PCR colorimetric dot-blot assay and clinical pretest probability for diagnosis of Pulmonary Tuberculosis in Smear-Negative patients

<p>Abstract</p> <p>Background</p> <p>Smear-negative pulmonary tuberculosis (SNPTB) accounts for 30% of Pulmonary Tuberculosis (PTB) cases reported annually in developing nations. Polymerase chain reaction (PCR) may provide an alternative for the rapid detection of <it>Mycobacterium tuberculosis </it>(MTB); however little data are available regarding the clinical utility of PCR in SNPTB, in a setting with a high burden of TB/HIV co-infection.</p> <p>Methods</p> <p>To evaluate the performance of the PCR dot-blot in parallel with pretest probability (Clinical Suspicion) in patients suspected of having SNPTB, a prospective study of 213 individuals with clinical and radiological suspicion of SNPTB was carried out from May 2003 to May 2004, in a TB/HIV reference hospital. Respiratory specialists estimated the pretest probability of active disease into high, intermediate, low categories. Expectorated sputum was examined by direct microscopy (Ziehl-Neelsen staining), culture (Lowenstein Jensen) and PCR dot-blot. Gold standard was based on culture positivity combined with the clinical definition of PTB.</p> <p>Results</p> <p>In smear-negative and HIV subjects, active PTB was diagnosed in 28.4% (43/151) and 42.2% (19/45), respectively. In the high, intermediate and low pretest probability categories active PTB was diagnosed in 67.4% (31/46), 24% (6/25), 7.5% (6/80), respectively. PCR had sensitivity of 65% (CI 95%: 50%–78%) and specificity of 83% (CI 95%: 75%–89%). There was no difference in the sensitivity of PCR in relation to HIV status. PCR sensitivity and specificity among non-previously TB treated and those treated in the past were, respectively: 69%, 43%, 85% and 80%. The high pretest probability, when used as a diagnostic test, had sensitivity of 72% (CI 95%:57%–84%) and specificity of 86% (CI 95%:78%–92%). Using the PCR dot-blot in parallel with high pretest probability as a diagnostic test, sensitivity, specificity, positive and negative predictive values were: 90%, 71%, 75%, and 88%, respectively. Among non-previously TB treated and HIV subjects, this approach had sensitivity, specificity, positive and negative predictive values of 91%, 79%, 81%, 90%, and 90%, 65%, 72%, 88%, respectively.</p> <p>Conclusion</p> <p>PCR dot-blot associated with a high clinical suspicion may provide an important contribution to the diagnosis of SNPTB mainly in patients that have not been previously treated attended at a TB/HIV reference hospital.</p

Viraggi di colore nelle pitture parietali di Ercolano: un'indagine archeometrica

La pittura parietale dei centri vesuviani costituisce uno dei nuclei documentari pi\uf9 ricchi e importanti per la conoscenza della pittura antica e del modo in cui, come arte applicata, questa veniva utilizzata per decorare gli interni, negli spazi pubblici e in quelli privati. Il campione ercolanese, meno noto ma non meno interessante di quello pompeiano, offre nuove informazioni, se riletto anche alla luce dei contributi delle scienze archeometriche. Nel caso specifico, specifiche analisi chimiche consentono di meglio comprendere la dinamica della trasformazione dei colori per effetto dell'eruzione del 79 e quindi di meglio "immaginare" la policromia degli spazi antichi

Ecological dynamics approach in physical education to promote cognitive skills development: A review

The aim of this paper is to carry out a theoretical transposition of the principles of the ecological dynamic approach in the field of physical and sports education, aimed at defining educational approaches capable of promoting an effective acquisition of cognitive skills, through the practice of physical activity and sport. Physical education, according to an ecological dynamics perspective, considers the performer a complex adaptive system, which interacts with the environments in a functionally integrated way, underlining the interrelationship between motor processes, cognitive and perceptive functions. The cognitive area of Life Skills (Cognitive Life Skills, CLS), divided by the WHO, into decision making, problem solving, creative thinking and critical thinking processes, can be framed as an intrinsic part of goal-directed behaviour influenced by functional constraints determined by individual-environment interaction. Therefore, physical and sport activity practiced according to the principles of the ecological dynamic approach can be configured as an elective tool to promote the development of cognitive skills. In this article, the relevant theories of ecological dynamics are discussed and recent empirical data on the perceptual-cognitive processes which are activated through the practice of physical education and sport are described to underline the potential of such practices for the development of cognitive skills. The development of this specific theoretical transposition represents a starting point for the definition and experimentation of ecological dynamic interventions designed with the aim of investigating the effects of physical and sporting activity on the development of cognitive skills for life

Characterization of plaster and stucco paintings from the Basilica of santa Maria Maggiore in Trient

Risultati delle analisi archeometriche su campioni di intonaci dallo scavo di santa Maria Maggiore a Trento dall'età romana a quella rinascimental