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This article has been cited by other articles in PMC. Abstract Smear microscopy has suboptimal sensitivity, and there is a need to improve its performance since it is commonly used to diagnose tuberculosis TB. We prospectively evaluated the diagnostic accuracy of the small membrane filtration SMF method, an approach that uses a vacuum manifold and is designed to concentrate bacilli onto a filter that can be examined microscopically.
We enrolled hospitalized adults suspected to have pulmonary TB in Kampala, Uganda. We performed per-specimen primary and per-patient analyses.
From October to Junewe enrolled patients sputum specimens.
The participants were mostly female In the per-specimen analysis, the sensitivity of the SMF method Subgroup analyses showed that SMF performed poorly in specimens having a low volume or low bacterial load.
The SMF method performed poorly compared to standard smear techniques and was sensitive to sample preparation techniques. The optimal laboratory SMF protocol may require striking a fine balance between sample dilution and filtration failure rate.
Despite the recent development of new diagnostic modalities 2in much of the world, the diagnosis of pulmonary TB continues to rely on microscopic examination of stained sputum smears. Acid-fast bacillus AFB smear microscopy is inexpensive and rapid, has high positive predictive value in areas of high TB prevalence, and identifies the most infectious subset of TB patients 3.
Overall, the suboptimal sensitivity of smear microscopy results in delays in diagnosis with consequent disease progression, poor outcomes, and uninterrupted transmission of M. Concentration of bacilli is a strategy to increase the sensitivity of sputum AFB smear microscopy.
The small membrane filtration SMF method uses a vacuum manifold to concentrate bacilli present in a clinical sample onto a small membrane that can subsequently be stained and examined microscopically for AFB.
By increasing the concentration of bacilli in the microscopic field, the SMF method may increase the sensitivity of smear microscopy. The SMF method reduces biohazard potential through the use of bleach sodium hypochloritewhich kills M.
This study prospectively evaluated the diagnostic accuracy of the SMF method using a new, multitest vacuum manifold that allowed semiautomation and a new laboratory protocol intended to reduce the filtration failure rate by dilution of the sputum sample.
The study focused mainly on HIV-infected adults with suspected pulmonary TB—a population predicted to include a large proportion of individuals with relatively low bacillary burdens in their sputum and in whom the concentration effect of the SMF method would be most useful.
Nonstudy clinicians referred potentially eligible, interested individuals to study personnel. We used a questionnaire to collect demographic and clinical information. For each participant, two sputum samples were collected on the day of enrollment spot specimensand a third sputum sample was collected, usually the day after enrollment but within 4 days morning specimen.
A posteroanterior chest radiograph was performed on all nonpregnant study participants. The SMF manifold version 5.
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The prototype manifold shown contains 10 workstations, each fitted with a stainless steel screw-on port that holds an SMF filter apparatus. Each SMF filter apparatus is comprised of four parts, as follows: This filter apparatus allows efficient staining of bacilli after they have been collected and immobilized on the membrane, which minimizes membrane loss or disruption.
The version of the manifold prototype version 5.The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) represents the most current, directly-measured, harmonized dataset focused on lifestyle and obesity among children from all regions of the world. Washington Nationals' Ryan Zimmerman, bottom, slides home to score against St.
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PD (Arch. Pedro Santos Jr.) Salvan, George - Licensure Examination for Architects Reviewer. BP History of Architecture Reviewer. [email protected] What PD covers • Subdivisions • Condominiums What PD covers • Medium cost housing • Open market housing.