RESUMEN
Este documento está basado en la guía provisional de la Organización Mundial de la Salud sobre las pruebas de laboratorio para el virus de la viruela del mono, 23 de mayo de 2022, y tiene por objeto proporcionar orientación a los Laboratorios Nacionales de Referencia sobre la detección del virus de la viruela del mono
This document is based on World Health Organization interim guidance on Laboratory testing for monkeypox virus, 23 May 2022, and is intended to provide guidance to National Reference Laboratories on monkeypox virus laboratory detection
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Humanos , Manejo de Especímenes/normas , Monkeypox virus/aislamiento & purificación , Contención de Riesgos Biológicos/normas , Mpox/diagnóstico , Laboratorios/normas , Manejo de Especímenes/métodos , Monkeypox virus/genética , Diagnóstico DiferencialRESUMEN
Newborn screening using dried plasma spots offers preanalytical advantages over conventional cards for plasma-associated targets of interest. Herein we present dried plasma spot-based methods for measuring metabolites using a 250+ compound liquid chromatography tandem mass spectrometry library. Quality assurance reduced this library to 134, and from these, 30 compounds determined the normal newborn reference ranges.
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Biomarcadores/sangre , Cromatografía Liquida , Pruebas con Sangre Seca/métodos , Metaboloma , Tamizaje Neonatal/métodos , Espectrometría de Masas en Tándem , Conservación de la Sangre/métodos , Conservación de la Sangre/normas , Pruebas con Sangre Seca/normas , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Tamizaje Neonatal/normas , Estudios Prospectivos , Valores de Referencia , Manejo de Especímenes/métodos , Manejo de Especímenes/normasRESUMEN
Correct processing of blood cultures may impact individual patient management, antibiotic stewardship, and scaling up of antimicrobial resistance surveillance. To assess the quality of blood culture processing, we conducted four assessments at 16 public hospitals across different regions of Peru. We assessed the following standardized quality indicators: 1) positivity and contamination rates, 2) compliance with recommended number of bottles/sets and volume of blood sampled, 3) blood culture utilization, and 4) possible barriers for compliance with recommendations. Suboptimal performance was found, with a median contamination rate of 4.2% (range 0-15.1%), with only one third of the participating hospitals meeting the target value of < 3%; and a median positivity rate of 4.9% (range 1-8.1%), with only 6 out of the 15 surveilled hospitals meeting the target of 6-12%. None of the assessed hospitals met both targets. The median frequency of solitary blood cultures was 71.9% and only 8.9% (N = 59) of the surveyed adult bottles met the target blood volume of 8 - 12 mL, whereas 90.5% (N = 602) were underfilled. A high frequency of missed opportunities for ordering blood cultures was found (69.9%, 221/316) among patients with clinical indications for blood culture sampling. This multicenter study demonstrates important shortcomings in the quality of blood culture processing in public hospitals of Peru. It provides a national benchmark of blood culture utilization and quality indicators that can be used to monitor future quality improvement studies and diagnostic stewardship policies.
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Cultivo de Sangre/normas , Hospitales Públicos/normas , Sepsis/diagnóstico , Manejo de Especímenes/normas , Cultivo de Sangre/estadística & datos numéricos , Humanos , Perú , Control de Calidad , Sepsis/sangre , Manejo de Especímenes/estadística & datos numéricos , Encuestas y Cuestionarios/normasRESUMEN
OBJECTIVE: The coronavirus disease 2019 (COVID-19) is a pandemic viral disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of the disease among the obstetric population remains unclear, and the study of the placenta can provide valuable information. Adequate sampling of the placental tissue can help characterize the pathways of viral infections. METHODS: A protocol of placental sampling is proposed, aiming at guaranteeing representativity of the placenta and describing the adequate conservation of samples and their integrity for future analysis. The protocol is presented in its complete and simplified versions, allowing its implementation in different complexity settings. RESULTS: Sampling with the minimum possible interval from childbirth is the key for adequate sampling and storage. This protocol has already been implemented during the Zika virus outbreak. CONCLUSION: A protocol for adequate sampling and storage of placental tissue is fundamental for adequate evaluation of viral infections on the placenta. During the COVID-19 pandemic, implementation of this protocol may help to elucidate critical aspects of the SARS-CoV-2 infection.
OBJETIVO: A doença do novo coronavírus (COVID-19) é uma doença viral pandêmica causada pelo coronavírus da síndrome respiratória aguda 2 (SARS-CoV-2). O impacto da doença entre a população obstétrica ainda é incerto, e o estudo da placenta pode fornecer informações valiosas. Assim, a coleta adequada do tecido placentário pode ajudar a caracterizar algumas propriedades das infecções virais. MéTODOS: Um protocolo de coleta placentária é proposto, objetivando a garantia de representatividade da placenta, descrevendo a maneira de conservação adequada das amostras, e visando garantir sua integridade para análises futuras. O protocolo é apresentado em suas versões completa e simplificada, permitindo sua implementação em diferentes configurações de infraestrutura. RESULTADOS: A amostragem com o intervalo mínimo possível do parto é essencial para coleta e armazenamento adequados. Esse protocolo já foi implementado durante a epidemia de vírus Zika. CONCLUSãO: Um protocolo para coleta e armazenamento adequados de tecido placentário é fundamental para a avaliação adequada de infecções virais na placenta. Durante a pandemia de COVID-19, a implementação deste protocolo pode ajudar a elucidar aspectos críticos da infecção por SARS-CoV-2.
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COVID-19/virología , Placenta/virología , Manejo de Especímenes/métodos , Manejo de Especímenes/normas , Femenino , Humanos , Embarazo , Virología/métodos , Virología/normas , Virosis/virologíaRESUMEN
Abstract Objective The coronavirus disease 2019 (COVID-19) is a pandemic viral disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of the disease among the obstetric population remains unclear, and the study of the placenta can provide valuable information. Adequate sampling of the placental tissue can help characterize the pathways of viral infections. Methods A protocol of placental sampling is proposed, aiming at guaranteeing representativity of the placenta and describing the adequate conservation of samples and their integrity for future analysis. The protocol is presented in its complete and simplified versions, allowing its implementation in different complexity settings. Results Sampling with the minimum possible interval from childbirth is the key for adequate sampling and storage. This protocol has already been implemented during the Zika virus outbreak. Conclusion A protocol for adequate sampling and storage of placental tissue is fundamental for adequate evaluation of viral infections on the placenta. During the COVID-19 pandemic, implementation of this protocol may help to elucidate critical aspects of the SARS-CoV-2 infection.
Resumo Objetivo A doença do novo coronavírus (COVID-19) é uma doença viral pandêmica causada pelo coronavírus da síndrome respiratória aguda 2 (SARS-CoV-2). O impacto da doença entre a população obstétrica ainda é incerto, e o estudo da placenta pode fornecer informações valiosas. Assim, a coleta adequada do tecido placentário pode ajudar a caracterizar algumas propriedades das infecções virais. Métodos Um protocolo de coleta placentária é proposto, objetivando a garantia de representatividade da placenta, descrevendo a maneira de conservação adequada das amostras, e visando garantir sua integridade para análises futuras. O protocolo é apresentado em suas versões completa e simplificada, permitindo sua implementação em diferentes configurações de infraestrutura. Resultados A amostragem com o intervalo mínimo possível do parto é essencial para coleta e armazenamento adequados. Esse protocolo já foi implementado durante a epidemia de vírus Zika. Conclusão Um protocolo para coleta e armazenamento adequados de tecido placentário é fundamental para a avaliação adequada de infecções virais na placenta. Durante a pandemia de COVID-19, a implementação deste protocolo pode ajudar a elucidar aspectos críticos da infecção por SARS-CoV-2.
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Humanos , Femenino , Embarazo , Placenta/virología , Manejo de Especímenes/métodos , Manejo de Especímenes/normas , COVID-19/virología , Virología/métodos , Virología/normas , Virosis/virologíaRESUMEN
BACKGROUND: The kinetics of hematopoietic recovery after autologous stem cell transplantation (ASCT) may be affected by laboratory procedures. The aim of this study was to evaluate the influence of characteristics of the cryopreserved units of peripheral blood stem cells (PBSC) on postthawing cell viability and engraftment outcomes after ASCT. STUDY DESIGN AND METHODS: This was a retrospective cohort study including individuals referred for ASCT. Cryopreservation was conducted at a single processing facility between 2014 and 2019, and patients received clinical care at six transplant centers. Covariates and outcome data were retrieved from participants' records. RESULTS: The study population comprised 619 patients (345 [55.7%] male). Median age was 53 years. Multiple myeloma was the most common diagnosis (62.7%). Higher preapheresis CD34+ cell count, lower nucleated cell (NC) concentration per cryobag, and composition of the cryoprotectant solution (5% dimethyl sulfoxide [DMSO] and 6% hydroxyethyl starch) were statistically significantly associated with higher postthawing cell viability. The linear regression model for time to neutrophil and platelet engraftment included the infused CD34+ cell dose and the composition of the cryoprotectant solution. Patients who had PBSC cryopreserved using 10% DMSO solution presented six times higher odds (odds ratio [OR] = 6.9; 95% confidence interval [CI]: 2.2-21.1; p = .001) of delayed neutrophil engraftment (>14 days) and two times higher odds (OR = 2.3, 95%CI: 1.4-3.7; p = .001) of prolonged hospitalization (>18 days). DISCUSSION: The study showed that mobilization efficacy, NC concentration, and the composition of the cryoprotectant solution significantly affected postthawing cell viability. In addition, the composition of the cryoprotectant solution significantly impacted engraftment outcomes and time of hospitalization after ASCT.
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Trasplante de Células Madre Hematopoyéticas , Células Madre Hematopoyéticas/fisiología , Laboratorios , Células Madre de Sangre Periférica/fisiología , Práctica Profesional , Adulto , Anciano , Supervivencia Celular , Estudios de Cohortes , Criopreservación/normas , Femenino , Congelación/efectos adversos , Movilización de Célula Madre Hematopoyética/normas , Trasplante de Células Madre Hematopoyéticas/normas , Células Madre Hematopoyéticas/citología , Humanos , Laboratorios/normas , Masculino , Persona de Mediana Edad , Mieloma Múltiple/sangre , Mieloma Múltiple/epidemiología , Mieloma Múltiple/terapia , Trasplante de Células Madre de Sangre Periférica , Células Madre de Sangre Periférica/citología , Práctica Profesional/normas , Estudios Retrospectivos , Manejo de Especímenes/métodos , Manejo de Especímenes/normas , Trasplante Autólogo , Resultado del TratamientoRESUMEN
En los antecedentes, brinda detalles técnicos de enfermedades previas al COVID-19 y sigue esta consigna internacional: "Sin embargo, a la luz de la posible introducción de un caso sospechoso relacionado con el 2019-nCoV en la Región de las Américas, la Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS / OMS) recomienda a los Estados Miembros garantizar su identificación oportuna, el envío de las muestras a laboratorios Nacionales o de referencia y la implementación del protocolo de detección molecular para 2019-nCoV, según la capacidad del laboratorio." Aborda las tres mutaciones del virus conocidas hasta la fecha del documento y las tres variantes conocidas: Reino Unido e Irlanda del Norte, República de Sudáfrica y Brasil, siendo la de mayor transmisibilidad, según el documento, la del Reino Unido. El primero de los objetivos del documento es: "Brindar los lineamientos generales para la toma de muestra, conservación, transporte y diagnóstico del SARS-Cov-2 en los laboratorios descentralizados bajo la técnica de Reacción en Cadena de la Polimerasa (PCR) en tiempo Real, en atención a pacientes que cumplen con la definición de caso y se tipifica como "sospechoso inusitado"." Incluye como anexo 2 el documento: "Lineamientos para el abordaje de casos positivos para SARS-COV-2 de viajeros que ingresan al país por el aeropuerto internacional "La Aurora" (AILA)"
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Humanos , Masculino , Femenino , Neumonía Viral/diagnóstico , Manejo de Especímenes/normas , Infecciones por Coronavirus/diagnóstico , Betacoronavirus , Contención de Riesgos Biológicos/métodos , Monitoreo Epidemiológico , Equipo de Protección Personal/normas , Guatemala , Indicadores y Reactivos/administración & dosificación , Laboratorios/normasRESUMEN
BACKGROUND: The CDC protocol for SARS-CoV2 RT-PCR diagnosis (2019-nCoV CDC kit) is considered a gold standard worldwide; based on three different FAM probes (N1 and N2 for viral detection; RP for RNA extraction quality control), three reactions per sample are needed for SARS-CoV-2 diagnosis. RESULTS: We herein describe a sample pooling protocol: pooling 3 RNA extractions into a single PCR reaction; we tested this protocol with 114 specimens grouped in 38 pools and found no significant differences for N1 and N2 Ct values between pool and single sample PCR reaction. CONCLUSION: This pool of three protocol has a sensitivity of 100 % compared to the standard single sample protocol. For a typical 96-well plate, this pool assay allows 96 samples processing, speeding up diagnosis and reducing cost while maintaining clinical performance, particularly useful for SARS-CoV-2 diagnosis at developing countries.
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Prueba de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , SARS-CoV-2/aislamiento & purificación , Manejo de Especímenes/métodos , Prueba de Ácido Nucleico para COVID-19/economía , Pruebas Diagnósticas de Rutina , Humanos , Nasofaringe/virología , ARN Viral/genética , Juego de Reactivos para Diagnóstico , Reacción en Cadena en Tiempo Real de la Polimerasa , SARS-CoV-2/genética , Sensibilidad y Especificidad , Manejo de Especímenes/normas , Factores de TiempoRESUMEN
Los coronavirus son un grupo de virus ARN altamente diversos de la familia Coronaviridae que se dividen en 4 géneros: alfa, beta, gamma y delta, y que causan enfermedades de leves a graves en humanos y animales (1-3). Existen coronavirus humanos endémicos como los alfacoronavirus 229E y NL63 y los betacoronavirus OC43 y HKU1 que pueden causar enfermedades de tipo influenza o neumonía en humanos (1, 3). Sin embargo, dos coronavirus zoonóticos que causan enfermedades graves en humanos han emergido: el coronavirus del Síndrome respiratorio agudo grave (SARS-CoV) en 2002-2003 y el coronavirus del Síndrome respiratorio de Oriente Medio (MERS-CoV) (1-5). En enero de 2020, el agente etiológico responsable de un grupo de casos de neumonía grave en Wuhan, China, fue identificado como un nuevo betacoronavirus, distinto del SARS-CoV y MERS-CoV (6). El 11 de febrero de 2020, el Comité Internacional de Taxonomía de Virus (ICTV) anunció la denominación del virus como coronavirus del síndrome respiratorio agudo grave 2 (SARS-CoV-2) (7), mientras que, el mismo día, la OMS nombró la enfermedad como enfermedad por coronavirus COVID-19 (8). Para fines de comunicación, haremos referencia a este virus como "el virus responsable de COVID-19" o "el virus COVID-19". La secuencia genómica completa de este nuevo agente está disponible y se han desarrollado diferentes protocolos de detección (9). A la luz de la circulación actual de COVID-19 en la región de las Américas, la Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS / OMS) recomienda a los Estados Miembros garantizar la identificación oportuna de casos sospechosos, la toma y el envío de muestras a los laboratorios de referencia, y la implementación de protocolos de detección molecular, según la capacidad del laboratorio.
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Neumonía Viral/diagnóstico , Manejo de Especímenes/normas , Infecciones por Coronavirus/diagnóstico , Técnicas de Laboratorio Clínico/normas , Pruebas Enzimáticas Clínicas/normas , ARN/normas , Reacción en Cadena de la Polimerasa/normas , Equipo de Protección Personal/normas , BetacoronavirusRESUMEN
The SARS-CoV-2 pandemic has spread rapidly throughout the world. Its main transmission mechanisms are through droplets and by contact with contaminated surfaces. At the in-hospital level, the formation of bioaerosols becomes important when carrying out therapeutic and diagnostic procedures, facilitating air transmission. This condition could be associated with the significant number of deceased health officials. Physical distancing, frequent hand washing, and permanent use of a mask are useful tools to control the disease. Among the aerosol-generating procedures (PGAs) are endotracheal intubation, bronchoscopy, open aspiration of secretions, nebulizations, manual ventilation, prone positioning, disconnection of the mechanical ventilator, non-invasive positive pressure ventilation, tracheostomy and cardiopulmonary resuscitation. The correct use of personal protection elements (PPE) and the realization of these in rooms with negative pressure or with frequent air changes considerably reduce the risk of becoming ill.
La pandemia del SARS-CoV-2 se ha diseminado rápidamente por el mundo. Sus principales mecanismos de transmisión son a través de gotitas y por contacto con superficies contaminadas. A nivel intrahospitalario, cobra importancia la formación de bioaerosoles al realizar procedimientos terapéuticos y de diagnóstico facilitando la transmisión aérea. Esta condición podría estar asociada al importante número de funcionarios de la salud fallecidos. El distanciamiento físico, el lavado frecuente de manos y el uso permanente de mascarilla son útiles herramientas para controlar la enfermedad. Dentro de los procedimientos generadores de aerosoles (PGAs) están la intubación endotraqueal, broncoscopía, aspiración abierta de secreciones, nebulizaciones, ventilación manual, posicionamiento en prono, desconección del ventilador mecánico, ventilación no invasiva a presión positiva, traqueostomía y reanimación cardiopulmonar. El uso correcto de los elementos de protección personal (EPP) y la realización de éstos en salas con presión negativa o con recambios frecuentes del aire disminuyen considerablemente el riesgo de enfermar.
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Humanos , Terapéutica , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Técnicas y Procedimientos Diagnósticos , Neumonía Viral/transmisión , Manejo de Especímenes/normas , Exposición Profesional/prevención & control , Aerosoles , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo/patogenicidad , Betacoronavirus/patogenicidadRESUMEN
Violence is a growing public health problem worldwide. Nurses increasingly must perform forensic procedures with the responsibility to collect, document, preserve, and store evidence that may be used in the investigation of a violent crime. However, few nurses receive education in forensic evidence collection as part of their training. This study aimed to evaluate the relationship between nurses' knowledge and performance of forensic evidence procedures. This is a descriptive survey study of nurses working in a prehospital emergency care service in Aracaju, Brazil. A 32-question survey related to forensic evidence knowledge and procedures was completed by 128 nurses. Descriptive statistics and Kendall's Tau-b were used to describe the sample and evaluate correlations. Results revealed an overall linear relationship between knowledge and performance of forensic evidence procedures (r = .69). The strongest correlation was between knowledge and documentation (r = .71). Weaker correlations were demonstrated between knowledge and evidence collection (r = .47), evidence preservation (r = .47), and overall evidence procedure execution (r = .53). Forensic nursing knowledge is related to forensic evidence procedure performance. Although the study showed that nurses agreed forensic evidence procedures are important for criminal investigations, most reported they were unprepared to carry out these procedures. The need for additional training and adherence to established institutional protocols are identified as contributing factors.
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Documentación/métodos , Documentación/normas , Servicios Médicos de Urgencia/métodos , Servicios Médicos de Urgencia/normas , Enfermería Forense/métodos , Enfermería Forense/normas , Manejo de Especímenes/normas , Adulto , Brasil , Documentación/estadística & datos numéricos , Servicios Médicos de Urgencia/estadística & datos numéricos , Femenino , Enfermería Forense/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Manejo de Especímenes/estadística & datos numéricos , Encuestas y Cuestionarios , Violencia/estadística & datos numéricosRESUMEN
BACKGROUND: Collection of biologic samples from the nasal cavity and paranasal sinuses is of critical importance to the study of infectious or inflammatory conditions that affect both upper and lower airways. Numerous techniques for the study of ex-vivo samples exist, with specific applications, strengths, and weaknesses associated with each of them. In this compendium we summarize the available methods for collection of primary human samples and incorporate expert discussion of the pros, cons, and applications associated with each technique. METHODS: An expert panel containing members of the American Rhinologic Society's Research and Grants Committee compiled this educational reference. Rationale for use and the potential advantages and disadvantages are discussed. Research protocols and key references are enumerated. RESULTS: Sampling of the nasal cavity and paranasal sinuses can be achieved through a number of methods. Nonspecific sinonasal secretions may be collected via forced exhalation, nasal lavage, and nasal spray aspiration. Targeted collection of sinonasal secretions may be achieved via endoscopic placement of absorbent matrices. Nasal cytology or collection of superficial epithelium may be completed via brushing or scraping of endonasal structures. Collection of mucosal biopsies may be completed via sinonasal explant or full-thickness biopsy. CONCLUSION: Multiple sampling techniques are available to collect biologic samples from the sinonasal cavity. These techniques differ in their ease of application, reproducibility, sample yield, and utility for different sinonasal pathologies or research goals. An appreciation of the benefits and drawbacks of each approach will allow investigators to select the techniques most appropriate for achieving research objectives.
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Cavidad Nasal/patología , Senos Paranasales/patología , Manejo de Especímenes , Técnicas Citológicas , Exosomas/metabolismo , Humanos , Líquido del Lavado Nasal/citología , Mucosa Nasal/metabolismo , Mucosa Nasal/patología , Manejo de Especímenes/instrumentación , Manejo de Especímenes/métodos , Manejo de Especímenes/normasRESUMEN
For tissues obtained from glioma samples with/without nonneoplastic brain there is no consensus for universal reference gene but there are some potential genes that might have good stability, under certain conditions. Considering all points described in this work, the care with tissue collection, until gene amplification, directly impacts on the reliable characterization of its mRNA levels. Moreover, it is clear the importance of selecting the most appropriate reference genes for each experimental situation, to allow the accurate normalization of target genes, especially for genes that are subtly regulated.
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Neoplasias Encefálicas/diagnóstico , Genes Esenciales , Glioma/diagnóstico , ARN Mensajero/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa/normas , Encéfalo/patología , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patología , Regulación Neoplásica de la Expresión Génica , Glioma/genética , Glioma/patología , Humanos , Estabilidad del ARN , ARN Mensajero/metabolismo , Manejo de Especímenes/métodos , Manejo de Especímenes/normasRESUMEN
Orienta na campanha para ações de combate ao Coronavírus (Covid-19) no município de Brejinho de Nazaré no Tocantins. Apresenta quais as definições de casos de infecção humana pelo COVID-19. Orientações de como notificar ao Centro de Informações Estratégicas de Vigilância em Saúde (CIEVS). Quais os períodos de incubação da doença. Fatores sobre a transmissão e tratamento. Investigação epidemiológica. Quais atribuições da Vigilância em Saúde. Orientações para a coleta de amostras no Laboratório Central de Saúde Pública do Tocantins (LACEN-TO) bem como a técnica de coleta de Swabde nasofaringe e orofaringe (swabs combinados), o acondicionamento, transporte e envio das amostras. Mostra as medidas de prevenção e controle Precauções padrão, as medidas de isolamento. Transporte do paciente. Como se dá a Limpeza e desinfecção de superfícies.
He guides in the campaign for actions to combat the Coronavirus (Covid-19) in the municipality of Brejinho de Nazaré in Tocantins. It presents the definitions of cases of human infection by COVID-19. Guidelines on how to notify the Health Surveillance Strategic Information Center (CIEVS). What are the disease incubation periods. Factors about transmission and treatment. Epidemiological investigation. Which attributions of Health Surveillance. Guidelines for the collection of samples at the Central Laboratory of Public Health of Tocantins (LACEN-TO) as well as the technique of collecting Swabde nasopharynx and oropharynx (combined swabs), packaging, transport and sending of samples . Shows prevention and control measures Standard precautions, isolation measures. Transporting the patient. How to clean and disinfect surfaces.
Orienta en la campaña de acciones para combatir el Coronavirus (Covid-19) en el municipio de Brejinho de Nazaré en Tocantins. Presenta las definiciones de casos de infección humana por COVID-19. Directrices sobre cómo notificar al Centro de Información Estratégica de Vigilancia Sanitaria (CIEVS). Cuáles son los períodos de incubación de la enfermedad. Factores de transmisión y tratamiento. Investigación epidemiológica. Qué atribuciones de la Vigilancia Sanitaria. Lineamientos para la recolección de muestras en el Laboratorio Central de Salud Pública de Tocantins (LACEN-TO) así como la técnica de recolección de Swabde nasofaringe y orofaringe (hisopos combinados), el empaque, transporte y envío de las muestras . Muestra medidas de prevención y control Precauciones estándar, medidas de aislamiento. Transporte del paciente. Cómo limpiar y desinfectar superficies.
Il guide dans la campagne d'actions de lutte contre le Coronavirus (Covid-19) dans la commune de Brejinho de Nazaré à Tocantins. Il présente les définitions des cas d'infection humaine par COVID-19. Lignes directrices sur la manière de notifier le Centre d'information stratégique de surveillance sanitaire (CIEVS). Quelles sont les périodes d'incubation de la maladie. Facteurs de transmission et de traitement. Enquête épidémiologique. Quelles attributions de Surveillance de la Santé. Directives pour le prélèvement d'échantillons au Laboratoire Central de Santé Publique de Tocantins (LACEN-TO) ainsi que la technique de prélèvement Swabde rhinopharynx et oropharynx (écouvillons combinés), emballage, transport et envoi des échantillons . Affiche les mesures de prévention et de contrôle Précautions standard, mesures d'isolement. Transport du patient. Comment nettoyer et désinfecter les surfaces.
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Humanos , Neumonía Viral/prevención & control , Manejo de Especímenes/métodos , Control de Enfermedades Transmisibles/normas , Infecciones por Coronavirus/prevención & control , Planes de Contingencia , Pandemias/prevención & control , Manejo de Especímenes/normas , Atención Hospitalaria/métodos , Monitoreo Epidemiológico , Equipo de Protección Personal/provisión & distribuciónRESUMEN
BACKGROUND: Lactate dehydrogenase (LDH) is a nonspecific biomarker for diseases including lymphoma. Serum and plasma are generally considered interchangeable for LDH testing. Investigation into falsely increased plasma LDH concentration results led to the hypothesis that a workflow change that included pneumatic tube system (PTS) transportation caused the errors. The following study was conducted to test the hypothesis. METHODS: Plasma and serum separator tube samples were each drawn in duplicate, centrifuged, transported either through the PTS or by hand courier, and evaluated by means of clinical chemistry and hematology assays. Smear slides were made out of the plasma and examined. Aggregate patient results before and after the PTS workflow change were compared. RESULTS: In post-PTS plasma samples, LDH activity was 26%-149% higher. Similarly, white blood cells (WBCs) were 14- to 156-fold higher and platelets were 1- to 13-fold higher. Smear examination revealed dramatically more cells and cell fragments. No significant hemolysis was observed in plasma by chemistry hemolysis indices or hemoglobin testing. These effects were not observed in similarly transported serum samples in gel separator tubes. Aggregate LDH patient results, including moving medians, demonstrated dramatic changes following PTS workflow implementation. CONCLUSIONS: PTS transportation led to falsely increased LDH concentration in plasma. These LDH concentration elevations are not heralded by standard indicators of hemolysis. These errors can be prevented by restricting LDH concentration testing to serum collected in gel separator tubes. Moving patient statistics can effectively detect important testing process changes not revealed by external QC or indices.
Asunto(s)
Análisis Químico de la Sangre/métodos , Fenómenos Fisiológicos Sanguíneos , Recolección de Muestras de Sangre , L-Lactato Deshidrogenasa/sangre , Manejo de Especímenes , Análisis Químico de la Sangre/normas , Recolección de Muestras de Sangre/métodos , Recolección de Muestras de Sangre/normas , Hemólisis , Humanos , Manejo de Especímenes/métodos , Manejo de Especímenes/normas , TransportesRESUMEN
BACKGROUND: Dried blood spot (DBS) sampling is a blood collection tool that uses a finger prick to obtain a blood drop on a DBS card. It can be used for therapeutic drug monitoring, a method that uses blood drug concentrations to optimize individual treatment. DBS sampling is believed to be a simpler way of blood collection compared with venous sampling. The aim of this study was to evaluate the quality of DBSs from patients with tuberculosis all around the world based on quality indicators in a structured assessment procedure. METHODS: Total 464 DBS cards were obtained from 4 countries: Bangladesh, Belarus, Indonesia, and Paraguay. The quality of the DBS cards was assessed using a checklist consisting of 19 questions divided into 4 categories: the integrity of the DBS materials, appropriate drying time, blood volume, and blood spot collection. RESULTS: After examination, 859 of 1856 (46%) blood spots did not comply with present quality criteria. In 625 cases (34%), this was due to incorrect blood spot collection. The DBS cards from Bangladesh, Indonesia, and Paraguay seemed to be affected by air humidity, causing the blood spots not to dry appropriately. CONCLUSIONS: New tools to help obtain blood spots of sufficient quality are necessary and environmental specific recommendations to determine plasma concentration correctly. In addition, 3% of the DBS cards were rejected because the integrity of the materials suggesting that the quality of plastic ziplock bags currently used to protect the DBS cards against contamination and humidity may not be sufficient.
Asunto(s)
Antituberculosos/sangre , Pruebas con Sangre Seca/normas , Monitoreo de Drogas/métodos , Manejo de Especímenes/normas , Tuberculosis/sangre , Bangladesh , Pruebas con Sangre Seca/métodos , Humanos , Humedad , Indonesia , Paraguay , Reproducibilidad de los Resultados , República de Belarús , Sensibilidad y Especificidad , Manejo de Especímenes/métodos , Tuberculosis/diagnóstico , Tuberculosis PulmonarRESUMEN
OBJECTIVE: To analyze women's perception of the quality of the service provided for colposcopy test in the city of Belém (PA), Brazil. METHOD: Quantitative-descriptive study on 400 women who underwent Pap test on the public healthcare network, using the Service Quality (SERVQUAL) model. We used the Cronbach's alpha index to measure the reliability of the scale, and data were analyzed by quartiles of the gaps of the dimensions: tangibility, responsiveness, reliability, assurance, and empathy. RESULTS: The assurance dimension, corresponding to the knowledge and courtesy of staff, featured the highest degree of importance to users; and empathy, which corresponds to the staff's concern with women's needs, featured the lower degree. The most expressive negative gaps concerned the structure of services and the attitude of healthcare professionals when collecting the material. CONCLUSION: All gaps featured negative relationship between what was expected and perceived, expressing dissatisfaction regarding the service.
Asunto(s)
Colonoscopía/normas , Prueba de Papanicolaou/métodos , Satisfacción del Paciente , Percepción , Manejo de Especímenes/normas , Adulto , Anciano , Brasil , Colonoscopía/psicología , Femenino , Humanos , Persona de Mediana Edad , Prueba de Papanicolaou/normas , Calidad de la Atención de Salud/normas , Manejo de Especímenes/psicología , Encuestas y CuestionariosRESUMEN
Cytogenetics is essential in myeloid neoplasms (MN) and pre-analytical variables are important for karyotyping. We assessed the relationship between pre-analytical variables (time from collection to sample processing, material type, sample cellularity, and diagnosis) and failures of karyotyping. Bone marrow (BM, n=352) and peripheral blood (PB, n=69) samples were analyzed from acute myeloid leukemia (n=113), myelodysplastic syndromes (n=73), myelodysplastic syndromes/myeloproliferative neoplasms (n=17), myeloproliferative neoplasms (n=137), and other with conclusive diagnosis (n=6), and reactive disorders/no conclusive diagnosis (n=75). The rate of unsuccessful karyotyping was 18.5% and was associated with the use of PB and a low number of nucleated cells (≤7×103/µL) in the sample. High and low cellularity in BM and high and low cellularity in PB samples showed no metaphases in 3.9, 39.7, 41.9, and 84.6% of cases, respectively. Collecting a good BM sample is the key for the success of karyotyping in MN and avoids the use of expensive molecular techniques.
Asunto(s)
Células de la Médula Ósea/patología , Cariotipificación/métodos , Leucemia Mieloide/genética , Síndromes Mielodisplásicos/genética , Trastornos Mieloproliferativos/genética , Manejo de Especímenes/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Leucemia Mieloide/diagnóstico , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/diagnóstico , Trastornos Mieloproliferativos/diagnóstico , Manejo de Especímenes/normas , Adulto JovenRESUMEN
ABSTRACT Objective: To analyze women's perception of the quality of the service provided for colposcopy test in the city of Belém (PA), Brazil. Method: Quantitative-descriptive study on 400 women who underwent Pap test on the public healthcare network, using the Service Quality (SERVQUAL) model. We used the Cronbach's alpha index to measure the reliability of the scale, and data were analyzed by quartiles of the gaps of the dimensions: tangibility, responsiveness, reliability, assurance, and empathy. Results: The assurance dimension, corresponding to the knowledge and courtesy of staff, featured the highest degree of importance to users; and empathy, which corresponds to the staff's concern with women's needs, featured the lower degree. The most expressive negative gaps concerned the structure of services and the attitude of healthcare professionals when collecting the material. Conclusion: All gaps featured negative relationship between what was expected and perceived, expressing dissatisfaction regarding the service.
RESUMEN Objetivo: Analizar la percepción de mujeres acerca de la calidad del servicio de colpocitología oncótica en Belém (PA). Método: Estudio cuantitativo-descriptivo con 400 mujeres que realizaron el examen de colpocitología oncótica en la red pública de salud, utilizando el modelo Service Quality (SERVQUAL). Se utilizó el Alpha de Cronbach para medir la confiabilidad de la escala, y los datos fueron analizados por los cuartiles de los gaps de las dimensiones: tangibilidad, responsividad, confiabilidad, credibilidad y empatía. Resultados: La dimensión credibilidad, correspondiente al conocimiento y a la cortesía de los funcionarios, presentó mayor grado de importancia para las usuarias; y la empatía, que corresponde a la preocupación demostrada por los funcionarios con las necesidades de las mujeres, exhibió menor grado. Los gaps negativos más expresivos se refieren a la estructura de los servicios y a la actitud de los profesionales con ocasión de la recolección del material. Conclusión: Todos los gaps presentaron relación negativa entre lo esperado y lo percibido expresando la insatisfacción con relación al servicio.
RESUMO Objetivo: Analisar a percepção de mulheres acerca da qualidade do serviço de colpocitologia oncótica em Belém (PA). Método: Estudo quantitativo-descritivo com 400 mulheres que realizaram o exame de colpocitologia oncótica na rede pública de saúde, utilizando o modelo Service Quality (SERVQUAL). Utilizou-se o Alpha de Cronbach para medir a confiabilidade da escala, e os dados foram analisados pelos quartis dos gaps das dimensões: tangibilidade, responsividade, confiabilidade, credibilidade e empatia. Resultados: A dimensão credibilidade, correspondente ao conhecimento e cortesia dos funcionários, apresentou maior grau de importância para as usuárias, e a empatia, que corresponde à preocupação demonstrada pelos funcionários com as necessidades das mulheres, exibiu menor grau. Os gaps negativos mais expressivos dizem respeito à estrutura dos serviços e a atitude dos profissionais por ocasião da coleta de material. Conclusão: Todos os gaps apresentaram relação negativa entre o esperado e o percebido expressando a insatisfação em relação ao serviço.