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Technique widely used in dermatology for the treatment of skin cancer. The historical perspective highlights the evolution of Mohs surgery since its development by Dr. Frederic Mohs in the 1930s, emphasizing its focus on basal cell carcinoma and subsequent renements in instrumentation, anesthesia, and tissue processing methods. Mohs surgery, which involves stepwise removal of cancerous tissue layers with immediate microscopic examination to ensure complete tumor removal while preserving healthy tissue. The advantages of Mohs surgery include high cure rates, tissue preservation, real-time margin assessment, and precise mapping. However, the procedure is time-consuming, requires specialized training, and may have higher costs compared to alternative treatments. Perioperative management considerations, including preoperative assessment, anesthesia techniques, surgical procedure, wound care, and follow-up, are discussed to ensure optimal outcomes and patient satisfaction. Understanding the historical context, surgical technique, advantages, and disadvantages of Mohs surgery is crucial for healthcare professionals involved in the management of skin cancer patients.
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Objective To analyze the diagnosis of imported malaria cases in Henan Province from 2015 to 2019, so as to provide the evidence for malaria surveillance during the post-elimination stage. Methods The data pertaining to malaria cases in Henan Province from 2015 to 2019 were extracted via the web-based Chinese Information System for Infectious Diseases Control and Prevention and the Parasitic Diseases Information Reporting Management System (PDIRMS) of Chinese Center for Disease Control and Prevention, and the diagnostic methods, diagnostic institutions and diagnostic time of imported malaria cases were analyzed. Results A total of 952 imported malaria cases were reported in Henan Province during the period from 2015 through 2019, and all cases were laboratory-confirmed. The positive rate of malaria rapid diagnostic tests (RDTs) was 98.61% (779/790), which was significantly greater than that (94.22%, 897/952) of microscopic examinations (χ2 = 22.773, P < 0.05). The proportion of imported malaria cases diagnosed in medical institutions increased from 65.22% (120/184) in 2015 to 81.50% (185/227) in 2019. Among the 238 imported malaria cases diagnosed in centers for disease control and prevention (CDC), 71.01% (169/238) were diagnosed in county-level CDC, and among the 704 cases diagnosed in medical institutions, only 8.38% (59/704) were diagnosed at county-level medical institutions. The median time from onset to definitive diagnosis of malaria was 3 days, and the median duration between onset and initial diagnosis of malaria was 1 day. The duration between initial diagnosis and definitive diagnosis of malaria varied significantly among years (χ2 = 24.956, P < 0.05), and the interquartile range from initial diagnosis to definitive diagnosis reduced from 4 days in 2016 to 2 days in 2019. In addition, the median time from initial diagnosis to definitive diagnosis was significantly longer in severe falciparum malaria cases than in non-severe falciparum malaria cases (2 days vs. 1 day; Z = 7.557, P < 0.05). Conclusions Medical institutions play a more and more important role in the identification and surveillance of malaria cases; however, the diagnostic capability of malaria remains low in county-level medical institutions. The diagnostic awareness and capability of county-level medical institutions requires to be improved, in order to play their roles as sentinel hospitals in the malaria surveillance during the post-elimination stage.
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Objective To evaluate the effectiveness of the application of Wondfo Rapid Diagnostic Kit (RDTs) in the diagnosis of imported malaria cases in the Malaria Reference Laboratory of Hubei Provence. Methods The complete blood samples of malaria cases and negative card deletion cases reported in Hubei Province from January 2015 to June 2018 were collected and retrospectively analyzed. The results of the provincial malaria reference laboratory were used as the standard, and were compared with those results detected by RDTs, microscopic examination and nested PCR. The differences were statistically analyzed. Results A total of 440 complete samples were collected by the Malaria Reference Laboratory of Hubei Provence, of which 418 samples were confirmed as positive, and 22 samples were confirmed as negative. In terms of the identification ability of P. falciparum, RDTs performed the best, with a coincidence rate of 100.00%, and the coincidence rates nested PCR and microscopic examination were 97.49% and 91.40%, respectively. In terms of the identification specificity for another 3 species of Plasmodium (P. vivax, P. ovarian and P. vivax), nested PCR was the best, the microscopy method was the second best, and RDTs was the lowest. Based on the comprehensive analysis of 12 individual indicators, RDTs had the highest score (32), while the microscopic examination and nested PCR scored 24 and 19, respectively. Conclusion RDTs had certain advantages in the detection of malaria, but they had a low identification specificity for different species. Thus, they can be used as auxiliary tools for microscopic examination and widely used in surveillance work after malaria elimination in Hubei Province.
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Se presentan 2 casos de bacteriemia por Helicobacter cinaedi. El primero se diagnosticó en un varón de 76 años y resultó secundario a la colocación de un acceso vascular; el segundo correspondió a un lactante febril de 37 días de vida, asociado a un cuadro de gastroen-terocolitis aguda. H. cinaedi es un microorganismo que presenta dificultad para desarrollarse en diferentes medios de cultivo y lograr su identificación a nivel de especie. En ambos casos fue fundamental la observación microscópica en fresco de las botellas de hemocultivo, la utilización de la espectrometría de masas y la posterior secuenciación del gen hsp60 para llegar a esa instancia. En los últimos anos se han informado infecciones por H. cinaedi con frecuencia creciente en otras partes del mundo. En este trabajo presentamos los primeros casos de bacteriemia por H. cinaedi documentados en Argentina.
Two cases of bacteremia caused by Helicobacter cinaedi are presented. The first case was diagnosed in a 76-year-old male patient, and was secondary to a vascular access device placement; the second case corresponded to a febrile infant of 37 days of life, and was associated with acute gastroenteritis. H. cinaedi is a microorganism difficult to grow in different culture media and also to identify to species level. In both cases, the microscopic observation of blood culture bottles, the use of mass spectrometry and the subsequent sequencing of the hsp60 gene were essential. In the recent literature, H. cinaedi infections are being reported more frequently. In this report we present the first documented cases of bacteremia caused by H. cinaedi in Argentina.
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Humans , Male , Infant , Aged , Helicobacter Infections/diagnosis , Bacteremia/diagnosis , Argentina/epidemiology , Mass Spectrometry/methods , Blood Culture/methodsABSTRACT
Background: Maternal and fetal status are reflected in placenta. Toxemia of pregnancy exerts great impact on placenta and thereby fetal and maternal outcomes. Placenta reflects changes of toxemia and these changes are seen morphology as well as histology. Hence study of placenta gives information on the in-utero fetal condition.Methods: A total of 1000 placenta, 500 each from hypertensive and normotensive groups were included in this study conducted in Anatomy Department of SBKS Medical College and Research Centre, Vadodara. Histological evaluation of the samples taken was done under microscope.Results: Microscopic examination of the placenta revealed the presence of calcification, infarction, fibrinoid necrosis, villous hyalinization, syncytial knots and cytotrophoblastic cellular proliferation in both control and hypertension groups. In the present study, calcification was seen in 35.8% in the control group, while the same was seen in 53.8% patients in test group. Fibrinoid necrosis was seen in 48.8% patients in control group as against 69% patients in test group. Villous Hyalinization was seen in 7.40% and 21.4% patients in control and test groups respectively. On the other hand, syncytial knots were seen in 38% and 69% patients in control and test groups respectively. In test group, cytotrophoblastic cellular proliferation was seen in 69% patients while in control group, it was seen in 33.2% patients. Infarction was also seen in test (42.4%) and control (12.6%) groups.Conclusions: Hypertensive disorders of pregnancy have significant effect on the histology of placenta and also influences the fetal outcomes.
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OBJECTIVE: To compare black rice (Oryza sativa L) extract with three different staining methods for human sperm head assessment. METHODS: Semen samples were collected from 34 volunteers. Four smears of each ejaculate were prepared for staining using the rapid Papanicolaou (PAP) stain, SpermBlue, DipQuick, and black rice extract. The percentage of defective sperm heads (mean±standard deviation) was compared. RESULTS: Black glutinous rice extract, a natural dye, was used instead of hematoxylin to stain the nuclei of the sperm heads. The percentage of defective sperm heads showed a significant difference between black rice extract and DipQuick (p=0.000). In contrast, black rice extract and rapid PAP showed no statistically significant difference (p=0.974). A strong correlation (r =0.761) was found between the findings obtained using rapid PAP and black rice extract. In contrast, a weak correlation (r =0.248) was obtained between DipQuick and black rice extract for the percentage of defective sperm heads. CONCLUSION: The results showed good agreement and a strong correlation between the rapid PAP and black rice extract stains. The advantages of black rice extract as a novel substitute for hematoxylin for nuclear staining include ease of preparation, local availability, and favorable nuclear staining properties. Further studies could also focus on comparing staining techniques in clinical samples.
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Humans , Coloring Agents , Hematoxylin , Semen , Sperm Head , Spermatozoa , VolunteersABSTRACT
To investigate the status of Strongyloides(S.) stercoralis infections among migrant workers in Malaysia for the first time and identify risk factors. Methods: Four diagnostic methods were employed for the detection of S. stercoralis including microscopy, enzyme-linked immunosorbent assay (ELISA) using a commercial kit, ELISA using the rSs1a antigen and polymerase chain reaction (PCR). Low and semi-skilled workers from five working sectors (i.e. manufacturing, food service, agriculture and plantation, construction and domestic service) were tested on a voluntary basis. Results: The overall seroprevalence of S. stercoralis from 483 workers employing the ELISA commercial kit for IgG was 35.8% (n=173; 95% CI: 31.5%-40.1%) whereas seroprevalence using the rSs1a-ELISA was 13.0% (n=63; 95% CI: 10.0%-16.0%). Cross tabulation between the ELISA commercial kit and rSs1a-ELISA showed that only 6.4% (n=31; 95% CI: 4.2%-8.6%) of the samples were positive in both tests. Microscopic examination of all 388 fecal samples were negative; however subsequent testing by a nested PCR against DNA from the same samples successfully amplified DNA from three male subjects (0.8%; 3/388). Male workers, India and Myanmar nationality, food service occupation and those living in the hostel were statistically significant with seroprevalence (P<0.005). Conclusion: This is the first report on the epidemiology of S. stercoralis infections among the migrant workers in Malaysia. Our results highlight the importance of using appropriate diagnostic tools for detection. The presence of anti-S. stercoralis antibodies in the study population calls for improvements in personal hygiene and sanitation standards among migrant workers in Malaysia through control strategies including health education campaigns and programs aimed at increasing awareness and healthy behaviors.
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Objective To understand the laboratory technicians’ abilities in blood slide making and reading in 10 prefectures of Yunnan Province which have passed the provincial malaria elimination evaluation, so as to provide the evidence for improving the malaria elimination surveillance and parasite examination. Methods Thirty negative blood slides were randomly sampled to evaluate coating, dyeing and clean quality and reading results, and 4 laboratory technicians were sampled to evaluate their reading abilities from each prefecture level and its 2 subordinate counties (districts) respectively, and then the results were analyzed. Results A total of 869 negative blood samples were evaluated. The coincidence rate was 100%. The proportions of good coating, dyeing and clean quality were 96.09%, 91.71% and 96.89%, respectively. Totally 576 blood slides were used to evaluate the reading ability. The number of correct reading was 505, and the correct rate was 87.67%. Among them, the Plasmodium vivax correct reading rate was 87.76%, the P. falciparum correct reading rate was 87.50%, and the correct reading rate of mixed infections was 47.62%. The laboratory technicians’ ability to the mixed infections was significantly lower than the ability to the others (χ2 = 37.169, P < 0.05), however, in the laboratory technicians’ abilities, there was no significant difference among the center (s) for disease control and prevention, general hospitals and township hospitals (χ2 = 2.782, P > 0.05), and the prefecture, county and township levels (χ2 = 0.358, P > 0.05) . Conclusion The 10 prefectures have passed the provincial evaluation in blood slide making and microscopic examination skill indicators requested, but the medical and public health institutions at all levels still should further improve their laboratory technicians’ abilities in blood slide making and microscopic examination skills.
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Objective To understand the laboratory technicians’ abilities in blood slide making and reading in 10 prefectures of Yunnan Province which have passed the provincial malaria elimination evaluation, so as to provide the evidence for improving the malaria elimination surveillance and parasite examination. Methods Thirty negative blood slides were randomly sampled to evaluate coating, dyeing and clean quality and reading results, and 4 laboratory technicians were sampled to evaluate their reading abilities from each prefecture level and its 2 subordinate counties (districts) respectively, and then the results were analyzed. Results A total of 869 negative blood samples were evaluated. The coincidence rate was 100%. The proportions of good coating, dyeing and clean quality were 96.09%, 91.71% and 96.89%, respectively. Totally 576 blood slides were used to evaluate the reading ability. The number of correct reading was 505, and the correct rate was 87.67%. Among them, the Plasmodium vivax correct reading rate was 87.76%, the P. falciparum correct reading rate was 87.50%, and the correct reading rate of mixed infections was 47.62%. The laboratory technicians’ ability to the mixed infections was significantly lower than the ability to the others (χ2 = 37.169, P < 0.05), however, in the laboratory technicians’ abilities, there was no significant difference among the center (s) for disease control and prevention, general hospitals and township hospitals (χ2 = 2.782, P > 0.05), and the prefecture, county and township levels (χ2 = 0.358, P > 0.05) . Conclusion The 10 prefectures have passed the provincial evaluation in blood slide making and microscopic examination skill indicators requested, but the medical and public health institutions at all levels still should further improve their laboratory technicians’ abilities in blood slide making and microscopic examination skills.
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To investigate the status of Strongyloides(S.) stercoralis infections among migrant workers in Malaysia for the first time and identify risk factors. Methods: Four diagnostic methods were employed for the detection of S. stercoralis including microscopy, enzyme-linked immunosorbent assay (ELISA) using a commercial kit, ELISA using the rSs1a antigen and polymerase chain reaction (PCR). Low and semi-skilled workers from five working sectors (i.e. manufacturing, food service, agriculture and plantation, construction and domestic service) were tested on a voluntary basis. Results: The overall seroprevalence of S. stercoralis from 483 workers employing the ELISA commercial kit for IgG was 35.8% (n=173; 95% CI: 31.5%-40.1%) whereas seroprevalence using the rSs1a-ELISA was 13.0% (n=63; 95% CI: 10.0%-16.0%). Cross tabulation between the ELISA commercial kit and rSs1a-ELISA showed that only 6.4% (n=31; 95% CI: 4.2%-8.6%) of the samples were positive in both tests. Microscopic examination of all 388 fecal samples were negative; however subsequent testing by a nested PCR against DNA from the same samples successfully amplified DNA from three male subjects (0.8%; 3/388). Male workers, India and Myanmar nationality, food service occupation and those living in the hostel were statistically significant with seroprevalence (P<0.005). Conclusion: This is the first report on the epidemiology of S. stercoralis infections among the migrant workers in Malaysia. Our results highlight the importance of using appropriate diagnostic tools for detection. The presence of anti-S. stercoralis antibodies in the study population calls for improvements in personal hygiene and sanitation standards among migrant workers in Malaysia through control strategies including health education campaigns and programs aimed at increasing awareness and healthy behaviors.
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@#Fibres are important trace evidence that can be found during the course of crime scene investigation. The identification and analysis of these fibres shed light as to the circumstances surrounding a particular crime. Identifying the factors that affect the transference of fibres under various environments are crucial in providing robust conclusions of a case per se, as highlighted in this work. Donor garments were made up of four different types of fibre; 100% cotton, 100% nylon, 100% polyester and 100% wool, that were used to observe the differences in the number of transferred fibres to the recipient garment (100% cotton) and vice versa with increasing contact times of 30, 60, 180, and 300 seconds respectively. To simulate contact between the donor garment worn by a suspect and the recipient garment worn by a victim in real-life situations, the donor garment was placed on top of the recipient garment which was laid on a piece of plywood. The numbers of transferred fibres, both from the donor to the recipient garment and from the recipient to the donor garment were observed and tested using microscopic examination, burning test, solubility test and dye extractability test. Results indicated that different types of garments transferred different number of fibres with increasing contact times, and the identification of the fibres are possible via the different tests applied in this work.
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Objective To evaluate the creditability of warning message of white differential count (WDF) and white precursor cell (WPC) channels in Sysmex XN-3000 hematology analyzer,and verify its optimal threshold and adjust the alarm threshold.Methods A total of 61 EDTA-K2 anticoagulated blood samples without abnormal warning and 521 EDTA-K2 anticoagulated blood samples with abnormal warning were simultaneously detected in WDF and WPC channels.After the smear specimens of blood sample were automatically prepared by the instrument,microscopic examinations were performed manually.The results of microscopic examination were considered as the gold standard to determine the reliability of the warning message from the instrument and verify the reasonability of initial warning threshold value provided by the manufacture.Consequently,the threshold values were adjusted based on the requirements in practical work.Results The warning messages of atypical lymphocytes and blasts/abnormal lymphocytes in WDF channel were higher sensitive (95.8％ and 100％ respectively),but lower specific (34.7％ and 23.5％ respectively) compared with microscopic examination.The warning messages of atypical lymphocyte,blasts and abnormal lymphocytes in WPC channel were lower sensitive (81.3％,66.7％,and 76.5％ respectively) but higher specific (61.9％,55.5％ and 88.3 ％ respectively) compared with microscopic examination.According to the ROC curve analysis,the prognostic values of warning message of microscopic examination were of medium level,except the warning message for abnormal lymphocytes was poor compared with WPC channel.Combining the practical retest rules,the optimal critical threshold values of atypical lymphocytes and blasts/Abn lymph in WDF channel were adjusted as 120,and they were adjusted as 140 in WPC channel.Conclusion The high sensitive WDF channel should first be used for screening,and the detectable warning message could be retested by using high specific WPC channel to shorten the turnaround time of the test results and improve the working efficiency.The initial critical warning threshold provided by the manufacture should be verified and adjusted to the optimum critical threshold in order to ensure the accuracy of test results.
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To understand the quality of production of blood slides and laboratory personnel’s ability to microscopically examine Plasmodium at Jiangsu Province clinic inspection stations at all levels, so as to provide the evidence for the construction of malaria diagnostic laboratories and the evaluation of malaria elimination effect.After the reexamination of the negative blood slides of the examination stations of the malaria center in each county (district), the negative blood slides of the outpatient inspection station in the district and all the positive blood slides of the direct report of the network from 2011 to 2017, the staining and cleanliness of the blood smears, microscopic examination results and the coincidence rate of positive blood species were comprehensively analyzed.A total of 19 109 checked blood samples were examined. The qualified rates of blood preparation, dyeing and cleanliness were 87.5%, 89.3% and 87.6%, respectively. The quality of reexamined blood slides in different years showed statistically significant difference (all P < 0.05), by using chi-square trend test, and there was a trend of increasing year by year. There was a significant difference in the quality of the reexamined blood slides among the different cities with districts (P < 0.05). In addition, there were 1 860 blood samples from 2012 to 2017, and the total coincidence rate was 87.4% and the coincidence rate of positive blood smear examinations was 98.9%. The species coincidence rates of Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and mixed infection were 95.4%, 33.3%, 56.0%, 76.5% and 9.1%, respectively (P < 0.05). The total coincidence rates of blood smear reexaminations in different years were 85.0%, 90.1%, 86.0%, 85.3%, 90.0% and 87.6% from 2012 to 2017, respectively, and the difference was not statistically significant (P > 0.05).The quality of blood slides at the primary clinic inspection stations in Jiangsu Province conforms to the standard established by the provincial malaria reference laboratory; however, the ability of Plasmodium species identification is insufficient and needs to be improved.
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Objective To compare the application effects of three methods,namely microscopic examination,antigen detec-tion(RDT)and nucleic acid test(PCR)in malaria detection between municipal and districts/counties centers for disease con-trol and prevention in Shanghai,and analyze the malaria detection ability of the laboratories in Shanghai. Methods The blood smears,whole blood samples,case review confirmation records and case data of malaria cases and suspected cases in Shanghai from 2012 to 2015 were collected by Shanghai Municipal Center for Disease Control and Prevention,and the detection results were analyzed and compared. Results A total of 212 samples with complete data were submitted by all districts(counties)in Shanghai from 2012 to 2015,the samples submitted by Jinshan Districts were the most(41.98%),and among the first diagnosis hospitals,those submitted by the tertiary hospitals were the most(82.07%). The submitted samples in the whole year were in-creased gradually from January to October. All the 212 samples were detected by three methods(the microscopic examination, RDT and PCR)in the laboratory of Shanghai Municipal Center for Disease Control and Prevention,and 167 were tested and con-firmed comprehensively as positives,accounting for 78.77%,and 45 were confirmed as negatives,accounting for 21.23%. The samples were detected by the method of microscopy and domestic RDT in the laboratories of the centers for disease control and prevention at district/county level,totally 153 were tested as positives,accounting for 72.17%,41 were unclassified,account-ing for 19.34%,53 were negative,accounting for 25.00%,and 6 were undetected,accounting for 2.83%. The coincidence of microscopic examination between the report hospitals and the centers for disease control and prevention at district/county level was 78.16%,and the coincidence between centers for disease control and prevention at district/county level and municipal level was 93.20%. The utilization rate of RDT in the laboratory of district/county level was 73.58%. The coincidence of RDT tests be-tween those domestic and imported was 93.59%. Compared with the detection results by municipal center for disease control and prevention,37 samples were misjudged by the laboratories of district/county level. Almost all(99.37%)of the confirmed malar-ia cases were imported overseas,including Africa(85.44%),Asia(13.92%)and America(0.63%). Conclusion The surveil-lance after malaria elimination in Shanghai should be carried out by combining with different detection methods and resource in-tegration.
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Objective To investigate the capabilities of Plasmodium microscopic examinations of professional staff in medi-cal institutions in Wuxi City,so as to provide evidences for improving malaria control and elimination work in the future. Meth-ods The data of questionnaires for laboratorial staff in charge of Plasmodium microscopic examinations were collected and ana-lyzed in the medical institutions in Wuxi City in 2016,and the influencing factors related to the capabilities of Plasmodium mi-croscopic examinations were analyzed by the method of logistic regression. Results Totally 54 laboratorial workers in 54 medi-cal institutions in Wuxi City were investigated,16 of them were male,and 38 were female,and the ratio of male to female was 0.42:1. Among the 54 laboratorial workers,12 persons(22.22％)had the experience of detecting Plasmodium in the work. The multivariable analysis showed the ability to detect Plasmodium was associated with male laboratorial workers(adjusted OR =0.11,95％CI:0.02-0.53),laboratorial workers with intermediate or higher professional titles(adjusted OR=5.31,95％CI:1.04-27.19)and laboratorial workers from county and township medical institutions(adjusted OR=0.04,95％CI:0.01-0.98). Conclusions All of the medical institutions in Wuxi City have the capability of microscopic examinations of Plasmodium. How-ever,the ability of laboratorial staff in primary hospitals still should be improved.
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BACKGROUND: Demodicosis is a parasitic skin disease caused by Demodex mites, and the determination of mite density per square centimeter is important to diagnose demodicosis. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd). However, no study has previously compared these two methods with respect to clinical types and distribution patterns of demodicosis. OBJECTIVE: The aim of this study was to compare the value of SSSB and DME findings in reference to the clinical types and distribution patterns of demodicosis. METHODS: The medical records of 35 patients diagnosed with demodicosis between December 2011 and June 2015 were retrospectively reviewed. Demodicosis was classified according to four clinical types (pityriasis folliculorum, rosacea type, acne type, and perioral type) and three distribution patterns (diffuse pattern, U-zone pattern, and T-zone pattern). Two samples, one for SSSB and one for DME, were obtained from a lesion of each patient. RESULTS: In all patients, mean Dd and the proportion with a high Dd (>5D/cm²) by DME (14.5±3.3, 80.0%, respectively) were higher than by SSSB (5.5±1.3, 37.1%, respectively; p<0.01, p=0.02, respectively). In terms of clinical types, for rosacea type, mean Dd and proportion with a high Dd by DME (12.4±3.5, 84.6%, respectively) were significantly greater than those determined by SSSB (3.6±1.2, 23.1%; p=0.04, p=0.04, respectively). In terms of distribution pattern, for the diffuse pattern, mean Dd and the proportion with a high Dd by DME (17.5±3.7, 100%, respectively) were significantly higher than those determined by SSSB (6.0±2.7, 26.7%; p<0.01, p<0.01, respectively). CONCLUSION: The results of our study revealed that DME is a more sensitive method for detecting Demodex than SSSB, especially in patients with diffuse pattern and suspected rosacea type. Further research is needed to confirm this finding.
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Humans , Acne Vulgaris , Biopsy , Medical Records , Methods , Mites , Retrospective Studies , Rosacea , Skin Diseases, Parasitic , SkinABSTRACT
Abstract: INTRODUCTION Natural and artificial ecotope infestation by the kissing bug triatomines and their colonization and infection by Trypanosoma cruzi , the Chagas disease agent, were evaluated in nine municipalities of the State of Rio Grande do Norte, Brazil. METHODS Following identification, triatomine intestinal contents were analyzed by direct microscopic examination, xenoculture, and polymerase chain reaction (PCR) for parasite detection. Trypanosoma cruzi isolates were genotyped using three different markers. RESULTS Of 842 triatomines captured, 65% were Triatoma brasiliensis , 17.8% Triatoma pseudomaculata , 12.5% Panstrongylus lutzi , and 4.7% Rhodnius nasutus . Triatoma brasiliensis and P. lutzi adults were found in the intradomicile. T. brasiliensis, T. pseudomaculata , and R. nasutus nymphs and adults were found in the peridomicile and wild environment. Intradomiciliary and peridomiciliary infestation indexes were 5.6% and 33.7%, respectively. In the peridomicile, chicken coops were the most infested ecotope. The T. cruzi triatomine infection rate was 30.2%, of which PCR detected 29%. P . lutzi (78.1%), T . brasiliensis (24.5%), and T . pseudomaculata (22.7%) were the most infected species. TcII and III genotypes were detected in T. brasiliensis and TcIII in P. lutzi . CONCLUSIONS T. brasiliensis was found in all environments and most ecotopes with high T. cruzi infection rates. High infection rates were also detected in T . pseudomaculata and P. lutzi , suggesting their role in the interchange between the wild and peridomestic transmission cycles. The combination of PCR, microscopic examination, and xenoculture contributed to improving T. cruzi infection evaluation in triatomine bugs. The TcII and TcIII genotypes were predominant in the study area.
Subject(s)
Animals , Panstrongylus/parasitology , Rhodnius/parasitology , Triatoma/parasitology , Trypanosoma cruzi/isolation & purification , Insect Vectors/parasitology , Panstrongylus/genetics , Rhodnius/genetics , Triatoma/genetics , Brazil , Polymerase Chain Reaction , Chagas Disease/transmission , Genotype , Insect Vectors/classificationABSTRACT
Scabies is caused by a mite, Sarcoptes scabiei var hominis, an obligate human parasite that burrows downwards into the epidermis. Scabies may be transmitted from objects, but it is most often transmitted by direct skin-to-skin contact, with a higher risk from prolonged contact. Treatment must involve the entire household or community to prevent reinfection. In Korea, the incidence of scabies has decreased dramatically since the late 1980s, but recent outbreaks in nursing homes and hospitals have been raising public health concerns. Herein, we describe 5 cases of scabies that occurred in 3 generations of a family and were confirmed by dermoscopy-oriented skin scraping with microscopic examination.
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Humans , Dermoscopy , Diagnosis , Disease Outbreaks , Epidermis , Family Characteristics , Incidence , Korea , Hexachlorocyclohexane , Mites , Nursing Homes , Parasites , Public Health , Sarcoptes scabiei , Scabies , SkinABSTRACT
Introducción: la utilidad diagnóstica del estudio de médula ósea en pacientes con VIH ha sido evaluada en pocos estudios en Latinoamérica. Se desconoce la frecuencia con la que este estudio aporta a la identificación de infecciones oportunistas en nuestro medio. Diseño: estudio analítico de corte transversal. Métodos: revisión retrospectiva de historias clínicas de pacientes VIH-SIDA, hospitalizados en el Hospital Universitario de Santander entre 2009 y 2012, quienes fueron sometidos a estudio de médula ósea para evaluar citopenias. Se excluyeron casos con historia de neoplasia y quimioterapia tres meses antes del aspirado. Se calculó tamaño de muestra para evaluación de asociaciones. Resultados: se evaluaron 92 muestras de médula ósea de 83 pacientes, encontrando una prevalencia de infección oportunista de 23% con examen directo y 34.5% cuando se realizaron cultivos. La histoplasmosis fue la infección más frecuente 20.6%, seguida de Mycobacterias 10.8%e infección por Criptococcus spp 3.2%. La clínica hematológica que predominó en casos positivos para oportunista fue pancitopenia febril en 41% y monocitopenia en 32%. La deshidrogenasa láctica ≥ 600 UI/dL, se asoció con un diagnóstico positivo para infección oportunista en el estudio microscópico de médula ósea, con OR 5.42 (IC95% 1.09-26.9 p =0.03). Conclusión: el estudio de médula ósea en los pacientes con VIH-SIDA permitió un diagnóstico de infección oportunista en una cuarta parte de los casos, siendo especialmente útil para la identificación temprana de histoplasmosis. Se requieren estudios para evaluar el impacto en estancia hospitalaria, desenlaces clínicos y costos del uso de este examen de forma temprana en el abordaje de pacientes VIH hospitalizados en medicina interna. (Acta Med Colomb 2015; 40: 93-100).
Introduction: the diagnostic utility of the study of bone marrow in patients with HIV has been evaluated in a few studies in Latin America. The frequency with which this study contributes to the identification of opportunists in our country is unknown. Design: Analytical cross-sectional study. Methods: a retrospective review of medical records of HIV-AIDS patients hospitalized at the University Hospital of Santander between 2009 and 2012 who underwent bone marrow study to evaluate cytopenia. Cases with a history of malignancy and chemotherapy three months before vacuuming were excluded. Sample size for evaluation of partnerships was calculated. Results: 92 samples of bone marrow of 83 patients were evaluated, finding a prevalence of opportunistic infection in 23% with direct examination and 34.5% when cultures were performed. Histoplasmosis was the most common infection with 20.6%, followed by 10.8% Mycobacteria and Cryptococcus spp infection 3.2%. The hematologic clinic that prevailed in the positive cases for opportunist was pancitopenia febril (in 41% of the cases) and monocitopenia (in 32% of the cases). The LDH ≥ 600 IU / dL was associated with a positive diagnosis for opportunistic infection in the microscopic study of bone marrow, with OR 5.42 (95% CI 1.09-26.9 p = 0.03). Conclusion: the study of bone marrow in patients with HIV-AIDS allowed a diagnosis of opportunistic infection in a quarter of cases, and is especially useful for early identification of histoplasmosis. Studies to assess the impact on hospital stay, clinical outcomes and costs of using this test early in the approach to HIV patients hospitalized in Internal Medicine are required. (Acta Med Colomb 2015; 40: 93-100).
Subject(s)
Acquired Immunodeficiency Syndrome , Bone Marrow , Opportunistic Infections , Medical Records , Costs and Cost Analysis , NeoplasmsABSTRACT
Objective To establish and evaluate the review criteria of blood routine detection by the Sysmex XE‐5000 hematolo‐gy analyzer in our hospital for improving the effectiveness of the measurement results .Methods 606 blood samples were collected from the outpatients and inpatients during 2014 and performed the microscopic examination by 2 technologists‐in‐charge with the double‐blind method .The average value of these results was used as the judging criteria .According to the 41 items of rule formula‐ted by the international expert group and combining with the patients characteristics of infectious disease hospital and instrument features in this hospital ,20 items of review criteria for blood routine test of our hospital was formulated .Results With the micro‐scopic examination results as the criteria ,among 606 detected samples ,116 samples were in line with the rules and the review rate was 19 .14(116/606) ,in which the true positive rate was 6 .93% (42/606) ,the false positive rate was 12 .21% (74/606) ,the false negative rate was 2 .64% (16/606) ,the true negative rate was 78 .22% (474/606) ,the sensitivity was 72 .41% and the specificity was 86 .5% .The expected values of positive and negative results were 36 .21% and 96 .73% respectively .The total effective rate was 85 .15% .Conclusion The review criteria formulated by this laboratory are reasonable and effective ,which has an important significance in the clinical application for increasing the detection speed of blood routine ,improving the laboratory reports quality , without missed true blood patients and accurately providing the valuable information for clinicians .