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Laboratory diagnosis of thrombophilia by endothelial-cell-modulated coagulation.

This study investigated whether the addition of endothelial cells to blood or blood plasma is of value in global laboratory diagnostic testing for thrombotic tendency. Plasma from thrombotic patients and healthy individuals was exposed to human umbilical vein endothelial cells (HUVEC), in monolayers or suspensions, and fibrin deposition or clotting time, respectively, was registered. The latter was determined by a novel rheometric procedure that also gave information about coagulum rigidity. Plasma from patients (n = 10) tended to deposit more fibrin on HUVEC monolayers than plasma from healthy individuals (n = 10). When mixed with suspended HUVEC, plasma from patients (n = 14) showed shorter clotting times than plasma from healthy individuals [n = 13; 4.79 +/- 1.02 min (mean +/- SD) compared with 6.80 +/- 1.50 min, P < 0.001]. Coagulum rigidity among patients also differed from that of healthy individuals (P < 0.05). The study showed that the addition of endothelial cells to blood plasma is of value in global laboratory diagnostic testing for thrombotic tendency.

Adult↗

Laboratory diagnosis of urinary tract infection in ambulatory women.

We evaluated the accuracy and work load of six different approaches to identifying urinary tract infections in a general microbiology laboratory. Midstream urine (MSU) specimens from 387 ambulatory women were examined for pyuria and were cultured using a dual-plating technique that detects both low (10(2) to 10(4) organisms per milliliter) and high (greater than or equal to 10(5) organisms per milliliter) colony counts. Seventy-four urinary tract infections (defined as greater than or equal to 10(5) organisms per milliliter of MSU or greater than or equal to 10(2) aerobic gram-negative bacilli per milliliter of MSU in symptomatic patients) were identified. Twenty-four (32%) of the infections were characterized by low colony counts and would not have been identified using a 10(5) or greater colony-forming units/mL criterion for infection. Using the presence of pyuria to direct microbiological processing of urine specimens was the most accurate and efficient method of identifying urinary tract infections among voided specimens from ambulatory women, particularly if rapid screening methods for pyuria can be used.

Adolescent↗

Current laboratory diagnosis of Q fever.

Q fever is a worldwide zoonosis caused by the strictly intracellular bacterium Coxiella burnetii. Among symptomatic patients (one-half of patients remain asymptomatic), acute Q fever most frequently manifests as a self-limited febrile illness, pneumonia, or hepatitis. Endocarditis is the predominant form of chronic Q fever. All the classical techniques of bacteriology may be used for diagnosis of C burnetii infection. Nonetheless, because of the risk of contamination, isolation must be performed in biosafety level 3 laboratories. Moreover, to date no diagnostic tests for detection by polymerase chain reaction or specific antibodies for immunochemistry are available commercially. Hence, Q fever is diagnosed in most cases by serology. The most reliable technique appears to be micro-immunofluorescence, which exhibits both good sensitivity and specificity. A wider use of this serology in cases of blood culture-negative endocarditis, atypical pneumonia, unexplained fever, and hepatitis should lead to an increase of diagnosed cases.

Animals↗

Laboratory diagnosis of malassimilation.

In many instances, the cause for malassimilation can be determined with ease, but finding the cause sometimes can be elusive and require the use of sophisticated laboratory techniques not available to the general veterinary practitioner. In either case, the clinician, whether generalist or specialist, must make an informed decision based on the results of many different testing modalities, and not only on the results of the laboratory tests described here. A flow chart is provided to assist the diagnostician in selecting and applying the more clinically oriented laboratory tests useful in dealing with a patient with chronic diarrhea and weight loss.

Animals↗

[The laboratory diagnosis and epidemiology of cutaneous leishmaniasis in Paraná State, southern Brazil].

Between 1986 and 1997 a total of 1418 patients were examined at the Clinical Analysis Teaching and Research Laboratory of Maringá State University (LEPAC/UEM) for cutaneous leishmaniasis by direct examination of stained smears made from the lesions, the Montenegro skin test and the indirect immunofluorescent antibody test. Nine hundred and fifty five patients (67.3%) were positive for at least one of the three tests and of these 804 (84.2%) were considered to have contracted the disease in Paraná State; 665 (69.6%) were between 15 and 49 years old; 658 (68.9%) were males; 523 (54.8%) sought medical advice during the first three months of their infections and 74 (7.7%) had mucosal lesions. Of the 83 counties of Paraná State, where the patients had most probably acquired their infections, 44.7% were from the counties of São Jorge do Ivaí (10.2%), Doutor Camargo (9.8%), Terra Boa (7.3%), Maringá (7.3%), Jussara (6.0%) and Cianorte (4.5%). Seventy seven strains of Leishmania (Viannia) braziliensis were isolated and 63.6% of these strains belong to serodema 1.

Adolescent↗

[Laboratory diagnosis in tuberculosis].

The most reliable signs of tuberculosis infection is detection of M. tuberculosis complex in biological fluids and biopsy specimens from focus of lesions. The sensitivity of laboratory diagnostic methods is different for different biological materials, which dictates the utilization of a complex laboratory approach, including microscopy, bacteriological methods, detection of specific IgG, IgM, IgA, and polymerase chain reaction.

Bacteriological Techniques↗