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[PMID]:29465590
[Au] Autor:Nishimura T; Arima K; Abe Y; Kanagae M; Mizukami S; Okabe T; Tomita Y; Goto H; Horiguchi I; Aoyagi K
[Ad] Endereço:Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto.
[Ti] Título:Relationship between bone turnover markers and the heel stiffness index measured by quantitative ultrasound in middle-aged and elderly Japanese men.
[So] Source:Medicine (Baltimore);97(8):e9962, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the present study was to investigate the age-related patterns and the relationships between serum levels of tartrate-resistant acid phosphatase-5b (TRACP-5b) or bone-specific alkaline phosphatase (BAP), and the heel stiffness index measured by quantitative ultrasound (QUS) in 429 Japanese men, with special emphasis on 2 age groups (40-59 years and 60 years or over). The heel stiffness index (bone mass) was measured by QUS. Serum samples were collected, and TRACP-5b and BAP levels were measured. The stiffness index was significantly decreased with age. Log (TRACP-5b) was significantly increased with age, but Log (BAP) was stable. Generalized linear models showed that higher levels of Log (TRACP-5b) and Log (BAP) were correlated with a lower stiffness index after adjusting for covariates in men aged 60 years or over, but not in men aged 40 to 59 years. In conclusion, higher rates of bone turnover markers were associated with a lower stiffness index only in elderly men. These results may indicate a different mechanism of low bone mass among different age groups of men.
[Mh] Termos MeSH primário: Fosfatase Alcalina/sangue
Indicadores Básicos de Saúde
Calcanhar/diagnóstico por imagem
Fosfatase Ácida Resistente a Tartarato/sangue
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Biomarcadores/sangue
Densidade Óssea
Remodelação Óssea/fisiologia
Testes Diagnósticos de Rotina
Calcanhar/fisiopatologia
Seres Humanos
Japão
Modelos Lineares
Masculino
Meia-Idade
Ultrassonografia/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); EC 3.1.3.1 (Alkaline Phosphatase); EC 3.1.3.2 (Tartrate-Resistant Acid Phosphatase)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009962


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[PMID]:29465557
[Au] Autor:Wang Y; Xu W; Zhang Q; Bao T; Yang H; Huang W; Tang H
[Ad] Endereço:Department of Human Resources, West China Hospital, Sichuan University, Chengdu.
[Ti] Título:Follow-up of blood glucose distribution characteristics in a health examination population in Chengdu from 2010 to 2016.
[So] Source:Medicine (Baltimore);97(8):e9763, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The worldwide prevalence and incidence of diabetes and obesity are increasing in pandemic proportions. Thus, regular health examination is an important way for early detection of diabetes and glucose intolerance. The present study aims to detect the blood glucose distribution characteristics of the participants in the Health Examination Center at West China Hospital, Sichuan University from 2010 to 2016.A prospective cohort included 9168 Chinese participants, aged 18 years or more, who had available information on fasting blood glucose concentrations at the start of the study (2010). Examination surveys were conducted every year from 2010 to 2016. Cases having serum level of fasting blood glucose between 2.2 and 6.1 mmol/L were considered as normality, while serum level of fasting blood glucose < 2.2 or higher than 6.2 mmol/L were considered as abnormality.The percentage of participants having normal level of glucose was gradually reduced both in males and females from 2010 to 2016, by which the percentage of males having normal level of glucose was significantly lower than that in females. Moreover, the mean level of glucose was significantly increased from 2010 to 2016 both in males and females overall, and the mean level of glucose was higher in males compared with that in females every year. Furthermore, we showed that the level of glucose was gradually increased year by year in each age group, and the level of glucose was higher in aged cases compared with the young population.The study population in the current study showed higher levels of glucose with ages increasing, and males indicated higher expression of glucose than that in females. Some preventive action may be adopted early and more attention can be paid to this health-examination population.
[Mh] Termos MeSH primário: Glicemia/análise
Saúde da População/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
China
Testes Diagnósticos de Rotina/métodos
Jejum/sangue
Feminino
Seguimentos
Seres Humanos
Masculino
Programas de Rastreamento/métodos
Meia-Idade
Estudos Prospectivos
Distribuição por Sexo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009763


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[PMID]:29390456
[Au] Autor:Pan Y; Li D; Ma J; Shan L; Wei M
[Ad] Endereço:Department of Cardiology, Shanghai East Hospital.
[Ti] Título:NT-proBNP test with improved accuracy for the diagnosis of chronic heart failure.
[So] Source:Medicine (Baltimore);96(51):e9181, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The circulating concentration of N-terminal pro-brain natriuretic peptide (NT-proBNP) has been shown to be a diagnostic tool for the detection of heart failure. Several factors influence NT-proBNP levels including age, sex, and body mass index (BMI). Therefore, the diagnostic sensitivity of NT-proBNP level for heart failure is relatively higher, but its specificity is low. This study aims to improve the diagnostic accuracy rate of this test by including multiple variables in the diagnostic test.The suspected chronic heart failure outpatients were divided into heart failure with reduced ejection fraction, heart failure with mid-range ejection fraction, heart failure with preserved ejection fraction, and normal heart function groups. Area under the receiver-operating characteristic (ROC) curve, cut-off value, and logistic regression analysis were used to select the model variables, sensitivity and specificity.In all, 436 subjects enrolled into this study were divided in 2 groups: model establishment (n = 300) and model validation (n = 136). In the model establishment group, the area under the curve (AUC) and cut-off value of NT-proBNP was 0.926 and 257.4 pg/mL, respectively. When age, glomerular filtration rate, BMI, atrial fibrillation, and sex were entered into the diagnosis model, AUC, sensitivity, and specificity further increased to 0.955 (95% confidence interval [CI] 0.934, 0.976), 94.2% (from 93.0%), and 86.7% (from 74.2%). The ROC curve of corrected NT-proBNP diagnostic formula for heart failure was also significantly higher (P = .037).The corrected NT-proBNP diagnostic formula was found to improve the diagnostic accuracy of chronic heart failure.
[Mh] Termos MeSH primário: Ecocardiografia Doppler/métodos
Insuficiência Cardíaca/sangue
Insuficiência Cardíaca/diagnóstico por imagem
Peptídeo Natriurético Encefálico/sangue
Fragmentos de Peptídeos/sangue
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Área Sob a Curva
Biomarcadores/sangue
China/epidemiologia
Doença Crônica
Bases de Dados Factuais
Testes Diagnósticos de Rotina/métodos
Feminino
Insuficiência Cardíaca/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Curva ROC
Estudos Retrospectivos
Medição de Risco
Sensibilidade e Especificidade
Índice de Gravidade de Doença
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Peptide Fragments); 0 (pro-brain natriuretic peptide (1-76)); 114471-18-0 (Natriuretic Peptide, Brain)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009181


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[PMID]:29253402
[Au] Autor:Lew JB; Simms KT; Smith MA; Hall M; Kang YJ; Xu XM; Caruana M; Velentzis LS; Bessell T; Saville M; Hammond I; Canfell K
[Ad] Endereço:Cancer Council NSW, Cancer Research Division, Sydney, NSW, Australia.
[Ti] Título:Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: effectiveness and economic assessment for the National Cervical Screening Program.
[So] Source:Lancet Public Health;2(2):e96-e107, 2017 Feb.
[Is] ISSN:2468-2667
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Australia's National Cervical Screening Program currently recommends cytological screening every 2 years for women aged 18-69 years. Human papillomavirus (HPV) vaccination was implemented in 2007 with high population coverage, and falls in high-grade lesions in young women have been reported extensively. This decline prompted a major review of the National Cervical Screening Program and new clinical management guidelines, for which we undertook this analysis. METHODS: We did effectiveness modelling and an economic assessment of potential new screening strategies, using a model of HPV transmission, vaccination, natural history, and cervical screening. First, we evaluated 132 screening strategies, including those based on cytology and primary HPV testing. Second, after a recommendation was made to adopt primary HPV screening with partial genotyping and direct referral to colposcopy of women positive for HPV16/18, we evaluated the final effect of HPV screening after incorporating new clinical guidelines for women positive for HPV. Both evaluations considered both unvaccinated and vaccinated cohorts. FINDINGS: Strategies entailing HPV testing every 5 years and either partial genotyping for HPV16/18 or cytological co-testing were the most effective. One of the most effective and cost-effective strategies comprised primary HPV screening with referral of women positive for oncogenic HPV16/18 direct to colposcopy, with reflex cytological triage for women with other oncogenic types and direct referral for those in this group with high-grade cytological findings. After incorporating detailed clinical guidelines recommendations, this strategy is predicted to reduce cervical cancer incidence and mortality by 31% and 36%, respectively, in unvaccinated cohorts, and by 24% and 29%, respectively, in cohorts offered vaccination. Furthermore, this strategy is predicted to reduce costs by up to 19% for unvaccinated cohorts and 26% for cohorts offered vaccination, compared with the current programme. INTERPRETATION: Primary HPV screening every 5 years with partial genotyping is predicted to be substantially more effective and potentially cost-saving compared with the current cytology-based screening programme undertaken every 2 years. These findings underpin the decision to transition to primary HPV screening with partial genotyping in the Australian National Cervical Screening Program, which will occur in May, 2017. FUNDING: Department of Health, Australia.
[Mh] Termos MeSH primário: Detecção Precoce de Câncer/economia
Detecção Precoce de Câncer/métodos
Infecções por Papillomavirus/diagnóstico
Vacinas contra Papillomavirus/administração & dosagem
Neoplasias do Colo do Útero/diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Austrália
Biologia Celular/economia
Análise Custo-Benefício
Testes Diagnósticos de Rotina/economia
Feminino
Seres Humanos
Meia-Idade
Infecções por Papillomavirus/prevenção & controle
Prevenção Primária/economia
Avaliação de Programas e Projetos de Saúde
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Papillomavirus Vaccines)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE


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[PMID]:28460659
[Au] Autor:Pai M; Furin J
[Ad] Endereço:McGill Global Health Programs and McGill International Tuberculosis Centre, McGill University, Montreal, Canada.
[Ti] Título:Tuberculosis innovations mean little if they cannot save lives.
[So] Source:Elife;6, 2017 05 02.
[Is] ISSN:2050-084X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The past decade has seen the emergence of new diagnostics and drugs for tuberculosis, a disease that kills over 1.8 million people each year. However, these new tools are yet to reach scale, and access remains a major challenge for patients in low and middle income countries. Urgent action is needed if we are committed to ending the TB epidemic. This means raising the level of ambition, embracing innovation, increasing financial investments, addressing implementation gaps, and ensuring that new technologies reach those who need them to survive. Otherwise, the promise of innovative technologies will never be realized.
[Mh] Termos MeSH primário: Antituberculosos/uso terapêutico
Testes Diagnósticos de Rotina/métodos
Acesso aos Serviços de Saúde
Tuberculose/epidemiologia
Tuberculose/mortalidade
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antitubercular Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180211
[Lr] Data última revisão:
180211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28941616
[Au] Autor:Dalton KP; Podadera A; Granda V; Nicieza I; Del Llano D; González R; de Los Toyos JR; García Ocaña M; Vázquez F; Martín Alonso JM; Prieto JM; Parra F; Casais R
[Ad] Endereço:Instituto Universitario de Biotecnología de Asturias, Departamento de Bioquímica y Biología Molecular, Edificio Santiago Gascón, Universidad de Oviedo, Campus El Cristo, 33006, Oviedo, Spain. Electronic address: daltonkevin@uniovi.es.
[Ti] Título:ELISA for detection of variant rabbit haemorrhagic disease virus RHDV2 antigen in liver extracts.
[So] Source:J Virol Methods;251:38-42, 2018 Jan.
[Is] ISSN:1879-0984
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The emergence and rapid spread of variant of the rabbit hemorrhagic disease virus (RHDV2) require new diagnostic tools to ensure that efficient control measures are adopted. In the present study, a specific sandwich enzyme-linked immunosorbent assay (ELISA) for detection of RHDV2 antigens in rabbit liver homogenates, based on the use of an RHDV2-specific monoclonal antibody (Mab) 2D9 for antigen capture and an anti-RHDV2 goat polyclonal antibody (Pab), was developed. This ELISA was able to successfully detect RHDV2 and RHDV2 recombinant virions with high sensitivity (100%) and specificity (97.22%). No cross-reactions were detected with RHDV G1 viruses while low cross-reactivity was detected with one of the RHDVa samples analyzed. The ELISA afforded good repeatability and had high analytical sensitivity as it was able to detect a dilution 1:163,640 (6.10ng/mL) of purified RHDV-N11 VLPs, which contained approximately 3.4×10 molecules/mL particles. The reliable discrimination between closely related viruses is crucial to understand the epidemiology and the interaction of co-existing pathogens. In the work described here we design and validate an ELISA for laboratory based, specific, sensitive and reliable detection of RHDVb/RHDV2. This ELISA is a valuable, specific virological tool for monitoring virus circulation, which will permit a better control of this disease.
[Mh] Termos MeSH primário: Antígenos Virais/análise
Infecções por Caliciviridae/veterinária
Testes Diagnósticos de Rotina/métodos
Ensaio de Imunoadsorção Enzimática/métodos
Vírus da Doença Hemorrágica de Coelhos/isolamento & purificação
Fígado/virologia
[Mh] Termos MeSH secundário: Animais
Antígenos Virais/imunologia
Infecções por Caliciviridae/diagnóstico
Infecções por Caliciviridae/virologia
Reações Cruzadas
Vírus da Doença Hemorrágica de Coelhos/imunologia
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Medicina Veterinária/métodos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antigens, Viral)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170925
[St] Status:MEDLINE


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[PMID]:28464837
[Au] Autor:Makuuchi R; Jere S; Hasejima N; Chigeda T; Gausi J
[Ad] Endereço:Nippon International Cooperation for Community Development, 101 Nishi-rokkaku-cho, Nakagyo-ku, Kyoto, 604-8217, Japan. makuuchiryoko@gmail.com.
[Ti] Título:The correlation between malaria RDT (Paracheck pf.®) faint test bands and microscopy in the diagnosis of malaria in Malawi.
[So] Source:BMC Infect Dis;17(1):317, 2017 05 02.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Faint test bands of Paracheck Pf.® are interpreted as malaria positive according to world health organization (WHO) guideline. However if there are conspicuous number of faint test bands, a performance of Paracheck Pf.® could be influenced depending on whether interpreting faint test bands as malaria positive or negative. Finding out the frequency and accurate interpretation of faint test bands are important to prevent the overdiagnosis and drug resistance. METHODS: A cross-sectional, descriptive study was conducted to find out the frequency of faint test bands and evaluate the performance of Paracheck Pf.® by sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of diagnosis of Paracheck Pf.® using microscopy as the gold standard. 388 suspected patients with malaria in Malawi were recruited in this study. Malaria rapid diagnostic tests (RDTs) and microscopy were used and patients' information which includes age, sex, body temperature and signs or symptoms of malaria were recorded. RESULTS: Among all patients involved in the study, 29.1% (113/388) were found malaria positive by RDT. Overall 5.4% (21/388) of all Paracheck Pf.® tests resulted in a "faint test band" and 85.7% (18/21) corresponded with malaria negative by microscopy. Faint test bands which corresponded with malaria positive by microscopy were lower parasite density and there are no patients who showed definitive symptom of malaria, such as fever. When Paracheck Pf.® "faint test bands" were classified as positive, accuracy of diagnosis was 76.5% (95% CI 72%-80.7%) as compared to 80.4% (95% CI 76.1%-84.2%) when Paracheck Pf.® "faint test bands" were classified as negative. CONCLUSIONS: This study shows that frequency of faint test bands is 5.4% in all malaria RDTs. The accuracy of diagnosis was improved when faint test bands were interpreted as malaria negative. However information and data obtained in this study may not be enough and more intensive research including a frequency and property of faint test bands is needed for significant interpretation of faint test bands.
[Mh] Termos MeSH primário: Malária/diagnóstico
Kit de Reagentes para Diagnóstico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Estudos Transversais
Testes Diagnósticos de Rotina/métodos
Feminino
Febre/diagnóstico por imagem
Febre/etiologia
Seres Humanos
Malária/etiologia
Malária Falciparum/diagnóstico
Malaui
Masculino
Microscopia/métodos
Meia-Idade
Exame Físico
Sensibilidade e Especificidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180120
[Lr] Data última revisão:
180120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2413-x


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[PMID]:29235792
[Au] Autor:Danilova VM; Vynogradova RP; Chernysh IY
[Ti] Título:[Inventive activity of the Departments of Chemistry and Biochemistry of Enzymes, and Protein Structure and Function of the Palladin Institute of Biochemistry of NAS of Ukraine. Part III. Diagnostic test-systems for analysis of fibrinolysis blood system and novel approaches to thrombosis treatment].
[So] Source:Ukr Biochem J;88(4):129-37, 2016 Jul-Aug.
[Is] ISSN:2409-4943
[Cp] País de publicação:Ukraine
[La] Idioma:rus; ukr
[Ab] Resumo:This article continues analysis of scientific achievements of the Institute of Biochemistry in the study of hemostasis system. Two previous articles were focused on the studies of blood coagulation proteins and development of the immune-enzyme test-systems for evaluation of the risk of thrombosis upon various pathologies. This article highlights the research on the blood fibrinolysis system and new approaches to thrombosis treatment, which were developed (and are under development) in the Palladin Institute of Biochemistry of the NAS of Ukraine, in particular, in the Department of Chemistry and Biochemistry of Enzymes headed previously by Dr.Sci.(Biol.) S. O. Kudinov and now by Dr.Sci.(Biol.) T .V. Grinenko, and also in the Department of Protein Structure and Function headed by Dr.Biol.Sci. E. M. Makogonenko. The fundamental knowledge of protein molecule functions and mechanisms of regulation of blood coagulation and fibrinolysis opens up new opportunities to diagnose hemostasis disorders and control the effectiveness of the cardiovascular disease treatment and also contributes to development of new techniques for isolation of new proteins ­ promising therapeutic agents.
[Mh] Termos MeSH primário: Academias e Institutos/história
Bioquímica/história
Transtornos da Coagulação Sanguínea/diagnóstico
Testes Diagnósticos de Rotina/história
Invenções/história
[Mh] Termos MeSH secundário: Bioquímica/recursos humanos
Transtornos da Coagulação Sanguínea/história
Fibrinólise/fisiologia
História do Século XX
História do Século XXI
Seres Humanos
Ucrânia
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.15407/ubj88.04.129


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[PMID]:29227083
[Au] Autor:Edgerly D
[Ti] Título:All of the Stuff: Avoid drowning in the sea of diagnostic tools.
[So] Source:JEMS;42(5):18, 2017 05.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ambulâncias
Testes Diagnósticos de Rotina/utilização
Serviços Médicos de Emergência/organização & administração
Procedimentos Desnecessários
[Mh] Termos MeSH secundário: Tomada de Decisões
Diagnóstico Diferencial
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:28463665
[Au] Autor:Cristovam E; Almeida D; Caldeira D; Ferreira JJ; Marques T
[Ad] Endereço:1​Laboratory of Microbiology and Molecular Biology, Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira, 126, 1349-019 Lisbon, Portugal.
[Ti] Título:Accuracy of diagnostic tests for Legionnaires' disease: a systematic review.
[So] Source:J Med Microbiol;66(4):485-489, 2017 Apr.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Rapid and effective diagnosis of Legionnaires' disease (LD) cases is extremely important so that timely and appropriate therapy can be provided, thereby lowering the morbidity and mortality rates and reducing the health and economic costs associated with this disease. METHODOLOGY: Diagnosis is established solely by microbiological tests. There are several methods available, each with different performance, sensitivity and specificity characteristics, and further understanding is required. Our objective was to assess the accuracy of urinary antigen detection, direct fluorescent antibody (DFA) staining, serological testing and the polymerase chain reaction (PCR) method versus culture analysis (the reference standard) in patients suspected of being infected with Legionella or patients with laboratory-confirmed LD. We performed a MEDLINE search in November 2014. Two authors independently assessed the trials and extracted data. Pooled analysis was performed through Meta-DiSc version 1.4. RESULT: The inclusion criteria were met by 11 studies. All the studies evaluated PCR and DFA tests to detect Legionella in clinical specimens, comparing them to culture techniques, and were included in the meta-analysis. The pooled sensitivity and specificity for PCR were 83 % [95 % confidence interval (CI): 79-87 %] and 90 % (95 % CI: 88-92 %), respectively. DFA was evaluated in one study and the sensitivity and specificity of this test were 67 % (95 % CI: 30-93 %) and 100 % (95 % CI: 91-100 %), respectively. PCR had high sensitivity and specificity for early diagnosis of LD. CONCLUSION: Culture analysis is deemed necessary for epidemiological studies, molecular strain typing and antibiotic sensibility evaluations; however, the performance of PCR in recent studies calls for additional, well-designed studies in order to achieve the best standard test, which will enable optimization of the Legionella infection diagnostic.
[Mh] Termos MeSH primário: Testes Diagnósticos de Rotina/métodos
Técnica Direta de Fluorescência para Anticorpo/métodos
Doença dos Legionários/diagnóstico
Reação em Cadeia da Polimerase/métodos
[Mh] Termos MeSH secundário: Antígenos de Bactérias/análise
Seres Humanos
Doença dos Legionários/microbiologia
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antigens, Bacterial)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000454



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