Immunochromatography screening devices for cannabinoids in oral fluid sample

Abstract Cannabis sativa L. is one of the most consumed drugs in the world and recent studies have associated its use with an increase in the number of traffic accidents in different countries. In many countries, like Brazil, simple and reliable methodologies are still needed for the detection of drugs on site, mainly cannabinoids, considering its prevalence of use and oral fluid (OF) has been proved as an appropriate biological matrix for this purpose. Considering that, this work aims to review previous studies on immunochromatographic devices for on-site detection of cannabinoids in OF, discussing their sensitivity, specificity, cut-offs values and confirmatory methods. This data shows the importance of choosing a screening device and it reinforces the need for its implementation in Brazil. The research was conducted on 5 databases and all original articles, published in the last 10 years, were selected. A total of 32 articles were found, providing data for 17 screening devices of distinct brands. Only 2 screening devices showed satisfactory sensitivity and specificity in the evaluated studies (≥80% and ≥90% respectively). However, it should be considered that the screening devices still have some limitations, such as a higher cut-off than those recommended by international guidelines (cut-off > 2 ng/mL), therefore demonstrating the need for more studies in the area and the importance of confirmatory analysis usually fulfilled by LC-MS/MS, GC-MS/MS or GC-MS. Thus, the screening analyzes should not be evaluated by itself, but in association with confirmatory results and observational traits (behavioral changes), for a better understanding of the traffic scenario

Use of oral fluids to detect anti Lawsonia intracellularis antibodies in experimentally infected pigs / Utilização de fluidos orais para detecção de anticorpos anti Lawsonia intracellularis em suínos experimentalmente infectados

Several pathogens and antibodies derived from serum or produced in tissues associated with the oral cavity are present in the oral fluid (OF). Considering the applicability of this alternative sample, recent studies in veterinary medicine have tested OF as a replacement for serum in diagnostic assays. The aim of this study was to standardize the immunoperoxidase monolayer assay (IPMA) to detect anti-Lawsonia intracellularis immunoglobulin A (IgA) and immunoglobulin G (IgG) in OF samples from experimentally infected pigs. Sixty-two pigs were divided into two groups: control (T1, n=30) and inoculated with L. intracellularis (T2, n=32). Blood, OF and fecal samples were collected at 0, 7, 14, 21, 28 and 42 days post-inoculation (dpi). Some adaptations of the standard technique for serum were made to IPMA for the detection of IgA and IgG in OF. The IPMA showed high specificity and sensitivity for serum samples and high specificity and moderate sensitivity for the detection of IgA and IgG in OF. There was high agreement between the results of serum IgG and OF IgA and IgG. Based on our results, oral fluid samples may be used for the evaluation and determination of anti-L. intracellularis antibodies in pigs, but not for individual diagnosis of swine proliferative enteropathy.(AU)

Vários patógenos e anticorpos derivados do soro ou produzidos em tecidos associados a cavidade oral estão presentes no fluido oral (FO). Considerando a aplicabilidade dessa amostra alternativa, estudos recentes em medicina veterinária têm testado o FO como substituto do soro para testes diagnósticos. O objetivo desse estudo foi padronizar a imunoperoxidase em monocamada de célula (IPMC) para a detecção de imunoglobulina A e imunoglobulina G anti-Lawsonia intracellularis em amostras de FO de suínos experimentalmente infectados. Um total de 62 suínos foram divididos em dois grupos: controle (T1, n=30) e inoculados com L. intracellularis (T2, n=32). Sangue, FO e amostras de fezes foram coletados aos 0, 7,14, 21, 28 e 42 dias após a inoculação (dpi). Algumas adaptações da técnica foram realizadas na técnica padrão da IPMC para a detecção de IgA e IgG. A IPMC demostrou alta especificidade e sensibilidade para amostras de soro e alta especificidade de moderada sensibilidade para a detecção de IgA e IgG em FO. Houve alta concordância entre resultados de detecção de IgG em soro com a IgA e IgG em amostras de FO. Baseado em nossos resultados, amostras de fluido oral podem ser usadas em avaliações e detecção de anticorpos anti-L. intracellularis em suínos, porém não de forma individual.(AU)

HIV prevalence in recently incarcerated adult males in the Federal District, Brasilia, Brazil

Abstract INTRODUCTION: This study intends to describe a HIV intake screening strategy in recently incarcerated adults in Distrito Federal, Brasilia, Brazil. METHODS: We tested 455 recently incarcerated adults in Distrito Federal in 2016 using rapid tests (RT) applied to oral samples (OS). RESULTS: The estimated frequency of positive tests was 0.88% (95% confidence interval [CI] 0.34% to 2.24%). CONCLUSIONS: The present findings reveal the potential significance of detecting new HIV infection cases in a vulnerable population using point-of-care rapid diagnostic tests.

Perfil de alcaloides de la hoja de coca en el fluido oral de un mascador de hoja de coca y un bebedor de té de coca: Estudio preliminar / Coca alkaloids profile in oral fluid from people chewing coca leaves and drinking coca tea: Preliminary study

Actualmente el fluido oral (FO) es aceptado como una matriz biológica alternativa para detectar drogas en toxicología clínica y forense. En países como Argentina donde el uso de hojas de coca (mascar hojas de coca o beber té de coca) es legal son necesarios procedimientos adecuados para logar una clara diferenciación entre los individuos que usan las hojas de coca de manera legal de aquéllos que usan cocaína en forma ilegal. Poca es la información que hay en la literatura sobre el perfil de los alcaloides de la hoja de coca en FO de personas que mascan hojas de coca o toman té de coca y hasta el presente trabajo no se hallaron datos sobre el perfil en FO de la higrina (HIG) y cuscohigrina (CUS). De este estudio preliminar participaron dos voluntarios. Los resultados mostraron que la CUS e HIG siguieron siendo positivas después que la cocaína (COC) y benzoilecgonina (BE) cayeron por debajo de los valores cut- off propuestos por las guías internacionales para FO en casos de screening (15 a 20 ng/ mL) y de confirmación (8 a 10 ng/mL) en el caso del mascador de coca. En el participante que tomó una taza de té de coca, en el último punto examinado (1 h) resultó ser positivo para la COC y BE y también para la CUS e HIG. El FO podría ser una muestra útil para confirmar el uso legal de la hoja de coca, aun cuando futuros estudios son necesarios para corroborar estos primeros datos.

Nowadays oral fluid (OF) is accepted as an alternative biological sample for detecting drugs in clinical and forensic toxicology. In countries like Argentina, where the use of coca leaves (coca leaves chewing and coca tea drinking) is legal, adequate procedures are required to allow a clear differentiation between people who use coca leaves (legal practice) and those who use cocaine (illicit practice). There is scarce literature regarding coca leaf alkaloids profile in OF from people who chew coca leaves and drink coca tea. Until now, coca leaf alkaloids profile of hygrine (HYG) and cuscohygrine (CUS) in OF were not described in the literature. The current preliminary study was performed with two healthy volunteers. In this research CUS and HYG have been found to be positive (detectable) even when cocaine (COC) and benzoylecgonine (BE) are dropped below the cut-off values proposed by international guidelines for screening (15 to 20 ng/mL), and confirmation (8 to 10 ng/mL) in OF. In addition, CUS and HYG were also found to be positive at the same time of the last detection of COC and BE after coca tea consumption. The OF would be a useful sample to confirm the legal use of coca leaf, even when more researches are therefore needed.

Immune Disorders of Dentoalveolar Anomalies in Schoolchildren

Increasing in IL-1, IL-6, IL-8 and TNF-α level in blood and oral fluid indicates an increase in antigenic stimulation of monocyte-macrophage, lymphoid cell elements, endothelial cells, fibroblasts of various organs and tissues, specifies systemic inflammatory response syndrome development and protective-adaptive reactions and maladaptation reactions formation at children with DAA.

Detection of occult hepatitis B in serum and oral fluid samples

In occult hepatitis B infection (OBI), hepatitis B virus DNA (HBV DNA) can be detected in serum samples; however, oral fluid collection for detection of HBV DNA has not yet been explored, despite the availability of collection devices. Serum and oral fluid samples from 45 hepatitis B core antibody (anti-HBc)-positive patients were collected for the amplification of the HBV polymerase gene. HBV DNA was detected in five serum and four oral fluid samples (the detection limit for oral fluid was 1.656 log IU/mL in paired serum). In conclusion, simple methodologies of sample collection and in-house polymerase chain reaction (PCR) allowed detection of HBV DNA, and these could be used to improve the diagnosis of OBI, especially in locations with limited resources.

Survey of porcine respiratory disease complex-associated pathogens among commercial pig farms in Korea via oral fluid method

Oral fluid analysis for herd monitoring is of interest to the commercial pig production in Korea. The aim of this study was to investigate pathogen-positive rates and correlations among eight pathogens associated with porcine respiratory disease complex by analyzing oral fluid samples from 214 pig groups from 56 commercial farms. Samples collected by a rope-chewing method underwent reverse-transcriptase polymerase chain reaction (RT-PCR) or standard polymerase chain reaction (PCR) analysis, depending on the microorganism. Pathogens were divided into virus and bacteria groups. The former consisted of porcine reproductive and respiratory syndrome virus and porcine circovirus type 2 (PCV2), and the latter Pasteurella multocida, Haemophilus parasuis, Actinobacillus pleuropneumoniae, Mycoplasma hyopneumoniae (MHP), Mycoplasma hyorhinis, and Streptococcus suis (SS). All pathogens were detected more than once by PCR. Age-based analysis showed the PCR-positive rate increased with increasing age for PCV2 and MHP, whereas SS showed the opposite. Correlations between pathogens were assessed among 36 different pair combinations; only seven pairs showed statistically significant correlations. In conclusion, the oral fluid method could be a feasible way to detect various swine respiratory disease pathogens and, therefore, could complement current monitoring systems for respiratory diseases in the swine industry.

Rapid Oral Fluid HIV Antibody Testing in Exposed Babies: A Diagnostic Study.

Aims: The usefulness of rapid oral fluid HIV antibody tests has rarely been evaluated in exposed babies. Study Design: A diagnostic survey comparing the performance of oral fluid HIV antibody test and the routine rapid blood screening test. Place and Duration of Study: University College Hospital, Ibadan and Nigerian Institute of Medical Research, Lagos, between May 2010 and April 2011. Methodology: The study involved children aged less than 18 months referred for screening in two large HIV care programmes in Nigeria using rapid antibody tests - an oral fluid test (Test A) and the routine blood test (Test B). The testing was blinded and HIV status was confirmed using DNA PCR. Results: A total of 94 children were studied with ages ranging from 0.13 to less than 18months. Out of the 94 parallel tests, when compared with DNA PCR, there were 7 (7.5%) discordant results. Test A gave one false positive, one false negative and no indeterminate result. Test B gave four false positive, one false negative and two indeterminate results. Test A had a sensitivity of 93.3%, specificity of 98.7%, positive predictive value of 93.3% and negative predictive value of 98.7% compared with Test B which had 90.0%, 92.9%, 60.0% and 98.7% respectively. Among the caregivers 88 (93.6%) preferred oral fluid testing to blood as it is painless and easy to perform. Conclusion: Compared with the rapid antibody blood test, the oral fluid test correlates better with DNA PCR in detecting the absence of infection in HIV exposed babies. Given this performance, it may be useful in expanding testing in HIV exposed children in settings where there are challenges with early infant diagnosis.

Detection of porcine reproductive and respiratory syndrome virus in oral fluid from naturally infected pigs in a breeding herd

The objectives of the present study were to evaluate the anatomic localization of porcine reproductive and respiratory syndrome virus (PRRSV) in naturally infected pigs and to determine whether oral fluid could be used to detect the virus in infected animals. Two sows, seven 2-month-old grower pigs, and 70 6-month-old gilts were included in this study. PRRSV in sera and oral fluid were identified by nested reverse transcription PCR (nRT-PCR) while lung, tonsil, and tissue associated with oral cavity were subjected to nRT-PCR, immunohistochemistry, and in situ hybridization. In sows, PRRSV was identified in oral fluid and tonsils. PRRSV was also detected in oral fluid, tonsils, salivary glands, oral mucosa, and lungs of all seven grower pigs. However, viremia was observed in only two grower pigs. Double staining revealed that PRRSV was distributed in macrophages within and adjacent to the tonsillar crypt epithelium. In gilts, the North American type PRRSV field strain was detected 3 to 8 weeks after introducing these animals onto the farm. These results confirm previous findings that PRRSV primarily replicates in tonsils and is then shed into oral fluid. Therefore, oral fluid sampling may be effective for the surveillance of PRRSV in breeding herds.

Saliva as a diagnostic fluid in sports medicine: potential and limitations / Saliva como fluido diagnóstico para utilização na medicina esportiva: potencialidades e limitações

The use of saliva in the diagnosis of pathologies and/or monitoring of athletes in competitions or trainings is an attractive alternative due to the fact that samples are easily obtained and it is mostly a less invasive method in comparison with venous blood collection. The saliva is a hypotonic fluid in relation to plasma, containing compounds produced in the salivary glands (immunoglobulin A [IgA] and α-amylase) as well as compounds diffused in the plasma (water, electrolytes, proteins, metabolites and hormones). It plays a pivotal role in the protection of oral mucosa against microbes and in food digestion. Its production and composition depend on the sympathetic and parasympathetic nervous system activity, whose antagonistic action may result in different saliva volumes with distinct ionic and protein profiles. The aim of this review was to present a critical analysis of the potential and limitations of saliva as a diagnostic tool in sports medicine. Although there are studies that have deployed it to monitor athletes in training and doping, the standardization of some preanalytical variables are still required, among which the following ones are worth mentioning: the accurate choice of collection system, which allows the easy quantification of volume with adequate sample recovery; well-defined collection schedules in accordance with the circadian variations of the analyte; prevention of sample contamination with blood from oral mucosa lesions. Another key point for its application in sports is the establishment of reference intervals for analytes quantified in the saliva, collected from a population that comprises healthy individual that exercise regularly and systematically, with physical activity progression.

A utilização de saliva como alternativa para o diagnóstico de patologias e/ou monitoramento de atletas em competições ou treinos é muito atrativa devido à facilidade de obtenção da amostra e, principalmente, pela natureza menos invasiva que a coleta de sangue venoso. A saliva é um fluído hipotônico em relação ao plasma; contém compostos produzidos localmente nas glândulas salivares (imunoglobulina A [IgA] e α-amilase), além de compostos difundidos do plasma (água, eletrólitos, proteínas, metabólitos e hormônios). A saliva desempenha funções importantes na proteção da mucosa oral contra microrganismos e na digestão dos alimentos. Sua produção e sua composição são dependentes da atividade do sistema nervoso autônomo simpático e parassimpático, cuja ação antagônica pode resultar em diferentes volumes de saliva com perfis proteico e iônico distintos. O objetivo da presente revisão é apresentar uma análise crítica das potencialidades e limitações da utilização da saliva como ferramenta diagnóstica para a medicina esportiva. Embora existam estudos que a utilizam para o monitoramento de atletas em situações de exercício e doping, ainda é necessário padronizar algumas variáveis pré-analíticas, como a escolha correta do melhor sistema de coleta, que permite quantificar facilmente o volume, com boa recuperação de amostra; os horários de coleta bem definidos, de acordo com as possíveis variações circadianas do analito; e a contaminação da saliva com sangue proveniente de lesões da mucosa oral, que tem de ser evitada. Outro ponto fundamental para aplicação no esporte é o estabelecimento de valores de referência para analitos quantificados na saliva, obtidos de uma população composta de sujeitos saudáveis e exercitados de forma constante e sistematizada, com progressão de cargas de esforço.

Orientações para o diagnóstico de influenza em suínos / Guidelines for diagnosis of swine influenza

Este trabalho descreve a colheita adequada de amostras, as técnicas/procedimentos disponíveis para o diagnóstico de influenza A em suínos, assim como os resultados e suas respectivas interpretações, para auxiliar médicos veterinários de campo na identificação dessa doença. Em suínos vivos, as amostras adequadas são: secreção nasal, fluido oral e sangue (soro). Para suínos mortos, colher preferencialmente amostras de pulmão com consolidação cranioventral. Secreção nasal e fragmentos de pulmão refrigerado são utilizados para detectar partícula viral viável (isolamento viral - IV) ou ácido nucleico viral (RT-PCR convencional e RT-PCR em tempo real). As amostras não devem ser congeladas, pois o vírus é inativado a -20°C. A caracterização molecular dos isolados é feita pela análise filogenética obtida pelo sequenciamento de DNA. O soro é utilizado para a detecção de anticorpos (Acs) por meio do teste da inibição da hemaglutinação e ELISA. O fluido oral pode ser utilizado para detecção de anticorpo (ELISA) ou de vírus. Fragmentos de pulmão fixados em formol a 10% são examinados microscopicamente para identificar pneumonia broncointersticial e para detecção de antígeno viral pela imuno-histoquímica (IHQ). Para o sucesso do diagnóstico, as amostras devem ser colhidas de suínos que estão preferencialmente na fase aguda da doença, para aumentar as chances de detecção viral. As melhores opções para o diagnóstico de influenza A em suínos vivos são RT-PCR e isolamento viral de amostras de swab nasal ou fluido oral. Pulmão para análise por RT-PCR, isolamento viral ou IHQ é a amostra de escolha em suínos mortos. Testes sorológicos têm valor diagnóstico limitado e são utilizados apenas para determinar o estado imune do rebanho, não indicando doença clínica, pois os Acs são detectados 7-10 dias pós-infecção (fase subaguda). O diagnóstico de influenza é importante para avaliar o envolvimento desse agente no complexo de doença respiratória suína. Além disso, o isolamento do vírus influenza é essencial para o monitoramento dos principais subtipos circulantes em uma determinada região ou país, assim como para a detecção de novos rearranjos virais, já que influenza é considerada uma zoonose.

This article is intended to describe the adequate sample collection, the laboratory procedures/techniques, the expected results and their interpretation for diagnosis of influenza infection in swine, serving as a support for field veterinarians. In live pigs, the samples to be taken are nasal secretions, oral fluids and blood. For dead pigs, preference should be given to samples of cranioventral lung consolidation. Nasal discharge and chilled lung fragments are used for detection of virus (virus isolation - VI) or viral nucleic acids (conventional RT-PCR and real-time RT-PCR). Samples should not be frozen, because the virus is inactivated at -20°C. Molecular characterization of isolates is performed by phylogenetic analysis of gene sequences obtained by DNA sequencing. Serum is used for the detection of antibodies using hemagglutination inhibition (HI) test and ELISA. Oral fluid may be used for either antibody (ELISA) or viral detection. Fragments of lung fixed in 10% formaldehyde are used for histopathological analysis to identify bronchointerstitial pneumonia, and for immunohistochemistry (IHC) for antigens. For a successful diagnosis, sampling should be preferably performed in the acute phase of the disease to improve chances of virus detection. The best options to perform the diagnosis of influenza A in a swine herd are RT-PCR and VI from nasal swabs or oral fluid in live pigs and/or lung tissue for RT-PCR, VI or IHC in dead pigs. Serological tests are of very limited diagnostic value and are useful only to determine the immune status of the herd, not indicating clinical disease, because antibodies are detected after 7-10 days post infection (subacute phase). The diagnosis of influenza is important to evaluate the involvement of this agent in the complex of respiratory diseases in pigs. Furthermore, the isolation of influenza virus is essential for monitoring the main subtypes circulating in a given region or country, as well as for the detection of potential new viral reassortants, because influenza is considered a zoonosis.

Avaliação de testes rápidos para o diagnóstico da infecção pelo vírus da hepatite c / Rapid assessment tests for the diagnosis of infection with hepatitis c

O objetivo deste estudo foi avaliar o desempenho de testes rápidos para o diagnóstico de anti-HCV em amostras de soro, sangue total e fluido oral em populações com diferentes perfis de endemicidade e comportamento de risco para o HCV. Foram obtidas amostras biológicas de 3 grupos entre fevereiro de 2010 a setembro de 2011: (I) 194 indivíduos atendidos em centros de referência para o diagnóstico das hepatites virais no Rio de Janeiro (IOC/Fiocruz e UFRJ) que forneceram amostras pareadas de soro, sangue total e fluido oral avaliadas pelos testes rápidos WAMA Imuno-Rápido HCV (WAMA Diagnóstica) e Bioeasy HCV Rapid Test (Bioeasy Diagnóstica Ltda) e, 174 amostras de fluido oral avaliadas pelo teste rápido Oraquick HCV (Orasure); (II) indivíduos residentes em áreas remotas [...], onde 430 amostras pareadas de soro, sangue total e fluido oral foram avaliadas pelos testes Wama e Bioeasy e 459 amostras foram avaliadas pelo teste rápido Orasure; (III) indivíduos usuários de crack residentes em duas regiões geográficas do Brasil (Sudeste e Nordeste) e profissionais de beleza residentes na cidade do Rio de Janeiro que forneceram 200 amostras pareadas de soro, sangue total e fluido oral para avaliação nos testes Wama e Bioeasy e 43 amostras de fluido oral para uso no teste rápido Orasure. O anti-HCV foi avaliado em amostras de soro por dois testes imunoenzimáticos [...] e aquelas amostras reagentes foram submetidas ao PCR para detecção do HCV RNA...

The objective of this study is to evaluate the performance of rapid tests for the diagnosis of anti-HCV in sera, whole blood and oral fluid samples from populations with different endemicity profiles and risk behavior for HCV. Biological samples were obtained from 3 groups from February 2010 toSeptember 2011: (I) 194 individuals referred to Reference Centers for Viral Hepatitis Diagnosis at Rio de Janeiro (IOC/Fiocruz e UFRJ) who donate paired sera, whole blood and oral fluid samples evaluated by rapid tests WAMA Imuno-Rápido HCV (WAMA Diagnóstica) and Bioeasy HCV Rapid Test (Bioeasy Diagnóstica Ltda) and, 174 oral fluid samples evaluated by rapid test Oraquick HCV (Orasure); (II)individuals residing in remote areas [...], where 430 paired sera, whole blood and oral fluid samples were evaluated by Wama and Bioeasy and 459 samples evaluated by Orasure rapid test; (III) crack users residing in two geographical areas of Brazil (Southeast and Northeast) and beauty professionals residing at Rio de Janeiro city who donated 200 paired sera, whole blood and oral fluid samples for evaluation at Wama and Bioeasytests and 43 oral fluid samples to use in Orasure rapid test. Anti-HCV was evaluated in sera samples by two enzyme immunoassays [...] and those reactive samples were submitted to PCR for HCV RNA detection. [...] Sensitivity and specificity of rapid tests varied respectively from 76.03 percent to 93.84 percent and 93.75percent to 100percent when all anti-HCVreactive individuals by ELISA were included...

Performance Evaluation of the OraQuick Hepatitis C Virus Rapid Antibody Test

BACKGROUND: A reliable rapid assay for hepatitis C virus (HCV) may be helpful in various clinical settings. We evaluated the performance of the OraQuick HCV Rapid Antibody Test (OraSure Technologies Inc., Bethlehem, PA, USA). METHODS: Clinical sensitivity and specificity were evaluated with oral fluids and sera from 137 patients diagnosed with hepatitis C and 300 healthy blood donors in a multi-center collaborative study. The stored sera of 200 proven HCV-infected patients and 200 healthy subjects were also evaluated. Analytical sensitivity was estimated with 4 commercial seroconversion panels and 7 Korean reference panels. The performance of 4 laboratory-based tests (3 chemiluminescence assays and 1 enzyme immunoassay) and 4 rapid test kits was compared. We also assessed the interference due to bilirubin, hemoglobin, lipid, rheumatoid factor, multipara, and several viral infections. RESULTS: The clinical sensitivity and specificity of the OraQuick HCV test using oral fluid were 97.8% (95% confidence interval [CI], 93.2-99.4%) and 100% (95% CI, 98.4-100%), respectively. The clinical sensitivity using serum samples was 100%. Using the 4 seroconversion panels, the OraQuick HCV test showed results comparable to those of the laboratory-based assays; its analytical sensitivity was higher than that of the other rapid test kits. There was no cross-reactivity with common interfering factors. CONCLUSIONS: The clinical performance of the OraQuick HCV Test is comparable to that of laboratory-based tests with both serum and oral fluid. This supports the supplementary use of rapid HCV testing using oral fluid in various medical and non-medical settings.

Performance Evaluation of the OraQuick Hepatitis C Virus Rapid Antibody Test

BACKGROUND: A reliable rapid assay for hepatitis C virus (HCV) may be helpful in various clinical settings. We evaluated the performance of the OraQuick HCV Rapid Antibody Test (OraSure Technologies Inc., Bethlehem, PA, USA). METHODS: Clinical sensitivity and specificity were evaluated with oral fluids and sera from 137 patients diagnosed with hepatitis C and 300 healthy blood donors in a multi-center collaborative study. The stored sera of 200 proven HCV-infected patients and 200 healthy subjects were also evaluated. Analytical sensitivity was estimated with 4 commercial seroconversion panels and 7 Korean reference panels. The performance of 4 laboratory-based tests (3 chemiluminescence assays and 1 enzyme immunoassay) and 4 rapid test kits was compared. We also assessed the interference due to bilirubin, hemoglobin, lipid, rheumatoid factor, multipara, and several viral infections. RESULTS: The clinical sensitivity and specificity of the OraQuick HCV test using oral fluid were 97.8% (95% confidence interval [CI], 93.2-99.4%) and 100% (95% CI, 98.4-100%), respectively. The clinical sensitivity using serum samples was 100%. Using the 4 seroconversion panels, the OraQuick HCV test showed results comparable to those of the laboratory-based assays; its analytical sensitivity was higher than that of the other rapid test kits. There was no cross-reactivity with common interfering factors. CONCLUSIONS: The clinical performance of the OraQuick HCV Test is comparable to that of laboratory-based tests with both serum and oral fluid. This supports the supplementary use of rapid HCV testing using oral fluid in various medical and non-medical settings.

Evaluation of Calypte AWARE HIV-1/2 OMT antibody test as a screening test in an Indian setting.

Purpose: Integrated counselling and testing centres (ICTC) provide counselling and blood testing facilities for HIV diagnosis. Oral fluid tests provide an alternative for people whodo not want blood to be drawn. Also, it avoids the risk of occupational exposure. The goal of this study was to evaluate the utility of Calypte AWARE HIV-1/2 OMT antibody test as a screening test in an Indian setting. Materials and Methods: A cross-sectional study was carried out after ethics committee approval in 250 adult ICTC clients. Blood was collected and tested from these clients for HIV diagnosis as per routine policy and the results were considered as the gold standard. Also, after another written informed consent, oral fluid was collected from the clients and tested for the presence of HIV antibodies. Twenty five clients who had and 25 clients who had not completed their secondary school education (Group A and Group B, respectively) were also asked to perform and interpret the test on their own and their findings and experiences were noted. Result: The sensitivity, specificity, PPV and NPV of the oral fluid antibody test were 100%, 98.51%, 94.11% and 100%, respectively. Seventy six percent of clients preferred oral fluid testing. Group B found it difficult to perform the test as compared to Group A and this difference was statistically significant (P ≤ 0.05). Conclusion: Oral fluid testing can be used as a screening test for HIV diagnosis; however, confirmation of reactive results by blood-based tests is a must.

Oral fluid, a substitute for serum to monitor measles IgG antibody.

We have analyzed the suitability and potential of Oral Fluid (OF) to substitute serum in estimating measles IgG antibodies, during community surveys, by comparing the Optical Density (OD) of measles IgG antibodies in OF and serum of 100 apparently asymptomatic children. IgG antibody status was determined using commercially available - Measles IgG Capture ELISA. Sensitivity 89.5%, specificity 90.6% Concordance of 89%, coefficient of correlation r is equal to 0.97 (Karl Pearson's) and rho is equal to 0.86 (Spearman's), was found between OD value of OF and serum. The study emphasizes the potential of OF to surrogate serum in estimating Measles IgG antibody among children. The OF collection is advantageous over blood as it is painless. It is suitable for non-technical staff, easy to transport and less bio-hazardous.

Progress of the studies on rescuing the shock casualties with oral fluid resuscitation / 解放军医学杂志

Oral fluid resuscitation in early period of hypovolemic shock is an important measure in the treatment of casualties in the battlefield as well as in mass casualties in lieu of the means of establishing a venous line. The main tasks in the study of oral rehydration resuscitation are the proposition of appropriate prescriptions of the liquids to be given and methods of administration on the basis of a clear elucidation of the mechanism underlying the function of the digestive system in regard to transportation and absorption of the given ingredients. The aim of the study is to fully replenish maximal amount of fluid containing glucose and electrolytes in a convenient, expeditious, and effective way in a minimal span of time, in order to increase circulating blood volume. At the same time, ischemia and tolerance to oral fluids of the gastro-intestinal tract should be improved, electrolyte imbalance and incidence of secondary infection should be alleviated, and finally hypovolemic shock is corrected, so that the victim is kept alive and prepared for further definitive surgical intervention.

Effects of Preoperative NPO and Oral Fluid on Gastric Fluid Volume and pH / 대한마취과학회지

BACKGROUND: To reduce the risk of Mendelson's syndrome, it is customary to fast patients for 8 hours before anesthesia. However preoperative fast is unpleasant for patients, who complain frequently of thirst and dry mouth, and this conventional fast may be over-cautious. We have studied the effect of ingestion of barley tea, a Korean popular beverage, 3 hours before anesthesia on gastric contents (volume and pH), blood sugar level, thirst, and anxiety. METHODS: We studied prospectively 284 adult patients undergoing elective surgery. The patients in the control group (n=142) fasted for at least 8 hours, and those in the experimental group (n=142) received 250 ml of barley tea 3 hours before anesthesia. On arrival in the operating room, subjects were asked to assess thirst and anxiety. After induction of anesthesia, gastric contents were aspirated via 18 French Salem sump tube and gastric volume, pH and blood sugar level were measured. RESULTS: There were no statistically significant differences in gastric fluid volume and pH and blood sugar level between control and experimental groups. However, patients in experimental group complained of less thirst than those in control group. CONCLUSIONS: This study demonstrates that in adult patients undergoing elective surgery, allowing patients to drink 250 ml of barley tea until 3 hours before anesthesia may relieve patients from thirst without compromising safety.