scholarly journals Utility of Urine Reagent Strips in CSF Analysis as An Aid to Rapid Diagnosis of Meningitis

2020 ◽  
Vol 7 (6) ◽  
pp. A306-310
Author(s):  
Abhirami Ganesh R ◽  
Prabhu M H
Keyword(s):  
Rural Areas ◽  
High Specificity ◽  
Turnaround Time ◽  
Rapid Diagnosis ◽  
Medical Emergency ◽  
Index Test ◽  
Protein Levels ◽  
Csf Analysis ◽  
Cell Counts ◽  
Strip Test

Background: Bacterial Meningitis is a medical emergency and timely intervention has an implication on the prognosis and outcome. Examination of the CSF for leucocytes, glucose and proteins are the cornerstones in the diagnosis of meningitis in general and to arrive at the cause. Hence, this study is done to evaluate the usefulness of urinary reagent strip for rapid diagnosis of meningitis.   Methods: This is a prospective single blinded study on 100 CSF samples subjected to index test (Urine reagent strip test-Dirui H10) and definitive test comprised of CSF microscopy and biochemical analysis for proteins and sugar. The diagnostic accuracy of each index test at different cut off levels tabulated in the form of sensitivity, specificity, PPV and NPV.   Result: The sensitivity and specificity for leukocytes by the strip method for ≥15 cells/cumm were 92% and 98.66%, and for protein levels >30 mg/dl were 84.33% and 94.11% respectively. The test showed high specificity (100%) but less sensitivity for glucose <50mg/dl. It was observed that the accuracy of the tests increased with increase in the values of cell counts and proteins and decrease in sugar reaching 100% accuracy for higher cut-offs.   Conclusion: Urine reagent strip can be utilized for the rapid analysis of CSF in both rural areas as well as in centres where the facility is available as it reduces turnaround time.

scholarly journals A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19

2020 ◽  
Author(s):  
Medha Tandon ◽  
Tejas R Mehta ◽  
Maha Daimee ◽  
Viral Patel ◽  
Apoorv Prasad ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neurological Complications ◽  
Common Finding ◽  
Pathophysiological Mechanism ◽  
Neurological Manifestations ◽  
Protein Levels ◽  
Csf Analysis ◽  
Cell Counts ◽  
Neurological Illness ◽  
Elevated Protein

Abstract Background: Here we performed a systematic review of literature of CSF findings associated with neurological complications in coronavirus disease-2019 (COVID-19) to establish a pattern and understand the significance of CSF analysis which can possibly be useful in deciding prognosis and exploring therapeutic options in the future. Methods: We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords “SARS-CoV-2 in cerebrospinal fluid”, “SARS-CoV-2 and CNS Complication”.Results: We performed CSF analysis results in total of 113 patients from 67 papers. There were 7 patients out of 113 patients (6.2 %) were fatal and 35 patients (31 %) were considered severe and rest non-severe. Elevated cell counts (>5 cells/µL) were found in 43% (3/7) of the fatal cases, 25.7% (9/35) of the severe cases and 29.4% (15/51) of non-severe cases. The average CSF protein of 110.0 mg/dl found in fatal, and in 85.4mg/dl in non-fatal cases. Whereas, average CSF protein levels were 78 mg/dl in severe and 103 mg/dl in non-severe cases. In addition, 76.5% (13/17) of the patients with CNS complications and 74.1% (40/54) of the patients with a PNS manifestation showed elevated protein levels.Conclusion: The most common finding of CSF analysis in the setting of neurological manifestations in Covid-19 is noted to be elevated CSF protein with occasionally elevated, predominantly lymphocytic cell count. Interestingly, CSF protein is noted to be majorly elevated in all spectrums of severity of neurological illness including CNS and PNS complications. This may be indicative of only one common pathophysiological mechanism of neurological illness. In future, A combination of SARS-CoV-2 CSF RT-PCR, CSF IgM testing, and CNS targeting antibodies should be further studied to understand pathophysiology of neurological complications in Covid-19.

Personalized antibiotic therapy – a rapid high performance liquid chromatography–tandem mass spectrometry method for the quantitation of eight antibiotics and voriconazole for patients in the intensive care unit

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tony Böhle ◽  
Ulrike Georgi ◽  
Dewi Fôn Hughes ◽  
Oliver Hauser ◽  
Gudrun Stamminger ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antibiotic Therapy ◽  
High Performance ◽  
High Specificity ◽  
Serum Levels ◽  
Turnaround Time ◽  
Target Range ◽  
Therapeutic Drug ◽  
Monitoring Method ◽  
Adjustment Procedure

AbstractObjectivesFor a long time, the therapeutic drug monitoring of anti-infectives (ATDM) was recommended only to avoid the toxic side effects of overdosing. During the last decade, however, this attitude has undergone a significant change. Insufficient antibiotic therapy may promote the occurrence of drug resistance; therefore, the “one-dose-fits-all” principle can no longer be classified as up to date. Patients in intensive care units (ICU), in particular, can benefit from individualized antibiotic therapies.MethodsPresented here is a rapid and sufficient LC-MS/MS based assay for the analysis of eight antibiotics (ampicillin, cefepime, cefotaxime, ceftazidime, cefuroxime, linezolid, meropenem, and piperacillin) applicated by continuous infusion and voriconazole. In addition a dose adjustment procedure for individualized antibiotic therapy has been established.ResultsThe suggested dose adjustments following the initial dosing of 121 patient samples from ICUs, were evaluated over a period of three months. Only a minor percentage of the serum levels were found to be within the target range while overdosing was often observed for β-lactam antibiotics, and linezolid tended to be often underused. The results demonstrate an appreciable potential for β-lactam savings while enabling optimal therapy.ConclusionsThe presented monitoring method provides high specificity and is very robust against various interferences. A fast and straightforward method, the developed routine ensures rapid turnaround time. Its application has been well received by participating ICUs and has led to an expanding number of hospital wards participating in ATDM.

scholarly journals K2P2.1 (TREK-1) potassium channel activation protects against hyperoxia-induced lung injury

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tatiana Zyrianova ◽  
Benjamin Lopez ◽  
Riccardo Olcese ◽  
John Belperio ◽  
Christopher M. Waters ◽  
...  
Keyword(s):  
Lung Injury ◽  
Lung Compliance ◽  
Alveolar Epithelial Cells ◽  
Pharmacological Intervention ◽  
Alveolar Epithelial ◽  
Protein Levels ◽  
Cell Counts ◽  
Novel Approach ◽  
Intracellular Ca ◽  
Cell Depolarization

AbstractNo targeted therapies exist to counteract Hyperoxia (HO)-induced Acute Lung Injury (HALI). We previously found that HO downregulates alveolar K2P2.1 (TREK-1) K+ channels, which results in worsening lung injury. This decrease in TREK-1 levels leaves a subset of channels amendable to pharmacological intervention. Therefore, we hypothesized that TREK-1 activation protects against HALI. We treated HO-exposed mice and primary alveolar epithelial cells (AECs) with the novel TREK-1 activators ML335 and BL1249, and quantified physiological, histological, and biochemical lung injury markers. We determined the effects of these drugs on epithelial TREK-1 currents, plasma membrane potential (Em), and intracellular Ca2+ (iCa) concentrations using fluorometric assays, and blocked voltage-gated Ca2+ channels (CaV) as a downstream mechanism of cytokine secretion. Once-daily, intra-tracheal injections of HO-exposed mice with ML335 or BL1249 improved lung compliance, histological lung injury scores, broncho-alveolar lavage protein levels and cell counts, and IL-6 and IP-10 concentrations. TREK-1 activation also decreased IL-6, IP-10, and CCL-2 secretion from primary AECs. Mechanistically, ML335 and BL1249 induced TREK-1 currents in AECs, counteracted HO-induced cell depolarization, and lowered iCa2+ concentrations. In addition, CCL-2 secretion was decreased after L-type CaV inhibition. Therefore, Em stabilization with TREK-1 activators may represent a novel approach to counteract HALI.

scholarly journals Neonatal Ureaplasma parvum meningitis complicated with subdural hematoma: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Canyang Zhan ◽  
Lihua Chen ◽  
Lingling Hu
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Subdural Hematoma ◽  
Central Nervous System Infection ◽  
Neonatal Meningitis ◽  
High Morbidity ◽  
Ureaplasma Parvum ◽  
Protein Levels ◽  
Csf Analysis ◽  
Empirical Antibiotics

Abstract Background Neonatal meningitis is a severe infectious disease of the central nervous system with high morbidity and mortality. Ureaplasma parvum is extremely rare in neonatal central nervous system infection. Case presentation We herein report a case of U. parvum meningitis in a full-term neonate who presented with fever and seizure complicated with subdural hematoma. After hematoma evacuation, the seizure disappeared, though the fever remained. Cerebrospinal fluid (CSF) analysis showed inflammation with CSF pleocytosis (1135–1319 leukocytes/μl, mainly lymphocytes), elevated CSF protein levels (1.36–2.259 g/l) and decreased CSF glucose (0.45–1.21 mmol/l). However, no bacterial or viral pathogens in either CSF or blood were detected by routine culture or serology. Additionally, PCR for enteroviruses and herpes simplex virus was negative. Furthermore, the CSF findings did not improve with empirical antibiotics, and the baby experienced repeated fever. Thus, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the infection. U. parvum was identified by mNGS in CSF samples and confirmed by culture incubation on mycoplasma identification medium. The patient’s condition improved after treatment with erythromycin for approximately 5 weeks. Conclusions Considering the difficulty of etiological diagnosis in neonatal U. parvum meningitis, mNGS might offer a new strategy for diagnosing neurological infections.

scholarly journals Changes of Hematocrit, Hemoglobin, Serum Protein Levels and Red Blood Cell Counts Before and After Stroke

1976 ◽  
Vol 13 (4) ◽  
pp. 207-214
Author(s):  
Hiroshi Yamanouchi ◽  
Hideo Tohgi ◽  
Masakuni Kameyama ◽  
Mototaka Murakami ◽  
Tamotsu Matsuda
Keyword(s):  
Blood Cell ◽  
Serum Protein ◽  
Red Blood Cell ◽  
Protein Levels ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
Before And After

Evaluation of the first immunosuppressive drug assay available on a fully automated LC-MS/MS-based clinical analyzer suggests a new era in laboratory medicine

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sebastian Hörber ◽  
Andreas Peter ◽  
Rainer Lehmann ◽  
Miriam Hoene
Keyword(s):  
High Specificity ◽  
Turnaround Time ◽  
Immunosuppressive Drugs ◽  
Immunosuppressive Drug ◽  
Ease Of Use ◽  
Analytical Performance ◽  
University Hospital ◽  
Therapeutic Monitoring ◽  
Mean Deviation ◽  
Liquid Chromatography Tandem Mass

AbstractObjectivesDue to its high specificity, liquid chromatography-tandem mass spectrometry (LC-MS/MS) is considered the gold standard in diagnostic areas such as therapeutic monitoring of immunosuppressive drugs (ISDs). However, many laboratories still rely on immunoassays for ISD quantification in a tradeoff between analytical performance and the advantages of fully automated analyzers – shorter turnaround times, greater ease of use, and 24/7 availability.MethodsThe LC-MS/MS-based Thermo Scientific™ Cascadion™ SM Immunosuppressant Panel was evaluated for >6 months in the routine laboratory of a university hospital. We assessed the analytical performance of the panel and compared it to conventional LC-MS/MS as well as to immunoassays (cyclosporine A, sirolimus, tacrolimus (Siemens) and everolimus (Thermo Fisher)). In addition, both ISD panel and Cascadion analyzer were scrutinized with regards to, e.g., turnaround time, usability, and robustness.ResultsAll ISDs showed high linearity and precision (CV≤6%) and a good correlation with conventional LC-MS/MS. The mean deviation to the immunoassays was 17–19% and negative for all ISDs except everolimus with a positive 19% bias. No weak points were revealed when challenging assay and system with, e.g., high haematocrit, sedimented whole blood or priority samples. The Cascadion integrated well into our 24/7 routine and could easily be operated simultaneously with several other analyzers by technical staff without LC-MS experience.ConclusionsThe ISD panel showed excellent analytical performance and demonstrated that a fully automated LC-MS-based analysis starting from primary samples is feasible, suggesting that LC-MS could become an integral part of 24/7 diagnostics in the near future.

scholarly journals Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

Nutrients ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 226
Author(s):  
Elena Paillaud ◽  
Johanne Poisson ◽  
Clemence Granier ◽  
Antonin Ginguay ◽  
Anne Plonquet ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Healthcare Associated Infections ◽  
Serum Leptin ◽  
Protein Levels ◽  
Reactive Protein ◽  
Cell Counts ◽  
Hospitalized Older Adults ◽  
Healthcare Associated

We aimed to determine whether serum leptin levels are predictive of the occurrence of healthcare-associated infections (HAIs) in hospitalized older patients. In a prospective cohort, 232 patients had available data for leptin and were monitored for HAIs for 3 months. Admission data included comorbidities, invasive procedures, the Mini Nutritional Assessment (MNA), BMI, leptin, albumin and C-reactive protein levels, and CD4 and CD8 T-cell counts. Multivariate logistic regression modelling was used to identify predictors of HAIs. Of the 232 patients (median age: 84.8; females: 72.4%), 89 (38.4%) experienced HAIs. The leptin level was associated with the BMI (p < 0.0001) and MNA (p < 0.0001) categories. Women who experienced HAIs had significantly lower leptin levels than those who did not (5.9 μg/L (2.6–17.7) and 11.8 (4.6–26.3), respectively; p = 0.01; odds ratio (OR) (95% confidence interval): 0.67 (0.49–0.90)); no such association was observed for men. In a multivariate analysis of the women, a lower leptin level was significantly associated with HAIs (OR = 0.70 (0.49–0.97)), independently of comorbidities, invasive medical procedures, and immune status. However, leptin was not significantly associated with HAIs after adjustments for malnutrition (p = 0.26) or albuminemia (p = 0.15)—suggesting that in older women, the association between serum leptin levels and subsequent HAIs is mediated by nutritional status.

scholarly journals ASSESSMENT OF SNAKE ANTIVENOM ACTIVITY OF TAMARINDUS INDICA SEED COAT EXTRACT

2021 ◽  
Vol 9 (09) ◽  
pp. 489-497
Author(s):  
Priyanka D. Mundhe ◽  
◽  
Balasaheb S. Pawade ◽  
Indrasen G. Waykar ◽  
Innus K. Shaikh ◽  
...  
Keyword(s):  
Snake Venom ◽  
Seed Coat ◽  
Rural Areas ◽  
Proteolytic Enzymes ◽  
Lethal Dose ◽  
Medical Emergency ◽  
Dependent Manner ◽  
Tamarindus Indica

Snakebite is a life-threatening medical emergency, and globally responsible for millions of deaths. In snakebites accidents only deaths are not a concern, it leads to more morbidities. Due to scanty healthcare facilities in rural areas of India, many people seek alternative treatment available in ethnic practices. Tamarindus Indica (TI) plant is rich in medicinal value and used to treat many diseases including snakebite treatment traditionally. In view of this TI seed coat extract (TISCE) was evaluated for antivenom activity. The phytochemical screening of TISCE was performed to understand its chemical composition. TISCE was evaluated for antivenom activity against Indian cobra venom (ICV), common krait venom (CKV), Russells viper venom (RVV), and saw-scaled viper venom (SCV) for phospholipase A2 (PLA-2), haemorrhagic in vitro and in vivo, procoagulant, proteolytic activity, and lethality studies. TISCE majorly contains saponins, glycosides, alkaloids, and phenolic compounds. Minimum indirect haemorrhagic dose (MIHD) observed for ICV (12.5 µg), CKV (5.0 µg),RVV (10.0 µg), and SVV (12.5 µg). TISCE inhibits the procoagulant activity of all venoms at a concentration of 18.0 µg. It also shows the neutralization of proteolytic enzymes of venom in a dose-dependent manner. A pre-incubated mixture containing five lethal dose 50 (LD50) of venom and TISCE was injected intravenously, all mice survived as venom neutralized by TISCE. The present study demonstrates the ability of TISCE to neutralize snake venom using suitable in vivo and in vitro methods. Further studies required to unravelling the specific active chemical constituent of TISCE that may used as novel alternative snakebite treatment. TISCE was able to prolong the deaths during the simulation study and may be used in the topical pharmaceutical formulation that will reduce local venom reactions causing much morbidity, which will collectively with Anti-snake venom (ASV), used to treat envenomed patients more effectively.

scholarly journals A rapid and affordable point of care test for antibodies against SARS-CoV-2 based on hemagglutination and artificial intelligence interpretation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vanessa Redecke ◽  
Kazuki Tawaratsumida ◽  
Erin T. Larragoite ◽  
Elizabeth S. C. P. Williams ◽  
Vicente Planelles ◽  
...  
Keyword(s):  
Test Performance ◽  
Learning Algorithm ◽  
Point Of Care ◽  
Method Comparison ◽  
High Specificity ◽  
Turnaround Time ◽  
Analysis Tool ◽  
Point Of Care Test ◽  
Specificity And Sensitivity ◽  
A Cell

AbstractDiagnostic tests that detect antibodies (AB) against SARS-CoV-2 for evaluation of seroprevalence and guidance of health care measures are important tools for managing the COVID-19 pandemic. Current tests have certain limitations with regard to turnaround time, costs and availability, particularly in point-of-care (POC) settings. We established a hemagglutination-based AB test that is based on bi-specific proteins which contain a dromedary-derived antibody (nanobody) binding red blood cells (RBD) and a SARS-CoV-2-derived antigen, such as the receptor-binding domain of the Spike protein (Spike-RBD). While the nanobody mediates swift binding to RBC, the antigen moiety directs instantaneous, visually apparent hemagglutination in the presence of SARS-CoV-2-specific AB generated in COVID-19 patients or vaccinated individuals. Method comparison studies with assays cleared by emergency use authorization demonstrate high specificity and sensitivity. To further increase objectivity of test interpretation, we developed an image analysis tool based on digital image acquisition (via a cell phone) and a machine learning algorithm based on defined sample-training and -validation datasets. Preliminary data, including a small clinical study, provides proof of principle for test performance in a POC setting. Together, the data support the interpretation that this AB test format, which we refer to as ‘NanoSpot.ai’, is suitable for POC testing, can be manufactured at very low costs and, based on its generic mode of action, can likely be adapted to a variety of other pathogens.

scholarly journals Kushiyaki-related Streptococcus suis meningitis with ventriculitis: A case report

2021 ◽  
Author(s):  
Masaru Kurihara ◽  
Michitaka Nasu ◽  
David Itokazu ◽  
Yasuharu Tokuda
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
High Risk ◽  
Streptococcus Suis ◽  
Gram Positive ◽  
Meningeal Irritation ◽  
Protein Levels ◽  
Cell Counts ◽  
Gram Positive Cocci

This report describes Streptococcus suis meningitis with ventriculitis in a 66-year-old kushiyaki chef, which presented with fever and meningeal irritation signs. Cerebrospinal fluid testing revealed increased cell counts and protein levels, and presence of gram-positive cocci. Kushiyaki chefs are at high risk of this infection and prophylaxis should be considered.

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