Effects of stepping exercise with single-tooth sandals on medial longitudinal arch and sole surface temperature / 体力科学

Single-tooth sandals under new development have special material and shape characteristics. Exercises with single-tooth sandals can increase pressing stimulus on the soles of the feet, thereby suppressing a decline in medial longitudinal arch and elevating sole surface temperature. This study thus aimed to examine the effects of exercise with single-tooth sandals on medial longitudinal arch and sole surface temperature. Sixteen young adults (23 ± 5 years) participated in 20 min of stepping exercise on the spot. They randomly put on a regular normal sandal (N conditions) or a single-tooth sandal (Z conditions) on each left and right side. Before and after exercise, medial longitudinal arch and sole surface temperature were assessed by digital caliper and straightedge and thermography, respectively. No significant differences in baseline parameters were observed between N and Z conditions. After exercise, arch height and arch height ratio significantly reduced in N conditions, but not in Z conditions. Central sole surface temperature in Z conditions also increased significantly, and the changes in surface temperature were significantly higher in Z conditions than in N conditions. Therefore, these findings suggest that exercise with single-tooth sandals has a positive effect on a suppressing decline in medial longitudinal arch and an elevation in sole surface temperature.

Cost minimization analysis of an in-house molecular test for cytomegalovirus in relation to a commercial molecular system

ABSTRACT Introduction: Cytomegalovirus may cause severe disease in immunocompromised patients. Nowadays, quantitative polymerase chain reaction is the gold-standard for both diagnosis and monitoring of cytomegalovirus infection. Most of these assays use cytomegalovirus automated molecular kits which are expensive and therefore not an option for small laboratories, particularly in the developing world. Objective: This study aimed to optimize and validate an in-house cytomegalovirus quantitative polymerase chain reaction test calibrated using the World Health Organization Standards, and to perform a cost-minimization analysis, in comparison to a commercial cytomegalovirus quantitative polymerase chain reaction test. Study design: The methodology consisted of determining: optimization, analytical sensitivity, analytical specificity, precision, curve variability analysis, and inter-laboratorial reproducibility. Patients (n = 30) with known results for cytomegalovirus tested with m2000 RealTime System (Abbott Laboratories, BR) were tested with the in-house assay, as well as patients infected with other human herpes virus, in addition to BK virus. A cost-minimization analysis was performed, from a perspective of the laboratory, assuming diagnostic equivalence of the methodologies applied in the study. Results: The in-house assay had a limit of detection and quantification of 60.3 IU/mL, with no cross-reactivity with the other viral agents tested. Moreover, the test was precise and had a R 2 of 0.954 when compared with the m2000 equipment. The cost analysis showed that the assay was economically advantageous costing a median value of 37.8% and 82.2% in comparison to the molecular test in use at the hospital and the m2000 equipment, respectively. Conclusions: These results demonstrated that in-house quantitative polymerase chain reaction testing is an attractive alternative in comparison to automated molecular platforms, being considerably less expensive and as efficacious as the commercial methods.

Effect of in-house training of health care personnel on biomedical waste management in a tertiary care hospital, Warangal, Telangana, India

Background: Every day, relatively large amount of potentially infectious and hazardous wastes is generated in the health-care hospitals and facilities around the world. Indiscriminate disposal and improper management of waste generated in health care facilities causes serious threat to environment and to human health that requires specific treatment and management prior to its final disposal.Methods: Cross-sectional study was conducted among 241 health care personnel working at Mahatma Gandhi Memorial hospital, Warangal. Data was collected and pre and post analysis was done using a pre-validated self-administered questionnaire. Data was entered in MS Excel and analysed using SPSS 17 software.Results: Among 241 respondents, 33.2% were sanitary staff, 35.3% are nursing staff and 31.5% are nursing students. Only 35.7% of participants has knowledge regarding the colour of the bag into which expired antibiotics are discarded and 45.2% of participants were aware of the colour of the bag in which IV bottles, gloves were discarded. Scoring for 10 was done in both pre and post-test and post test scores were found to be higher and there is significant increase in level of knowledge of biomedical waste management rules in study population in post-test analysis (p<0.001).Conclusions: Training program on the waste management in the health sector has significant effect in increasing knowledge of the healthcare personnel

Implementation of an in-house flow cytometric analysis of DNA fragmentation in spermatozoa / 亚洲男科学杂志(英文版)

An increased amount of DNA fragmentation in the spermatozoa (SDF) is linked to male infertility. The Sperm Chromatin Structure Assay (SCSA) is widely used for analysis of SDF. However, the current software (SCSASoft®) linked to this assay is licensed and often located within larger diagnostic centers. In this study, we present a protocol for using other types of software than SCSASoft® to determine the SDF index (DFI) with clinical relevance. This protocol is engineered after collecting and analyzing 254 samples from fertility patients and sperm donors over a 15-month period. DFI is analyzed using a strict protocol where the spermatozoa are treated with a strong acid (pH 1.2) followed by acridine orange. DFI is determined by a standard flow cytometric software, FACSDiva 6.1.3. Analysis of the outcome of the fertility treatment is included for 137 patients receiving either intrauterine inseminations (IUI) or timed coitus (TC). The results show that the chance of pregnancy declines as DFI increases. We also found that the male DFI affects the chance of pregnancy independent of the female age. We have shown that a standard flow cytometric software can be used when determining a clinical relevant DFI. These findings are a significant step toward implementing the analysis as a part of the routine, in-house diagnosing of the male fertility patient and subsequently optimizing the treatment course of the couple with reduced human and financial costs.

Offline two-dimensional liquid chromatography coupled with ion mobility-quadrupole time-of-flight mass spectrometry enabling four-dimensional separation and characterization of the multicomponents from white ginseng and red ginseng / 药物分析学报

Inherent complexity of plant metabolites necessitates the use of multi-dimensional information to accomplish comprehensive profiling and confirmative identification. A dimension-enhanced strategy, by offline two-dimensional liquid chromatography/ion mobility-quadrupole time-of-flight mass spec-trometry (2D-LC/IM-QTOF-MS) enabling four-dimensional separations (2D-LC, IM, and MS), is proposed. In combination with in-house database-driven automated peak annotation, this strategy was utilized to characterize ginsenosides simultaneously from white ginseng (WG) and red ginseng (RG). An offline 2D-LC system configuring an Xbridge Amide column and an HSS T3 column showed orthogonality 0.76 in the resolution of ginsenosides. Ginsenoside analysis was performed by data-independent high-definition MSE (HDMSE) in the negative ESI mode on a Vion TM IMS-QTOF hybrid high-resolution mass spectrometer, which could better resolve ginsenosides than MSE and directly give the CCS information. An in-house ginsenoside database recording 504 known ginsenosides and 58 reference compounds, was estab-lished to assist the identification of ginsenosides. Streamlined workflows, by applying UNIFI TM to auto-matedly annotate the HDMSE data, were proposed. We could separate and characterize 323 ginsenosides (including 286 from WG and 306 from RG), and 125 thereof may have not been isolated from the Panax genus. The established 2D-LC/IM-QTOF-HDMSE approach could also act as a magnifier to probe differ-entiated components between WG and RG. Compared with conventional approaches, this dimension-enhanced strategy could better resolve coeluting herbal components and more efficiently, more reli-ably identify the multicomponents, which, we believe, offers more possibilities for the systematic exposure and confirmative identification of plant metabolites.

Performance of an in-house real-time PCR assay for detecting Cytomegalovirus infection among transplant patients from a tertiary care centre

Background: Quantitative Cytomegalovirus (CMV) polymerase chain reactions are increasingly being used for monitoring CMV DNAemia in haematopoietic stem cell transplants and solid organ transplants. Objective: In this study, a commercial CMV viral load assay was compared with an in-house viral load assay. Materials and Methods: A total of 176 whole-blood samples were tested for CMV DNAemia using both assays. Results: Our evaluation showed a difference of 1 log10copies/ml between the two assay systems in determining CMV viral loads in the clinical samples. Conclusion: The in-house viral load assay had a better correlation with clinical findings compared to the commercial assay. Quality assessment of these assays was done by the United Kingdom National External Quality Assessment Scheme (UKNEQAS), an external proficiency testing programme, and by the National Institute for Biological Standard and Control (NIBSC) standard. For UKNEQAS and NIBSC standards, the bias between the assays was 0.73 log10and 0.85 log10, respectively. This difference is well within the acceptable range already reported in the literature.

Application of the transfer statement in inhouse transfer of critical patients / 中华医院管理杂志

Objective To evaluate the use of transfer statements in inhouse transport of critical patients.Methods By means of continuous enrollment,123 critical patients were enrolled as a control group for conventional transport,and 111 such patients were enrolled as an observation group for transport using the transfer statement.Then the incidence of adverse events,transport during and nurse-nurse collaboration level of the two groups were compared.Results In the control group,its incidence of adverse events was 13.8%,the mean transport during was(19.5 ± 8.4)minutes,and the mean score for nurse-nurse collaboration level was ( 101.87 ± 7.13 ).In the observation group,its incidence of adverse events was 5.4%,the mean transport during was(13.5 ± 5.4)minutes,and the mean score for nurse-nurse collaboration level was(106.15 ± 8.86).Implementing the transfer statement has cut back the incidence of adverse events (P<0.05)and the transport duration significantly(t=3.833,P<0.01),while improving the level of nurse-nurse cooperation significantly(t= -4.261,P<0.05).Conclusions The transfer statement can increase the safety of patient transport,promote organization and coordination of nurses,and improve the efficiency of transport.

Identification of viridans streptococci With Matrix-Assisted Laser Desorption & Ionization Time-of-flight Mass Spectrometry by an In-house Method and a Commercially Available System

Two matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS)-based methods were compared for their ability to identify viridans streptococci. One approach employed a reference database and software developed in-house. All inhouse measurements were performed using an Autoflex II Instrument (Bruker Daltonics GmbH, Germany). The other system, a VITEK-MS (BioMérieux, France) was operated on the commercially available V2.0 Knowledge Base for Clinical Use database. Clinical isolates of viridans streptococci (n=184) were examined. Discrepant results were resolved by 16S rDNA sequencing. Species-level identification percentages were compared by a chi-square test. The in-house method correctly identified 179 (97%) and 175 (95%) isolates to the group and species level respectively. In comparison, the VITEK-MS system correctly identified 145 (79%) isolates to the group and species level. The difference between the two methods was statistically significant at both group and species levels. Using the Autoflex II instrument combined with an extraction method instead of whole cell analysis resulted in more reliable viridans streptococci identification. Our results suggest that combining extraction with powerful analysis software and the careful choice of well-identified strains included into the database was useful for identifying viridans streptococci species.

An in-house real-time polymerase chain reaction: standardisation and comparison with the Cobas Amplicor HBV monitor and Cobas AmpliPrep/Cobas TaqMan HBV tests for the quantification of hepatitis B virus DNA

This study aimed to standardise an in-house real-time polymerase chain reaction (rtPCR) to allow quantification of hepatitis B virus (HBV) DNA in serum or plasma samples, and to compare this method with two commercial assays, the Cobas Amplicor HBV monitor and the Cobas AmpliPrep/Cobas TaqMan HBV test. Samples from 397 patients from the state of São Paulo were analysed by all three methods. Fifty-two samples were from patients who were human immunodeficiency virus and hepatitis C virus positive, but HBV negative. Genotypes were characterised, and the viral load was measure in each sample. The in-house rtPCR showed an excellent success rate compared with commercial tests; inter-assay and intra-assay coefficients correlated with commercial tests (r = 0.96 and r = 0.913, p < 0.001) and the in-house test showed no genotype-dependent differences in detection and quantification rates. The in-house assay tested in this study could be used for screening and quantifying HBV DNA in order to monitor patients during therapy.

Development and evaluation of flavi-immunoglobulinM capture enzyme-linked immunosorbent assay.

In this study, we report the evaluation of In-house fl avi virus immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (ELISA), which can be used as a screening test to determine the infecting fl avivirus serotype over the current serological methods. A panel of 88 sera (inclusive of well characterized dengue, Japanese Encephalitis (JE) and West Nile virus (WNV) positive and negative samples tested and confi rmed by commercial kit) was used for evaluation of the kit. The sensitivity and specifi city of the In-house capture assay versus the commercial kit for the sero-diagnosis of dengue was 100% and 87% respectively, for JE IgM, it was found to be 90% and 100% respectively, and for West Nile it was 87.5% and 90.9%. Based on the study, we concluded that this fl avivirus-serotyping ELISA provides rapid results and may be used as an accurate alternate to other serological tests for the specifi c diagnosis of fl avivirus infections.

Importancia y perfil del coordinador de donación en México / Importance and profile of the Transplant Coordinator in Mexico

La figura y función del coordinador de donación es todavía desconocida en nuestra sociedad médica. Debe de existir un coordinador de donación en cada hospital para poder localizar a los potenciales donadores y aprovechar todos los órganos y tejidos posibles. Estudios de diversos países están a favor de la figura de coordinador para aumentar su índice de trasplantes. Debe tener conocimiento de los criterios y estar presente en todos los pasos de una donación para que culminen en trasplante. Debe ser una persona responsable, con liderazgo, comprometida con su puesto y saber que no hay horarios fijos, pero que tendrá como recompensa el devolverle una mejor calidad de vida a los pacientes.

The figure and function of the transplant coordinator is still unknown in our medical society. Every hospital should have a coordinator so this potential organ donors can be identified and have a good use of these organs an tissues. A number of studies around the world have been made and they all agree in the need of a coordinator to increase their transplant numbers. The coordinator must know the criteria and be a part of every step in the donation process, so it will end in a transplant. The coordinator must be a responsible, compromised, with leadership and aware that there are no established work-hours, but having the reward of giving back a life quality to sick people.

In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity / Método de ELISA in-house na análise da reatividade de IgG anti-Trypanosoma cruzi para o diagnóstico diferencial e avaliação da morbidade da doença de Chagas

INTRODUCTION: The goal was to develop an in-house serological method with high specificity and sensitivity for diagnosis and monitoring of Chagas disease morbidity. METHODS: With this purpose, the reactivities of anti-T. cruzi IgG and subclasses were tested in successive serum dilutions of patients from Berilo municipality, Jequitinhonha Valley, Minas Gerais, Brazil. The performance of the in-house ELISA was also evaluated in samples from other relevant infectious diseases, including HIV, hepatitis C (HCV), syphilis (SYP), visceral leishmaniasis (VL), and American tegumentary leishmaniasis (ATL), and noninfected controls (NI). Further analysis was performed to evaluate the applicability of this in-house methodology for monitoring Chagas disease morbidity into three groups of patients: indeterminate (IND), cardiac (CARD), and digestive/mixed (DIG/Mix), based on their clinical status. RESULTS: The analysis of total IgG reactivity at serum dilution 1:40 was an excellent approach to Chagas disease diagnosis (100 percent sensitivity and specificity). The analysis of IgG subclasses showed cross-reactivity, mainly with NI, VL, and ATL, at all selected serum dilutions. Based on the data analysis, the IND group displayed higher IgG3 levels and the DIG/Mix group presented higher levels of total IgG as compared with the IND and CARD groups. CONCLUSIONS: These findings demonstrated that methodology presents promising applicability in the analysis of anti-T. cruzi IgG reactivity for the differential diagnosis and evaluation of Chagas disease morbidity.

INTRODUÇÃO: O objetivo foi desenvolver um método sorológico in-house de alta especificidade e sensibilidade para diagnosticar e monitorar a morbidade da doença de Chagas. MÉTODOS: Para tal, a reatividade sorológica de IgG e subclasses foi testada em soros de pacientes chagásicos de Berilo, Vale do Jequitinhonha/MG/Brasil. A reatividade sorológica foi também avaliada em amostras de pacientes com outras doenças infecto-contagiosas relevantes, incluindo o HIV, vírus da hepatite C (VHC), sífilis (SYP), leishmaniose visceral (LV), leishmaniose tegumentar americana (LTA) e controles não infectados (NI) para verificar o desempenho do método. Outras análises foram feitas para avaliar a aplicabilidade desta metodologia no monitoramento da morbidade da doença de Chagas. Com este propósito os pacientes com doença de Chagas foram anteriormente classificados em três grupos: indeterminados (IND), cardíacos (CARD) e digestivos/mistos (DIG/Mis) conforme seu estado clínico. RESULTADOS: A análise da reatividade sorológica de IgG total na diluição 1:40 mostrou ser uma abordagem importante no diagnóstico da doença de Chagas (100 por cento de sensibilidade e especificidade e ausência de reação cruzada com as demais infecções). A análise das subclasses de IgG mostrou reação cruzada principalmente com NI, LV e LTA em todas as diluições. O grupo IND apresentou a maior reatividade para IgG3 e o grupo DIG/Mis apresentou nível mais elevado de IgG se comparados aos grupos IND e CARD. CONCLUSÕES: Estes achados demonstram que o método de ELISA in-house apresenta uma promissora aplicabilidade no diagnóstico diferencial e na avaliação da morbidade da doença de Chagas.

SAD phasing with in-house Cu Kα radiation using barium as anomalous scatterer.

Phasing of lysozyme crystals using co-crystallized barium ions was performed using single-wavelength anomalous diffraction (SAD) method using Cu Kα radiation with in-house source of data collection. As the ion binding sites vary with respect to the pH of the buffer during crystallization, the highly isomorphic forms of lysozyme crystals grown at acidic and alkaline pH were used for the study. Intrinsic sulphur anomalous signal was also utilized with anomalous signal from lower occupancy ions for phasing. The study showed that to solve the structure by SAD technique, 2.8-fold data redundancy was sufficient when barium was used as an anomalous marker in the in-house copper X-ray radiation source for data collection. Therefore, co-crystallization of proteins with barium containing salt can be a powerful tool for structure determination using lab source.

Comparison of in-house HIV-1 genotypic drug resistant test with commercial HIV-1 genotypic test kit.

Background: The use of combination antiretroviral therapy (cART) has become a standard of care in the treatment of HIV infection. However, antiretroviral drug resistance occurs in a substantial number of patients. In resourcelimited settings, genotypic resistance assay using a commercial kit is costly. Objective: Focus on the validation of an in-house HIV-1 specific genotypic drug resistance assay in Thai patients failing cART. Materials and methods: Results of HIV-1 genotypic drug resistance assay was evaluated by comparing an inhouse method to a commercial test. The TRUGENE HIV-1 genotyping kit was used in 79 plasma specimens (49 from HIV patients failing cART therapy and 30 from proficiency testing panels). Results: The results from the in-house assay were comparable to those obtained from the TRUGENE HIV-1 genotyping kit with >99.0% codon-to-codon agreement. The lower limit of detection by the in-house assay was approximately 100 copies/mL of HIV-1 RNA. In addition, this in-house assay would allow testing of samples from patients infected with HIV-1 subtype other than B. Conclusion: The in-house HIV-1 genotypic drug resistance assay may be used as an alternative to commercial kits, particularly in resource limited settings.

Avaliação do pool de plasma caseiro como controle normal para o tempo de tromboplastina parcial ativada (TTP) / Evaluation if in-house preparations of polled plasma can be used as a normal control of partial thromboplastin time (PTT)

INTRODUÇÃO: A utilização correta de um plasma-controle para a comparação com o plasma do paciente nos testes de coagulação é fundamental para a garantia de um resultado seguro dessas provas laboratoriais. OBJETIVO: O presente estudo analisou a viabilidade do uso de um pool de plasma caseiro, realizado com cinco (P5) e 20 (P20) amostras a partir de pacientes normais, para ser utilizado como controle normal do tempo de tromboplastina parcial (TTP). MATERIAL E MÉTODO: Os dois pools de plasma caseiro foram analisados em relação a um controle normal comercial (AP). Foram 10 dias de experimento e a cada dia os dois pools caseiro eram feitos. Para cada dia foi feito o TTP de P5, P20 e AP. Todos os pacientes com solicitação de TTP, em cada dia do experimento, tiveram a relação de tempos (R) determinada frente a P5, P20 e AP. As ferramentas estatísticas utilizadas foram média (X), análise de variância e teste de Tukey. RESULTADOS: A análise estatística demonstrou que os valores de TTP são significativamente diferentes entre AP e P5 e entre AP e P20, mas não há diferença significativa entre P5 e P20. Quando a relação de tempos foi analisada, não houve diferença significativa entre AP, P5 e P20. CONCLUSÃO: O estudo demonstrou que pode ser utilizado como controle normal um pool de plasma caseiro, feito a partir de cinco ou 20 amostras.

INTRODUCTION: Proper utilization of plasma control for comparison with the plasma of patients with coagulation tests is critical to ensure a safe outcome of these laboratory tests. OBJECTIVE: The purpose of this work was to know if in-house preparations of polled plasma can be used as a normal control of partial thromboplastin time (PTT). MATERIAL AND METHOD: We make two polled plasma, one with five (P5) samples and another with 20 (P20) samples, both of them from normal patients. Both pooled plasma were analyzed in comparison with a commercial lyophilized control (AP). The experiment was performed in 10 days, and P5 and P20 were made daily. At each day PTT was performed for P5, P20 and AP. All patients who asked for TTP, in each day of this experience, got a time relation (R) determined by a P5, P20 e AP. Tukey test was used as statistical analysis. RESULTS: Statistically significant differences were detected among the PTT for AP and P5, AP and P20, but no difference between P5 and P20 was observed. When the time relations were tested, there were no significant difference, among AP, P5, and P20. CONCLUSION: We found that in-house preparations of polled plasma (P5 and P20) can be used as a normal control of PTT.

Study on the evolution of the minor resistant mutations and the primary resistance in rural areas of Henan / 中华微生物学和免疫学杂志

Objective To evaluate the antiretroviral therapy(ART),analyze the prevalence of resistance in rural areas,Henan,and explore the presence of minor resistant variants in pre-ART.Methods One hundred and forty-nine AIDS patients initiating ART were recruited and investigated at intervals of 6 months. Method of In-house developed by our laboratory for genotypjc resistance test was to analyze the occurrence of resistance among the failure of ART,and the allele-specific real.time PCR(ASPCR)was used to detect the minor resistant variants at the baseline samples once the resistance occurred.Results Vimlload significantly decreased among the patients who received ART(t=275,P=0.0001),but the absolute counts of CD4+T lymphocytes had no significant change(t=1.765 168,P=0.0852).Rate of resistance among the patients of treatment failure was 4.88%.The result of ASPCR in the survey of baseline showed that the minor resistant variants of M184V were detected in 7 patients and mutation K103N presented in 5 patients.Conclusion The primary drug-resistant straias in the untreated patients were found in Henan,and they might develop the dominant resistance strains and bring about the failure of ART.

Quantification of LSD in illicit samples by high performance liquid chromatography

In the present study, a method using high performance liquid chromatography to quantify LSD, in blotter papers seized in Minas Gerais, was optimized and validated. Linearity, precision, recovery, limits of detection and quantification, and selectivity were the parameters used to evaluate performance. The samples were extracted with methanol:water (1: 1) in an ultra-sound bath. The linearity between 0.05 and 20.00 μg/mL (0.5 and 200.0μg of LSD/blotter) was observed with satisfactory mean intra and inter assay precision (RSDr = 4.4% and RSD R = 6.4%, respectively) and with mean recoveries of 83.4% and 84.9% to the levels of 1.00 and 20.00 μg/mL (10 and 200μg LSD/blotter). The limits of detection and quantification were 0.01 and 0.05 μg/mL, respectively (0.1 and 0.5 μg of LSD/blotter). The samples of blotters (n =22) were analyzed and the mean value of 67.55 μg of LSD/blotter (RSD=27.5%) was found. Thus, the method used showed satisfactory analytical performance, and proved suitable as an analytical tool for LSD determination in illicit samples seized by police forces.

No presente trabalho, um método utilizando cromatografia líquida de alta eficiência foi otimizado e validado para quantificar o LSD em selos apreendidos em Minas Gerais. A linearidade, precisão, recuperação, limites de detecção e quantificação e seletividade foram os parâmetros de desempenho avaliados. As amostras foram extraídas com metanol: água (1:1) em banho de ultra-som. A linearidade entre 0,05 a 20,00 mg/mL (0,5 a 200 μg LSD/blotter) foi observada com precisão média, intra e inter ensaio, satisfatória (RSDr = 4,4% e RSD R = 6,4%, respectivamente) e com recuperações médias de 83,4% e 84,9% para os níveis de LSD de 1,00 e 20,00 mg/mL (10 e 200 μg LSD/selo). Os limites de detecção e quantificação encontrados foram de 0,01 e 0,05 mg/mL, respectivamente (0,1 e 0,5 μg LSD/selo). As amostras de selos (n = 22) foram analisadas e o valor médio encontrado foi de 67,55 μg de LSD/selo (RSD% = 27,5). Desta forma, o método analítico apresentou desempenho satisfatório, capaz de ser utilizado como instrumento de análise para a determinação do LSD em amostras ilícitas apreendidas pelas forças policiais.

Uso clínico de la reacción en cadena de la polimerasa e hibridización en el diagnóstico de tuberculosis / Clinical use of the polymerase chain reaction and hybridization in diagnosing tuberculosis

La tuberculosis (TBC) es una causa importante de morbimortalidad en nuestro país. Las herramientas de diagnóstico no son 100% eficientes y rápidas para ayudar al clínico en su decisión médica. Nuevas pruebas, como la reacción en cadena de la polimerasa (PCR), son necesarias. Evaluar la utilidad clínica de una PCR para IS6110, en muestras clínicas de pacientes con sospecha de tuberculosis pulmonar o extrapulmonar. Sesenta y una muestras de 46 pacientes del Hospital General del Este, Dr. Domingo Luciani de Caracas, Venezuela, fueron procesadas para la detección del M. Tuberculosis. Se practicó baciloscopia, cultivo en LJ y PCR e hibridación. Los pacientes se clasificaron como TBC positivos si tenían evidencia clínica o radiológica, y positivas algunas de estas pruebas: PPD, ZN, cultivo, biopsia positiva o respuesta favorable al tratamiento. Los TBC negativos con evidencia clínica o radiológica positiva y todas las pruebas negativas. La sensibilidad de la PCR sola fue del 75% y la especificidad del 61%. La PCR e hibridación juntas mostraron sensibilidad del 90% y especificidad del 57%. Los valores predictivos positivos y negativos fueron del 62% y 88%, respectivamente

Tuberculosis (TBC) remains a leading cause of morbidity and mortality in Venezuela. The diagnos tic tools used are not 100% specific, sensitive, efficient or fast enough to help clinicians take the right clinical decision. New tests, like polymerase chain reaction (PCR), are necessary. We evaluated the clinical usefulness of an IS6110 in-house PCR in clinical samples from patients suspected of having pulmonary or extrapulmonary TBC. Sixty one samples from 46 patients were processed for detection of M. tuberculosis by ZN stained smear examination, LJ medium culture, and PCR and hybridization assay. The patients were classified as TBC positive when they had clinical or radiological evidence plus any positive of the following tests: PPD, ZN, LJ culture, biopsy or anti-TBC treatment response and TBC negative when they had clinical or radiological evidence but all the applied tests used were negative. PCR sensibility was 75% and specificity was 61%, using PCR alone, but when PCR and hybridization were evaluated together the sensibility was 90% and specificity was 57%. The predictive positive and negative values were 62% and 88% respectively

In-house daily consensus conference: An important quality control/quality assurance activity - Experience at a major referral center.

Background: For every practicing histopathologist, improvement of diagnostic accuracy is an important objective. Personal consults are an important component of quality control (QC)/quality assurance (QA) in our Section of Histopathology. In addition, the College of American Pathologists recommends a daily in-house consensus conference, which is a prospective system by which all difficult and problematic cases are reviewed and discussed and signed out by consensus. Design: In-house consensus conference is held daily using a multi-headed microscope. This collegial session is run by the seniormost consultant in the section and is attended by all histopathology consultants and residents. The consultants and residents present cases of their choice for discussion. The cases may be selected due to diagnostic difficulty, unusual nature of a case, management purposes such as performance of additional biopsies, special studies, etc., or request on the part of clinician or patient. Cases may be shown once or, in case of lack of consensus or difficulty in diagnosis, more than once after additional work-up suggested by the conference. Results: In a 4-month period, 774 (4.1%) cases of a total of over 14,000 well-mixed surgical cases were brought to the in-house daily consultation conference. Four hundred ninety-three cases (63.7%) were conclusively decided the first time while 198 cases (25.5%) were decided by consensus after being shown twice. In 83 cases (10.7%), a definite diagnosis could not be given. The cases on which a definite diagnosis was not possible represents 0.59% of all cases received in the department during the study period. The most common cases were shown from the gastrointestinal tract (115 cases or 14.8%), lymph nodes (110 cases or 14.2%) and soft tissue (82 cases or 10.6%). In most cases in which a definite diagnosis could not be given, the main reason was scanty material or crushed nature of the tissue. Conclusion: The in-house daily consensus conference is an extremely useful QC/QA exercise, which is very important in reaching an accurate diagnosis in difficult and challenging cases and minimizing diagnostic errors.

Utility of In-House PCR for HLA-B27 Typing: Comparison of Concordance Rate between PCR Kit and In-House PCR / 대한진단검사의학회지

BACKGROUND: Commercial kits of PCR method are widely used in HLA-B27 typing; however, their cost is relatively high. In this study, we evaluated the utility of an in-house PCR method by comparing it with that of a commercial kit. METHODS: HLA-B27 typing was done in 188 patients by using two PCR methods, Absolute(TM) HLAB27 PCR kit (Biosewoom, Korea) and an in-house PCR method. The primers used in the in-house method were prepared by Bioneer (Korea). Both PCR tests were done by Gene Amp PCR System 9600 (Perkin-Elmer Centus Corp., USA). RESULTS: The commercial kit and in-house PCR showed 100% concordance rate with each other in HLA-B27 typing. Of 188 patients tested 72 (38.3%) were positive and 116 (61.7%) were negative by the both tests. Of 62 patients with ankylosing spondylitis, 50 were positive (80.7%). CONCLUSIONS: The in-house PCR is a reliable and cost-effective method and can replace or supplement commercial kits for HLA-B27 typing.