scholarly journals Detection of Circulating VZV-Glycoprotein E-Specific Antibodies by Chemiluminescent Immunoassay (CLIA) for Varicella–Zoster Diagnosis

Pathogens ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 66
Author(s):  
Arnaud John Kombe Kombe ◽  
Jiajia Xie ◽  
Ayesha Zahid ◽  
Huan Ma ◽  
Guangtao Xu ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
High Titer ◽  
Diagnostic Approach ◽  
True Positive ◽  
Patient Age ◽  
Glycoprotein E ◽  
Blood Samples ◽  
Varicella Zoster ◽  
Patient Âgé ◽  
Chemiluminescent Immunoassay

Varicella and herpes zoster are mild symptoms-associated diseases caused by varicella–zoster virus (VZV). They often cause severe complications (disseminated zoster), leading to death when diagnoses and treatment are delayed. However, most commercial VZV diagnostic tests have low sensitivity, and the most sensitive tests are unevenly available worldwide. Here, we developed and validated a highly sensitive VZV diagnostic kit based on the chemiluminescent immunoassay (CLIA) approach. VZV-glycoprotein E (gE) was used to develop a CLIA diagnostic approach for detecting VZV-specific IgA, IgG, and IgM. The kit was tested with 62 blood samples from 29 VZV-patients classified by standard ELISA into true-positive and equivocal groups and 453 blood samples from VZV-negative individuals. The diagnostic accuracy of the CLIA kit was evaluated by receiver-operating characteristic (ROC) analysis. The relationships of immunoglobulin-isotype levels between the two groups and with patient age ranges were analyzed. Overall, the developed CLIA-based diagnostic kit demonstrated the detection of VZV-specific immunoglobulin titers depending on sample dilution. From the ELISA-based true-positive patient samples, the diagnostic approach showed sensitivities of 95.2%, 95.2%, and 97.6% and specificities of 98.0%, 100%, and 98.9% for the detection of VZV-gE-specific IgA, IgG, and IgM, respectively. Combining IgM to IgG and IgA detection improved diagnostic accuracy. Comparative analyses on diagnosing patients with equivocal results displaying very low immunoglobulin titers revealed that the CLIA-based diagnostic approach is overall more sensitive than ELISA. In the presence of typical VZV symptoms, CLIA-based detection of high titer of IgM and low titer of IgA/IgG suggested the equivocal patients experienced primary VZV infection. Furthermore, while no difference in IgA/IgG level was found regarding patient age, IgM level was significantly higher in young adults. The CLIA approach-based detection kit for diagnosing VZV-gE-specific IgA, IgG, and IgM is simple, suitable for high-throughput routine analysis situations, and provides enhanced specificity compared to ELISA.

POCUS Findings in Critically Ill Patients in Emergency Department

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S54-S58
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Vena Cava ◽  
Admission Rate ◽  
Point Of Care Ultrasound ◽  
True Positive ◽  
Medical Department ◽  
Patient Age ◽  
Patient Disposition ◽  
Patient Âgé

Background: Point of care ultrasound (POCUS) has been shown to improve diagnostic accuracy and has been used in a variety of contexts. However, the utility of POCUS as applied to critically ill patients has not been well studied. Materials and Methods: This was a retrospective descriptive study of critically ill patients who had received POCUS at Srinagarind Hospital’s Emergency Medical Department between July 2019 and June 2020. Data was collected from one year of POCUS studies and included ultrasound clips and images, patient age and sex, chief complaint, final diagnosis, and patient disposition. The data was described using descriptive statistics, including medians, counts and percentages. Results: POCUS data was collected from 2,500 studies performed on 369 patients. Median patient age was 62.7 years; 51.6% of patients were female. Top indications of POCUS scans were of respiratory (34.42%) and cardiovascular system (23.58%) presentations. The most frequent study types performed were cardiac, lung, and inferior vena cava examinations. Abnormal ultrasound findings were found in 258 patients (69.92%). True-positive ultrasound results were found in 162 patients (43.9%). The admission rate of critically ill patients was highest among patients who had true-positive results. Conclusion: The prevalence of positive POCUS results was quite high in critically ill patients. Moreover, POCUS showed high accuracy. The number of admitted patients was highest among patients who had true-positive ultrasound results. Keywords: Ultrasonography, Critical illness, Emergency medicine

Gestion orthopédique d’une ankylose de l’ATM chez l’enfant

2020 ◽  
Vol 54 (4) ◽  
pp. 407-418
Author(s):  
Pamela Villalon-Pooley ◽  
Camila Hernandez-Veliz ◽  
Maria Fernanda Pinto-Chavez ◽  
Pierre Bourdiol
Keyword(s):  
Patient Age ◽  
Patient Âgé

Parmi les fractures cranio-faciales, celles affectant le condyle mandibulaire font partie des fractures les plus souvent rencontrées chez le patient en âge pédiatrique. L’évolution sans traitement peut produire une ankylose temporo-mandibulaire entraînant troubles fonctionnels et asymétrie de la croissance cranio-faciale. Le traitement traditionnellement chirurgical est d’un pronostic généralement réservé. Dans cet article est présenté le cas d’un patient, âgé de quatre ans, atteint d’ankylose fibreuse de l’articulation temporo-mandibulaire gauche, suite probable d’une fracture du col du condyle non-diagnostiquée. La libération fonctionnelle de la fibro-ankylose articulaire a été l’objectif de la première étape thérapeutique. Celle-ci a été suivie, à l’âge de sept ans, d’une distraction articulaire obtenue au moyen de butées occlusales controlatérales disposées côté droit. Ceci a produit un ajustement de la croissance dento-alvéolaire assurant à la fois un rattrapage du déficit de croissance unilatéral de départ et une néoformation condylienne par remodelage de l’articulation temporo-mandibulaire gauche. Quatre années après la mise en route de la phase orthopédique initiale, la fonction articulaire restaurée et l’équilibre facial obtenu restent stables chez ce jeune patient

Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

2012 ◽  
Vol 32 (S 01) ◽  
pp. S39-S42 ◽  
Author(s):  
S. Kocher ◽  
G. Asmelash ◽  
V. Makki ◽  
S. Müller ◽  
S. Krekeler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Frequent Change ◽  
Patient Age ◽  
Treatment Regimens ◽  
Patient Âgé ◽  
The Relationship ◽  
Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

Hämophilie-Zentrum Bonn 1980 – 2009

2011 ◽  
Vol 31 (S 01) ◽  
pp. S4-S10 ◽  
Author(s):  
I. Besmens ◽  
H.-H. Brackmann ◽  
J. Oldenburg
Keyword(s):  
Young Patients ◽  
Severe Form ◽  
Coagulation Disorder ◽  
Care Providers ◽  
Long Distance ◽  
Patient Age ◽  
Patient Âgé ◽  
Number Of Patients ◽  
Clotting Disorder ◽  
Regional Character

SummaryThe Bonn Haemophilia Care Center provides patient care on a superregional level. The centre’s large service area is, in part, due to the introduction of haemophilia home treatment and related to this the individualized prophylaxis in children and adults by Egli and Brack-mann in Bonn in the early 1970s, that represented a milestone in German haemophilia therapy. Epidemiologic patient data from the two selected time points, 1980 and 2009, are evaluated to illustrate the change in the composition of the patient clientele. In 1980 a total of 639 patients were treated at the Bonn Haemophilia Center. 529 patients exhibited a severe form and 110 a non-severe form of the respective clotting disorder. In 2009 the Bonn Haemophilia Center took care for a total of 837 patients. There were 445 patients who suffered from a severe form of the considered clotting disorder while 392 showed a non-severe course. The number of less severely affected patients has increased significantly in 2009. Patients in 1980 were predominantly suffering from a severe form and most had to travel more than 150 km from their homes to the treatment center. In 2009 the number of patients living a medium-long distance from the care provider has significantly increased while the number of patients living more than 150km from the center has decreased. Comparing 2009 to 1980 a growth of the center’s regional character becomes apparent, especially when patient age and severity of the coagulation disorder are taken into consideration. The regional character was more strongly pronounced with milder disease severity and lower patient age. Due to the existence of well established primary haemophilia care in CCCs in Germany, the trend for the recent years is that the proportion of young patients that choose haemophilia care providers closer to their homes is increasing.

Predictors of Lymph Node Metastasis in T1 Breast Carcinoma, Stratified by Patient Age

2002 ◽  
Vol 8 (6) ◽  
pp. 349-355 ◽  
Author(s):  
Amila Orucevic ◽  
Vijaya B. Reddy ◽  
Kenneth J. Bloom ◽  
Pincas Bitterman ◽  
Cristina Magi-Galluzzi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Breast Carcinoma ◽  
Lymph Node Metastasis ◽  
Patient Age ◽  
Node Metastasis ◽  
Patient Âgé

scholarly journals How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Korsch ◽  
Winfried Walther ◽  
Bernt-Peter Robra ◽  
Aynur Sahin ◽  
Matthias Hannig ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Bisphosphonate Therapy ◽  
Bone Block ◽  
Patient Anxiety ◽  
Patient Age ◽  
Endocarditis Prophylaxis ◽  
Therapy Decision ◽  
Patient Âgé ◽  
Case Vignettes

Abstract Background There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons. Methods A total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes. The influence of different determinants on the therapy decision was investigated. Two case vignettes were designed for this purpose: vignette 1 with determinants “patient age” and “endocarditis prophylaxis” and vignette 2 with determinants “anxiety” and “bisphosphonate therapy”. Furthermore, the specialist designation was assessed for both. The options available to achieve a sufficient implant site were "bone split", "bone block", "augmentation with bone substitute material" and "bone resection". Therapy was either recommended or rejected based on principle. Results A total of 117 participants returned the questionnaire: 68 (58%) were OS and 49 (42%) MFS. “Patient age” and “patient anxiety” were not significantly associated with any therapy decision. However, required “endocarditis prophylaxis” led to significantly higher refusal rates for "bone split", "bone block" and "bone replacement material" and to higher rates of general refusal of a therapy. “Bisphosphonate therapy” was significantly associated with general refusal of therapy, but with no significant correlation with different therapy options. In vignette 1, OS refused therapy significantly more often than MFS, though there was no association with the specialist designation for other therapy modalities. In vignette 2, specialty was not significantly associated with the therapy decision. Conclusion “Patient age” as well as “patient anxiety” appear to have no or little influence on the treatment decision for severely atrophic single- or multiple-tooth gap by specialist surgeons. Surgeons more often refuse treatment for patients with endocarditis prophylaxis and bisphosphonate therapy.

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