scholarly journals Assessing the Need for Multiplex and Multifunctional Tick-Borne Disease Test in Routine Clinical Laboratory Samples from Lyme Disease and Febrile Patients with a History of a Tick Bite

2021 ◽  
Vol 6 (1) ◽  
pp. 38
Author(s):  
Kunal Garg ◽  
T. Sakari Jokiranta ◽  
Sanna Filén ◽  
Leona Gilbert
Keyword(s):  
Lyme Disease ◽  
Clinical Laboratory ◽  
Diagnostic Tools ◽  
Testing System ◽  
Test Results ◽  
System A ◽  
History Of ◽  
Tick Borne Disease ◽  
Routine Clinical Laboratory ◽  
Missed Opportunity

Human polymicrobial infections in tick-borne disease (TBD) patients is an emerging public health theme. However, the requirement for holistic TBD tests in routine clinical laboratories is ambiguous. TICKPLEX® PLUS is a holistic TBD test utilized herein to assess the need for multiplex and multifunctional diagnostic tools in a routine clinical laboratory. The study involved 150 specimens categorized into Lyme disease (LD)-positive (n = 48), LD-negative (n = 30), and febrile patients from whom borrelia serology was requested (n = 72, later “febrile patients”) based on reference test results from United Medix, Finland. Reference tests from DiaSorin, Immunetics, and Mikrogen Diagnostik followed the two-tier LD testing system. A comparison between the reference tests and TICKPLEX® PLUS produced 86%, 88%, and 87% positive, negative, and overall agreement, respectively. Additionally, up to 15% of LD and 11% of febrile patients responded to TBD related coinfections and opportunistic microbes. The results demonstrated that one (TICKPLEX® PLUS) test can aid in a LD diagnosis instead of four tests. Moreover, TBD is not limited to just LD, as the specimens produced immune responses to several TBD microbes. Lastly, the study indicated that the screening of febrile patients for TBDs could be a missed opportunity at reducing unreported patient cases.

scholarly journals Case Report: Two Cases of Subacute Thyroiditis Following SARS-CoV-2 Vaccination

2021 ◽  
Vol 8 ◽  
Author(s):  
Catherine Bornemann ◽  
Katharina Woyk ◽  
Caroline Bouter
Keyword(s):  
Viral Infections ◽  
Clinical Laboratory ◽  
Previous History ◽  
Subacute Thyroiditis ◽  
Clinical Test ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Lateral Neck ◽  
Test Results ◽  
History Of

Subacute thyroiditis is an inflammatory thyroid disorder associated with viral infections. Rare cases of subacute thyroiditis have also been described following vaccination. Recently, a few cases of subacute thyroiditis following SARS-CoV-2 vaccination have also been reported. Here, we present two cases of cytological proven subacute thyroiditis after receiving the first dose of a SARS-CoV-2 vaccination. We describe clinical, laboratory, imaging and cytological findings in two cases of subacute thyroiditis that presented in our department 2 weeks after SARS-CoV-2 vaccination with Spikevax (Moderna Biotech, Spain) and Vaxzevria (AstraZeneca; Sweden). Both cases did not have a previous history of thyroid disorders and presented with anterior and lateral neck pain. Clinical test results as well as cytological findings were consistent with subacute thyroiditis. Subacute thyroiditis may develop following a SARS-CoV-2 vaccination and should be considered as a possible side effect in cases that present with thyroid pain.

scholarly journals Laboratory Diagnosis of Amebiasis

2003 ◽  
Vol 16 (4) ◽  
pp. 713-729 ◽  
Author(s):  
Mehmet Tanyuksel ◽  
William A. Petri
Keyword(s):  
Cell Biology ◽  
Stool Specimen ◽  
Clinical Laboratory ◽  
Laboratory Diagnosis ◽  
Antigen Detection ◽  
Diagnostic Tools ◽  
Clinical Microbiology Laboratory ◽  
Stool Antigen ◽  
Routine Clinical Laboratory ◽  
Pcr Techniques

SUMMARY The detection of Entamoeba histolytica, the causative agent of amebiasis, is an important goal of the clinical microbiology laboratory. To assess the scope of E. histolytica infection, it is necessary to utilize accurate diagnostic tools. As more is discovered about the molecular and cell biology of E. histolytica, there is great potential for further understanding the pathogenesis of amebiasis. Molecular biology-based diagnosis may become the technique of choice in the future because establishment of these protozoa in culture is still not a routine clinical laboratory process. In all cases, combination of serologic tests with detection of the parasite (by antigen detection or PCR) offers the best approach to diagnosis, while PCR techniques remain impractical in many developing country settings. The detection of amebic markers in serum in patients with amebic colitis and liver abscess appears promising but is still only a research tool. On the other hand, stool antigen detection tests offer a practical, sensitive, and specific way for the clinical laboratory to detect intestinal E. histolytica. All the current tests suffer from the fact that the antigens detected are denatured by fixation of the stool specimen, limiting testing to fresh or frozen samples.

scholarly journals The Assessment of Nipple Areola Complex Sensation with Semmes-Weinstein Monofilaments—Normative Values and Its Covariates

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2145
Author(s):  
Anna Kasielska-Trojan ◽  
Agata Szulia ◽  
Tomasz Zawadzki ◽  
Bogusław Antoszewski
Keyword(s):  
Diagnostic Tools ◽  
Normative Values ◽  
Breast Size ◽  
Test Results ◽  
Suprasternal Notch ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
History Of ◽  
Tactile Threshold ◽  
Caucasian Women

Objective: To establish normative data for nipple-areola complex (NAC) sensibility examined with Semmes-Weinstein monofilament test (SWMT) and two-point discrimination (TPD) in women with varying breast sizes, including women with gigantomastia. We also aimed to identify clinical variables influencing NAC sensation. Methods: A total of 320 breasts in 160 Caucasian women (mean age 33.6 years, SD 11 years) were examined (including 50 hypertrophic breasts). NACs sensation was examined using Semmes-Weinstein monofilaments (SWM) and the Weber Two-Point Discrimination Test. Results: The nipple appeared to be the most sensitive part of NAC. In normal-sized breasts, sensation thresholds (SWM) correlated with: age, BMI, history of births, breast size and ptosis (for all locations), breastfeeding history (for nipple and upper areola) and areola diameter (for all locations apart from the nipple). Regression analysis showed that age, cup size and suprasternal notch-to-nipple distance are risk factors for diminished NAC sensation. Sensation thresholds in all NAC locations of hypertrophic breasts were significantly higher compared to normal-sized breasts, while TPD tests did not differ between the groups. Conclusions: We provided normative values of NAC sensation (tactile threshold and TPD) for different NAC areas. Our investigation indicated that SWM are useful diagnostic tools when the following factors are considered while examining NAC sensation: location (nipple vs. areola), age, breast size, suprasternal notch-to-nipple distance, history of births and breastfeeding. Hypertrophic breasts presented significantly higher sensation thresholds for all NAC locations. The report may serve as a reference data for further investigations regarding NAC sensation after different breast surgeries.

Observational studies on macroprolactin in a routine clinical laboratory

2018 ◽  
Vol 56 (8) ◽  
pp. 1259-1262 ◽  
Author(s):  
Julian H. Barth ◽  
Carys M. Lippiatt ◽  
Stephen G. Gibbons ◽  
Robert A. Desborough
Keyword(s):  
Retrospective Study ◽  
Polyethylene Glycol ◽  
Observational Studies ◽  
Clinical Laboratory ◽  
Median Period ◽  
History Of ◽  
Routine Clinical Laboratory ◽  
Subsequent Sample ◽  
Over Time ◽  
Made In

Abstract Background: It is now recommended that all samples with raised prolactin should be examined for the presence of macroprolactin. We performed a retrospective review of our experience of macroprolactin to determine the incidence and the natural history of macroprolactin. Methods: A retrospective study of macroprolactin was made in a large clinical laboratory. Macroprolactin was measured on those samples where it is requested and where the total prolactin is >1000 mIU/L. Prolactin was measured using the Siemens Centaur and macroprolactin was measured following polyethylene glycol (PEG)-precipitation. Results: The incidence of macroprolactin in samples where the total prolactin was >1000 mIU/L was 36/670 (5.4%). During this period, 12,064 samples were received for prolactin analysis. Over the period since 2006, 22 subjects had a sample with an isolated macroprolactin measurement followed by another sample without macroprolactin after a median period of 0.46 years. Twenty-five subjects had multiple consecutive measurements of macroprolactin lasting a median period of 2.1 years. Fourteen subjects had more than six samples which had been subjected to PEG precipitation. In these subjects, the reproducibility of PEG precipitation over a median of 6 years was 1.1% CV (recovery 75% [26–110] (median [range])). Conclusions: The presence of macroprolactin can change over time and we cannot advise that once a test for macroprolactinemia has been performed that it is not necessary to repeat the investigation if a subsequent sample is hyperprolactinemic; nor can one assume that macroprolactin will not develop even if it has been excluded previously.

scholarly journals Novel Diagnosis of Lyme Disease: Potential for CAM Intervention

2009 ◽  
Vol 6 (3) ◽  
pp. 283-295 ◽  
Author(s):  
Aristo Vojdani ◽  
Frank Hebroni ◽  
Yaniv Raphael ◽  
Jonathan Erde ◽  
Bernard Raxlen
Keyword(s):  
Lyme Disease ◽  
Herbal Medicines ◽  
Clinical Diagnostics ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Clinical Diagnostic ◽  
Wide Range ◽  
Tick Borne Disease

Lyme disease (LD) is the most common tick-borne disease in the northern hemisphere, producing a wide range of disabling effects on multiple human targets, including the skin, the nervous system, the joints and the heart. Insufficient clinical diagnostic methods, the necessity for prompt antibiotic treatment along with the pervasive nature of infection impel the development and establishment of new clinical diagnostic tools with increased accuracy, sensitivity and specificity. The goal of this article is 4-fold: (i) to detail LD infection and pathology, (ii) to review prevalent diagnostic methods, emphasizing inherent problems, (iii) to introduce the usage ofin vivoinduced antigen technology (IVIAT) in clinical diagnostics and (iv) to underscore the relevance of a novel comprehensive LD diagnostic approach to practitioners of Complementary and Alternative Medicine (CAM). Utilization of this analytical method will increase the accuracy of the diagnostic process and abridge the time to treatment, with antibiotics, herbal medicines and nutritional supplements, resulting in improved quality of care and disease prognosis.

Stance performance under different sensorimotor conditions in patients with post-traumatic otolith disorders

2007 ◽  
Vol 17 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Dietmar Basta ◽  
Andrew Clarke ◽  
Arne Ernst ◽  
Ingo Todt
Keyword(s):  
Otolith Organs ◽  
Test Results ◽  
Dynamic Posturography ◽  
System A ◽  
Test Conditions ◽  
Trunk Sway ◽  
History Of ◽  
Balance Deficits ◽  
Post Traumatic ◽  
And Gender

Dynamic posturography with the Equitest® system is helpful to screen patients for balance deficits, but diagnostic specificity, for otolith disorders is unknown until now. It was therefore the aim of our present paper to examine patients with a well-defined otolith disorder on the Equitest® at different test conditions while simultaneously recording trunk sway by means of the Sway Star® system. A total of 22 patients with different types of otolith disorders were included in this study. All test results of the patients were matched with respect to age and gender to controls without history of ENT diseases. The overall sensitivity of the Equitest® system in our series was only higher than 50% in 2 conditions. The results of the trunk sway recordings were significantly different between patients with a sacculo-utricular disorder and controls in all test conditions. The results suggest that a disorder of the otolith organs seems to affect especially the trunk sway to a large extent.

scholarly journals Pediatric unilateral knee swelling: a case report of a complicated differential diagnosis and often overlooked cause

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Katherine E. Guardado ◽  
Shane Sergent
Keyword(s):  
Differential Diagnosis ◽  
Lyme Disease ◽  
The United States ◽  
Lyme Arthritis ◽  
Tick Bite ◽  
Joint Effusion ◽  
Test Results ◽  
History Of ◽  
Vector Borne

Abstract Lyme disease is the most common vector-borne illness in the United States. However, Lyme arthritis is a diagnosis that is often missed, even in children, who are the population with the highest incidence of Lyme disease. Lyme arthritis, which presents in the later stage of Borrelia burgdorferi infection, needs to be recognized and managed promptly, especially in endemic areas or when exposure to ticks is known. We present a case of a 3-year-old female presenting to the emergency department with a history of limping for 2 weeks. The mother of the child recognized a tick bite. However, the child was not taken to seek care expeditiously, because she had not developed any rashes. Test results demonstrated that the patient was IgG positive and IgM negative for Lyme disease, with Western blot confirming the diagnosis of Lyme arthritis. Most patients presenting with Lyme arthritis do not recall having a tick bite, making it difficult to differentiate it from other pediatric conditions. When this diagnosis is missed, it can result in long-term morbidity, which is generally refractory to intravenous antibiotic therapy, oftentimes requiring synovectomy. Hence, this underscores the importance of the consideration of Lyme arthritis as a differential diagnosis in patients presenting with joint effusion.

Prevalence and clinical characteristics of patients with biologically false-positive reactions with serological syphilis testing in contemporary practice: 10-year experience at a tertiary academic hospital

2020 ◽  
pp. sextrans-2020-054628
Author(s):  
Yuri Ishihara ◽  
Koh Okamoto ◽  
Hironori Shimosaka ◽  
Yoshikazu Ono ◽  
Yoshiaki Kanno ◽  
...  
Keyword(s):  
False Positive ◽  
Clinical Characteristics ◽  
Clinical Laboratory ◽  
Serological Test ◽  
Laboratory Data ◽  
Test Results ◽  
Academic Hospital ◽  
History Of ◽  
Low Incidence ◽  
Contemporary Practice

ObjectivesBiologically false positive (BFP) reactions are well described in early literature. However, only a few recent reports described the incidence and clinical characteristics of patients with BFP reactions. We reviewed the serological test results of patients tested for syphilis in our hospital in the past decade and described the clinical characteristics of patients with BFP reactions.MethodsThis is a retrospective study of patients tested for syphilis in a tertiary academic hospital. All serological results were retrieved from the clinical laboratory database. We calculated the incidence of BFP reactions. Clinical characteristics and laboratory data of patients with BFP reactions were reviewed manually.ResultsAmong 94 462 subjects, 588 patients had BFP reactions (0.62%). Most BFP reactions were observed in patients aged over 60 years, with a history of malignancy and autoimmune diseases. Eighty-five per cent of patients had low rapid plasma reagin (RPR) titre (≤1:4), but two patients had extremely high RPR titre (≥1:256). BFP reactions were more likely to persist beyond 6 months among patients with RPR titre of ≥1:8. There was no statistically significant correlation between RPR titre and total protein albumin gap, surrogate of immunoglobulin levels among patients with BFP reactions.ConclusionThere was a low incidence of BFP reactions in the last decade. A minority of BFP reactions had high non-treponemal antibody titre and persisted longer than 6 months. In the era of re-emergence of syphilis, this information could help clinicians interpret the results of well-established diagnostic tests for syphilis.

scholarly journals Clinical, Laboratory and Ultrasonographic Findings of Diabetic Dog with Emphysematous Cystitis

2019 ◽  
Vol 47 ◽  
Author(s):  
Francisco Felipe De Magalhães ◽  
Francisco Jucélio Correia Canuto ◽  
Gisele De Oliveira Matos Gomes ◽  
Marília Lídia Maia Rôla ◽  
Roméria Rodrigues Barbosa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Urinary Bladder ◽  
Clinical Laboratory ◽  
Urine Culture ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Diagnostic Tools ◽  
Emphysematous Cystitis ◽  
History Of ◽  
Diabetic Dog

Background: Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the accumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detection of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact.                                                                                       Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 hours with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocytosis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the presence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis.                                                                                                   Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog. Emphysematous cystitis is complicated, characterized by the presence of gas in the wall and lumen of the urinary bladder. It is usually reported in patients with diabetes mellitus. The patient presented with a very high glycemic index (376 mg/dL), in addition to having a history of urinary obstruction and presence of bladder stones, which may have acted as predisposing factors for the onset of emphysematous cystitis. In the present case, ultrasonography was the examination of choice. Hyperechoic reverberation-forming lines, identified as gas present in the topography of the urinary bladder, were easily visualized, as described in the literature. For the treatment of this condition, adequate management of the diet and the correct use of antimicrobials are of fundamental importance since the presence of diabetes mellitus in this patient can present serious complications in the future. This report shows the importance of the use of a combination of diagnostic tools to arrive at the correct diagnosis of the patient.

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