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23 июня 2024 12:29

Other Poxviruses
Since the eradication of smallpox (variola virus), MCV is thought to be the only poxvirus with a human reservoir. However, there are many other zoonotic poxviruses (e.g., monkeypox, cowpox, orf) that can infect humans. While uncommon, these infections are increasingly being recognized outside of their usual geographic distribution, with the 2003 US outbreak of monkeypox as a most notable example (Lewis-Jones, 2004). As such, these viruses are of concern from a bioterrorism and outbreak prevention perspective.

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 июня 2024 12:26

HIV NAAT testing also represents an important surrogate marker for
follow-up in the care of persons living with HIV. Indeed, HIV viral load
should be performed at 2 to 8 weeks after ART initiation or modification and regularly every 3 to 12 months thereafter depending on the clinical stability and viral load suppression history of the individual (USDHHS, 2019). HIV resistance testing is also an important component of diagnostic testing and should be performed for all persons with HIV at entry into care and in other settings such as virologic failure and suboptimal viral load reduction (USDHHS, 2019). A minimal HIV-1 viral load of 500 to 1000 copies/mL is typically required for this purpose. Although resistance testing can be performed by genotypic or phenotypic methods, the genotypic method is preferred as it provides more rapid turnaround time and a detailed assessment of mutations present in key HIV genome regions. Genotypic-phenotypic correlations are well established and documented in detail in the Stanford HIV Drug Resistance Database

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 июня 2024 12:19

HIV testing in the infant with perinatal HIV exposure needs to be performed by NAAT at 2 to 3 weeks, 1 to 2 months, and 4 to 6 months after birth. Antibody-based testing is not recommended until the age of 18 months given the risk of false-positive results from passive maternal antibody transfer (USDHHS, 2018). Additional testing at birth and after cessation of antiretroviral therapy should be performed for infants at high risk of HIV. The reader is referred to the DHHS guidelines on the management of HIV in pregnancy and perinatally for further detail (USDHHS, 2018).

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 июня 2024 12:12

Ganciclovir, foscarnet, and cidofovir anabolism. The UL97 kinase adds the initial phosphate to GCV. Cellular kinases add two additional phosphates. The active form of the drug, GCV triphosphate, is incorporated into viral deoxyribonucleic acid (DNA) by the viral DNA polymerase. CDV is a monophosphate analog and does not require initial viral kinase activity. Cellular kinases add additional phosphates to produce CDV diphosphate, the triphosphorylated form of the drug. Resistance is conferred only by DNA polymerase mutations. FOS is a pyrophosphatase analog, which does not require activation. Resistance is also conferred only by DNA polymerase mutations. The DNA polymerase is the ultimate target of all three drugs. CDV, Cidofovir; CMV, cytomegalovirus; FOS, foscarnet; GCV, ganciclovir (From Lurain NS, Chou S: Antiviral drug resistance of human cytomegalovirus. Clin Microbiol Rev 23[4]:689–712, 2010.)

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 июня 2024 21:18

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

24 мая 2024 12:16

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

24 мая 2024 12:07

Diagnostic Methods
Diagnostic testing is an important tool to inform appropriate patient management decisions. Indeed, confirming the diagnosis of a respiratory viral infection may enable clinicians to avert unnecessary antibiotic use, guide the use of appropriate antiviral therapy (e.g., oseltamivir for confirmed influenza infection), and inform appropriate infection prevention and control strategies for a specific viral agent. Ideally, testing should be performed as early as possible in the disease course. Viral loads in respiratory specimens typically peak within the first 2 days following symptom onset and gradually decline to undetectable levels 5 to 8 days into the disease course; it could be longer in severely ill or immunocompromised individuals (Lee et al., 2009).
The specimen
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 мая 2024 08:56

پاسخ سوالات بعدی ویروس شناسی 👇

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 мая 2024 08:51

Clinical Diseases
Although C. albicans is the most common pathogen within the genus Candida, the frequency of the non-albicans species associated with infections has increased over the last few decades (Diekema et al., 2012; Pfaller et al., 2014). Numerous reports describe invasive infections caused by C. tropicalis (Chai et al., 2010; Kothavade et al., 2010), C. parapsilosis (Pammi et al., 2013), C. glabrata (Rodrigues, Silva et al., 2014), C. krusei (Pelletier et al., 2005), and C. lusitaniae (Hawkins & Baddour, 2003). C. auris has recently emerged and represents a challenge to both infection control and treating clinicians alike (Spivak & Hanson, 2018). Resistance to antifungal agents has emerged
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23 мая 2024 08:46

132)
Histopathologic Stains
Other more specialized stains include Mayer’s mucicarmine stain for demonstration of the mucoid capsule of C. neoformans and the Fontana-Masson stain for demonstration of melanin or melanin-like substances in the lightly pigmented agents of phaeohyphomycosis as well as the staining of minute amounts of melanin pigment in the cell wall of C. neoformans/C. gattii species complex. A book by Chandler and Watts (1987) provides greater detail on the utilization of stains to detect fungi in tissue.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 17:32

130)
conidiogenesis is a process in which the conidium does not develop until a septum is formed between the conidium and the parent cell. The conidium originates from the whole of the parent cell. The most important human pathogens that exhibit thallic conidiogenesis are the dermatophytes and the dimorphic fungi in the genus Coccidioides. As conidiogenesis progresses in these species, barrel-shaped conidia called arthroconidia are produced; these fragment easily and are disseminated with little difficulty, resulting in a high degree of infectivity demonstrated by these important human pathogens (Fig. 60.9). The thallic conidia of the dermatophytes are separated by size into two types: large septate macroconidia (Fig. 60.10) and small, one-celled microconidia that are simpler structures (Fig. 60.11).
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 17:26

128)
The immunofluorescence assay has been more sensitive in histochemical stains in some reports, but the skill and care of the observers undoubtedly play a role in the comparative sensitivity of the techniques. The diagnostic accuracy of the serum or BAL (1-3)- beta- d- glucan assay has a high negative predictive value and is useful as a screening tool for this disease; however, positive beta-D- glucan results do not exclude other fungal infections, resulting in reflex to additional diagnostic testing (Karageorgopoulos et al., 2013). Cysts of P. jirovecii occasionally may also be encountered in Gram-stained preparations, although this technique is not a sensitive method for detection
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 17:19

126)
A definitive diagnosis of a mycetoma can be achieved by the demonstration of grains (or granules) in a tissue biopsy, in draining exudates from a sinus tract, or in material aspirated from an unopened lesion (Fig. 60.38). These grains are microscopically composed of broad, interwoven, septate hyphae 2 to 5 μm in diameter that are lined with intense eosinophilic material (Splendore-Hoeppli phenomenon) (Fig. 60.39). For dematiaceous fungi, these grains are associated with a dark pigment and generally are called black grains; with fungi that are nondematiaceous and produce nonpigmented hyphae, these are called white grains. Identification of the etiologic agent requires culture on standard fungal media such as Sabouraud dextrose agar, which may take 4 weeks or longer to grow
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 16:30

124)
TABLE 60.3
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 16:25

LABORATORY SAFETY
The greatest hazard for laboratory personnel comes from handling mold cultures of the dimorphic pathogens, Coccidioides immitis/posadasii and H. capsulatum. These isolates are classified as risk group 3 (RG3) pathogens, and biosafety level 3 practices, containment equipment, and facilities are highly recommended for propagating and manipulating cultures, as well as for processing soil or other environmental materials known or likely to contain infectious conidia from these agents
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 июня 2024 12:27

149) به جدول سوال 146 توجه کنید.

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 июня 2024 12:24

Laboratory Diagnosis. CSF findings are similar to those described with HSV. As with HSV, VZV PCR is best diagnosed by laboratory-developed or commercial targeted PCR and can be diagnosed by the FilmArray ME panel (Leber et al., 2016; Liesman et al., 2018).

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 июня 2024 12:17

Virology
EBV or human gammaherpesvirus-4 (HHV-4) (family: Herpesviridae; subfamily: Gammaherpesvirinae; genus: Lymphocryptovirus) is an enveloped, double-stranded DNA virus comprised of a 172 kb genome and two major types, type 1 and type 2. During primary infection via the salivary route, EBV infects both epithelial cells of the oral cavity and B cells in pharyngeal lymphoid tissue. The initial binding of EBV to B cells is mediated by the high-affinity interaction of the gp350 envelope glycoprotein with CD21, complement receptor 2 (CR2) (Shannon-Lowe & Rowe, 2014). EBV establishes latency in resting memory-like B cells where it resides as an episome at 5 to 500 copies per cell (Dunmire et al., 2018).

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 июня 2024 12:08

CONGENITAL AND PERINATAL VIRAL INFECTIONS
Introduction
Congenital and perinatal viral infections are important causes of fetal and neonatal mortality, and for those who survive through the neonatal period, these infections may significantly contribute to subsequent childhood morbidity. Congenital and perinatal viral infections are synonymous with the TORCH acronym, which was initially used to group five infections (Toxoplasmosis, Syphilis [Other], Rubella, CMV, and HSV) that presented similarly with rash and ocular findings. Infections with Toxoplasma gondii and Treponema pallidum are covered elsewhere in this volume (see Chapters 65 and 61, respectively), and in this section rubella virus, CMV, and HSV will be covered in detail. A number of other viruses may be transmitted in utero, including HIV-1, hepatitis B, hepatitis C, Parvovirus B19, varicella zoster virus (VZV), enteroviruses, Zika virus, and the recently described SARS-CoV-2

فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

14 июня 2024 21:43

📚هر دوره یا کلاسی شرکت میکنی دست نگه دار!!!
👆دیگه لازم نیس پولی به کلاس های آموزشی بدی اینجا کاملا #رایگان همه چی برات گذاشتن فقط کافیست روی لینک زیر بزنید و عضو کانالها بشید👇👇🌺

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

24 мая 2024 12:11

138)
Epidemiology
At least 15 serotypes within species B, C, and E cause respiratory tract infections, and certain serotypes (4, 7, 14, and 21) are associated with outbreaks of severe respiratory disease in crowded populations, such as in military recruits (Lion, 2014). Outbreaks of adenoviral keratoconjunctivitis are also an important concern. Adenoviruses do not demonstrate a distinct seasonality. Transmission occurs via aerosolized droplets or direct conjunctival inoculation, and contact and droplet isolation precautions are advised for hospitalized patients.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

24 мая 2024 12:04

136)
Parainfluenza Viruses
Virology
Parainfluenza viruses (PIVs) (family: Paramyxoviridae) are enveloped, nonsegmented, single-stranded RNA viruses. Four species causing human respiratory infection are described: Human parainfluenza virus 1 and 3 (PIV-1 and PIV-3) in the Respirovirus genus, and Human orthorublavirus 2 and 4 (PIV-2 and PIV-4) in the Orthorublavirus genus.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 мая 2024 08:55

135)
Most mucormycetes grow well on standard fungal medium. Unfortunately, recovery of these organisms from tissue may be difficult leading to a negative culture result even though histologic evidence of a mucormycete is present in the clinical material (Roden et al., 2005). Aggressive processing of a specimen has been indicated as a potential cause of this inability to grow leading to damage of the organism so it is no longer viable. To increase the likelihood of successful culture, it has been suggested that tissue be minced or teased, rather than homogenized, after which it is inoculated onto the surface of a primary isolation agar (Ribes et al., 2000). Mucormycetes are also inhibited by cycloheximide, so nonselective fungal medium should be included when fungal cultures are performed. Isolates grow rapidly (within 48–72 hours) and produce abundant aerial hyphae that rapidly reach the lid of the Petri dish, colloquially referred to as lid lifters (Fig. 60.43). The hyphae are characterized as woolly and initially white, turning gray to black as spores develop.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 мая 2024 08:48

این سوال از زیر تصویر طراحی شده است :
به همین علت تاکید می شود که درسنامه هایی که نکات ریز را برای شما باز کرده است تهیه کنید
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

23 мая 2024 08:40

GROWTH TEMPERATURE
Most molds grow best at 25° to 30°C. Most yeasts, however, grow well at 35° to 37°C and are often recovered first on enriched blood agar plates in the bacteriology laboratory. In some cases, growth of a fungus at elevated temperatures is useful for differentiation of species.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 17:29

129)
STRUCTURE OF YEASTS AND HYPHAE
The morphology of the fungus is an important characteristic for the identification of both yeasts and molds. The filamentous structure of a mold is referred to as hyphae (singular, hypha), and a mass of hyphae is known as a mycelium. The mycelium growing on the surface of or within the agar is known as the vegetative mycelium, whereas filamentous extensions above the colony are called aerial mycelium. True hyphae may have cross-walls that contain pores for communication through the hyphae or cross-walls that are complete, dividing the hyphae into multiple cells
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 17:21

Sick Building Syndrome
Dematiaceous molds have also been associated with the condition known as sick building syndrome. The mold most commonly associated with this condition is Stachybotrys chartarum, and although the causative association of mold contamination within a building with disease has been questioned, health concerns to indoor mold exposure leading to persistent allergy symptoms or asthmalike symptoms have been documented (Al-Ahmad et al., 2010). Others have also suggested that toxins associated with molds such as S. chartarum are associated with health problems following exposure (Straus, 2009; Terr, 2009). NIOSH (2012) has provided a document that presents a comprehensive review on preventing occupational respiratory disease from exposures caused by dampness in office buildings, schools, and other nonindustrial buildings.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 17:11

125)
Sexual reproductive structures are of occasional value for fungal identification in the general mycology laboratory. Although they are infrequently encountered in vitro, recognition of sexual structures for heterothallic fungi requires that a compatible mating strain be available for testing. Homothallic fungi, on the other hand, can produce sexual structures in culture without this mating process. The two structures most likely to be demonstrated in he laboratory from homothallic species are the naked asci of Saccharomyces cerevisiae and the cleistothecium of Scedosporium boydii (previously known as Pseudallescheria boydii and formerly considered to be the sexual phase of Scedosporium apiospermum but now recognized as a separate species) (Gilgado et al., 2008), Aspergillus nidulans, or the Aspergillus glaucus group of fungi. The naked asci of Saccharomyces resemble oval yeast cells in which one to four individual haploid ascospores are enclosed (Fig. 60.12). The ascospores in this species may be visualized in wet preparations but are detected more reliably using a Gram stain or an acid-fast stain. A cleistothecium is a sexual fruiting body (ascocarp) in which the ascospores are entirely enclosed and can be released only by rupture of the cleistothecial wall (Fig. 60.13). The wall is composed of single or multiple layers of specialized hyphae. A perithecium is a sexual structure similar to a cleistothecium, but it contains an opening at the apex of the pear-shaped structure.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 16:27

123 )
TABLE 60.6
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

22 мая 2024 16:21

121)
If disseminated infection is suspected, blood cultures for Histoplasma should be performed. The Isolator technique is a sensitive technique for recovering the yeast phase from blood, although other blood culture detection systems can also be used to detect this fungus. Other clinical specimens should be inoculated to an enriched agar, such as brain-heart infusion agar supplemented with sheep blood, which is incubated at 25° to 30°C. Colonies of Histoplasma usually appear after incubation for 10 to 14 days but occasionally require incubation for up to 4 weeks. They are fluffy and vary from white to buff-brown. Diagnostic asexual forms include microconidia and macroconidia. Microconidia, which are produced
first, are similar to the structures produced by Blastomyces. The more characteristic macroconidia have roughened projections from the periphery of the conidia, a configuration referred to as tuberculate (Fig. 60.25). The macroconidia of the saprobe, Sepedonium, may be confused with Histoplasma, so differentiation of these two fungi is important. The macroscopic appearance of the colonies, the rate of growth, the growth of H. capsulatum on media containing cycloheximide, the presence of yeast forms in tissue, and the clinical history usually are sufficient to diagnose histoplasmosis. Final confirmation most often is provided by nucleic acid hybridization probe testing from the culture isolate. Conversion of the mold to the yeast phase also confirms identification, but this is often difficult and has been supplanted in most clinical laboratories by the molecular probe technique (AccuProbe).
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