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Recent infection testing algorithm

Angela R Rourk, Frederick S Nolte, Christine M Litwin
OBJECTIVES: With the recent introduction of automated treponemal tests, a new reverse syphilis algorithm has been proposed and now used by many clinical laboratories. We analyzed the impact of instituting the reverse screening syphilis algorithm in a laboratory that serves a geographic area with a moderately high prevalence of syphilis infection. METHODS: Serum samples sent for syphilis testing were tested using a treponemal enzyme immunoassay (EIA) as the screening assay...
October 22, 2016: American Journal of Clinical Pathology
Michael Camilleri, Joseph H Sellin, Kim E Barrett
Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (more than 4 weeks in duration) are more elusive. We review on the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties...
October 20, 2016: Gastroenterology
Jean-François Sarrazin, François Philippon, Mikaël Trottier, Michel Tessier
Cardiovascular implantable electronic device (CIED) infection and prosthetic valve endocarditis (PVE) remain a diagnostic challenge. Cardiac imaging plays an important role in the diagnosis and management of patients with CIED infection or PVE. Over the past few years, cardiac radionuclide imaging has gained a key role in the diagnosis of these patients, and in assessing the need for surgery, mainly in the most difficult cases. Both (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and radiolabelled white blood cell single-photon emission computed tomography/computed tomography (WBC SPECT/CT) have been studied in these situations...
September 26, 2016: World Journal of Cardiology
Robert J Blount, Minh-Chi Tran, Charles K Everett, Adithya Cattamanchi, John Z Metcalfe, Denise Connor, Cecily R Miller, Jennifer Grinsdale, Julie Higashi, Payam Nahid
BACKGROUND: Interferon-gamma release assays may be used as an alternative to the tuberculin skin test for detection of M. tuberculosis infection. However, the risk of active tuberculosis disease following screening using interferon-gamma release assays in immigrants is not well defined. To address these uncertainties, we determined the incidence rates of active tuberculosis disease in a cohort of high-risk immigrants with Class B TB screened with interferon-gamma release assays (IGRAs) upon arrival in the United States...
2016: BMC Public Health
Claudia R Molins, Mark J Delorey, Christopher Sexton, Martin E Schriefer
Current recommendation for the laboratory confirmation of Lyme disease is serology-based diagnostics. Specifically, a standardized two-tiered testing (STTT) algorithm is applied that utilizes a first-tier immunofluorescence assay (IFA) or enzyme immunoassay (EIA) that if positive or equivocal is followed by second-tier immunoblotting. Despite the standardization and performance achievements, STTT is considered technically complex and subjective, as well as insensitive for early acute infection. These issues have prompted development of novel algorithms and testing platforms...
August 24, 2016: Journal of Clinical Microbiology
K-D Heller
BACKGROUND: Periprothetic infection after primary or revision arthroplasty is of increasing importance. The incidence of infection in primary arthroplasty is approximately 1 %. Revision arthroplasty has higher infection rates, which increase with the number of revision surgeries. Aim of this Paper: An overview of the current diagnosis of periprosthetic infection. METHODS: This selective analysis is based on a lecture by the author at the DKOU 2015. RESULTS: Periprosthetic infection is taken as having been demonstrated when either two periprosthetic cultures contain the same microorganism, or if there is a fistula communicating with a joint...
August 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Karen Staines, Ambalika Batra, William Mwangi, Helena J Maier, Steven Van Borm, John R Young, Mark Fife, Colin Butter
Quantitative real-time PCR assays are widely used for the quantification of mRNA within avian experimental samples. Multiple stably-expressed reference genes, selected for the lowest variation in representative samples, can be used to control random technical variation. Reference gene assays must be reliable, have high amplification specificity and efficiency, and not produce signals from contaminating DNA. Whilst recent research papers identify specific genes that are stable in particular tissues and experimental treatments, here we describe a panel of ten avian gene primer and probe sets that can be used to identify suitable reference genes in many experimental contexts...
2016: PloS One
Sheila M Keating, Reshma Kassanjee, Mila Lebedeva, Shelley N Facente, Jeffrey C MacArthur, Eduard Grebe, Gary Murphy, Alex Welte, Jeffrey N Martin, Susan Little, Matthew A Price, Esper G Kallas, Michael P Busch, Christopher D Pilcher
OBJECTIVE: HIV seroconversion biomarkers are being used in cross-sectional studies for HIV incidence-estimation. Bio-Rad Geenius HIV1/2 Supplemental Assay is an immunochromatographic single-use assay that measures antibodies (Ab) against multiple HIV-1/2 antigens. The objective of this study was to determine whether the Geenius assay could additionally be used for recency estimation. DESIGN: This assay was developed for HIV-1/2 confirmation; however, quantitative data acquired gives information on increasing concentration and diversity of antibody responses over time during seroconversion...
August 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Alireza Abdollahi, Hana Saffar
It is estimated that the number of HIV infected children globally has increased from 1.6 million in 2001 to 3.3 million in 2012. The number of children below 15 years of age living with HIV has increased worldwide. Published data from recent studies confirmed dramatic survival benefit for infants started anti-retroviral therapy (ART) as early as possible after diagnosis of HI. Early confirmation of HIV diagnosis is required in order to identify infants who need immediate ART. WHO has designed recommendations to improve programs for both early diagnoses of HIV infection and considering ART whenever indicated? It is strongly recommended that HIV virologocal assays for diagnosis of HIV have sensitivity of at least 95% and ideally greater than 98% and specificity of 98% or more under standardized and validated conditions...
2016: Iranian Journal of Pathology
Reshma Kassanjee, Christopher D Pilcher, Michael P Busch, Gary Murphy, Shelley N Facente, Sheila M Keating, Elaine Mckinney, Kara Marson, Matthew A Price, Jeffrey N Martin, Susan J Little, Frederick M Hecht, Esper G Kallas, Alex Welte
OBJECTIVE: Assays for classifying HIV infections as 'recent' or 'nonrecent' for incidence surveillance fail to simultaneously achieve large mean durations of 'recent' infection (MDRIs) and low 'false-recent' rates (FRRs), particularly in virally suppressed persons. The potential for optimizing recent infection testing algorithms (RITAs), by introducing viral load criteria and tuning thresholds used to dichotomize quantitative measures, is explored. DESIGN: The Consortium for the Evaluation and Performance of HIV Incidence Assays characterized over 2000 possible RITAs constructed from seven assays (Limiting Antigen, BED, Less-sensitive Vitros, Vitros Avidity, BioRad Avidity, Architect Avidity, and Geenius) applied to 2500 diverse specimens...
September 24, 2016: AIDS
Michael Saulino, David J Anderson, Jennifer Doble, Reza Farid, Fatma Gul, Peter Konrad, Aaron L Boster
INTRODUCTION: Troubleshooting helps optimize intrathecal baclofen (ITB) therapy in cases of underdose, overdose, and infection. METHODS: An expert panel of 21 multidisciplinary physicians currently managing >3200 ITB patients was convened, and using standard methodologies for guideline development, created an organized approach to troubleshooting ITB. They conducted a structured literature search that identified 263 peer-reviewed papers, and used results from an online survey of 42 physicians currently managing at least 25 ITB patients each...
August 2016: Neuromodulation: Journal of the International Neuromodulation Society
Cornelia Adlhoch, Ana Avellon, Sally A Baylis, Anna R Ciccaglione, Elisabeth Couturier, Rita de Sousa, Jevgenia Epštein, Steen Ethelberg, Mirko Faber, Ágnes Fehér, Samreen Ijaz, Heidi Lange, Zdenka Manďáková, Kassiani Mellou, Antons Mozalevskis, Ruska Rimhanen-Finne, Valentina Rizzi, Bengü Said, Lena Sundqvist, Lelia Thornton, Maria E Tosti, Wilfrid van Pelt, Esther Aspinall, Dragoslav Domanovic, Ettore Severi, Johanna Takkinen, Harry R Dalton
BACKGROUND: Hepatitis E virus (HEV) is endemic in EU/EEA countries, but the understanding of the burden of the infection in humans is inconsistent as the disease is not under EU surveillance but subject to national policies. STUDY: Countries were asked to nominate experts and to complete a standardised questionnaire about the epidemiological situation and surveillance of HEV in their respective EU/EEA country. This study reviewed surveillance systems for human cases of HEV in EU/EEA countries and nominated experts assessed the epidemiology in particular examining the recent increase in the number of autochthonous cases...
September 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Panagiotis Bountris, Elena Topaka, Abraham Pouliakis, Maria Haritou, Petros Karakitsos, Dimitrios Koutsouris
Cervical cancer (CxCa) is often the result of underestimated abnormalities in the test Papanicolaou (Pap test). The recent advances in the study of the human papillomavirus (HPV) infection (the necessary cause for CxCa development) have guided clinical practice to add HPV related tests alongside the Pap test. In this way, today, HPV DNA testing is well accepted as an ancillary test and it is used for the triage of women with abnormal findings in cytology. However, these tests are either highly sensitive or highly specific, and therefore none of them provides an optimal solution...
June 2016: Healthcare Technology Letters
Olga P Nyssen, Adrian G McNicholl, Francis Megraud, Vincenzo Savarino, Giuseppina Oderda, Carlo A Fallone, Lori Fischbach, Franco Bazzoli, Javier P Gisbert
BACKGROUND: Non-bismuth quadruple sequential therapy (SEQ) comprising a first induction phase with a dual regimen of amoxicillin and a proton pump inhibitor (PPI) for five days followed by a triple regimen phase with a PPI, clarithromycin and metronidazole for another five days, has been suggested as a new first-line treatment option to replace the standard triple therapy (STT) comprising a proton pump inhibitor (PPI), clarithromycin and amoxicillin, in which eradication proportions have declined to disappointing levels...
2016: Cochrane Database of Systematic Reviews
Adrian John Brink, Johan Van Wyk, V M Moodley, Craig Corcoran, Pieter Ekermans, Louise Nutt, Tom Boyles, Olga Perovic, Charles Feldman, Guy Richards, Marc Mendelson
Antibiotic resistance has increased worldwide to the extent that it is now regarded as a global public health crisis. Interventions to reduce excessive antibiotic prescribing to patients can reduce resistance and improve microbiological and clinical outcomes. Therefore, although improving outpatient antibiotic use is crucial, few data are provided on the key interventional components and the effectiveness of antibiotic stewardship in the primary care setting, in South Africa. The reasons driving the excessive prescription of antibiotics in the community are multifactorial but, perhaps most importantly, the overlapping clinical features of viral and bacterial infections dramatically reduce the ability of GPs to distinguish which patients would benefit from an antibiotic or not...
June 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Bouchra Serhir, Denis Hamel, Florence Doualla-Bell, Jean Pierre Routy, Sylvie-Nancy Beaulac, Mario Legault, Micheline Fauvel, Cécile Tremblay
BACKGROUND: Accurate and practical biologic tools to estimate HIV incidence is crucial to better monitor the epidemic and evaluate the effectiveness of HIV prevention and treatment programs. METHODS: We evaluated two avidity assays to measure recent HIV infection: the Sedia HIV-1 LAg-Avidity EIA (Sedia Biosciences, Portland) and the Centers for Disease Control and Prevention (CDC)-modified Bio-Rad-Avidity assay (Bio-Rad Laboratories, Mississauga, ON). Longitudinal specimens (n = 473) obtained from 123 treatment-naive seroconverted individuals enrolled in the Primary HIV-1 Infection (PHI) cohort of Quebec were used to determine the average time an individual is considered to be recently infected (mean duration of recent infection; MDRI), for the two avidity assays alone and in combination using a nonparametric survival method analysis...
2016: PloS One
Andrea A Kim, Bharat S Parekh, Mamo Umuro, Tura Galgalo, Rebecca Bunnell, Ernest Makokha, Trudy Dobbs, Patrick Murithi, Nicholas Muraguri, Kevin M De Cock, Jonathan Mermin
INTRODUCTION: A recent infection testing algorithm (RITA) that can distinguish recent from long-standing HIV infection can be applied to nationally representative population-based surveys to characterize and identify risk factors for recent infection in a country. MATERIALS AND METHODS: We applied a RITA using the Limiting Antigen Avidity Enzyme Immunoassay (LAg) on stored HIV-positive samples from the 2007 Kenya AIDS Indicator Survey. The case definition for recent infection included testing recent on LAg and having no evidence of antiretroviral therapy use...
2016: PloS One
Rachael M Liesman, Matthew J Binnicker
PURPOSE OF REVIEW: An increasing number of laboratories have implemented multiplex molecular panels for the diagnosis of gastrointestinal infections. This review focuses on recent data addressing the performance of US Food and Drug Administration-cleared multiplex gastrointestinal panels and discusses the advantages and limitations of these tests in the immunocompromised population. RECENT FINDINGS: Testing for gastrointestinal pathogens using multiplex molecular panels increases sensitivity and detection of coinfections compared with routine testing methods...
August 2016: Current Opinion in Infectious Diseases
Josep M Llovet, Jessica Zucman-Rossi, Eli Pikarsky, Bruno Sangro, Myron Schwartz, Morris Sherman, Gregory Gores
Liver cancer is the second leading cause of cancer-related deaths globally and has an incidence of approximately 850,000 new cases per year. Hepatocellular carcinoma (HCC) represents approximately 90% of all cases of primary liver cancer. The main risk factors for developing HCC are well known and include hepatitis B and C virus infection, alcohol intake and ingestion of the fungal metabolite aflatoxin B1. Additional risk factors such as non-alcoholic steatohepatitis are also emerging. Advances in the understanding of the molecular pathogenesis of HCC have led to identification of critical driver mutations; however, the most prevalent of these are not yet druggable targets...
2016: Nat Rev Dis Primers
Frank Lammert, Kurinchi Gurusamy, Cynthia W Ko, Juan-Francisco Miquel, Nahum Méndez-Sánchez, Piero Portincasa, Karel J van Erpecum, Cees J van Laarhoven, David Q-H Wang
Gallstones grow inside the gallbladder or biliary tract. These stones can be asymptomatic or symptomatic; only gallstones with symptoms or complications are defined as gallstone disease. Based on their composition, gallstones are classified into cholesterol gallstones, which represent the predominant entity, and bilirubin ('pigment') stones. Black pigment stones can be caused by chronic haemolysis; brown pigment stones typically develop in obstructed and infected bile ducts. For treatment, localization of the gallstones in the biliary tract is more relevant than composition...
2016: Nature Reviews. Disease Primers
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