Ending Post

Well everyone,

The semester has finally come to a close. I have tried to share a lot of information and in doing so, you all have shared information with and taught me a lot. I would like to thank everyone who chose to read and comment on my posts. I hope you found the information I presented informative and well as interesting, and most importantly, I hope that you can take the information you’ve learned from my blog and use it going forward. Though the course is ending and this blog is no longer a requirement, I really enjoyed working on it so in the future, from time to time, I may still post tid-bits of interesting information that I come across. 

Again, thanks for reading!

Natashia R. Reese

UAB CLS Graduate Student

Joke of the day:

Quality Control in the Microbiology Lab

Hello everyone,

This week in lecture we discussed quality in the clinical microbiology laboratory. This related directly to laboratory tour our class to of VA Medical Center. Here’s what I learned:

Laboratory quality control is designed to detect, reduce, and correct deficiencies in a laboratory's internal analytical process prior to the release of patient results, in order to improve the quality of the results reported by the laboratory. QC is associated with the internal activities that insure diagnostic accuracy as well as those external activities that ensure positive patient outcome. Positive patient outcomes are:
• Reduced length of stay
• Reduced cost of stay
• Reduced turn-around time for diagnosis of infection
• Change to appropriate antimicrobial therapy
• Customer ( physician or patients )satisfaction
The items list above are the responsibility of all laboratory personnel .

The Standard operating procedures manual (SOPM)  is considered part of QC program. The SOPM defines test performance, tolerance limits, reagent preparation, required quality control ,result reporting and references. The SPOM is available in the work area and is the definitive laboratory reference that is used often for questions relating to individual test .

Continuing education program are also apart of quality control to ensure that sufficient qualified personnel are employed for the volume and complexity of the work performed.

Also apart of quality control, the laboratories are required to participate in an external proficiency testing (PT). The laboratory must maintain an average score of 80%to maintain licensure in any subspecialty area. The laboratory's procedures, reagents, equipment and personnel are all checked in the process. PT provides an insight into the laboratories performance.

And last, the media, is also a part of quality. Sterility checks are performed of all media used in the laboratory. This done by taking a representative sample of the lot and testing it for sterility. 5% of any lot is tested when a batch of 100 or fewer unit is received   and maximum of 10 units are tested in large batches. Sterility is checked by incubating the medium for 48 hours at the temperature at which it will be used.

Of course these are just a few areas of quality control in the microbiology lab. There are many, many more but these are some that not only did we learn about in class but I also heard the microbiology supervisor mentioned that she participated in in her lab.

I have included a link to a video that I thought was interesting called, Meet the Pathologists Behind the CAP's Surveys.  This video is of members of the College of American Pathologists that attended the 2011 AACC Annual Meeting in Atlanta and explained how Board-certified pathologists shape CAP's world-renown Proficiency Testing Program. If you’re interest check it out!!!
http://www.youtube.com/watch?v=tKEJ8mgmqME

Thanks for reading!

Graduate Project - Treatment and Prognosis

Hello everyone,

So as the semester comes to a close and we look back, we have discussed and learned a lot about Systemic Lupus Erythrematosus. We’ve learned about the different types, the many and varying symptoms, the diagnosis,, we’ve even learned the many people that we know that are sufferers of the disease. Now it’s time we chat a little about treatment and prognosis.

Treatment

As we know there is no cure for SLE so the goal of treatment is to control symptoms. Treatment decisions are based on symptoms and the severity of those symptoms.

Mild disease may be treated with:

• Nonsteroidal anti-inflammatory medications (NSAIDs) treat arthritis and pleurisy


• Corticosteroid creams to treat skin rashes


• An antimalaria drug (hydroxychloroquine) and low-dose corticosteroids for skin and arthritis symptoms


• You should wear protective clothing, sunglasses, and sunscreen when in the sun.

Treatment for more severe lupus may include:

• High-dose corticosteroids or medications to decrease the immune system response


• Cytotoxic drugs (drugs that block cell growth)

Also, it is important to have preventive heart care, up-to-date immunizations, tests to screen for thinning of the bones (osteoporosis), and therapy and support groups which may help relieve depression and mood changes that may occur in patients with this disease.

Prognosis

SLE is one of the most serious rheumatic diseases and it can affect so many organs that a cause of death in some people with SLE may not be directly attributed to the condition. In fact, a primary cause of death among patients with lupus is atherosclerosis which is a disease of the coronary blood vessels resulting from accelerated buildup of plaque. Never the less because of more effective and aggressive treatment, the prognosis for SLE has improved markedly over the past two decades. Only three drugs were FDA-approved for the treatment of lupus (Prednisone, Aspirin, Hydroxychloroquine) until the 2011 FDA approval of belimumab so advances are being made. It has been seen that treatment early in the course of the illness improves long-term progress. About 85 - 95% of people with lupus survive 10 years and most people with lupus can live normal lives as longs as the disorder is carefully monitored and treatment adjusted as necessary to prevent serious complications.

So, there has been a lot of information shared and now it’s time to put it all to the test. This blog post is what I like to call "SLE Review"!!! Below you will find a crossword puzzle that all about Lupus. If you dare try it out. Test your knowledge and see how much you’ve learned so far.

I hope that you have found this information that I shared on Lupus not only informative but interesting.

Thanks for reading and good luck!

Graduate Project - Antinuclear Antibodies (ANAs) – Diagnosing Lupus

Hello again,

After my post on diagnosing Lupus I recieved a lot of questions on using Antinuclear Antibodies (ANAs) to diagnose Lupus so that’s what we will cover in this post.

The primary test for SLE is Antinuclear Antibodies (ANAs) which checks for antinuclear antibodies that attack the cell nucleus. High levels of ANA are found in more than 98% of patients with SLE. However there are other conditions that may cause high levels of ANA, so a positive test is not a definite diagnosis for SLE. Other diseases are scleroderma, Sjögren syndrome, or rheumatoid arthritis. ANAs may also be weakly present in about 20 - 40% of healthy women. Drugs such as hydralazine, procainamide, isoniazid, and chlorpromazine can also produce positive antibody tests. A negative ANA test makes a diagnosis of SLE unlikely but not impossible. High or low concentrations of ANA also do not necessarily indicate the severity of the disease, since antibodies tend to come and go in patients with SLE.

In general, the ANA test is considered a screening test. If SLE-like symptoms are present and the ANA test is positive, other tests for SLE will be administered. If SLE-like symptoms are not present and the test is positive, the doctor will look for other causes, or the results will be ignored if the patient is feeling healthy.

Antinuclear Antibodies (ANAs) Pattern seen in SLE:

Homogeneous (Diffuse)

• Uniform fluorescence of entire nucleus with or without masking of nucleoli


• Chromosome region of metaphase mitotic cells positive with smooth or peripheral staining intensity greater than or equal to interphase nuclei

Also, additional, more specific tests, such as the anti-double strand DNA (dsDNA) and anti-smith antibodies (Sm), are used to confirm the diagnosis of lupus.

Tests used to diagnose SLE may include:

• Antibody tests, including antinuclear antibody (ANA) panel


• CBC


• Chest x-ray


• Kidney biopsy


• Urinalysis

Remember, no one test can diagnose or rule out the disease and one would have to present with at least 4 of the 11 typical.

Malar rash – a rash over the cheeks and nose, often in the shape of a butterfly

Discoid rash – a rash that appears as red, raised, disk-shaped patches

Photosensitivity – a reaction to sun or light that causes a skin rash to appear or get worse

Oral ulcers – sores appearing in the mouth

Arthritis – joint pain and swelling of two or more joints in which the bones around the joints do not become destroyed

Serositis – inflammation of the lining around the lungs (pleuritis) or inflammation of the lining around the heart that causes chest pain which is worse with deep breathing (pericarditis)

Kidney disorder – persistent protein or cellular casts in the urine

Neurological disorder – seizures or psychosis

Blood disorder – anemia (low red blood cell count), leukopenia (low white blood cell count), lymphopenia (low level of specific white blood cells), or thrombocytopenia (low platelet count)

Immunologic disorder – abnormal anti-double-stranded DNA or anti-Sm, positive antiphospholipid antibodies

Abnormal antinuclear antibody (ANA)

Hopefully this post added to your wealth of knowledge on SLE.

Thanks for reading comment and post!!!

Mycobacterium tuberculosis

Hello everyone,

This week in lecture we discussed Mycobacterium tuberculosis. Just so happen this very same week I had to renew my annual TB skin test. This made me wonder, what was the big deal that we had to get tested for TB each year. So I did some research and I found that transmission of tuberculosis, including multidrug-resistant tuberculosis, is a recognized risk for laboratory workers. Health care workers in general are considered to be apart of the high-risk infection groups for Tuberculosis. UAB state that, "Given the nature of their work, students engaged in health professional training programs could have a higher risk of contracting Rubeola, Rubella, Mumps, Tetanus, Diphtheria, Varicella, Tuberculosis, Pertussis, and Hepatitis B. All UAB students in the Joint Health Sciences programs and in the Schools of Medicine, Dentistry, Optometry, Public Health, Nursing, and Health Professions are required to be immunized."

So what does UAB require for Tuberculosis Screening?

• All international students and scholars must show proof of a non-reactive Tuberculin skin test or negative blood test (Quantiferon), or appropriate treatment if positive, within three months prior to enrollment or visiting


• PPD (skin test) screening requires a 2-step process, with PPD (skin test) placements at 1-3 weeks apart.


• Non-reactive (negative) Tuberculin skin test or chest x-ray reports done outside the United States will not be accepted.


• Individuals with a history of a reactive Tuberculin skin test or blood test must provide a current chest x-ray (taken since their last positive TB test but within three months prior to enrollment or visiting), indicating that the person is free of active tuberculosis. Individuals with a positive TB screening test should complete the TB Questionnaire, submit it to Student Health Services, and consult the UAB Student Health Services TB Testing Policy to view the required follow-up.

So what is the TB skin test:

The Mantoux tuberculin skin test (TST) is the standard method of determining whether a person is infected with Mycobacterium tuberculosis. The TST is performed by injecting 0.1 ml of tuberculin purified protein derivative (PPD) into the inner surface of the forearm. The TST is an intradermal injection and when placed correctly, the injection should produce a pale elevation of the skin 6 to 10 mm in diameter. The skin test reaction should be read between 48 and 72 hours after administration. The reaction should be measured in millimeters of the induration (palpable, raised, hardened area or swelling), making sure not to measure the erythema (redness). The diameter of the indurated area should be measured across the forearm.

How Are TST Reactions Interpreted?

Classification of the Tuberculin Skin Test Reaction:

An induration of 5 or more millimeters is considered positive in -HIV-infected persons -A recent contact of a person with TB disease -Persons with fibrotic changes on chest radiograph consistent with prior TB -Patients with organ transplants -Persons who are immunosuppressed for other reasons (e.g., taking the equivalent of >15 mg/day of prednisone for 1 month or longer, taking TNF-a antagonists)

An induration of 10 or more millimeters is considered positive in -Recent immigrants (< 5 years) from high-prevalence countries -Injection drug users -Residents and employees of high-risk congregate settings -Mycobacteriology laboratory personnel -Persons with clinical conditions that place them at high risk -Children < 4 years of age - Infants, children, and adolescents exposed to adults in high-risk categories

An induration of 15 or more millimeters is considered positive in any person, including persons with no known risk factors for TB. However, targeted skin testing programs should only be conducted among high-risk groups.

So as you can see from the chart, laboratory personnel and other adults in high-risk categories induration measurement is greater other categories to be consider positive.

So as students, we should understand our risk and take the TB screening process seriously. I know we are all busy, but we shouldn’t put it off. Make sure to get your TB screening annually and take the necessary precaution to remain TB negative.

Also, I have included a few links: two on Mycobacterium tuberculosis to provide more information on the bacteria and disease and one on the TB skin test Mantoux Method that I mention above. Also I have included a link from a journal insert on Tuberculosis in laboratory workers. If you are interested please check them out.

As always, read, comment, and post!

Thanks for reading!!!

Tuberculosis Http://www.youtube.com/watch?V=jtyx694ubio

Mycobacterium tuberculosis Http://www.youtube.com/watch?V=u7o93nmgp1e

Tuberculosis in laboratory workers http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1961675/pdf/brmedj03110-0055.pdf

Mantoux Method Http://www.youtube.com/watch?V=br86g-itrtq

Antimicrobial Resistance and Susceptibility Testing

Hello Again!!!

This week’s lecture we discussed antimicrobial susceptibility testing.

Antibiotic use has been beneficial and, when prescribed and taken correctly, their value in patient care is enormous. However, these drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. People infected with antimicrobial-resistant organisms are more likely to have longer, more expensive hospital stays, and may be more likely to die as a result of the infection.

What cause antimicrobial resistance?

Inappropriate and irrational use of medicines provides favourable conditions for resistant microorganisms to emerge and spread. For example, when patients do not take the full course of a prescribed antimicrobial or when poor quality antimicrobials are used, resistant microorganisms can emerge and spread.

Selecting an Antimicrobial Drug

Before antimicrobial therapy can begin three factors must be known:

• Overall medical conditions of patient

• Nature of microorganism causing infection

• Degree of microorganism susceptibility (sensitivity to various drugs

Antimicrobial Susceptibility Testing

The purpose of performing antimicrobial susceptibility testing is to assist clinicians with the selection of appropriate targeted antibiotic therapy in order to optimize clinical outcomes. Infection-related and overall mortality is reduced when patients are treated expeditiously with an antibiotic to which the organism is susceptible.

Methods

The methods of antimicrobial susceptibility testing we learned about are qualitative and quantitative. The disk diffusion method, also known as the Kirby-Bauer method, is a qualitative method of susceptibility testing . Broth microdilution and agar dilution methodologies are considered quantitative because they can measure the minimum inhibitory concentration (MIC). The MIC is defined as the lowest concentration of an antibiotic that inhibits visible growth of a microorganism. Both quantitative methods are considered the reference methods for susceptibility testing because of their high levels of reproducibility.

How do we prevent antimicrobial resistance?

• Limit drug use - less selective pressure

• Proper drug use - viruses are not affected, use full dose to ensure elimination of pathogens

• Narrow range antibiotics - kill only the targeted microbes; less likely complications

• Multiple drug treatments - drugs can work synergistically; much less likely to get drug resistances

Also, for more prevention methods and to learn what initiatives the Center for Disease Control and Prevent are taking to combat this problem, I have included a link to their "Get Smart for Healthcare" page so check it out.

http://www.cdc.gov/getsmart/healthcare/

Also, for those of you who are interested, I’ve included links to journal articles on "Antimicrobial‐Resistant Pathogens Associated With Healthcare‐Associated Infections" as well as "Frequent Acquisition of Multiple Strains of Methicillin-Resistant Staphylococcus aureus by Healthcare Workers in an Endemic Hospital Environment." I found them very interesting so check them out.

http://www.jstor.org/stable/10.2307/30146980

http://www.jstor.org/stable/full/10.1086/591861

Until next time, read, comment, and post!

Thanks for reading!!! 

Joke of the day:

Diagnosing Lupus - Graduate Project

Hello Everyone,

In weeks prior I’ve discussed different aspects of Lupus. Now I want to discuss in detail how Lupus is diagnosed.

As we’ve learned Lupus is chronic and complex, as well as unpredictable and varies greatly from one individual to the next making it often difficult to diagnose. Because of this, there is no single laboratory test that can determine if a person has lupus. To complicate matters even more, many symptoms of lupus are similar to those of other diseases, and symptoms can develop gradually as well as come and go over weeks and months. It can often take years for a diagnosis to be made. To diagnose lupus, a doctor should be able to find physical or laboratory evidence of the condition, such as swelling of joints, protein in the urine, fluid around the lungs or heart, or a skin biopsy that shows evidence of the disease. The doctor also will look at a person’s medical history and special tests to rule out other diseases.

Doctors use the American College of Rheumatology's “Eleven Criteria of Lupus” to help make—or exclude—a diagnosis of lupus.

Typically, four or more of the following criteria must be present to make a diagnosis of systemic lupus.

So what happens after you diagnosed with Lupus?
Though there is no cure for lupus, in the past several years, treatment has improved considerably and currently there are medications that are proving effective. Only three drugs were FDA-approved for the treatment of lupus (Prednisone, Aspirin, Hydroxychloroquine) until the 2011 FDA approval of Belimumab so advances are being made. Suprising to some, most people with lupus can live normal lives as longs as the disorder is carefully monitored and treatment adjusted as necessary to prevent serious complications. Also, it is recommended that those that have been recently diagnosed with Lupus educate themselve as much as possible about the disease as well as seek support as apart of treatment. I've included a link below that I found very informative titled, "Living with Lupus".

Also, I've included and interactive link, "Could I have Lupus", which is a checklist/quiz that anyone can take if they suspect they may be suffering from Lupus.
http://www.lupus.org/newsite/pages/lupusChecklist.aspx

Until next time, check out the criteria chart above, the links above and below, comment, and post!
Thanks for reading!!!

Living With Lupus:
http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnliving.aspx?articleid=2252&zoneid=527

Diagnosing Lupus:
http://www.lupus.org/webmodules/webarticlesnet/templates/new_learndiagnosing.aspx?articleid=2239&zoneid=524

Lupus in Dogs

Hello again,

After reviewing some of the comments made on my previous post, "Celebrities with Lupus", I received a good bit of feed back concerning former President George Bush Sr. and wife Barbar’s famous pet springer spaniel, Millie, having lupus. Because it sparked so many questions, I wanted to take a moment and provided some information on canine lupus.

Lupus in dogs, just as in humans, is a general term for an autoimmune disease characterized by the formation of antibodies against the body’s own tissues. There are two distinct forms of lupus in dogs. They are discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE). DLE, sometimes referred to as "collie nose" or "nasal solar dermatitis," is one of the most common immune-mediated skin diseases in dogs.

Symptoms

The symptoms of lupus vary widely and often are missed until the disease has reached an advanced stage.

DLE is a relatively benign variant of SLE wherein a dog becomes allergic to its own tissues. DLE primarily affects facial skin. The most common site is the hairless surface of the bridge of the nose. Other sites are the lips, mouth, and the area around the eyes, the ear flaps and, rarely, the genitalia or feet. Dogs with DLE usually are otherwise healthy.

SLE is a much more serious condition than its cutaneous counterpart. SLE is a multi-system, immune-mediated disease characterized by the formation of antibodies against normal body cells and tissues. Basically, the dog’s body attacks itself, from the inside out. While a large number of autoimmune symptoms can be caused by SLE, the most common sign of this disease is shifting leg lameness.

Treatment

DLE cannot be cured but is more manageable than the systemic form of the disease. The goals of treating DLE are to control and resolve the facial skin lesions, particularly on the hairless areas of the top of the muzzle. Treatment may include oral or topical antibiotics, topical lotions or ointments, oral vitamin E, oral fatty acid supplements and oral or topical corticosteroids. Affected dogs should be kept out of the sun as much as possible, because the symptoms of DLE worsen with exposure to ultraviolet light.

SLE is also incurable. The goals of treating SLE are to manage the symptoms of the disease, relieve the dog from pain and lameness and prevent progressive renal or other organ failure if possible. Because the effects of SLE often vary, not all cases need to be treated aggressively at all times. Dogs suffering from severe, acute-onset SLE may need to be hospitalized for initial management, until their condition is stabilized. There are a number of drugs that can be used to help manage SLE, including corticosteroids to suppress the abnormal immune reaction and non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammatory response. Secondary bacterial skin infections should be treated aggressively with appropriate antibiotics.

Hopefully this has answered your questions and for you pet owners made you just a little more knowledgeable about pet health.

Until next time, check out the image below, comment, and post!
Thanks for reading!!!

Conjunctivitis (Pink Eye)

Hello again,

Last week in lecture we discussed infections of the eye. Naturally my first thought was of the infamous Conjunctivitis, better known as "pink eye". The more I thought about it, the more I realized I didn’t really know the cause or transmission of pink eye. As crazy as it sounds, I though you got pink eye by looking at the infected eye of a person with it. Not very wise I know, but hey, I was a kid!

So here’s what I have learned:

Conjunctivitis is a common eye condition that causes inflammation of the conjunctiva. The conjunctiva is the thin layer that lines the inside of the eyelid and covers the white part of the eye. The reason Conjunctivitis is referred to as "pink eye" is because it can cause the white of the eye to take on a pink or red color. The most common causes of conjunctivitis are viruses and bacteria.

Viral conjunctivitis can be caused by a number of different viruses which are usually associated with an upper respiratory tract infection, cold, or sore throat. It usually begins in one eye and may progress to the second eye within days. Viral conjunctivitis spreads easily and rapidly between people and can result in epidemics.

Bacterial conjunctivitis is caused by infection of the eye with certain bacteria, commonly Streptococcous pneumonia and Haemophilus influenzae. Bacterial conjunctivitis also usually begins in one eye and may sometimes progress to the second eye.

Both the bacterial and viral forms of the condition are contagious. The germs that cause conjunctivitis may be present in nasal secretions and in the discharge from the eyes. People can become infected simply by touching the face of someone with the disease and then rubbing their own eyes without first washing their hands. Sharing contaminated towels or eye makeup also can spread the infection. Infectious conjunctivitis can spread quickly through child-care and school settings and among members of the same family. Because of this bacterial conjunctivitis is a leading cause of children being absent from day care or school. Bacterial conjunctivitis can remain contagious until treatment with antibiotics is started. The viral form is usually contagious before the symptoms appear and for as long as symptoms, including any discharge from the eye, last.

So how do we prevent pink eye?

The best way to prevent infectious conjunctivitis is to wash hands frequently, especially after touching the face of someone who has the infection. It is a good idea for people with infectious conjunctivitis to wash their hands often to avoid spreading the infection. It is also wise not to share makeup; disposable items, such as paper towels and cotton balls; or towels. Also, to prevent re-infection once the infection goes away you should throw away and replace any eye or face makeup you used while infected, replace contact lens solutions that you used while your eyes were infected, throw away disposable contact lenses and cases that were used while your eyes were infected and clean extended wear lenses as well as eyeglasses and cases that were used while infected.

So as you can see, it takes a little more that just looking at someone with pink to catch it!

Until next time, check out the link and image below, comment, and post!
Thanks for reading!!!

http://www.cdc.gov/conjunctivitis/about/index.html

Joke of the day:

Graduate Project - Celebrities with Lupus

Hello again,

One thing for sure about Lupus is it doesn’t discriminate. No matter you socioeconomic status, anyone can get lupus. While researching the disease, I found there are many celebrities that we all are familiar with that have lupus. A total shock to me and one of the most famous sufferers of lupus was Micheal Jackson.  Michael was diagnosed with the disease in 1984, shortly after his hit album Thriller. Reportedly there are numerous pictures of him with what could easily be a lupus rash on his face and the lupus might explain his avoidance of the sun.  Another singer, Seal battled discoid lupus when he was a child. His trademark facial scarring, butterfly rash, is a result of the disease.  Even former President George Bush Sr. and wife Barbar’s famous pet springer spaniel, Millie, suffered from lupus. I was not aware, but it appears animals can get the disease as well. America's Next Top Model star Mercedes Scelba-Shorte, also known as Mercedes Yvette, revealed she had lupus while on the show. I saw that episode and for me, that was my first time ever even hearing of the disease. Symptoms Mercedes had that were displayed on screen was hair loss and spots or around the hairline. Toni Braxton recently admitted to having lupus after her failing health caused her to cancel entire concert tours. The new edition to the “celebrities with lupus” category is comedian and America’s Got Talent host Nick Cannon. Nick open up about his battle with lupus early this year after being hospitalized for kidney failure, common in patients with lupus, in January and then hospitalized again, weeks later, with blood clots in his lungs. The blood clots were found to be directly connected to his kidney infection.  Other celebrities with disease are actress Jasmine Guy, American Idol contestant Leslie Hunt, sister of Sharon Stone Kelly Stone, and even Lady Gaga!

So why is this important? Celebrities being the face of the disease bring exposure to it that many would never have. Take me for example, I first learned of the disease by watching a reality competition television show. The type of awareness these celebrities can bring to the disease can contribute to more people being aware of the signs and symptoms and seeking help if they feel they may be sufferers of the disease.  Lupus is one of the most serious rheumatic diseases and early diagnosis and control of symptoms are key for a positive prognosis. Though I’m not a celebrity, I am doing my part to spread the word about Lupus and I hope those of you who view and read my blog do the same!

Until next time, check out the images and link below, comment, and post!

Thanks for reading!!!
http://cure4lupus.org/store/index.php?main_page=page&id=148&chapter=2

GI Infections and Handwashing

Hello everyone,

This week in lecture we covered gastrointestinal infections.  A few common GI infection we discussed was infections with the bacteria Salmonella spp., Shigella spp. Escherichia coli, and Campylobacter spp.. Most infections occur through what is called the fecal-oral route, in which trace amounts of infected fecal particles are unintentionally consumed. Although this sounds impossible in a society with good sanitation, something as simple as poor hand washing habits after using the restroom can spread diseases to other people through door knobs, shared hand towels, or direct contact. If the recipient happens to touch their mouth or food, they may become infected. Certainly, infected food preparation areas or food preparers in restaurants are also potential sources of illness. Diarrhea, fever, vomiting, and dysentery are some of the most common symptoms. Diarrheal infections are highly contagious. They can spread from person to person via the routes mentioned earlier and most cases are contagious for as long as a person has diarrhea, but some infections can be contagious for even longer. Through excellent hygiene, clean drinking water, and safe food preparation, most gastrointestinal infections can be avoided. The most effective way to prevent contagious diarrheal infections and most gastrointestinal infections is to wash your hands frequently. As simple as that sound, most people do not wash their hands well enough or often enough to prevent the spread of disease. A 2006 American Society of Microbiology study revealed that after using the toile only 75 percent of women and 50 percent of men wash their hands and, of middle and high school student only 33 percent females and 8 percent of males wash their hands. Because of these statistics I have included some links from CDC and Mayo Clinic that will provide information on the importance of hand washing as well as proper hand washing techniques. As future laboratorians we will be in constant contact with infectious agents and this is one way we can keep ourselves as well as our family’s and community safe by preventing the spread of disease. 

Until next time, check out the links below, comment, and post!
Thanks for reading!!!

Hand washing Do’s and Don’ts – http://www.mayoclinic.com/health/hand-washing/HQ00407
Wash Your Hands – http://www.cdc.gov/features/handwashing/index.html
Hand Washing in Healthcare Settings – http://www.cdc.gov/handhygiene/
Hand Washing Saves Lives – http://www.cdc.gov/Features/HandHygiene/

Joke of the day:

Wouldn't this be the best thing ever...

Types of Lupus – Graduate Project

Hello everyone,

These week’s research for my graduate topic was on the different types of lupus. There are four types of lupus Systemic lupus, Cutaneous Lupus, Drug-induced Lupus, and Neonatal Lupus.

First we will start with Systemic lupus Erythematosus. Just to add to the information presented last week, systemic lupus is the most common form of lupus, and is what most people mean when they refer to "lupus." Systemic lupus can be mild or severe and invole multiple organ systems.. Some of the more serious complications involving major organ systems are:

• inflammation of the kidneys (lupus nephritis), which can affect the body’s ability to filter waste from the blood and can be so damaging that dialysis or kidney transplant may be needed


• an increase in blood pressure in the lungs (pulmonary hypertension)


• inflammation of the nervous system and brain, which can cause memory problems, confusion, headaches, and strokes


• inflammation in the brain’s blood vessels, which can cause high fevers, seizures, behavioral changes,


• hardening of the arteries (coronary artery disease), which is a buildup of deposits on coronary artery walls that can lead to a heart attack

Approximately 70 percent of lupus cases are systemic. In about half of these cases, a major organ will be affected.

　

Next is Cutaneous Lupus Erythematosus. Cutaneous refers to the skin, and this form of lupus is limited to the skin. Although there are many types of rashes and lesions caused by cutaneous lupus, the most common rash is raised, scaly and red, but not itchy. It is commonly known as a discoid rash, because the areas of rash are shaped like disks, or circles. Another common example of cutaneous lupus is a rash over the cheeks and across the bridge of the nose, known as the butterfly rash. Other rashes or sores may appear on the face, neck, scalp, other areas of the skin that are exposed to sunlight or fluorescent light, or in the mouth, nose, or vagina. Hair loss and changes in the pigment, or color, of the skin are also symptoms of cutaneous lupus.

Approximately 10 percent of people who have cutaneous lupus will develop systemic lupus. However, it is likely that these people already had systemic lupus, with the skin rash as their main symptom.

Also there is Drug-induced Lupus Erythematosus. Drug-induced lupus is a lupus-like disease caused by certain prescription drugs. The symptoms of drug-induced lupus are similar to those of systemic lupus, but only rarely will any major organs be affected.

The drugs most commonly connected with drug-induced lupus are hydralazine which is used to treat high blood pressure or hypertension, procainamide which is used to treat irregular heart rhythms, and isoniazid which is used to treat tuberculosis. Drug-induced lupus is more common in men because they are given these drugs more often; however, not everyone who takes these drugs will develop drug-induced lupus. The lupus-like symptoms usually disappear within six months after these medications are stopped.

Last but not least there is Neonatal lupus. Before this week, I had never heard of it. Neonatal Lupus is a rare condition that affects infants of women who have lupus and is caused by antibodies from the mother crossing the placenta and acting upon the infant in the womb. At birth, the infant may have a skin rash, liver problems, or low blood cell counts, but these symptoms disappear completely after several months with no lasting effects. Some infants with neonatal lupus can also have a serious heart defect. With proper testing, physicians can now identify most at-risk mothers, and the infant can be treated at or before birth. Most infants of mothers with lupus are entirely healthy.

As always, as I learn more about the disease, I will be passing that information along to you all!!!

Also, for those of you who are interested, I’ve included a link to a journal article on Neonatal Lupus. I  founf it very interesting so check it out.

Until next time, read, comment, and post!

Thanks for reading!!!
http://web.ebscohost.com.ezproxy3.lhl.uab.edu/ehost/pdfviewer/pdfviewer?sid=e6c9ee31-81ca-4b19-8cbf-1253f5fe35c9%40sessionmgr113&vid=2&hid=111

URT Infections

Hello everyone,

This week in lecture we covered upper respiratory tract (URT) infections. URT infections are very common and unfortunately they have been a constant staple in my life. However after lecture, I realized I didn’t know as much about them as I thought. For starters, infections such as the common cold, thrush, sinusitis, croup, pharyngitis are all URT infections. Also, pharyngitis is the formal name for soar/strep throat and as simple as that sounds, that is something that I didn’t know. There are many organisms that cause pharyngitis such as viruses, Streptococcus pyogenes, and Arcanobacterium haemolyticum, however Streptococcus pyogenes causes 15-35% of those infections.

At some point in our lives we’ve all headed to the doctor complaining of a soar throat and received that awful, gagging swab of the throat and tonsils, with that huge cotton swab. That process is called a throat culture and as awful as it is, it is a vital tool used in diagnosing pharyngitis and isolating Streptococcus pyogenes. This week in lab we were able to work through that diagnostic process. We received a throat swabs, we performed rapid tests, we cultured the swabs, made preliminary identifications and performed confirmatory test on organisms that were isolated from culture, and report our findings in a final report. Lab this week was a lot fun to say the least.

In closing, the lecture/lab combination is ideal for me in learning infectious disease. I get such a deeper understanding when I can apply the knowledge I’ve obtained.

　

Until next time, check out the images below, comment, and post!

Thanks for reading!!!

 

Joke of the day:



SLE - Graduate Project

Hello everyone,

Some of you may know this, but in order to complete the MSCLS program here at UAB, all graduate students are required to complete a graduate project. My graduate project is on Systemic Lupus Erythrematosus (SLE), better known as Lupus. SLE is an autoimmune disease in which the immune system produces antibodies to cells within the body leading to widespread inflammation and tissue damage. SLE is characterized by its multiorgan involvement which can affect the skin, joints, kidneys, lungs, nervous system, as well as other organs of the body. The causes of SLE are unknown but are believed to be linked to genetic, environmental, and hormonal factors. SLE is very hard to diagnose because of the multiple factors that play a role in the disease. Because of this, no one test can diagnose or rule out the disease and one would have to present with at least 4 of the 11 typical symptoms to even be considered to have the disease. However, SLE is unpredictable and varies greatly from one individual to the next.

Epidemiological studies on SLE also show marked gender, age, racial, temporal and regional variations as disease triggers. There is higher disease prevalence of SLE in women compared to men with females being affected in 80–90% of the reported cases. Conditions associated with SLE can occur from infancy to old age, with peak occurrence between ages 15 and 40. Blacks, Hispanics, Asians, and Native Americans, are affected more than Caucasians. Although there is a strong familial aggregation, the disease is relatively uncommon and most cases are sporadic within related groups.

So as you can see, there is a lot to be learned about SLE and that is what made it so intriguing to me. With that being said, as I learn more about the disease, I will be passing that information along to you all!!!

Until next time, read, comment, and post!

Thanks for reading!!!

Just to get everyone up to speed

Hello again! Here is my bi-weekly check-in:

Just to get everyone up to speed, the course’s discussions are on bacterial infections by body site. We began with the blood, the CNS, and this week past week we discussed the urinary tract. One thing I’ve learned is the first important step in tackling these topics, is to know what is the normal flora of the site you are dealing with. For instance, blood and CSF are sterile!  NO BUGS SHOULD BE FOUND THERE!!! However, if they are, there’s a problem. And who knew there were so many bacterial causes of meningitis. I only knew of Neisseria meningitidis; I never considered Haemophilus influenzae!  Another interesting fact is that women are at a higher risk for urinary tract infections than men. I learned that in general, women suffer more urinary tract infections than men because women have a shorter urethra. Talk about getting the short end of the stick! But I have to say, the most interesting part of the course is the lab. That’s where we can put it all to use and it makes all the concepts so much clearer. In closing, the course is off to a good start and I’m excited about what’s up ahead.

Also, for those of you who are interested, I’ve included a link to a webpage that I found helpful. It discussed several bacteria and where they are considered normal flora as well as what pathogens they cause. I think it can be very helpful in the student laboratory so check it out.

Until next time, check out the link below, comment, and post!

Thanks for reading!!!

Todar's Online Textbook of Bacteriology http://textbookofbacteriology.net/normalflora.html

Joke of the day:

Hey everyone!

My name is Natashia Reese and welcome to my blog! I am Graduate Student at the University of Alabama at Birmingham studying Clinical Laboratory Science. The purpose of this blog is to fulfill requirements for my M.S. degree so I will be posting interesting topics discussed in my Infectious Disease course, as well as other interesting fun facts I pick up along the way. My greatest interests are Microbiology and Infectious Disease so this should be fun!  Thanks for taking time to read my blog and I hope you visit again. Please feel free to post comments! I look forward to hearing from you!!!

Joke of the day: