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https://www.readbyqxmd.com/read/28749111/syncope-in-pediatric-patients-a-practical-approach-to-differential-diagnosis-and-management-in-the-emergency-department-digest
#1
Colleen Fant, Ari Cohen, Michelle N Vazquez
Syncope is a condition that is often seen in the emergency department. Most syncope is benign, but it can be a symptom of a life-threatening condition. While syncope often requires an extensive workup in adults, in the pediatric population, critical questioning and simple, noninvasive testing is usually sufficient to exclude significant or life-threatening causes. For low-risk patients, resource-intensive workups are rarely diagnostic, and add significant cost to medical care. This issue will highlight critical diseases that cause syncope, identify high-risk "red flags," and enable the emergency clinician to develop a cost-effective, minimally invasive algorithm for the diagnosis and treatment of pediatric syncope...
April 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28739268/xpert%C3%A2-mtb-rif-usefulness-for-the-diagnosis-of-tuberculosis-and-resistance-to-rifampicin
#2
REVIEW
Andrea Vergara Gómez, Julià González-Martín, Alberto L García-Basteiro
The advent of the Xpert® MTB/RIF technique was a revolution in the diagnosis of tuberculosis, especially in areas with high incidence and low resources. It allows the detection of Mycobacterium tuberculosis complex and simultaneously the most common resistance mutations to rifampicin in less than 2h. For respiratory samples the sensitivity is very high, but it decreases for extrapulmonary samples and children. Although it is faster and simpler than conventional methods, it presents some limitations and new and better techniques are needed to reduce the number of cases and deaths caused by tuberculosis...
July 21, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28726914/3d-printed-smartphone-based-point-of-care-tool-for-fluorescence-and-magnetophoresis-based-cytometry
#3
Stephanie Knowlton, Ashwini Joshi, Philip Syrrist, Ahmet F Coskun, Savas Tasoglu
In developing countries, there are often limited resources available to provide important medical diagnostics, which severely limits our ability to diagnose conditions and administer proper treatment, leading to high mortality rates for treatable conditions. Here, we propose a multiplex tool capable of density-based cell sorting via magnetic focusing in parallel with fluorescence imaging to provide highly specific clinical assays. While many cell sorting techniques and fluorescence microscopes generally are costly and require extensive user training, limiting accessibility and usability in developing countries, this device is compact, low-cost, and portable...
July 20, 2017: Lab on a Chip
https://www.readbyqxmd.com/read/28723694/exosomes-a-cancer-theranostics-road-map
#4
Angeliki Panagiotara, Athina Markou, Evi S Lianidou, George P Patrinos, Theodora Katsila
Interindividual variability is yet to be fully characterized, and for this, optimum patient stratification and companion diagnostics are still lacking. Especially when complex disease phenotypes and/or polygenic diseases are considered, patient monitoring and disease management become rather challenging, while acquired resistance to therapy and/or toxicity events are among the unmet needs in the clinic. No doubt, biomarkers are of great importance to disease management and tailor-made theranostics. Microfluidics has gathered great attention lately, mostly due to its low-invasive nature compared to tissue biopsies...
July 20, 2017: Public Health Genomics
https://www.readbyqxmd.com/read/28723116/integrated-magnetic-bead-quantum-dot-immunoassay-for-malaria-detection
#5
Chloe Kim, Gwendolyn Hoffmann, Peter C Searson
Malaria persists as a disease of high morbidity and mortality due to improper diagnosis, overuse of drugs, rapidly evolving drug resistant parasites, and poor disease monitoring. The two common tests used in developing countries, microscopic examination of Glemsa slides and rapid diagnostic tests (RDTs), have limitations associated with variability in specificity and sensitivity, and qualitative outcome. Here we report on an immunoassay using magnetic beads for capture and quantum dots for detection of histidine-rich protein 2 (HRP2)...
June 23, 2017: ACS Sensors
https://www.readbyqxmd.com/read/28718841/development-of-an-immunosensor-for-pfhrp-2-as-a-biomarker-for-malaria-detection
#6
Aver Hemben, Jon Ashley, Ibtisam E Tothill
Plasmodium falciparum histidine-rich protein 2 (PfHRP 2) was selected in this work as the biomarker for the detection and diagnosis of malaria. An enzyme-linked immunosorbent assay (ELISA) was first developed to evaluate the immunoreagent's suitability for the sensor's development. A gold-based sensor with an integrated counter and an Ag/AgCl reference electrode was first selected and characterised and then used to develop the immunosensor for PfHRP 2, which enables a low cost, easy to use, and sensitive biosensor for malaria diagnosis...
July 18, 2017: Biosensors
https://www.readbyqxmd.com/read/28716879/international-issues-teleneurology-in-humanitarian-crises-lessons-from-the-m%C3%A3-decins-sans-fronti%C3%A3-res-experience
#7
Altaf Saadi, Farrah J Mateen
Humanitarian emergencies defined by armed conflict, political strife, famine, or natural disaster can devastate populations rapidly. Neurologic disorders accompany these complex humanitarian emergencies but often go unheeded, exacerbated by a scarcity of neurologists. Teleneurology offers the promise of neurologic care remotely in the face of this inadequate local clinician supply. We describe our experiences as voluntary neurology teleconsultants with Médecins Sans Frontières in order to highlight both the promises and challenges of teleneurology in humanitarian contexts...
July 18, 2017: Neurology
https://www.readbyqxmd.com/read/28716373/loop-mediated-isothermal-amplification-in-disposable-polyester-toner-microdevices
#8
Kezia Gomes de Oliveira, Juliane Cristina Borba, Alexandre Melo Bailão, Célia Maria de Almeida Soares, Emanuel Carrilho, Gabriela Rodrigues Mendes Duarte
In recent years, isothermal DNA amplification methods have emerged as an alternative in molecular diagnostics due to its ease of operation. The purpose of using isothermal amplification is to simplify the diagnostics work by i) eliminating heating cycles, ii) reducing equipment costs, and iii) providing rapid and accurate results in laboratories with limited resources. Here we show a simple and fast method for E. coli detection in disposable polyester-toner (PeT) microdevice. The amplification by LAMP of the malB gene from E...
July 14, 2017: Analytical Biochemistry
https://www.readbyqxmd.com/read/28715460/early-infant-diagnosis-of-hiv-1-infection-in-luanda-angola-using-a-new-dna-pcr-assay-and-dried-blood-spots
#9
Francisco Martin, Claudia Palladino, Rita Mateus, Anna Bolzan, Perpétua Gomes, José Brito, Ana Patrícia Carvalho, Yolanda Cardoso, Cristovão Domingos, Vanda Sofia Lôa Clemente, Nuno Taveira
BACKGROUND: Early diagnosis and treatment reduces HIV-1-related mortality, morbidity and size of viral reservoirs in infants infected perinatally. Commercial molecular tests enable the early diagnosis of infection in infants but the high cost and low sensitivity with dried blood spots (DBS) limit their use in sub-Saharan Africa. OBJECTIVES: To develop and validate a sensitive and cheap qualitative proviral DNA PCR-based assay for early infant diagnosis (EID) in HIV-1-exposed infants using DBS samples...
2017: PloS One
https://www.readbyqxmd.com/read/28705184/prevalence-of-gestational-diabetes-mellitus-based-on-various-screening-strategies-in-western-kenya-a-prospective-comparison-of-point-of-care-diagnostic-methods
#10
Sonak D Pastakia, Benson Njuguna, Beryl Ajwang' Onyango, Sierra Washington, Astrid Christoffersen-Deb, Wycliffe K Kosgei, Ponnusamy Saravanan
BACKGROUND: Early diagnosis of gestational diabetes mellitus (GDM) is crucial to prevent short term delivery risks and long term effects such as cardiovascular and metabolic diseases in the mother and infant. Diagnosing GDM in Sub-Saharan Africa (SSA) however, remains sub-optimal due to associated logistical and cost barriers for resource-constrained populations. A cost-effective strategy to screen for GDM in such settings are therefore urgently required. We conducted this study to determine the prevalence of gestational diabetes mellitus (GDM) and assess utility of various GDM point of care (POC) screening strategies in a resource-constrained setting...
July 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28702501/patterns-of-cervical-cancer-care-in-argentina-applying-asco-recommendations-adjusted-by-local-resources
#11
REVIEW
Agustín Apás Pérez De Nucci, Lucas Minig, Myriam Perrotta
There are significant differences in cervical cancer incidence and mortality between low-middle and high-income countries. The American Society of Clinical Oncology (ASCO) resource-stratified clinical practice guideline was designed to provide an appropriate cervical cancer treatment based on the best available evidence in scenarios with different diagnostic and therapeutic resources. Argentina, a Latin American high middle income country, shows however, that cervical cancer rates are similar to those of low-income countries...
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28696417/harnessing-low-density-lipoprotein-receptor-protein-6-lrp6-genetic-variation-and-wnt-signaling-for-innovative-diagnostics-in-complex-diseases
#12
REVIEW
Z-M Wang, J-Q Luo, L-Y Xu, H-H Zhou, W Zhang
Wnt signaling regulates a broad variety of processes in both embryonic development and various diseases. Recent studies indicated that some genetic variants in Wnt signaling pathway may serve as predictors of diseases. Low-density lipoprotein receptor protein 6 (LRP6) is a Wnt co-receptor with essential functions in the Wnt/β-catenin pathway, and mutations in LRP6 gene are linked to many complex human diseases, including metabolic syndrome, cancer, Alzheimer's disease and osteoporosis. Therefore, we focus on the role of LRP6 genetic polymorphisms and Wnt signaling in complex diseases, and the mechanisms from mouse models and cell lines...
July 11, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28690716/wilson-s-disease-and-diagnostic-conundrum-in-a-low-income-country
#13
Pratap Kumar Patra
Wilson's disease is a well-known leading cause of chronic liver disease in children. However it may remain undiagnosed in a resource limited setting for a long period. We describe a six year male child diagnosed Wilson's disease with extreme elevation of liver enzymes which is not reported earlier. The diagnosis was also baffling because of inconsistency of other laboratory parameters.
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28686933/personal-resources-and-depression-in-schizophrenia-the-role-of-self-esteem-resilience-and-internalized-stigma
#14
Alessandro Rossi, Silvana Galderisi, Paola Rocca, Alessandro Bertolino, Paola Rucci, Dino Gibertoni, Paolo Stratta, Paola Bucci, Armida Mucci, Eugenio Aguglia, Giovanni Amodeo, Mario Amore, Antonello Bellomo, Roberto Brugnoli, Grazia Caforio, Bernardo Carpiniello, Liliana Dell'Osso, Fabio di Fabio, Massimo di Giannantonio, Carlo Marchesi, Palmiero Monteleone, Cristiana Montemagni, Lucio Oldani, Rita Roncone, Emilio Sacchetti, Paolo Santonastaso, Alberto Siracusano, Patrizia Zeppegno, Mario Maj
Depression in schizophrenia represents a challenge from a diagnostic, psychopathological and therapeutic perspective. The objective of this study is to test the hypothesis that resilience and self-stigma affect depression severity and to evaluate the strength of their relations in 921 patients with schizophrenia. A structural equation model was tested where depression is hypothesized as affected by resilience, internalized stigma, gender and negative symptoms, with the latter two variables used as exogenous covariates and the former two as mediators...
June 27, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28683790/very-low-sensitivity-of-wet-mount-microscopy-compared-to-pcr-against-culture-in-the-diagnosis-of-vaginal-trichomoniasis-in-uganda-a-cross-sectional-study
#15
Sheila Nabweyambo, Othman Kakaire, Stefanie Sowinski, Alfred Okeng, Henry Ojiambo, Joshua Kimeze, Irene Najjingo, Freddie Bwanga
BACKGROUND: Trichomonas vaginalis (TV) causes the Trichomoniasis Syndrome composed of vaginitis in women, urethritis in men and tube infection in both sexes. This infection is strongly associated with premature rupture of membranes, preterm delivery, low birth weight, promoting HIV sexual transmission and infertility. Prevention of these complications requires accurate early detection and effective treatment of infected individuals. In the resource limited settings, the wet mount microscopy (WMM) is often the only available test for laboratory detection of TV, but its accuracy and that of polymerase chain reaction (PCR) tools in Uganda remain poorly studied...
July 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28683395/microfluidic-paper-based-analytical-devices-for-potential-use-in-quantitative-and-direct-detection-of-disease-biomarkers-in-clinical-analysis
#16
REVIEW
Wei Yin Lim, Boon Tong Goh, Sook Mei Khor
Clinicians, working in the health-care diagnostic systems of developing countries, currently face the challenges of rising costs, increased number of patient visits, and limited resources. A significant trend is using low-cost substrates to develop microfluidic devices for diagnostic purposes. Various fabrication techniques, materials, and detection methods have been explored to develop these devices. Microfluidic paper-based analytical devices (μPADs) have gained attention for sensing multiplex analytes, confirming diagnostic test results, rapid sample analysis, and reducing the volume of samples and analytical reagents...
June 23, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28681823/comparative-analysis-of-syndromic-case-management-and-polymerase-chain-reaction-based-diagnostic-assays-for-treatment-of-neisseria-gonorrhoeae-chlamydia-trachomatis-and-genital-mycoplasmas-in-patients-of-genitourinary-discharge
#17
Nazneen Arif, Sujeesh Sebastian, Neena Khanna, Seema Sood, Benu Dhawan
To respond to the situation of high prevalence and need for effective treatment for sexually transmitted infections (STIs) in low-resource settings, syndromic diagnostic approach was recommended by the World Health Organization and was adopted by National AIDS Control Organization at the primary health centre level. A retrospective study was undertaken in symptomatic patients attending an STI clinic to validate the syndromic approach for genitourinary discharge syndrome. For aetiological diagnosis, culture and/or polymerase chain reaction was used...
April 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28680737/assessment-of-accessibility-to-the-diagnosis-and-treatment-of-brain-tumors-in-argentina-preliminary-results
#18
Alejandra T Rabadán, Diego Hernandez, Néstor Vazquez, Rafael Torino, Blanco V Marcelo
BACKGROUND: As far as public health is concerned, brain tumors burden is significant despite their low incidence, because they comprise high direct costs (specific diagnostic resources, high complexity treatments, and rehabilitation) and high-unforeseen costs (labor leave, family, and social issues). Although the Argentine's Health System is supposed to provide healthcare to all the population, it would not guarantee equity of access for brain tumors treatment. In order to analyze this hypothesis we decided to carry out a survey to obtain data on access, availability and resources for tumor management in Argentina...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28674617/an-ffrct-diagnostic-strategy-versus-usual-care-in-patients-with-suspected-coronary-artery-disease-planned-for-invasive-coronary-angiography-at-german-sites-one-year-results-of-a-subgroup-analysis-of-the-platform-prospective-longitudinal-trial-of-ffrct-outcome
#19
Roisin Colleran, Pamela S Douglas, Martin Hadamitzky, Matthias Gutberlet, Lukas Lehmkuhl, Borek Foldyna, Michael Woinke, Ulrich Hink, Jonathan Nadjiri, Alan Wilk, Furong Wang, Gianluca Pontone, Mark A Hlatky, Campbell Rogers, Robert A Byrne
AIM: Diagnostic evaluation practices for suspected coronary artery disease (CAD) may vary between countries. Our objective was to compare a CT-derived fractional flow reserve (FFRCT) diagnostic strategy with usual care in patients with planned invasive coronary angiography (ICA) enrolled in the PLATFORM (Prospective Longitudinal Trial of FFRCT: Outcome and Resource Impacts) study at German sites. METHODS: Patients were divided into two consecutive observational cohorts, receiving either usual care or CT angiography (CTA)/FFRCT...
2017: Open Heart
https://www.readbyqxmd.com/read/28666537/dermal-exposure-to-weathered-mc252-crude-oil-results-in-echocardiographically-identifiable-systolic-myocardial-dysfunction-in-double-crested-cormorants-phalacrocorax-auritus
#20
K E Harr, M Rishniw, T L Rupp, D Cacela, K M Dean, B S Dorr, K C Hanson-Dorr, K Healy, K Horak, J E Link, D Reavill, S J Bursian, F L Cunningham
During the Deepwater Horizon Natural Resource Damage Assessment, gross morphologic cardiac abnormalities, including softer, more distensible musculature, were noted upon gross necropsy in hearts from laughing gulls and double-crested cormorants exposed to weathered MC252 crude oil. A species specific, echocardiographic technique was developed for antemortem evaluation of function that was used to evaluate and better characterize cardiac dysfunction. Control (n=12) and treated (n=13) cormorant groups of similar sex-ratio and ages were dermally treated with approximately 13ml of water or weathered MC252 crude oil, respectively, every 3 days for 6 dosages...
June 27, 2017: Ecotoxicology and Environmental Safety
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