Impact of the rapid antigen detection test in diagnosis and treatment of acute pharyngotonsillitis in a Pediatric emergency room

OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.

Quantitative detection of Staphylococcus aureus, Enterococcus faecalis and Pseudomonas aeruginosa in human oral epithelial cells from subjects with periodontitis and periodontal health

Epithelial cells in oral cavities can be considered reservoirs for a variety of bacterial species. A polymicrobial intracellular flora associated with periodontal disease has been demonstrated in buccal cells. Important aetiological agents of systemic and nosocomial infections have been detected in the microbiota of subgingival biofilm, especially in individuals with periodontal disease. However, non-oral pathogens internalized in oral epithelial cells and their relationship with periodontal status are poorly understood. The purpose of this study was to detect opportunistic species within buccal and gingival crevice epithelial cells collected from subjects with periodontitis or individuals with good periodontal health, and to associate their prevalence with periodontal clinical status. Quantitative detection of total bacteria and Staphylococcus aureus, Pseudomonas aeruginosa and Enterococcus faecalis in oral epithelial cells was determined by quantitative real-time PCR using universal and species-specific primer sets. Intracellular bacteria were visualized by confocal microscopy and fluorescence in situ hybridization. Overall, 33 % of cell samples from patients with periodontitis contained at least one opportunistic species, compared with 15 % of samples from healthy individuals. E. faecalis was the most prevalent species found in oral epithelial cells (detected in 20.6 % of patients with periodontitis, P = 0.03 versus healthy individuals) and was detected only in cells from patients with periodontitis. Quantitative real-time PCR showed that high levels of P. aeruginosa and S. aureus were present in both the periodontitis and healthy groups. However, the proportion of these species was significantly higher in epithelial cells of subjects with periodontitis compared with healthy individuals (P = 0.016 for P. aeruginosa and P = 0.047 for S. aureus). Although E. faecalis and P. aeruginosa were detected in 57 % and 50 % of patients, respectively, with probing depth and clinical attachment level ≥6 mm, no correlation was found with age, sex, bleeding on probing or the presence of supragingival biofilm. The prevalence of these pathogens in epithelial cells is correlated with the state of periodontal disease.

A comparison of face and facial feature detectors based on the viola-jones general object detection framework

[EN]The human face provides useful information during interaction; therefore, any system integrating Vision- BasedHuman Computer Interaction requires fast and reliable face and facial feature detection. Different approaches have focused on this ability but only open source implementations have been extensively used by researchers. A good example is the Viola–Jones object detection framework that particularly in the context of facial processing has been frequently used.

An study on ear detection and its applications to face detection

[EN]OpenCV includes di erent object detectors based on the Viola-Jones framework. Most of them are specialized to deal with the frontal face pattern and its inner elements: eyes, nose, and mouth. In this paper, we focus on the ear pattern detection, particularly when a head pro le or almost pro le view is present in the image. We aim at creating real-time ear detectors based on the general object detection framework provided with OpenCV. After training classi ers to detect left ears, right ears, and ears in general, the performance achieved is valid to be used to feed not only a head pose estimation system but also other applications such as those based on ear biometrics.

A new snowfall detection algorithm for high latitude regions based on a combination of active and passive sensors

Precipitation retrieval over high latitudes, particularly snowfall retrieval over ice and snow, using satellite-based passive microwave spectrometers, is currently an unsolved problem. The challenge results from the large variability of microwave emissivity spectra for snow and ice surfaces, which can mimic, to some degree, the spectral characteristics of snowfall. This work focuses on the investigation of a new snowfall detection algorithm specific for high latitude regions, based on a combination of active and passive sensors able to discriminate between snowing and non snowing areas. The space-borne Cloud Profiling Radar (on CloudSat), the Advanced Microwave Sensor units A and B (on NOAA-16) and the infrared spectrometer MODIS (on AQUA) have been co-located for 365 days, from October 1st 2006 to September 30th, 2007. CloudSat products have been used as truth to calibrate and validate all the proposed algorithms. The methodological approach followed can be summarised into two different steps. In a first step, an empirical search for a threshold, aimed at discriminating the case of no snow, was performed, following Kongoli et al. [2003]. This single-channel approach has not produced appropriate results, a more statistically sound approach was attempted. Two different techniques, which allow to compute the probability above and below a Brightness Temperature (BT) threshold, have been used on the available data. The first technique is based upon a Logistic Distribution to represent the probability of Snow given the predictors. The second technique, defined Bayesian Multivariate Binary Predictor (BMBP), is a fully Bayesian technique not requiring any hypothesis on the shape of the probabilistic model (such as for instance the Logistic), which only requires the estimation of the BT thresholds. The results obtained show that both methods proposed are able to discriminate snowing and non snowing condition over the Polar regions with a probability of correct detection larger than 0.5, highlighting the importance of a multispectral approach.

Smile detection for user interfaces

[EN]Perceptual User Interfaces (PUIs) aim at facilitating human-computer interaction with the aid of human-like capacities (computer vision, speech recognition, etc.). In PUIs, the human face is a central element, since it conveys not only identity but also other important information, particularly with respect to the user’s mood or emotional state. This paper describes both a face detector and a smile detector for PUIs. Both are suitable for real-time interaction.

Detection and localization of GLUTs in spermatozoa from different domestic species

Sperm cells need hexoses as a substrate for their function, for both the maintenance of membrane homeostasis and the movement of the tail. These cells have a peculiar metabolism that has not yet been fully understood, but it is clear that they obtain energy from hexoses through glycolisis and/or oxidative phosphorylation. Spermatozoa are in contact with different external environments, beginning from the testicular and epididymal fluid, passing to the seminal plasma and finally to the female genital tract fluids; in addition, with the spread of reproductive biotechnologies, sperm cells are diluted and stored in various media, containing different energetic substrates. To utilize these energetic sources, sperm cells, as other eukaryotic cells, have a well-constructed protein system, that is mainly represented by the GLUT family proteins. These transporters have a membrane-spanning α-helix structure and work as an enzymatic pump that permit a fast gradient dependent passage of sugar molecules through the lipidic bilayer of sperm membrane. Many GLUTs have been studied in man, bull and rat spermatozoa; the presence of some GLUTs has been also demonstrated in boar and dog spermatozoa. The aims of the present study were - to determine the presence of GLUTs 1, 2, 3, 4 and 5 in boar, horse, dog and donkey spermatozoa and to describe their localization; - to study eventual changes in GLUTs location after capacitation and acrosome reaction in boar, stallion and dog spermatozoa; - to determine possible changes in GLUTs localization after capacitation induced by insulin and IGF stimulation in boar spermatozoa; - to evaluate changes in GLUTs localization after flow-cytometric sex sorting in boar sperm cells. GLUTs 1, 2, 3 and 5 presence and localization have been demonstrated in boar, stallion, dog and donkey spermatozoa by western blotting and immunofluorescence analysis; a relocation in GLUTs after capacitation has been observed only in dog sperm cells, while no changes have been observed in the other species examined. As for boar, the stimulation of the capacitation with insulin and IGF didn’t cause any change in GLUTs localization, as well as for the flow cytometric sorting procedure. In conclusion, this study confirms the presence of GLUTs 1, 2 ,3 and 5 in boar, dog, stallion and donkey spermatozoa, while GLUT 4 seems to be absent, as a confirmation of other studies. Only in dog sperm cells capacitating conditions induce a change in GLUTs distribution, even if the physiological role of these changes should be deepened.

Supernova detection in a future extension of the IceCube neutrino telescope

Marking the final explosive burning stage of massive stars, supernovae are onernthe of most energetic celestial events. Apart from their enormous optical brightnessrnthey are also known to be associated with strong emission of MeV neutrinos—up tornnow the only proven source of extrasolar neutrinos.rnAlthough being designed for the detection of high energy neutrinos, the recentlyrncompleted IceCube neutrino telescope in the antarctic ice will have the highestrnsensitivity of all current experiments to measure the shape of the neutrino lightrncurve, which is in the MeV range. This measurement is crucial for the understandingrnof supernova dynamics.rnIn this thesis, the development of a Monte Carlo simulation for a future low energyrnextension of IceCube, called PINGU, is described that investigates the response ofrnPINGU to a supernova. Using this simulation, various detector configurations arernanalysed and optimised for supernova detection. The prospects of extracting notrnonly the total light curve, but also the direction of the supernova and the meanrnneutrino energy from the data are discussed. Finally the performance of PINGU isrncompared to the current capabilities of IceCube.

Detection of individual spin transitions of a single proton confined in a cryogenic Penning trap

Das in dieser Arbeit vorgestellte Experiment zur Messung des magnetischen Moments des Protons basiert auf der Messung des Verhältnisses von Zyklotronfrequenz und Larmorfrequenz eines einzelnen, in einer kryogenen Doppel-Penning Falle gespeicherten Protons. In dieser Arbeit konnten erstmalig zwei der drei Bewegungsfrequenzen des Protons gleichzeitig im thermischen Gleichgewicht mit entsprechenden hochsensitiven Nachweissystemen nicht-destruktiv detektiert werden, wodurch die Messzeit zur Bestimmung der Zyklotronfrequenz halbiert werden konnte. Ferner wurden im Rahmen dieser Arbeit erstmalig einzelne Spin-Übergänge eines einzelnen Protons detektiert, wodurch die Bestimmung der Larmorfrequenz ermöglicht wird. Mithilfe des kontinuierlichen Stern-Gerlach Effekts wird durch eine sogenannte magnetische Flasche das magnetische Moment an die axiale Bewegungsmode des Protons gekoppelt. Eine Änderung des Spinzustands verursacht folglich einen Frequenzsprung der axialen Bewegungsfrequenz, welche nicht-destruktiv gemessen werden kann. Erschwert wird die Detektion des Spinzustands dadurch, dass die axiale Frequenz nicht nur vom Spinmoment, sondern auch vom Bahnmoment abhängt. Die große experimentelle Herausforderung besteht also in der Verhinderung von Energieschwankungen in den radialen Bewegungsmoden, um die Detektierbarkeit von Spin-Übergängen zu gewährleisten. Durch systematische Studien zur Stabilität der axialen Frequenz sowie einer kompletten Überarbeitung des experimentellen Aufbaus, konnte dieses Ziel erreicht werden. Erstmalig kann der Spinzustand eines einzelnen Protons mit hoher Zuverlässigkeit bestimmt werden. Somit stellt diese Arbeit einen entscheidenden Schritt auf dem Weg zu einer hochpräzisen Messung des magnetischen Moments des Protons dar.

In vitro detection of cytotoxic T and NK cells in peripheral blood of patients with various drug-induced skin diseases

BACKGROUND: Cytotoxic cells are involved in most forms of drug-induced skin diseases. Till now, no in vitro test addressed this aspect of drug-allergic responses. Our report evaluates whether drug-induced cytotoxic cells can be detected in peripheral blood of nonacute patients with different forms of drug hypersensitivity, and also whether in vitro detection of these cells could be helpful in drug-allergy diagnosis. METHODS: GranzymeB enzyme-linked immunosorbent spot-forming (ELISPOT) and cell surface expression of the degranulation marker CD107a were evaluated on peripheral blood mononuclear cells from 12 drug-allergic patients in remission state and 16 drug-exposed healthy controls. RESULTS: In 10/12 allergic patients culprit but not irrelevant drug elicited granzymeB release after 48-72 h stimulation. It was clearly positive in patients with high proliferative response to the drug, measured in lymphocyte transformation tests. In patients, who showed moderate or low proliferation and low drug-response in granzymeB ELISPOT, overnight preincubation with interleukin (IL)-7/IL-15 enhanced drug-specific granzymeB release and allowed to clearly identify the offending agent. CD107a staining was positive on CD4+/CD3+, CD8+/CD3+ T cells as well as CD56+/CD3- natural killer cells. None of the drug-exposed healthy donors reacted to the tested drugs and allergic patients reacted only to the offending, but not to tolerated drugs. CONCLUSION: GranzymeB ELISPOT is a highly specific in vitro method to detect drug-reacting cytotoxic cells in peripheral blood of drug-allergic patients even several years after disease manifestation. Together with IL-7/IL-15 preincubation, it may be helpful in indentifying the offending drug even in some patients with weak proliferative drug-response.

Endocarditis due to Tropheryma whipplei: rapid detection, limited genetic diversity, and long-term clinical outcome in a local experience

The characteristic features of Whipple's disease include abdominal pain, diarrhoea, wasting, and arthralgias, with the causative agent, Tropheryma whipplei, being detected mainly in intestinal biopsies. PCR technology has led to the identification of T. whipplei in specimens from various other locations, including the central nervous system and the heart. T. whipplei is now recognized as one of the causes of culture-negative endocarditis, and endocarditis can be the only manifestation of the infection with T. whipplei. Although it is considered a rare disease, the true incidence of endocarditis due to T. whipplei is not clearly established. With the increasing use of molecular methods, it is likely that T. whipplei will be more frequently identified. Questions also remain about the genetic variability of T. whipplei strains, optimal diagnostic procedures and therapeutic options. In the present study, we provide clinical data on four new patients with documented endocarditis due to T. whipplei in the context of the available published literature. There was no clinical involvement of the gastrointestinal tract. Genetic analysis of the T. whipplei strains with DNA isolated from the excised heart valves revealed little to no genetic variability. In a selected case, we describe acridine orange staining for early detection of the disease, prompting early adaptation of the antibiotic therapy. We provide long-term follow-up data on the patients. In our hands, an initial 2-week course of intravenous antibiotics followed by cotrimoxazole for at least 1 year was a suitable treatment option for T. whipplei endocarditis.

Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars

The aim of this in vitro study was to compare the performance of two laser fluorescence devices (LF, LFpen), conventional visual criteria (VE), ICDAS and radiographic examination on occlusal surfaces of primary teeth. Thirty-seven primary human molars were selected from a pool of extracted teeth, which were stored frozen at -20°C until use. Teeth were assessed twice by two experienced examiners using laser fluorescence devices (LF and LFpen), conventional visual criteria, ICDAS and bitewing radiographs, with a 2-week interval between measurements. After measurement, the teeth were histologically prepared and assessed for caries extension. The highest sensitivity was observed for ICDAS at D(1) and D(3) thresholds, with no statistically significant difference when compared to the LF devices, except at the D(3) threshold. Bitewing radiographs presented the lowest values of sensitivity. Specificity at D(1) was higher for LFpen (0.90) and for VE at D(3) (0.94). When VE was combined with LFpen the post-test probabilities were the highest (94.0% and 89.2% at D(1) and D(3) thresholds, respectively). High values were observed for the combination of ICDAS and LFpen (92.0% and 80.0%, respectively). LF and LFpen showed the highest values of ICC for interexaminer reproducibility. However, regarding ICDAS, BW and VE, intraexaminer reproducibility was not the same for the two examiners. After primary visual inspection using ICDAS or not, the use of LFpen may aid in the detection of occlusal caries in primary teeth. Bitewing radiographs may be indicated only for approximal caries detection.

Sensitive and selective detection of free FXIII activation peptide: a potential marker of acute thrombotic events

Coagulation factor XIII (FXIII) stabilizes fibrin fibers and is therefore a major player in the maintenance of hemostasis. FXIII is activated by thrombin resulting in cleavage and release of the FXIII activation peptide (AP-FXIII). The objective of this study was to characterize the released AP-FXIII and determine specific features that may be used for its specific detection. We analyzed the structure of bound AP-FXIII within the FXIII A-subunit and interactions of AP-FXIII by hydrogen bonds with both FXIII A-subunit monomers. We optimized our previously developed AP-FXIII ELISA by using 2 monoclonal antibodies. We determined high binding affinities between the antibodies and free AP-FXIII and demonstrated specific binding by epitope mapping analyses with surface plasmon resonance and enzyme-linked immunosorbent assay. Because the structure of free AP-FXIII had been characterized so far by molecular modeling only, we performed structural analysis by nuclear magnetic resonance. Recombinant AP-FXIII was largely flexible both in plasma and water, differing significantly from the rigid structure in the bound state. We suggest that the recognized epitope is either occluded in the noncleaved form or possesses a structure that does not allow binding to the antibodies. On the basis of our findings, we propose AP-FXIII as a possible new marker for acute thrombotic events.

Eliminating exposure to aqueous solvents is necessary for the early detection and ultrastructural elemental analysis of sites of calcium and phosphorus enrichment in mineralizing UMR106-01 osteoblastic cultures

The mechanism underlying the mineralization of bone is well studied and yet it remains controversial. Inherent difficulties of imaging mineralized tissues and the aqueous solubility of calcium and phosphate, the 2 ions which combine to form bone mineral crystals, limit current analyses of labile diffusible, amorphous, and crystalline intermediates by electron microscopy. To improve the retention of calcium and phosphorus, we developed a pseudo nonaqueous processing approach and used it to characterize biomineralization foci, extracellular sites of hydroxyapatite deposition in osteoblastic cell cultures. Since mineralization of UMR106-01 osteoblasts is temporally synchronized and begins 78 h after plating, we used these cultures to evaluate the effectiveness of our method when applied to cells just prior to the formation of the first mineral crystals. Our approach combines for the first time 3 well-established methods with a fourth one, i.e. dry ultrathin sectioning. Dry ultrathin sectioning with an oscillating diamond knife was used to produce electron spectroscopic images of mineralized biomineralization foci which were high-pressure frozen and freeze substituted. For comparison, cultures were also treated with conventional processing and wet sectioning. The results show that only the use of pseudo nonaqueous processing was able to detect extracellular sites of early calcium and phosphorus enrichment at 76 h, several hours prior to detection of mineral crystals within biomineralization foci.

Promoting Amphibian Conservation through the College Classroom: Detection of Batrachochytrium dendrobatidis among Local Amphibians

Many global amphibian declines have been linked to the fungal pathogen Batrachochytrium dendrobatidis (Bd). The knowledge on Bd distribution provides a fundamental basis for amphibian conservation planning. Yet, such Bd distribution information is currently insufficient, in particular at a regional scale. The college classroom provides an excellent opportunity to expand the knowledge of Bd distribution. Here we provide an example of such research projects to detect Bd prevalence among local amphibians in a college course setting and present the results of work conducted in central Pennsylvania, USA. We collected toe clips and conducted PCR assays of six species, Plethodon cinereus, Desmognathus fuscus, Notophthalmus viridescens, Lithobates catesbeianus, L. clamitans, and L. sylvaticus (59 individuals). Four groups of students independently conducted entire projects, orally presented their findings, and submitted manuscripts to the professor at the end of the semester. This example demonstrates that it is feasible for an undergraduate class to complete a Bd-detection project within a single semester. Such a project not only contributes to Bd research but also promotes conservation education among students through hands-on research experiences. We found Bd infection in only one sample of N. viridescens, but no sign of infection in the rest of the samples. As a relatively high prevalence of Bd has been reported in surrounding areas, our results suggest spatial heterogeneity in Bd occurrence at a regional scale and thus, the need for continued efforts to monitor Bd prevalence.