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<p><b>OBJECTIVE</b>To investigate the diagnostic value of clinical manifestation, laboratory examination and imaging changes for pyogenic spondylitis and to summarize the clinical characteristics of patients with pyogenic spondylitis.</p><p><b>METHODS</b>The clinical data, of 20 patients with pyogenic spondylitis were diagnosed by histopathological examination from March 2012 to March 2015, were retrospectively analyzed. There were 9 males and 11 females, aged from 43 to 72 years old with an average of 58.9 years. Included 3 cases of cervical vertebrae, 7 cases of thoracic vertebrae, 10 cases of lumbar vertebrae. Patients of blood analysis, erythrocyte sedimentation rate(ESR), C reactive protein(CRP), X rays, CT and MRI were performed before treatment. Visual analogue scale (VAS) was used to evaluate the pain of patients suffering from vertebral pain.</p><p><b>RESULTS</b>All the patients had suffered from vertebral pain before treatment. VAS was 9 points in 4 cases, 8 points in 6 cases, 7 points in 1 case, 3 points in 6 cases, and 2 points in 3 cases. Among them, 7 patients complicated with neurological symptoms, 11 with aggravating night pain, 10 with fever. WBC and Neutrophil count (NEU) of 5 cases were increased and other 15 cases were normal;CRP of 19 cases were increased and 1 case was normal;ESR of all 20 cases were increased. X rays showed the intervertebral space narrowing in all 20 cases, 13 cases complicated with destruction of vertebral body; CT showed the lesions of vertebral body in the 20 cases and complicated with destruction, sclerosis of sclerotin; MRI showed that the lesions of the vertebral body in the T1 image had uneven medium low signal, in the T2 image of the 16 cases had uneven high signal and 2 cases had uniform and high signal, 2 cases had main high signal compliated with mixed signal. Thirteen patients underwent surgical treatment and 7 patients received conservative treatment, and the patients left hospital while VAS had significantly improved after treatment.</p><p><b>CONCLUSIONS</b>Pyogenic spondylitis is easy to be misdiagnosed or missed in clinic. It can be combined with the clinical manifestations, laboratory examination and imaging characteristics in order to make a definite diagnosis for purulent spondylitis in early.</p>
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Objective To study the concentration of plasma total homocysteine(tHcy) in patients with chronic renal failure(CRF).Methods 105 chronic renal failure patients and 35 health individuals to our hospital were chosen to measure the level of tHcy using enzymatic cycling assay method.Results The mean level of tHcy in renal failure period C RF patients was significantly higher than that in normal controls (t =3.12,P ＜ 0.05),and the level of plasma tHcy was significantly higher in Uremia stage than in renal failure period in CRF patients (t =6.41,P ＜0.05),and the level of plasma tHcy was significantly higher in renal failure period than in renal function decompensated period in CRF patients (t =11.27,P ＜ 0.05).Conclusion The level of plasma tHcy were significantly elevated in patients with CRF,and there is a trend that the level of plasma tHcy increases with severity of CRF.Serum tHcy concentration have significant value in the diagnosis and understanding the condition of patients with CRF.
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A propósito de un caso sobre diagnóstico presuntivo de prostatitis bacteriana crónica, se planteó la siguiente pregunta: ¿Cuál es la validez, seguridad y utilidad diagnóstica del urocultivo y espermocultivo para el diagnóstico de Prostatitis Bacteriana Crónica (PBC)?. Se realizó una búsqueda en el Clinical Queries de Pubmed, encontrándose 12 trabajos de investigación, de los cuales se seleccionó un artículo de diseño transversal, gratuito y completo que resolvía el escenario clínico. Finalmente fue analizado en tres puntos generales según CASPe:Validez de resultados: Ambas pruebas fueron comparadas con el patrón oro, Meares y Stamey. La interpretación de cada cultivo era ciego a los resultados de otras pruebas. Se comprobó un tamaño adecuado de pacientes con sospecha de Prostatitis Bacteriana Crónica. Las tres pruebas reportaron la técnica estándar. Resultados: Un espermocultivo positivo puede ser suficiente para diagnosticar (CP (+):8,09 ,IC 95%:1,19-55,3), un espermocultivo negativo no descarta la enfermedad (CP (-):0,58, IC 95%:0,46-0,74).Cultivos de orina por sí solos no son útiles para el diagnóstico (CP (+):999999, IC 95%:0,1-35) ni para el descarte de PBC (CP (-):0,96, IC 95%:0,57-1,07). Aplicación de los resultados: Si el resultado del espermocultivo es positivo, beneficiará al paciente confirmando el diagnóstico y evitando someterle a una técnica sensible y dolorosa.(AU)
A case report on a presumptive diagnosis of chronic bacterial prostatitis, the following question was posed: What are the validity, safety and diagnostic utility of urine culture and semen culture for the diagnosis of chronic bacterial prostatitis (CBP)? A search was performed in the PubMed Clinical Queries, being 12 researches found, from which it was selected cross-sectional study, available at full free text that solved the clinical setting. Finally, it was analyzed in three general points according to CASPe.Validity of results: Both tests were compared with the gold standard, Meares and Stamey. The interpretation of each culture was blind to the results of other tests. A suitable size of patients with suspected CBP was found. The three tests reported the standard technique. Results: While a positive semen culture may be enough to diagnose (CP (+): 8.09, 95% :1,19-55,3), a negative semen culture does not discard disease (CP (-): 0.58, 95 % :0,46-0, 74). Urine cultures alone are not useful for the diagnosis (CP (+): 999999, IC 95%:0,1-35) or for the discard of CBP (CP (-): 0.96, CI 95%: 0.57 to 1.07). Implementation of the outcome: If the result is a positive semen culture, it will benefit the patient confirming the diagnosis and avoiding subjecting to a sensible and painful technique.(AU)
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Tanzania is scaling up prevention; treatment; care and support of individuals affected with HIV. There is therefore a need for high quality and reliable HIV infection testing and AIDS staging. The objective of this study was to assess laboratories capacities of services in terms of HIV testing and quality control. A baseline survey was conducted from December 2004 to February 2005 in 12 laboratories which were conveniently selected to represent all the zones of Tanzania. The questionnaires comprised of questions on laboratory particulars; internal and external quality control for HIV testing and quality control of reagents. Source and level of customer satisfaction of HIV test kits supply was established. Of 12 laboratories; nine used rapid tests for screening and two used rapid tests for diagnosis. In the 12 laboratories; four used double ELISA and five used single ELISA and three did not use ELISA. Confirmatory tests observed were Western Blot in three laboratories; DNA PCR in two laboratories; CD4 counting in seven laboratories; and viral load in two laboratories. Although all laboratories conducted quality control (QC) of the HIV kits; only two laboratories had Standard Operating Procedures (SOPs). Internal and external quality control (EQC) was done at varied proportions with the highest frequency of 55.6(5/9) for tnternal quality control (IQC) for rapid tests and EQC for ELISA; and the lowest frequency of 14.3(1/ 7) for IQC for CD4 counting. None of the nine laboratories which conducted QC for reagents used for rapid tests and none of the five which performed IQC and EQC had SOPs. HIV kits were mainly procured by the Medical Store Department and most of laboratories were not satisfied with the delay in procurement procedures. Most of the laboratories used rapid tests only; while some used both rapid tests and ELISA method for HIV testing. In conclusion; the survey revealed inadequacy in Good Laboratory Practice and poor laboratory quality control process for HIV testing reagents; internal and external quality control
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AIDS Serodiagnosis , Clinical Laboratory Techniques , HIV Infections , HIV , HIV Testing , Rapid Diagnostic TestsABSTRACT
Objective To determine the clinical efficacy of cytokeratin 8 and 18 as a novel urine marker for transitional cell carcinoma (TCC) of urinary tract. Methods Urinary concentrations of cytokeratin 8 and 18 were determined by an enzyme-linked immunosorbent assay (ELISA) in 52 cases of TCC and 86 cases of other urological conditions. Results The urinary values of cytokeratin 8 and 18 in the TCC patients (mean 34.8 ?g/l) were significantly higher than those in the patients without TCC (mean 9.4 ?g/l)(P
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Objective To assess the diagnostic value of NMP22 and BTA stat in the detection of bladder cancer. Methods 82 symptomatic patients suspicious of bladder cancer were asked to have urine NMP22,BTA stat,and cytological examination before cystoscopy. Results 32 patients were pathologicaly diagnosed as transitional cell carcinoma,and 50 cases were other benign urological conditions.The sensitivity of NMP22 (87.5%) was significantly better than BTA stat (65.6%) and urinary cytology ( 21.9 %), P