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PubMed1996

Ten years of laboratory diagnosis of HIV: how accurate is it now?

The high expectations of laboratory diagnosis of HIV have mostly been met, but some problems remain. Current tests for anti-HIV antibodies are sensitive enough for many purposes, but for earliest diagnosis direct tests for virus are necessary. False negative results may occur, for instance because infection with virus variants such as HIV 1 subtype O is not recognised, or because of laboratory or clerical error. The laboratory monitoring of mothers and babies who have been treated with zidovudine, to establish whether perinatal infection has taken place will be difficult, and more reliable quantitative assays of HIV are needed to measure the risk of transmission from mother to baby. Proposals to introduce home testing for HIV may improve ascertainment of infection, but there must first be adequate support in place for those individuals who find themselves HIV-positive. Quality assurance, especially through clinical and laboratory audit, may now add more to diagnostic accuracy than the development of even more sensitive assays. The outstanding challenge is to make universally available tests with the accuracy and consistency achieved when best laboratory practice is enforced.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Laboratory diagnosis.

Explore the source record for details and available documents.

Clinical Laboratory Techniques↗
PubMed1981

[Effect of drugs on laboratory diagnosis--effect of propranolol on selected laboratory values].

In the accessible literature the influence of beta-blockers on laboratory methods is estimated only little systematically and nearly exclusively on parameters of the glucose and lipometabolism. The influence on several methods in vitro is without relevance to practice. Own examinations showed that in 32 patients with essential hypertension of stage I (after Baumann and Nitschkoff) under therapeutic doses of 50--80 mg propranolol a day in none of the 18 chemical parameters tested after a four weeks' treatment significant deviations relevant to practice appeared in comparison to the parameters before treatment.

Adolescent↗
PubMed1995

The laboratory diagnosis of mycobacterial diseases. Challenges and common sense.

The laboratory diagnosis of mycobacterial diseases is reviewed. It is re-emphasized that the diagnosis of mycobacterial diseases, especially tuberculosis (TB), is primarily clinical. With proper collection techniques and an appropriate number of sputa specimens acid-fast smears of concentrated sputa can still result in the detection of the majority of patients with cavitary TB who are responsible for the majority of TB transmission. Finally, the techniques used in the laboratory to diagnose mycobacterial diseases should be matched to the resources available to the laboratory and the incidence of those diseases in the area served by the laboratory.

Bacteriological Techniques↗
PubMed1992

Laboratory diagnosis of bacterial meningitis.

Bacterial meningitis is relatively common, can progress rapidly, and can result in death or permanent debilitation. This infection justifiably elicits strong emotional reactions and, hopefully, immediate medical intervention. This review is a brief presentation of the pathogenesis of bacterial meningitis and a review of current knowledge, literature, and recommendations on the subject of laboratory diagnosis of bacterial meningitis. Those who work in clinical microbiology laboratories should be familiar with the tests used in detecting bacteria and bacterial antigens in cerebrospinal fluid (CSF) and should always have the utmost appreciation for the fact that results of such tests must always be reported immediately. Academic and practical aspects of the laboratory diagnosis of bacterial meningitis presented in this review include the following: anatomy of the meninges; pathogenesis; changes in the composition of CSF; etiological agents; processing CSF; microscopic examination of CSF; culturing CSF; methods of detecting bacterial antigens and bacterial components in CSF (counter-immunoelectrophoresis, coagglutination, latex agglutination, enzyme-linked immunosorbent assay, Limulus amebocyte lysate assay, and gas-liquid chromatography); use of the polymerase chain reaction; and practical considerations for testing CSF for bacterial antigens.

Animals↗
PubMed1973

Laboratory diagnosis of trachoma: a collaborative study.

A collaborative study on the laboratory diagnosis of trachoma was carried out in three laboratories. A standardized complement fixation (CF) test with chlamydial (bedsonial) group antigen was found to be highly reproducible. The results obtained by different laboratories using the method and reagents suggested by the WHO International Reference Centre for Trachoma and other Chlamydial Infections agreed in more than 95% of the tests. Similar agreement was observed between the results obtained with these reagents and those routinely used in one of these laboratories. In confirmation of previous studies, the CF test was found to give positive results in only a limited proportion of trachoma cases. However, in an area where the disease is hyperendemic the rates showed good correlation with the intensity of clinical signs. A comparison was also made between Giemsa staining and a fluorescent antibody (FA) technique for the cytological examination of conjunctival scrapings. The results obtained with the former method correlated well with clinical activity but the positivity rate was lower than that obtained by the FA technique. The FA results, however, were not an accurate indicator of clinical intensity. These results suggest that the Giemsa method may detect only the most heavily infected individuals.

Child↗
PubMed2006

Laboratory diagnosis of human seasonal and pandemic influenza virus infection.

Laboratory diagnosis is important to distinguish influenza from other respiratory virus infections. It will be especially important in detecting the first cases of pandemic influenza. Good quality respiratory tract sampling is needed to maximise diagnostic yield in influenza infection. In the appropriate clinical setting, pandemic strain-specific nucleic acid testing is the initial test of choice for suspected pandemic influenza. It is more sensitive than virus isolation, and more sensitive and specific than serology, immunofluorescence and other antigen detection methods. Virus isolation is needed to monitor new influenza strains and for vaccine development. Analysis of influenza isolates is undertaken by the World Health Organization Global Influenza Surveillance Network. Monitoring for antiviral resistance will be needed with widespread use of neuraminidase inhibitors for treatment and prophylaxis during a pandemic.

Antibodies, Viral↗
PubMed2000

Laboratory diagnosis of infections in febrile neutropenic or immunocompromised patients.

Laboratory diagnosis of infections in febrile neutropenic or immunocompromised patients is particularly challenging, and covers the most frequent clinical presentations such as bloodstream infections, lung, CNS and skin infections, as well as invasive fungal infections. Classic methods such as direct examination, culture and tests for susceptibility are being more complemented by molecular detection of microorganisms (PCR in particular) and antigen detection in various body fluids or tissues; two promising methods which offer the advantage of speed and high sensitivity even after starting antimicrobial therapy.

Fever↗
PubMed1990

Comparative laboratory diagnosis of experimental herpes simplex keratitis.

We compared two commercially available tests, a direct immunofluorescence assay and an enzyme-linked immunosorbent assay (ELISA), to viral isolation in tissue culture for the laboratory diagnosis of untreated and partially treated experimental herpes simplex virus keratitis. New Zealand albino rabbits were inoculated bilaterally with herpes simplex virus-1 McKrae strain after corneal scarification. One eye of each rabbit was treated with a 1% trifluorothymidine solution daily, starting on the third day after inoculation. The direct immunofluorescence assay showed lower sensitivity for herpes simplex virus detection than viral isolation in tissue culture for both untreated and partially treated eyes. The Herpchek ELISA demonstrated similar sensitivity to tissue culture in detecting herpes simplex virus in untreated eyes. In the treated group, however, the Herpchek ELISA showed a higher percentage of eyes positive for herpes simplex virus than did viral isolation in tissue culture. After the initiation of antiviral therapy, eyes that no longer harbor infectious virus that can be isolated in tissue culture may remain herpes simplex virus antigen-positive and thus be more amenable to laboratory diagnosis using the rapid ELISA method.

Animals↗
PubMed1998

[Laboratory diagnosis of cytomegalovirus, HHV-6 and HHV-7 infectious diseases].

Cytomegalovirus, human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7) are members of subfamily Betaherpesvirinae of family Herpesviridae. After infection, these betaherpesviruses persistent for the rest of life. Those viruses are occasionally reactivated and shed either with or without clinical symptoms. The laboratory diagnosis of the viral infections is established by the following methods: (1) isolation of the virus from specimens; (2) detection of virus antigens, and/or viral nucleic acids; and (3) detection of seroconversion or a significant rise in antibody titer. Accurate and rapid laboratory diagnosis of the viral diseases is prerequisite to effective antiviral chemotherapy. Especially, it is most important to distinguish viral diseases to be treated from mere viral infections.

Antibodies, Viral↗
PubMed2004

[Progress in researches on the laboratory diagnosis of nongonococcal urethritis].

Nongonococcal urethritis(NGU) is one of the common sexually transmitted diseases. Chlamydia trachomatis is the commonest pathogen of NGU. Ureaplasma urealyticum, Mycoplasma genitalium, Trichomonas vaginalis and other pathogens also account for some cases of NGU. With the development of molecular biology and immunology, more and more new techniques, such as PCR, LCR, etc., have been used in the researches on the laboratory diagnosis of NGU. It is necessary to establish and standardize some reliable rapid diagnostic tests for NGU. This paper reviews the progress in researches on the concept, etiology, clinical features, laboratory diagnosis and treatment of NGU.

Animals↗
PubMed1997

Human papillomavirus: disease and laboratory diagnosis.

Human papillomaviruses (HPVs) can be classified biologically or phylogenetically into cutaneous or mucosal types. Cutaneous papillomaviruses produce benign skin tumours (warts) which occur commonly on the hands, face and feet. They spread readily among children and young adults during recreational activities. Laboratory diagnosis of skin warts is usually unnecessary as they can be distinguished morphologically. Large numbers of cutaneous warts may develop in patients with epidermodysplasia verruciformis, a rare familial disorder. Exposure to sunlight sometimes causes these lesions to progress to skin cancer. HPVs are the most common sexually transmitted viruses, infecting both men and women. They can be transmitted from the vagina at birth, and may cause recurrent respiratory papillomas in childhood or adult life. Genital infection usually clears within a few months, but may persist in some individuals. HPV has been firmly linked with cancer of the cervix, and is also associated with cancer at other mucosal sites. The distribution of genital HPV types varies and is related to the degree of cervical dysplasia present. HPV types 6 and 11 are frequently found in sexually active adults, and are associated with low-grade squamous epithelial lesions. HPV types 16, 18, 31 and 45 are found less frequently, and are associated with progression to invasive cancer. Commercial dot blot hybridisation and DNA-RNA hybridcapture assays are available for laboratory diagnosis of genital HPV infection. The polymerase chain reaction (PCR) is used for diagnosis and epidemiological surveys. Detection of particular HPV types could be useful in the diagnosis and management of cervical cancer in older women, and for resolving equivocal (borderline) cytology. HPV assays, which can distinguish between high-grade and low-grade disease, may also have a role in routine cervical screening.

Clinical Laboratory Techniques↗
PubMed1997

Laboratory diagnosis of acute measles infections in hospitalized children in Zambia.

Laboratory diagnosis of measles infection is rarely performed in developing countries and tends to depend on clinical symptoms alone. We evaluated detection of immunoglobulin M (IgM) antibodies for confirmation of acute measles infection in Zambia. In 149 hospitalized children with clinical diagnosis of measles, IgM antibodies were detected in 88.6% (132/149). The IgM-positive rate increased with time after onset of skin rash and all samples were positive after 4 days. In addition to IgM antibody test, virus isolations from throat swabs using B95a cells were also performed. These were positive in only 20.9% (14/67), and both IgM and virus isolation in combination increased the positive rate to 92.5% (62/67). Vaccinated children had higher neutralizing (Nt) antibody responses and, among IgM-negative patients, all 4 vaccinated children had high Nt antibodies while all 10 unvaccinated children had negative or low Nt results. The IgM antibody test was proved to be a sensitive method for laboratory confirmation of measles virus infection in developing countries.

Acute Disease↗
PubMed2002

Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis.

For the past 40 years, the Toxoplasma Serology Laboratory at the Palo Alto Medical Foundation Research Institute (TSL-PAMFRI) has been dedicated to the laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. TSL-PAMFRI is the "brain child" of Jack S. Remington. Jack's ceaseless devotion to objectivity and uncompromising excellence has made TSL-PAMFRI the Toxoplasma reference laboratory for the Centers for Disease Control and Prevention, the US Food and Drug Administration, and health care providers and clinical laboratories in the United States and other countries. Jack's leadership and vision created, defined, and significantly contributed to the development of laboratory methods for the diagnosis of the infection and diseases caused by T. gondii. A summary of the laboratory tests currently available at TSL-PAMFRI for the diagnosis of infection and disease caused by the parasite is presented here.

Animals↗
PubMed1980

The rapid laboratory diagnosis of anaerobic infection.

In order to assess the rapid laboratory diagnosis of anaerobic pyogenic infection, we compared the results of Gram stains, ultra-violet fluorescence and gas chromatography, all performed directly on pus, with those of anaerobic culture. Fluorescence was most rapid but there were many negatives unless Bacteroides melaninogenicus was present. Gas chromatography was rapid and sensitive but there were some false negatives, often in pure Bacteroides fragilis infection, and a few false positives. Gram-staining was also rapid, but only helpful on its own when there were large numbers of organisms of mixed or characteristic morphology. The three methods together almost always provided a reliable and rapid presumptive diagnosis of anaerobic pyogenic infection.

Anaerobiosis↗