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The new genetics of bipolar affective disorder: clinical implications.

Underrecognition and undertreatment of affective disorders (i.e., major depressive disorder and bipolar affective disorder) constitute a serious public health problem in this country. The recent availability of sufficient mapped restriction fragment length polymorphism (RFLP) probes to cover the human genome and of improved methods of genetic linkage analysis make the definition of the genetic basis of bipolar affective disorders (and recurrent depressions) feasible within the foreseeable future. However, the degree of genetic heterogeneity involved might make the use of tightly linked RFLPs for diagnostic testing, as has been done for Huntington's disease or cystic fibrosis, impractical. Assuming multiple disease loci, then widely applicable and useful "molecular" diagnostic tests will await the cloning of the disease genes or identification of pathogenic gene products. In addition, the combination of genetic heterogeneity and a substantial degree of assortative mating (i.e., people with affective disorders marrying each other) in families with these disorders could make the search for linked loci a "bottleneck" in the path toward developing such diagnostic tests. Recently, three disease loci have been tentatively identified on chromosome 6, 11, and X.

Bipolar Disorder↗

[Combined antibacterial therapy of infectious complications in oncological patients].

Rational antibacterial therapy of infections in oncological patients in relation to the polyetiological nature of the infections and polyresistance of their causative agents contemplates the use of drug combinations. The necessity of long-term antibacterial therapy in many oncological patients also predisposes to it. The choice of drugs for every patient should stem from bacteriological findings: isolation of the pathogen, its identification and assay of its antibiotic sensitivity. When isolation of the causative agent is not possible or could not be done immediately the drug should be chosen according to the general data on the etiological structure of infectious complications in the particular department and particular pathological process as well as antibiotic sensitivity of the bacteria isolated under such conditions.

Amikacin↗

DNA probes for antimicrobial susceptibility testing.

As DNA probes are used more frequently in the clinical laboratory for the detection and identification of pathogens in clinical samples, a means of determining the antimicrobial susceptibility profile of those pathogens will be required. DNA probes directed to specific resistance determinants offer a solution to this problem. Methods of determining the susceptibility of viruses to antiviral agents can also be accomplished with DNA probes. This article explores the advantages and disadvantages of using hybridization methods for susceptibility testing of organisms contained in clinical samples.

DNA Probes↗

Adaptation of biotechnology methods on the study of arthropods.

Biotechnological advances are rapidly being applied to the study of arthropods and arthropod-born diseases. Improved tools are available for species identification, study of species complexes, detection and identification of pathogens in vectors and detection and characterization of insecticide resistance. These techniques have their basis in hybridoma, DNA probe and biochemical assay technologies. Problem areas in assay development are discussed.

Animals↗

[Blastocystis hominis--intestinal parasite or commensal?].

Blastocystis hominis has long been classified among Blastomycetes. It was considered to be an apathogenous fungal organism which was very frequently detected in routine stool examinations. Following the first studies with an electronic microscope in 1967, Zierdt et al. (34) classified Blastocystis hominis among the protozoa. Since then, there have been increasingly frequent reports that Blastocystis hominis can be an important cause of intestinal diseases especially diarrhea. For a definite taxonomic correlation and for an identification as pathogen, more investigations are greatly necessary.

Animals↗

Overview of therapeutic and prophylactic antibiotics in obstetrics and gynecology.

Infection in the obstetrics-gynecology patient remains an important source of concern. Advances in the identification of pathogenic organisms have led to improvements in the diagnosis of pelvic infections. Important considerations in the selection of antibiotics for established infections include prior hospitalization status, the size of the bacterial inoculum causing the infection, the etiologic organisms and, in the case of prophylaxis, the type of operative procedure. The antibiotic must also be cost effective.

Anti-Bacterial Agents↗

Pasteur yeasts system, a test-kit for yeasts identification. Its evaluation in comparison with three commercial methods and conventional procedures.

The Pasteur Yeasts System is a commercial prepared kit and scheme for the rapid (48 h) identification of 23 yeasts belonging to 7 genera. The method consists of two parts: a gallery of media to evaluate germ tube production, urease activity, tetrazolium reduction, cycloheximide sensibility and fermentation of three carbohydrates, and an auxanographic method to determine the assimilation pattern of 16 carbohydrates. This system was tested in comparison with API 20 C Auxanogram, Mycotube, Candida Check and conventional procedures to identify 40 yeast strains. Pasteur Yeasts System provided correct identifications for 97.5% of the organisms and proved to have a high reproducibility, accuracy and reliability. The method is useful and facilitates the identification of pathogenic yeasts from clinical specimens in the routine laboratory.

Evaluation Studies as Topic↗

The darker side of fatherhood: clinical and developmental ramifications of the "Laius motif".

"The Darker Side of Fatherhood" is intended as a clinical sequel to an earlier article, "Oedipus Revisited: Laius and the 'Laius Complex'". After briefly summarizing the allegorical implications of the various forgotten Oedipus myths and the father's fateful role within the Theban tragedy, this paper elaborates on those pederastic and filicidal inclinations that I believe to be universal among fathers. When such wishes are subject to primal repression, they enhance adaptation, fueling a father's aggressive dialogue with sons and daughters from infancy through the oedipal era into adolescence. Maladaptations arise when fathers give free rein to a more or less unalloyed destructive aggressivity toward offspring, a manifest hostility that can further serve to defend against ambisexual amibitions or identifications. Another pathogenic situation occurs when a father succumbs to an excessive neurotic inhibition in a desperate effort to repress such urges, thereby depriving his children of age- and state-appropriated aggressive stimulation in the form of play, active providing, and necessary discipline. Observational, analytic, and clinical case examples are presented to illustrate the implications for observation, developmental theory, and technique of an emphasis on a father's gender- and generation-specific aggression toward his offspring and its abiding intrapsychic reverberations.

Adaptation, Psychological↗

Rapid histological staining procedures for material from immune-suppressed patients.

Immunocompromised patients require rapid diagnosis of infectious conditions, if treatment is to be effective. This paper describes rapid techniques for the identification of pathogens from transbronchial and other biopsy specimens. Included are rapid procedures for the following stains: Grocott-Gomori methenamine silver; Dieterle silver; periodic acid-Schiff; alcian blue; MacCallum-Goodpasture; and Kinyoun's acid-fast. The clinical usefulness of transbronchial biopsy is discussed.

Adult↗

Laboratory guidelines for blood cultures in Papua New Guinea.

Laboratory procedures for blood culture technology appropriate for Papua New Guinea are described. Included are the selection and use of culture media; the collection, inoculation and incubation of clinical material; the isolation and identification of pathogens; and the referral of isolates for further testing.

Bacteriological Techniques↗

[Gonorrhea diagnosis].

The diagnostic procedure in gonorrhoea always starts with staining methods that the physician at first has to rely on in spite of their limited evidence, and that may justify specific treatment. Only culture, oxydase reaction, and biochemical differentiation (e.g. carbohydrate degradation test) can provide exact identification of pathogenic species of Neisseria. Further techniques can answer for antibiotic resistance and penicillinase production. Serological methods are employed with chronic or complicated gonococcal infections as well as with epidemiological investigations.

Bacteriological Techniques↗

Immunofluorescence and Treponema infection: a method using immunofluorescence to study rabbit testicular tissue infected with T pallidum and T pertenue.

We compared immunofluorescent staining of rabbit testicular tissue infected with Treponema pallidum or T pertenue, and fixed in Bouin's fixative, 95% cold ethyl alcohol with 1% glacial acetic acid, or routine 10% buffered formalin solution. The fixative of choice clearly was Bouin's. Although we studied only rabbit tissue, we assume that these fixatives will work well in human biopsy or autopsy material when identification of pathogenic Treponema is needed.

Animals↗

Mycetoma caused by Nocardia madurae.

Actinomycotic mycetoma was diagnosed in a woman from Jamaica living in Ontario. This is the first case reported in Canada in which the infection was caused by Nocardia madurae. Despite oral therapy with trimethoprim-sulfamethoxazole, local excision of newly appearing nodules was required periodically for clinical improvement. Laboratory procedures were modified to aid in identification of pathogenic actinomycetes.

Adult↗

Broad-range polymerase chain reaction for detection and identification of bacteria.

Detection and identification of fastidious pathogenic bacteria have traditionally presented an obstacle to the clinical and laboratory microbiologist. The diagnosis of disease caused by these bacteria is often empiric relying on clinical observations or indirect laboratory tests. Recently, a technique called broad-range polymerase chain reaction (PCR) has been integrated into studies designed to detect and identify previously uncharacterized bacterial pathogens. By using regions of the bacterial 16S ribosomal RNA (rRNA) gene that are highly conserved to prime synthesis of the remainder of this gene, PCR amplification can be performed directly from clinical samples which may contain small numbers of bacteria. The resulting PCR-amplified DNA can be sequenced to identify variable regions of the 16S rRNA gene that are bacteria-specific. This technique has proven valuable in identifying new fastidious bacterial pathogens that have resisted detection and identification by traditional microbiological methods.

Angiomatosis, Bacillary↗

Disorders of the motor neurone.

The spinal muscular atrophies (SMAs) are defined as a group of inherited disorders sharing the common pathological feature of degeneration of the anterior horn cells of the spinal cord and, in some cases, additionally of the bulbar motor nuclei. They are classified according to clinical features, including severity and distribution of muscle weakness and on their modes of inheritance. The SMAs are not uncommon: SMA type I (severe, acute infantile SMA) alone has a gene frequency in the UK estimated at 0.006. Together they represent a significant source of morbidity and mortality. Over the past 3 years, two major advances have been made towards understanding the molecular basis of these clinically heterogeneous disorders. First, in 1990, it was reported that all three forms of childhood-onset proximal SMA were linked to probes mapping to the proximal long arm of chromosome 5. Significant progress has been made towards isolating the gene or genes responsible, and a protocol for prenatal disease prediction in families with a previously severely affected child has been established. Second, in 1991, the molecular defect in adult-onset X-linked spinal and bulbar muscular atrophy was defined as an expansion of a (CAG)n trinucleotide repeat which encodes a string of glutamine residues in the first exon of the androgen receptor. Little progress has been made in elucidating the molecular pathology of the other SMAs. None of them has been linked to chromosome 5q markers, or indeed to markers elsewhere; the conditions are rare and pedigrees generally small. When the gene (or genes) on proximal 5q underlying SMA types I, II and III is cloned, mutations in this can then be sought in the other SMAs. The product of the chromosome 5q gene presumably plays a crucial role in maintaining the integrity of motor neurones, so determination of its structure and function may well have consequences far beyond those pertaining to the inherited SMAs. The identification of pathogenic mutations in the SOD-1 gene in familial amyotrophic lateral sclerosis is of great interest, although it is not clear that similar mechanisms contribute to the more common sporadic form of the disease.

Age of Onset↗

Using a radioactive and non-radioactive exchangeable labeling system for laboratory diagnosis.

In this communication a safe and simple molecular diagnosis strategy was described, which can be applied for the identification of pathogens or oncogenes in clinical studies. In Southern or Northern analysis, we demonstrated the feasibility to exchange labeling probes from non-radioactive to radioactive or vice versa in a single membrane simply by stripping. We chose non-radioactive labeling because it is safe and easy to operate, but when the sensitivity is insufficient, it can be replaced by radioactive labeling. Our data show that radioactive or non-radioactive labeling is exchangeable in a single membrane and the sensitivity was comparable by either method under optimal conditions. The clinical implication is that for general hybridization starts with non-radioactive labeling, radioactive labeling is not needed unless the signals cannot be detected by non-radioactive labeling. Moreover, one membrane can be labeled repeatedly by different probes.

Blotting, Northern↗

A new option for chemical labelling of oligonucleotide probes with biotin molecules.

Utilization of molecular probes for identification of pathogenic microorganisms have great advantages if we compare results obtained with classic systems traditionally employed in the clinic and research laboratories. This new method with biotin is more sensitive and specific than others and exclude the use of radioactive markers.

Base Sequence↗