Application of laboratory diagnostic technologies for SARS-CoV-2: current progress and prospect / 南方医科大学学报

Since the outbreak of COVID-19 pandemic, the detection capability has been improving and the detection techniques have been evolving with innovations. qRT- PCR and mNGS, which represent the current mainstay diagnostic technologies, play key roles in disease diagnosis and monitoring of virus variation. The detection technologies based on serum and plasma IgM and IgG antibodies are important for auxiliary diagnosis. RT-LAMP is highly specific for a diagnostic purpose. Digital PCR could quantitatively detect nucleic acid and SHERLOCK has a higher sensitivity. These techniques all have great potential for future development and application for pathogen detection. In this review the authors summarize the basic rationales, technical characteristics and the current application of the SARS-CoV-2 detection techniques.

Del método holmesiano a la gesta clínico-epidemiológica del maestro Félix Pifano / From the holmesian method to the magister Felix Pifano`s clinical epidemiological exploit

El método holmesiano o sherlockiano según se le quiera designar, se advierte en la obra de Pifano y se sostiene en los siguientes enunciados: 1 Ciudadosa observación mediante el empleo combinado de los sentidos, asociada a un conocimiento intiutivo y razonamiento deductivo. 2 Prestar atención a los detalles y mantener alerta a las discrepancias. 3 Considerar las diversas opciones presentes en un caso. 4 Aprender a diferenciar y conocer lo que es importante de lo que no lo es. El Maestro Pifano dio a conocer a sus alumnos lo que consideraba importante al fusionar el método clínico condicente a formular un diagnóstico (historia clínica y anamnesis cuidadosa, examen físico integral e integrado, e investigaciones complementarias) con el método epidemiológico que situaba al paciente en un espacio geográfico, en un tiempo determinado e insertado en una comunidad donde concurrían los diferentes elementos que determinaban su condición de enfermo. En suma, en su concepción, el estudio integral del enfermo era indisoluble de su ambiente, del biotopo donde se desarrollaban los fenómenos de la ecología asociada al grupo a la cual pertenecía-soma, psiquis y mundo externo

The Holmesian or Skerlockian methodology considered four important steps, 1 Careful observation by use of the senses combined with intuitive knowledge and deductive reasoning. 2 Attention to details and alertness to discrepancies. 3 Considering the many options present in a case 4 Knowing what is important and what is not. Through the discussion we will show how these elements were present in the work of Félix Pifano, M.D. Master Pifano unveiled their students what was considered important to merge the leading clinical method to make a diagnosis (medical history and careful anamnesis, physical examination, integral and integrated and complementary procedures) with the epidemiological method that placed the patient in a geographic area, at a time determined and inserted in a community where the various elements that determined their condition of ill person. In short, in its conception, the comprehensive study of the patient was indissoluble of its environment, the biotope where unfolded the phenomena of ecology associated to the group to which he belonged-soma, psyche and world external

Sir Arthur Conan Doyle, Sherlock Holmes y las enfermedades infecciosas / Sir Arthur Conan Doyle, Sherlock Holmes and infectious diseases

Sir Arthur Conan Doyle, además de ameno escritor de best sellers, era médico y escribió excelentes cuentos sobre el ejercicio de su profesión en Inglaterra. Sin embargo, a pesar de mencionar The British Medical Journal y The Lancet en sus historias de Sherlock Holmes, al introducir enfermedades infecciosas en sus tramas, ignora descubrimientos importantes ya realizados en su época en el campo del tétanos. En todo caso, las apariciones de las enfermedades infecciosas en las historias del detective son escasas: una mención del tétanos, otra de la lepra y -la más analizada en la literatura médica- un caso de asesinato realizado mediante la inoculación de una bacteria, probablemente del agente de la melioidosis. También hizo a su héroe descubrir las acciones tóxicas de una medusa y de un trasplante de órganos. Poco para un médico y poco para un autor que también escribía ciencia ficción: pareciera que la historia de los grandes descubrimientos médicos de fines del siglo XX y comienzos del XXI pasó por su lado... y no la vio.

Besides a pleasant author of best sellers, Sir Arthur Conan Doyle was a medical doctor, writing excellent short stories about the exercise of his profession in England. However, even he mentions The British Medical Journal and The Lancet in the Sherlock Holmes’s stories, when in the plot introduces infectious diseases, Conan Doyle ignores important discoveries in the field of tetanus. Anyway, the appearing of infectious diseases in the adventures of the detective are rare: one mention of tetanus, another of leprosy and- the most analyzed in medical literature -a case of murder by inoculation of bacteria, probably the agent of melioidosis. Also he makes his hero discovers the toxic actions of a medusa and a transplant of solid organ. Little for a physician and less for an author who also wrote science fiction: it seems that the history of the great medical discoveries at the end of nineteenth century and beginning of the twentieth has passed by his side… and he just couldn’t see it.

New Tension-free Suture Method in the Forehead Reduction and Scalp Reduction

A variety of treatments has been used to correct long forehead and frontal alopecia. These include forehead reduction (scalp reduction), hair graft and flap transfer. Among these procedures, forehead reduction (scalp reduction) is the most simple and effective method. In this procedure, various fixation techniques of scalp flap to cranial bone are used to prevent retraction of the scalp. We used Sherlock (or Piranha) screw to anchor the scalp flap to cranial bone. Between August 1998 and May 2000, this technique had been performed for 37 patients. Average follow-up period was 15 months. For forehead reduction (scalp reduction), the scalp was elevated back to the occipital region through a pretrichial incision, and relaxation incisions of galea was made at a right angle to the vector of advancement. The Sherlock (or Piranha) screw was fixed to the cranial bone. The entire scalp was then repositioned anteriorly, advancing the hairline caudally and shortening the forehead. Retraction of the scalp was prevented by anchoring the galeal fascia to the cranial bone using Sherlock (or Piranha) screws. This technique allows sufficient advancement of the scalp and a tension-free closure. Postoperatively scar widening was less than that of other methods. There were not any infection, hematoma, hair loss nor permanent paresthesia on scalp. In 2 cases, screws were palpable and we removed a screw for 1 case. Advantages of using Sherlock (or Piranha) screw are that the procedure is easy and simple, and sufficient advancement of the scalp, tension-free closure, and less scar widening can be achieved. Disadvantages of this procedure include cost of screw and palpability of screw. In conclusion, by using Sherlock (or Piranha) screw, the procedure was simple and we could get aesthetically good results.