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PubMed1977

[Guidelines for the laboratory diagnosis of rheumatic diseases (author's transl)].

The methods for laboratory diagnosis of rheumatic diseases are subdivided into 10 groups according to their informative value. The following aspects are taken into consideration: general diagnosis of inflammation, infective processes with hemolytic streptococci and staphylococci, streptococcal agglutinations, rheumatoid factor tests in the strictest sense, detection of autoantibodies, the HLA-system, investigations in metabolic diseases and generalized skeletal diseases, bacteriological and serological investigations in joint infections and tests in symptomatic diseases of joints and muscles. In the evaluation of the individual methods and the discussion of their application in various types of disease, the following provisional diagnoses are gone into: streptococcal rheumatism, rheumatoid arthritis, monarthritis, ankylosing spondylitis, Reiter's syndrome and psoriatic arthritis, myositis and polymyositis.

Blood Sedimentation↗
PubMed2003

Evaluation of the concentration sputum smear technique for the laboratory diagnosis of pulmonary tuberculosis.

The microbiological diagnosis of pulmonary tuberculosis (PTB) plays a key role in routine and Tuberculosis (TB) Control Programmes in developing countries. Concentration of acid-fast bacilli (AFB) in clinical specimens is an important step in the laboratory diagnosis of mycobacterial diseases. Microscopy of smears of sputum by direct and after mechanical sedimentation and centrifugation methods followed by treatment with 5% sodium hypochlorite (NaOCl) solution for concentration of the organisms were compared and evaluated. The rate of recovery of AFB from sputum was 8.5%, 25.5% and 38.0% for direct smear microscopy, concentration by sedimentation of NaOCl-treated sputa followed by Ziehl-Neelsen staining and concentration by centrifugation after use of NaOCl respectively. Both the concentration methods by the use of NaOCl solution increased the yield of theAFB by more than threefold compared with the direct microscopy of sputum (P < 0.05). The concentration methods by sedimentation, and centrifugation by the treatment of NaOCl, increased the sensitivity to 75% and 77.9%, respectively, and the specificity to 100% for both techniques. In conclusion, the use of NaOCl in the concentration of AFB in sputum is recommended for use in routine laboratory diagnosis of PTB in developing countries.

Adult↗
PubMed1996

Disseminated intravascular coagulation: objective clinical and laboratory diagnosis, treatment, and assessment of therapeutic response.

Current concepts of the etiology, pathophysiology, clinical and laboratory diagnosis and management of fulminant and low-grade disseminated intravascular coagulation (DIC) have been presented. Considerable attention has been devoted to interrelationships within the hemostasis system. Only by clearly understanding the pathophysiological interrelationships can the clinician and laboratory scientist appreciate the divergent and wide spectrum of often confusing clinical and laboratory findings in patients with DIC. Objective clinical and laboratory criteria for diagnosis of DIC have been delineated, thus avoiding needless confusion and empirical decisions regarding the diagnosis. Many therapeutic decisions to be made are controversial and will remain so until more is published about specific therapeutic modalities and survival patterns. Also, therapy must be highly individualized depending on the nature of DIC, age, etiology of DIC, site and severity of hemorrhage or thrombosis, and hemodynamic and other clinical parameters. Also presented are clear criteria for severity of DIC and objective criteria for defining a response to therapy. Also, since it is often difficult for the individual physician to decide when to stop expensive therapy, objective criteria by which therapy may be stopped when continuation is likely fruitless are presented as a guideline.

Biomarkers↗
PubMed2006

Performance and clinical utility of a commercial von Willebrand factor collagen binding assay for laboratory diagnosis of von Willebrand disease.

BACKGROUND: Von Willebrand disease (VWD) diagnosis and classification usually require a combination of nonspecific and VW-factor (VWF)-specific assays. We evaluated the analytical performance of a commercially available collagen-binding assay (CBA) and its usefulness in conjunction with other assays for laboratory diagnosis of VWD. METHODS: We used a commercial CBA ELISA (Life Technologies) to evaluate 3085 plasma samples. We used standard procedures to perform other assays, including factor VIII activity (FVIII:C), VWF antigen (VWF:Ag), ristocetin cofactor activity, VWF collagen binding capacity (VWF:CB), and VWF multimeric analysis. RESULTS: CBA intra- and interassay CVs were <6% and <13%, respectively. Reference intervals were 45%-198% for VWF:CB and 0.75-1.32 for the VWF:CB/Ag ratio. Of 3085 samples tested, 235 (8%) had results commonly associated with VWD. Multimer analysis and phenotypic data in 156 samples identified VWD types as: 91 (58%) type 1, 62 (40%) type 2, and 3 (2%) type 3. Of the 91 type 1 samples, proportional decreases in functional activity were seen in 75 samples (82%) according to CBA and in 63 samples (69%) according to the ristocetin cofactor assay. Of the type 2 samples, 10 were further identified as probable type 2A, 26 as probable type 2B, 12 as probable type 2M, and 14 could not be subtyped. VWF:CBA/Ag ratios <0.5 occurred in 83% of VWD type 2A and 2B samples, indicating characteristic functional discordance. Mean (SD) VWF:CB values were significantly higher in individuals without group O blood [113 (45)] than in those with group O blood [83 (32)] (t-test, P = 0.007). CONCLUSIONS: The commercial CBA assay produces reliable results and is useful for laboratory diagnosis of VWD.

Collagen↗
PubMed2005

[Laboratory diagnosis and antibiotic susceptibilities of nontuberculous mycobacteria].

Nontuberculous mycobacteria (NTM) are found widespread in nature. They can live in soil, water supplies, plants and various environmental conditions. Today there are nearly 100 known NTM species and more than 50 of them are associated with human diseases. NTM can cause pulmonary diseases, lymphadenitis, skin, soft tissue and skeletal infections, catheter related bloodstream infections and disseminated infections in patients with underlying diseases like AIDS, chronic obstructive pulmonary diseases, emphysema, bronchiectasis, cystic fibrosis and chronic alcoholism. The laboratory diagnosis of NTM has improved in parallel to the improvements in molecular biology. The new DNA sequencing and microarray technologies have been started to use in laboratories. Antibiotic susceptibility tests can be used both for taxonomic and clinical purposes. In this review article, the importance of laboratory diagnosis and antibiotic susceptibilities of NTM have been discussed.

Environmental Microbiology↗
PubMedDate not supplied

Immunoblot analysis for laboratory diagnosis of ataxia-telangiectasia: use of Epstein-Barr virus-transformed or phytohemagglutinin-stimulated lymphoblasts for detection of ATM protein.

Ataxia-telangiectasia (A-T) is a genetic disorder characterized by a progressive ataxia, immunodeficiency, neurological abnormalities, hypersensitivity to ionizing radiation, and predisposition to cancer. The gene responsible for A-T (ATM) has been cloned and shown to code for a 350 kDa polypeptide containing 3,056 amino acid residues. Detection of ATM mutations for laboratory diagnosis of A-T is laborious and not practical, unless there are common mutations in a population. We describe here immunoblot analysis for the detection of ATM in seven Japanese A-T patients from five families and in controls using ATM3BA antibody. ATM protein was routinely and clearly detected in Epstein-Barr virus (EBV)-transformed or phytohemagglutinin (PHA)-stimulated lymphoblasts from controls. However, it could not be detected consistently in unstimulated peripheral blood mononuclear cells (PBMCs) from controls. We also detected ATM protein in control fibroblasts, but the background was relatively higher than in control lymphoblasts. ATM protein was not detected or dramatically decreased in EBV-transformed lymphoblasts from all seven patients tested and in fibroblasts from one patient. Immunoblot analysis using EBV-transformed or PHA-stimulated lymphoblasts represents a useful approach for laboratory diagnosis for A-T. The latter is especially preferable since it takes only 3 days to obtain sufficient cells for analysis.

Adult↗
PubMed1998

Acute phase proteins: clinical and laboratory diagnosis. A review.

Acute phase proteins play an important role in clinical laboratory diagnosis, especially after recent development of quantitation methods. Turbidimetry and nephelometry, spectrophotometric procedures based on the quantitation of scattered and reflected light, permit laboratory analyses of higher precision, sensitivity and specificity compared to previously employed methods.

Acute-Phase Proteins↗
PubMed2006

Interpretation of normal plasma mixing studies in the laboratory diagnosis of lupus anticoagulants.

INTRODUCTION: Mixing studies are part of the laboratory diagnosis of lupus anticoagulants (LA). They are used to determine the evidence of an inhibitor by demonstrating persistence of an abnormal clotting time by mixing patient plasma with normal plasma. Since there is no standardised interpretation of results of mixing studies, percent correction formulas are proposed. The sensitivity of mixing studies strongly depends on the interpretation of the results. MATERIALS AND METHODS: A retrospective analysis was performed on 361 samples, 75 LA-positive and 286 LA-negative samples. For all the LA-positive samples and for 181/286 LA-negative samples mixing tests on one or more screening tests were performed. A percent correction formula and the Rosner index were calculated for all mixing tests on aPTT and dPT. RESULTS: The <70% correction formula for the mixing tests on aPTT showed the highest sensitivity (95%). The Rosner index had a sensitivity (93%) comparable with the <70% correction formula. dPT is shown to be less sensitive in the detection for LA and, even when the screening test is prolonged, interpretation of the mixing test by the percent correction formula misclassifies many samples. Rosner index in the interpretation of mixing tests for dPT is more sensitive than the percent correction formula, 49% and 57%, respectively. CONCLUSIONS: This study demonstrates that the Rosner index and the percent correction formulas for interpretation of mixing studies are complementary and can help to reduce misclassification of LA-positive or LA-negative samples.

Humans↗
PubMed1989

[Clinical and laboratory diagnosis of streptococcal infection].

The problems related to the clinical and laboratory diagnosis of streptococcal infection at all levels of health service are analysed. The principles of microbiological streptococcal identification with the aid of express-systems and standard culture techniques are outlined. Particular emphasis is placed upon immunoassay of streptococci using a broad spectrum of extracellular products and antigens of the cell wall of group A streptococcus, and upon methodological approaches to solving certain clinical and diagnostic problems.

Antibodies, Bacterial↗
PubMed1990

[Recent progress in computer-assisted laboratory diagnosis].

To assist the physician in the clinical decision making process, the CALD (computer-assisted laboratory diagnosis) system was constructed. This was serially connected with a multi-center laboratory information system for practical use. From among the examples of CALD used, a diagnostic system for the blood spectrum and peripheral hemogram was selected for the evaluation of the principle and usefulness, and for a discussion of further problems. The method of selection of suitable tests for hepatobiliary disease screening (from a normal group and 10 groups of other diseases) and its diagnostic logic and usefulness of quantitative diagnosis using a discriminant curve were then discussed. The optimal combinations were most often found to involve 1-5 tests. Near maximal diagnostic efficiency was achieved by 50-100 combinations. The diagnostic efficiency of the optimal test was higher than expected, with a range of 80-100% (92.7% on average).

Acute Disease↗
PubMed1986

Nucleic acids as analytes in laboratory diagnosis.

The method of nucleic acid hybridization opens up new possibilities in laboratory diagnosis. This method, which enables us to assay for definite nucleic acid sequences in the specimen, has the advantage of high specificity and a strong binding force between the analyte nucleic acid and the nucleic acid probe. So far this method primarily works with radioactive labels. The development of non-radioactive detection systems suited for routine laboratories with sufficient sensitivity is still at its origin. One broad field of application for nucleic acid hybridization is the detection of the genome of certain viruses or bacteria in the specimen. Another more future oriented potential of these methods lies in the investigation and diagnosis of inborn errors of metabolism.

Bacterial Infections↗
PubMed1991

[Computer-assisted laboratory diagnosis--principles and clinical application].

Methods of computer-assisted diagnosis based on laboratory data are divided into so called rule-base system in which the diagnostic knowledge of physicians is programmed and those using multivariate analysis and mathematical models such as fuzzy interference. In this report, the principles and the technique of matrix discrimination method, which belongs to the latter group, are described, and its usefulness in clinical diagnosis evaluated. By the present method, subjects (diseases) are separated from two or more groups of subjects (diseases) to be discriminated on the basis of laboratory data. The method, based on the linear discrimination analysis, is characterized by optimization of selection of subjects to be discriminated and selection of test items and inference by the use of a discrimination curve. When this method was applied to discrimination of healthy individuals and patients with various liver and biliary disorders (11 diseases), all healthy individuals were discriminated from the patients. A mean of 97.0% of patients with hepatic parenchymal disorders were found in the top two, and 86.2% of those with space-occupying diseases in the top three, of the 12 diseases from which the disease of each patient was to be estimated. This diagnostic ability of the matrix discrimination method far exceeded the physicians' expectations.

Biliary Tract Diseases↗
PubMed2005

Audit of the laboratory diagnosis of Lyme disease in Scotland.

An audit was performed on the laboratory diagnosis of lyme disease in Scotland. The problem of a significant number of patients with clinical symptoms of lyme disease being reported as seronegative or equivocal by the confirmatory Western blot test was identified. Comparisons of current practice were made with American and European standards, and the Western blot scoring system revised. When applied retrospectively (April 2003 to March 2004), 39 (33 %) of 116 serum samples previously negative or equivocal became weak positive or stronger. Thirty-one (80 %) of these 39 samples were from patients with clinical details suggestive of early lyme disease. The changes were implemented and assessed prospectively for 6 months. There was a significant increase in the proportion of equivocal results, with fewer negatives compared to the same time period 1 year previously. This audit has helped clinicians in the diagnosis of lyme disease and the management of these patients in Scotland.

Blotting, Western↗
PubMedDate not supplied

[Laboratory diagnosis of animal brucellosis].

Brucellosis is still a topical disease both in humans and in animals. The need for a laboratory diagnosis is very important to confirm the disease. The present article reviews the principal techniques used in the laboratory for the diagnosis of brucellosis.

Agglutination Tests↗
PubMed1994

Accuracy of routine laboratory diagnosis of malaria in the United Kingdom.

AIMS: To study the accuracy of routine laboratory diagnosis of malaria with the aim of improving accuracy in diagnosis in the future. METHODS: A comparative study was made of all blood films submitted to two laboratories in London providing a slide-diagnostic service for malaria. RESULTS: There were 17 Plasmodium ovale infections, and of these only five (29.4%) were correctly diagnosed by the submitting laboratory; whereas of 210 other single species infections, 162 (77.1%) were correctly diagnosed (chi 2 = 18.4, p < 0.0001). There were six patients with mixed infections; only one (16.7%) was correctly diagnosed, whereas of 227 single species infections, 167 (73.6%) were correctly diagnosed (p = 0.007, using Fisher's exact test). There was no significant association between the presence of technical faults or numerous platelets and incorrect diagnosis. CONCLUSIONS: Plasmodium ovale and mixed infections were diagnosed incorrectly significantly more often than other species. The presence of technical faults or numerous platelets had no significant effect on whether or not submitting laboratories correctly diagnosed malaria.

Animals↗
PubMed1978

Laboratory diagnosis of rheumatic diseases.

Laboratory investigations have been perhaps the most important factor in the development of our understanding and classification of rheumatic diseases. Provided they are used and interpreted appropriately, they can assist considerably in the diagnosis and management of these diseases. They are an important adjunct to clinical findings, but not a substitute for them.

Adolescent↗
PubMed1996

Laboratory diagnosis of HIV infection in Papua New Guinea.

In Papua New Guinea, the laboratory diagnosis of HIV infection is based on proof of HIV antibody in the patient's serum. Under the government scheme, the testing is done in 30 laboratories, including the Papua New Guinea HIV Reference Laboratory (NRL), the Red Cross Blood Transfusion Service in Port Moresby, and 19 provincial and 9 district laboratories. An alternative testing strategy was adopted in 1993 based on a WHO recommendation, replacing the classical testing strategy (enzyme immunoassay + Western blot). The alternative testing strategy uses several EIA, rapid or simple HIV antibody assays for the detection and confirmation of the HIV antibody. This approach is faster and cheaper, with the same sensitivity and specificity as the classical testing algorithm. Except for the NRL, the Serodia Fujirebio HIV-1 gelatin particle agglutination assay is used throughout the country as the screening test. The PNG National HIV Reference Laboratory is the only laboratory authorized to perform confirmatory testing and to release positive results. Therefore, all serum samples reactive in the screening assay are sent to the NRL for confirmation by the battery of EIA, rapid or simple assays in accordance with the alternative testing strategy adopted. The paper explains the alternative testing strategy and highlights the principle of each individual test that is employed.

AIDS Serodiagnosis↗