of antibiotic resistance. Level of knowledge was higher in nurses than in less trained health workers. The tool was perceived as improving patient management and the rational use of antibiotics. Positive changes in health facility organisation were reported, such as task shifting and improved triage. eIMCI was also perceived as a learning tool, and users expressed a strong desire to expand the geographic and temporal scope of the intervention. Conclusion The use of eICMI was widely accepted and perceived as a powerful tool guiding daily practice. Findings suggest that it has positive effects on the health care system beyond the quality of consultation. To support large uptake and sustainability, better training of health workers in infectiology is essential and the medical content of eIMCI should be optimized to include frequent diseases and, for each of them, the appropriate management plan. Electronic supplementary material The online version of this article (10.1186/s12889-019-6692-6) contains supplementary material, which is available to authorized users.
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- 2019
19. Bringing patient-centered tuberculosis diagnosis into the light of day
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J. Lucian Davis
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Male ,Time Factors ,Patient-centered care ,lcsh:Medicine ,HIV Infections ,Diagnostic tools ,Smear microscopy ,South Africa ,0302 clinical medicine ,Sputum collection ,Diagnosis ,Medicine ,030212 general & internal medicine ,Diagnostics ,Fluorescence microscopy ,Microscopy ,Incidence ,General Medicine ,Africa, Eastern ,Middle Aged ,Prognosis ,Spot sputum ,Costs and Cost Analysis ,Female ,Medical emergency ,Research Article ,Adult ,Tuberculosis ,Asia ,030231 tropical medicine ,India ,Sensitivity and Specificity ,Specimen Handling ,03 medical and health sciences ,Young Adult ,Tuberculosis diagnosis ,Early morning sputum ,Humans ,Tuberculosis, Pulmonary ,business.industry ,Diagnostic Tests, Routine ,lcsh:R ,Sputum ,Mycobacterium tuberculosis ,medicine.disease ,CD4 Lymphocyte Count ,North America ,Commentary ,business ,Patient centered - Abstract
Background The use of early morning sputum samples (EMS) to diagnose tuberculosis (TB) can result in treatment delay given the need for the patient to return to the clinic with the EMS, increasing the chance of patients being lost during their diagnostic workup. However, there is little evidence to support the superiority of EMS over spot sputum samples. In this new analysis of the REMoxTB study, we compare the diagnostic accuracy of EMS with spot samples for identifying Mycobacterium tuberculosis pre- and post-treatment. Methods Patients who were smear positive at screening were enrolled into the study. Paired sputum samples (one EMS and one spot) were collected at each trial visit pre- and post-treatment. Microscopy and culture on solid LJ and liquid MGIT media were performed on all samples; those missing corresponding paired results were excluded from the analyses. Results Data from 1115 pre- and 2995 post-treatment paired samples from 1931 patients enrolled in the REMoxTB study were analysed. Patients were recruited from South Africa (47%), East Africa (21%), India (20%), Asia (11%), and North America (1%); 70% were male, median age 31 years (IQR 24–41), 139 (7%) co-infected with HIV with a median CD4 cell count of 399 cells/μL (IQR 318–535). Pre-treatment spot samples had a higher yield of positive Ziehl–Neelsen smears (98% vs. 97%, P = 0.02) and LJ cultures (87% vs. 82%, P = 0.006) than EMS, but there was no difference for positivity by MGIT (93% vs. 95%, P = 0.18). Contaminated and false-positive MGIT were found more often with EMS rather than spot samples. Surprisingly, pre-treatment EMS had a higher smear grading and shorter time-to-positivity, by 1 day, than spot samples in MGIT culture (4.5 vs. 5.5 days, P
- Published
- 2017
20. Concentration of fine needle aspirates similar to molecular method improves sensitivity of the diagnosis of tuberculous lymphadenitis in Addis Ababa, Ethiopia
- Author
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Olifan Zewdie, Eyob Hirpa, Adane Mihret, Gobena Ameni, and Tamrat Abebe
- Subjects
0301 basic medicine ,TBLN ,Adult ,DNA, Bacterial ,Male ,Pathology ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,030106 microbiology ,Biopsy, Fine-Needle ,Lymph node aspirate ,Data entry ,Tuberculosis, Lymph Node ,Diagnostic tools ,Polymerase Chain Reaction ,Sensitivity and Specificity ,Smear microscopy ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Medical microbiology ,Medicine ,Humans ,Prospective Studies ,Developing Countries ,Aged ,Microscopy ,business.industry ,Mycobacterium tuberculosis ,Middle Aged ,medicine.disease ,Tuberculous lymphadenitis ,Infectious Diseases ,PCR ,Cross-Sectional Studies ,FNA ,030220 oncology & carcinogenesis ,Addis Ababa ,Female ,Smear concentration ,Ethiopia ,Lymph Nodes ,business ,Fine-needle aspirate ,Research Article - Abstract
Background Tuberculous lymphadenitis (TBLN) diagnosis has been a true challenge solely by clinical evidence in developing countries, due to limited the diagnostic facility on hand. However, the availability and affordability of available diagnostic tools in resource-limited settings like Ethiopia necessitates the quest for other techniques with added value over direct Z-N microscopy. Therefore, we aimed at to assess whether the concentration of lymph node aspirate similarly improves the detection rate of tuberculous lymphadenitis or not. Materials and methods A cross-sectional study design was conducted on 132 individual subjects presumptive for tuberculous lymphadenitis from February to October 2013 in Addis Ababa, Ethiopia. Fine needle aspirate (FNA) samples were collected from the cases and cultured on Löwenstein-Jensen (LJ) slants. Identification of species and strains of mycobacteria was made by region of difference (RD) based polymerase chain reaction (PCR). Data entry and statistical analyses were performed by SPSS version 20. The confidence level of 95% was used for statistical significance. Result A total of 132 study subjects were included in our study. Of these 56.1% (74/132) were positive for M. tuberculosis on culture. The detection rate of direct smear microscopy and the concentration method were 29.5 and 65.2% respectively. The sensitivity of direct smear microscopy was 43.2%, for concentrated smear microscopy 94.5%, for PCR 93.2% and for cytomorphology 95.4%. The level of agreement of concentrated ZN smear microscopy was 0.62 which was very similar with kappa of 0.58 of molecular (PCR) technique. AFB positivity by the concentration method and molecular method was increased in caseous aspirates as compared to purulent and hemorrhagic aspirates though it was not statistically significant (p-value = 0.18) and (p = 0.62) respectively. Conclusion The concentration of FNA (Fine Needle Aspirate) aspirates for acid-fast smear microscopy similarly improves the sensitivity of acid fast bacilli in diagnosing of TBLN.
- Published
- 2017
21. How best to determine causative pathogens of pneumonia
- Author
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David R. Murdoch
- Subjects
0301 basic medicine ,Lung microbiome ,030106 microbiology ,Pneumonia ,Biology ,Diagnostic tools ,medicine.disease ,respiratory tract diseases ,Polymerase chain reaction ,03 medical and health sciences ,0302 clinical medicine ,PCR ,Immunology ,medicine ,Commentary ,030212 general & internal medicine ,Aetiology ,Pneumonia (non-human) ,Diagnostics ,Nucleic acid detection - Abstract
The biggest recent development in pneumonia diagnostics has been the increased availability and use of nucleic acid detection assays, although this change has brought with it new challenges about the interpretation of positive results. Recognition of the existence of the lung microbiome has challenged the traditional views of pneumonia pathogenesis and may provide the opportunity for new diagnostic tools that are focused on more than just detection of specific known pathogens.
- Published
- 2016
22. Clinical detection and characterization of bacterial pathogens in the genomics era
- Author
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Pierre-Edouard Fournier, Grégory Dubourg, and Didier Raoult
- Subjects
business.industry ,Systems biology ,Virulence ,Genomics ,Human pathogen ,Computational biology ,Review ,Biology ,Diagnostic tools ,Genome ,Human genetics ,Biotechnology ,Genetics ,Molecular Medicine ,Genetics(clinical) ,business ,Molecular Biology ,Genotyping ,Genetics (clinical) - Abstract
The availability of genome sequences obtained using next-generation sequencing (NGS) has revolutionized the field of infectious diseases. Indeed, more than 38,000 bacterial and 5,000 viral genomes have been sequenced to date, including representatives of all significant human pathogens. These tremendous amounts of data have not only enabled advances in fundamental biology, helping to understand the pathogenesis of microorganisms and their genomic evolution, but have also had implications for clinical microbiology. Here, we first review the current achievements of genomics in the development of improved diagnostic tools, including those that are now available in the clinic, such as the design of PCR assays for the detection of microbial pathogens, virulence factors or antibiotic-resistance determinants, or the design of optimized culture media for ‘unculturable’ pathogens. We then review the applications of genomics to the investigation of outbreaks, either through the design of genotyping assays or the direct sequencing of the causative strains. Finally, we discuss how genomics might change clinical microbiology in the future. Electronic supplementary material The online version of this article (doi:10.1186/s13073-014-0114-2) contains supplementary material, which is available to authorized users.
- Published
- 2014
23. Cohort profile: Greifswald approach to individualized medicine (GANI_MED)
- Author
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Uwe Lendeckel, Marcus Dörr, Vivian Werner, Kathleen Klein, Werner Siegmund, Beate Fiene, Rainer Rettig, Roberto Lorbeer, Nele Friedrich, Wolfgang Lieb, Matthias Schwab, Markus M. Lerch, Nicole Endlich, Jana Kuhn, Holger Kock, Wolfgang Rathmann, Pia Erdmann, Sylvia Stracke, Karlhans Endlich, Michael Hecker, Marek Zygmunt, Stephan B. Felix, Manuela Gesell Salazar, Julia Mayerle, Wolfgang Hoffmann, Hans J. Grabe, Konrad Meissner, Andrea Schulz, Konrad Ott, Henriette E. Meyer zu Schwabedissen, Henri Wallaschofski, Tim Kacprowski, Janina Krafczyk, Martin Langanke, Claudia Richardt, Christoph Havemann, Henry Völzke, Heinrich Assel, Matthias Nauck, Thomas Bahls, Tobias Fischer, Elke Hammer, Robin Haring, Uwe Völker, Heyo K. Kroemer, Karsten Suhre, Thomas Kocher, Ulf Schminke, Mariacarla Gadebusch-Bondio, Saskia Ungerer, Ralf Ewert, Marius Ueffing, Steffen Flessa, Karen Saljé, and Birte Holtfreter
- Subjects
medicine.medical_specialty ,Epidemiology ,Genomic data ,Alternative medicine ,Diagnostic tools ,Time based ,General Biochemistry, Genetics and Molecular Biology ,Cohort Studies ,Metabolic Diseases ,medicine ,Protocol ,Humans ,Medical physics ,ddc:610 ,Precision Medicine ,Medicine(all) ,business.industry ,Biochemistry, Genetics and Molecular Biology(all) ,Optimal treatment ,Personalized Medicine ,General Medicine ,Individualized Medicine ,therapy [Cardiovascular Diseases] ,3. Good health ,therapy [Metabolic Diseases] ,Cardiovascular Diseases ,Family medicine ,Cohort ,Personalized medicine ,business ,Biomarkers ,Cohort study ,metabolism [Biomarkers] - Abstract
Background Individualized Medicine aims at providing optimal treatment for an individual patient at a given time based on his specific genetic and molecular characteristics. This requires excellent clinical stratification of patients as well as the availability of genomic data and biomarkers as prerequisites for the development of novel diagnostic tools and therapeutic strategies. The University Medicine Greifswald, Germany, has launched the “Greifswald Approach to Individualized Medicine” (GANI_MED) project to address major challenges of Individualized Medicine. Herein, we describe the implementation of the scientific and clinical infrastructure that allows future translation of findings relevant to Individualized Medicine into clinical practice. Methods/design Clinical patient cohorts (N > 5,000) with an emphasis on metabolic and cardiovascular diseases are being established following a standardized protocol for the assessment of medical history, laboratory biomarkers, and the collection of various biosamples for bio-banking purposes. A multi-omics based biomarker assessment including genome-wide genotyping, transcriptome, metabolome, and proteome analyses complements the multi-level approach of GANI_MED. Comparisons with the general background population as characterized by our Study of Health in Pomerania (SHIP) are performed. A central data management structure has been implemented to capture and integrate all relevant clinical data for research purposes. Ethical research projects on informed consent procedures, reporting of incidental findings, and economic evaluations were launched in parallel. peerReviewed
- Published
- 2014
24. Combining systems biology models of apoptosis provides superior predictions of the responsiveness of melanoma cells to cell death inducing drugs
- Author
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Markus Rehm, Jochen H. M. Prehn, Maximilian Wuerstle, Paul Curtayne, and Andreas U. Lindner
- Subjects
Programmed cell death ,business.industry ,Melanoma ,Systems biology ,Apoptosis pathways ,General Medicine ,medicine.disease ,Diagnostic tools ,General Biochemistry, Genetics and Molecular Biology ,Signalling ,Apoptosis ,Apoptotic cell death ,Immunology ,Meeting Abstract ,medicine ,Cancer research ,business - Abstract
Background Key to the clinical management of melanoma is the development of new diagnostic tools that predict individual patient prognosis and select from potential treatments those which may be effective. Identifying individual biomarkers in tumour cells to predict susceptibility to apoptotic cell death has thus far been largely unsuccessful, as apoptosis pathways show a high degree of signalling redundancy.
- Published
- 2015
25. Thoracic pseudotumours: a pictorial essay
- Author
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L Tolkachier, Eduardo Eyheremendy, Andres Zanfardini, D Pascuzzi, C Carrera, and S De Luca
- Subjects
medicine.medical_specialty ,Inflammatory pseudotumour ,Tuberculosis ,Radiological and Ultrasound Technology ,business.industry ,Hydatid cyst ,General Medicine ,medicine.disease ,Diagnostic tools ,eye diseases ,Pneumonia ,Oncology ,Poster Presentation ,Medicine ,Radiology, Nuclear Medicine and imaging ,Round atelectasis ,Radiology ,Sarcoidosis ,Differential diagnosis ,business - Abstract
Content organisation Diagnostic tools for evaluation of thoracic tumours and pseudotumours. We included in the differential diagnosis: Paraffinoma (1), a hydatid cyst (1), inflammatory pseudotumour (3), nodular tuberculosis (2) and sarcoidosis granulomas (1), round pneumonia (1), nodular criptococosis (1), post-surgical or tuberculosis scarring processes (2), organising cryptogenetic pneumonia (2) and round atelectasis (3).
- Published
- 2015
26. A three minute- screening tool for temporomandibular joint involvement in children with juvenile idiopathic arthritis
- Author
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Michiel Hendrik Steenks, Nico M Wulffraat, Harriette Willemijn van Bruggen, Gabriella Giancane, and Rob J. de Leeuw
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Pediatrics ,Arthritis ,Physical examination ,Diagnostic tools ,stomatognathic system ,Rheumatology ,Internal medicine ,medicine ,Immunology and Allergy ,Juvenile ,Screening tool ,In patient ,Pediatrics, Perinatology, and Child Health ,skin and connective tissue diseases ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Temporomandibular joint ,stomatognathic diseases ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Poster Presentation ,Physical therapy ,business - Abstract
The temporomandibular joint (TMJ) is a possible localization of arthritis in patients with Juvenile Idiopathic Arthritis (JIA), with an estimated prevalence around 50%. Despite the decreasing involvement in the last years, maybe due to the current treatment strategies, TMJ remains one of the most clinically under recognized affected joints in JIA patients. The clinical examination of TMJ is often unreliable, even for experienced rheumatologists, leading to the need of more specific diagnostic tools.
- Published
- 2014
27. Innovative strategies for prediction and targeted prevention of glaucoma in healthy vasospastic individuals: context of neurodegenerative pathologies
- Author
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Kristina Yeghiazaryan, Olga Golubnitschaja, and Josef Flammer
- Subjects
Down syndrome ,genetic structures ,business.industry ,Health Policy ,Eye disease ,Biochemistry (medical) ,Disease progression ,Glaucoma ,Context (language use) ,Disease ,Bioinformatics ,Diagnostic tools ,medicine.disease ,Drug Discovery ,Meeting Abstract ,Medicine ,Neuronal thread protein ,business - Abstract
Scientific background and objectives Worldwide, 67 million patients are affected by the neurodegenerative eye disease glaucoma. Glaucomatous optic neuropathy (GON) is the second leading cause of permanent vision loss. GON is a chronic degenerative process the onset of which is not possible to monitor by currently existing diagnostic tools. Early treatment has been reported to be highly beneficial for well-timed treatment measures to slow-down the disease progression [1]. As reviewed by the authors, molecular pathomechanisms of glaucoma demonstrate both a considerable overlap and remarkable particularities to some other neurodegenerative disorders such as Alzheimer’s and Parkinson’s diseases [2]. Hence, versus controls the neuronal thread protein (NTP) demonstrates enhanced expression levels in glaucoma, patients with Down Syndrome, Alzheimer’s and some other neurodegenerative diseases indicating the axonal lesions. However, whereas the accumulation of TAU-protein is characteristic for Alzheimer’s disease and other tauopathies, glaucoma patients do not demonstrate an increase in the target protein versus controls [2]. A monitoring of the pathology-specific molecular patterns is particularly valuable to develop reliable diagnostic approaches before the manifest pathology. Predictive tests can specify individual predisposition for well-timed preventive measures.
- Published
- 2014
28. Automated classification of breast cancer morphology in histopathological images
- Author
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Nina Linder, Heikki Joensuu, Johan Lundin, Ville Ojansivu, Mikael Lundin, Matti Pietikäinen, Esa Rahtu, Institute for Molecular Medicine Finland, Clinicum, and Department of Oncology
- Subjects
Pathology ,medicine.medical_specialty ,Histology ,02 engineering and technology ,Diagnostic tools ,Facial recognition system ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Histogram ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Grading (tumors) ,business.industry ,Supervised learning ,Pattern recognition ,General Medicine ,medicine.disease ,Support vector machine ,Statistical classification ,Proceedings ,030220 oncology & carcinogenesis ,020201 artificial intelligence & image processing ,Artificial intelligence ,3111 Biomedicine ,business - Abstract
Background The morphology of a breast cancer tumour, as examined through an optical microscope, is currently assessed visually by the pathologist in parallel with making the cancer diagnosis. The grade of differentiation, which describes how closely the morphology of the tumour resembles the corresponding healthy tissue of an organ, is undisputedly related to the outcome of breast cancer [1]. However, tumour grade is largely regarded as an unreliable prognostic factor due to its poor reproducibility [2]. The visually determined morphology is afflicted with a poor interand intra observer agreement, which prevents grade from being fully utilized as an important outcome predictor. The same pathologist may assign different grade to the same tumour when assessment is repeated, and different pathologists disagree to a substantial level when assessing the same tumour [3]. Computational diagnostic tools for estimating the morphological properties of cancer tissue would enable objective and reproducible alternative for diagnosis. This could be achieved by fully utilizing the recent advances in digital microscopy and computer vision [4,5]. Some attempts have already been made for automated grading of histopathological breast cancer images, but these studies have covered only limited amount of data or produce just a partial grading [6,7]. We propose a texture based algorithm for automated classification of breast cancer morphology. The method uses the recently introduced LPQ [8] as well as LBP [9] descriptors and an SVM classifier. The LPQ and LBP descriptors each form a histogram representing the statistical texture properties and have been used earlier in many texture analysis applications which include surface inspection [9], tissue analysis [5], and face recognition [8], whereas SVM represents the state of the art among supervised learning based classification algorithms.
- Published
- 2013
29. Clinical review: The liver in sepsis
- Author
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Yannick Mallédant, Caroline Aninat, N. Nesseler, Philippe Seguin, Yoann Launey, Fabrice Morel, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'anesthésie réanimation chirurgicale [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou, and Le Corre, Morgane
- Subjects
Weakness ,medicine.medical_specialty ,Disease ,Review ,Critical Care and Intensive Care Medicine ,Diagnostic tools ,Bioinformatics ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,Medicine ,Humans ,Liver damage ,030304 developmental biology ,0303 health sciences ,business.industry ,Liver Diseases ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,medicine.disease ,[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,Pathophysiology ,3. Good health ,Liver ,030220 oncology & carcinogenesis ,Cytokines ,Liver dysfunction ,medicine.symptom ,business - Abstract
International audience; ABSTRACT: During sepsis, the liver plays a key role. It is implicated in the host response, participating in the clearance of the infectious agents/products. Sepsis also induces liver damage through hemodynamic alterations or through direct or indirect assault on the hepatocytes or through both. Accordingly, liver dysfunction induced by sepsis is recognized as one of the components that contribute to the severity of the disease. Nevertheless, the incidence of liver dysfunction remains imprecise, probably because current diagnostic tools are lacking, notably those that can detect the early liver insult. In this review, we discuss the epidemiology, diagnostic tools, and impact on outcome as well as the pathophysiological aspects, including the cellular events and clinical picture leading to liver dysfunction. Finally, therapeutic considerations with regard to the weakness of the pertinent specific approach are examined.
- Published
- 2012
30. A diagnostic challenge for schistosomiasis japonica in China: consequences on praziquantel-based morbidity control
- Author
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Yi-Biao Zhou, Hui-Min Zheng, and Qingwu Jiang
- Subjects
medicine.medical_specialty ,China ,Schistosomiasis ,Review ,Biology ,Diagnostic tools ,Schistosoma japonicum ,Praziquantel ,lcsh:Infectious and parasitic diseases ,Environmental health ,parasitic diseases ,medicine ,Parasitological examination ,Chemotherapy ,Animals ,Humans ,lcsh:RC109-216 ,Immunodiagnosis ,Schistosoma Japonicum Infection ,Diagnostic Tests, Routine ,Public health ,medicine.disease ,biology.organism_classification ,Infectious Diseases ,SCHISTOSOMIASIS JAPONICA ,Schistosomiasis japonica ,Immunology ,Parasitology ,Morbidity ,medicine.drug - Abstract
Worldwide schistosomiasis continues to be a serious public health problem. Over the past five decades, China has made remarkable progress in reducing Schistosoma japonicum infections in humans to a relatively low level. Endemic regions are currently circumscribed in certain core areas where re-infection and repeated chemotherapy are frequent. At present, selective chemotherapy with praziquantel is one of the main strategies in China's National Schistosomiasis Control Program, and thus diagnosis of infected individuals is a key step for such control. In this paper we review the current status of our knowledge about diagnostic tools for schistosomiasis japonica. A simple, affordable, sensitive, and specific assay for field diagnosis of schistosomiasis japonica is not yet available, and this poses great barriers towards full control of schistosomiasis. Hence, a search for a diagnostic approach, which delivers these characteristics, is essential and should be given high priority.
- Published
- 2011
31. Validity and reliability of the Brazilian-Portuguese version of three tools to diagnose delirium: CAM-ICU, CAM-ICU Flowsheet and ICDSC
- Author
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J Oliveira, Marco Antônio Sales Dantas de Lima, Jorge I. F. Salluh, PP Lemos, Dimitri Gusmao-Flores, Lucas C. Quarantini, GV Serpa, Lauro Reis Santana, MT Pitrowsky, Rita Márcia Pacheco Lins, Ricardo Ávila Chalhub, and Felipe Dal-Pizzol
- Subjects
medicine.medical_specialty ,education.field_of_study ,Pediatrics ,animal structures ,business.industry ,Critically ill ,health care facilities, manpower, and services ,Brain dysfunction ,Population ,Validity ,Critical Care and Intensive Care Medicine ,Diagnostic tools ,language.human_language ,Brazilian Portuguese ,mental disorders ,Poster Presentation ,medicine ,language ,Delirium ,medicine.symptom ,Intensive care medicine ,business ,education - Abstract
Delirium is a frequent form of acute brain dysfunction in critically ill patients. Several detection methods have been developed for use in these patients. This study has the objective to validate the Brazilian-Portuguese CAM-ICU and to compare the sensitivity and specificity of three diagnostic tools (ICDSC, CAM-ICU and CAM-ICU Flowsheet) for delirium in a mixed population of critically ill patients.
- Published
- 2011
32. Clinical review: What is the role for autopsy in the ICU?
- Author
-
Elien Mahieu, Greet De Vlieger, and Wouter Meersseman
- Subjects
medicine.medical_specialty ,Glucose control ,business.industry ,False belief ,MEDLINE ,Autopsy ,Review ,Critical Care and Intensive Care Medicine ,Diagnostic tools ,Intensive care unit ,law.invention ,law ,medicine ,Clinicopathological features ,Intensive care medicine ,business - Abstract
The availability of advanced diagnostic tools has grown in the past decades. Hence, a growing false belief exists that everything is known about the patient before death. Moreover, intensivists may wrongly believe that autopsy findings do not contribute to the understanding of pathophysiological events. The immediate result is that few ICUs nowadays assemble enough autopsy cases with new and interesting clinicopathological features. However, we believe that, at least in tertiary ICUs, autopsies remain a valuable examination, as a tool for quality control, as a way of establishing gold standards for diagnostic examinations and as an aid in developing guidelines for treatment and diagnosis of diseases frequently encountered in the ICU. Finally, due to the ever-expanding armamentarium of immunosuppressive agents, a growing list of opportunistic infections is discovered during autopsy. The present article gives an overview of autopsy studies conducted in the ICU and discusses the pros and cons of performing these.
- Published
- 2010
33. Molecular allergology approach to allergic diseases in the paediatric age
- Author
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Alessandra Zaffiro, Danila Zennaro, Claudia Alessandri, and Adriano Mari
- Subjects
Allergy ,biology ,business.industry ,lcsh:RJ1-570 ,lcsh:Pediatrics ,Review ,respiratory system ,Diagnostic tools ,Immunoglobulin E ,medicine.disease ,In vitro ,law.invention ,respiratory tract diseases ,Immune system ,law ,immune system diseases ,Immunology ,Recombinant DNA ,biology.protein ,otorhinolaryngologic diseases ,Medicine ,Paediatric age ,Allergenic extracts ,business - Abstract
Identification, characterization, and purification of allergens are essential for the structural and immunologic studies needed to understand how these molecules induce specific IgE antibody production by the human immune system. Advances in molecular biology techniques have led to the production of recombinant allergens having constant properties, allowing detection of specific IgE directed against different molecular components of an allergenic source. Presence of homologous allergens in different sources is the reason for cross-reaction. Molecule-based diagnostic tools can lead to better interpretation of poly-sensitizations, observed by ST and in vitro tests using allergenic extracts as they were made before. Some examples IgE sensitization to major genuine allergens and panallergens will be presented.
- Published
- 2009
34. Restrictions of anthelmintic usage: perspectives and potential consequences
- Author
-
Martin K. Nielsen
- Subjects
Veterinary medicine ,Public economics ,business.industry ,Treatment regimen ,Parasite Control ,Legislation ,Research needs ,Diagnostic tools ,medicine.disease ,Infectious Diseases ,Proceedings ,Parasitic disease ,Scale (social sciences) ,medicine ,Parasitology ,Anthelmintic ,business ,medicine.drug - Abstract
Given the increasing levels of anthelmintic resistance in equine parasites, parasitologists now recommend traditional treatment approaches to be abandoned and replaced by more sustainable strategies. It is of crucial importance to facilitate veterinary involvement to ensure that treatment decisions are based on parasitic knowledge. Despite recommendations given for the past two decades, strategies based on the selective therapy principle have not yet been implemented on a larger scale in equine establishments. In contrast, treatment regimens appear to be derived from recommendations originally given in 1966. The province of Quebec in Canada, and an increasing number of European countries, have implemented prescription-only restrictions on anthelmintic drugs. Denmark introduced this legislation ten years ago, and some evidence has been generated describing potential consequences. It is without dispute that Danish veterinarians are now deeply involved with parasite management in equine establishments. However, little is known about the impact on levels of anthelmintic resistance and the risk of parasitic disease under these circumstances. In addition, the legislation makes huge demands on diagnosis and parasite surveillance. No data have been published evaluating fecal egg count techniques and larval culture methods as clinical diagnostic tools, and very little is known about potential correlations with actual worm burdens. This article provides a general review of anthelmintic strategies currently used in equine establishments and outlines the recommendations now given for parasite control. Preliminary experience with prescription-only restrictions in Denmark is presented and current research needs to further evaluate this approach are discussed.
- Published
- 2009
35. Abdominal ultrasonography in HIV/AIDS patients in southwestern Nigeria
- Author
-
Mojisola Adejoke Olusola-Bello, Godwin Ogbole, Millicent Olubunmi Obajimi, Yvonne U Osuagwu, Isaac F. Adewole, Atinuke M Agunloye, MO Atalabi, A. J. Adekanmi, Adenike Temitayo Adeniji-Sofoluwe, AO Ogunseyinde, Sefiat A Olarinoye, and Yetunde Aken'ova
- Subjects
Adult ,Male ,medicine.medical_specialty ,lcsh:Medical technology ,Adolescent ,Nigeria ,HIV Infections ,Disease ,Diagnostic tools ,Kidney ,Quality of life ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Abdomen ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged ,Ultrasonography ,Acquired Immunodeficiency Syndrome ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Gallstones ,Middle Aged ,medicine.disease ,Surgery ,lcsh:R855-855.5 ,Radiology Nuclear Medicine and imaging ,Abdominal ultrasonography ,Splenomegaly ,Life expectancy ,Female ,Lymph Nodes ,business ,Research Article - Abstract
Background Though the major target of the HIV-virus is the immune system, the frequency of abdominal disorders in HIV/AIDS patients has been reported to be second only to pulmonary disease. These abdominal manifestations may be on the increase as the use of antiretroviral therapy has increased life expectancy and improved quality of life. Ultrasonography is an easy to perform, non invasive, inexpensive and safe imaging technique that is invaluable in Africa where AIDS is most prevalent and where sophisticated diagnostic tools are not readily available. Purpose: To describe the findings and evaluate the clinical utility of abdominal ultrasonography in HIV/AIDS patients in Ibadan, Nigeria Methods A Prospective evaluation of the abdominal ultrasonography of 391 HIV-positive patients as well as 391 age and sex-matched HIV-negative patients were carried out at the University College Hospital, Ibadan. Results Of the 391 cases studied, 260 (66.5%) were females; the mean age was 38.02 years, (range 15–66 years). The disease was most prevalent in the 4th decade with an incidence of 40.4%. Compared with the HIV-negative individuals, the HIV+ group of patients had a significantly higher proportion of splenomegaly (13.5% vs. 7.7%; p < 0.01), lymphadenopathy (2.0% vs. 1.3%; p < 0.70), and renal abnormalities (8.4% vs. 3.8%; p < 0.02). There were no differences in hepatic and pancreatic abnormalities between the HIV+ and HIV- groups. There were significantly fewer gallstones in the HIV+ group (1.4% vs. 5.1%; p < 0.01). Conclusion AIDS is a multi-systemic disease and its demographic and clinical pattern remains the same globally. Ultrasonography is optimally suited for its clinical management especially in Africa. Its accuracy and sensitivity may be much improved with clinico-pathologic correlation which may not be readily available in developing countries; further studies may provide this much needed diagnostic algorithms.
- Published
- 2008
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