Sputum Sample
Sputum is mucus that is coughed up from the lower airways.In medicine, sputum samples are usually used for microbiological investigations of respiratory infections and cytological investigation of respiratory systems.
Laboratory diagnosis of H. Pylori infection, Ola ElgaddarOla Elgaddar
A short presentation for the different laboratory techniques used in diagnosing Helicobacter Pylori infection. A special focus is given for the diagnostic performance of every test.
casoni test is an immediate hypersensitivity skin test previously used in the diagnosis of hydatid disease.
Intradermal injection of 0.2ml of hydatid fluid collected from animal/human cyst which is sterilized by seitz filtration OR membrane filtration.
equal volume of saline(control) injected on the other forearm and observation made for next 30 min and after 1 to 2 days.
As a precaution anaphylactic tray must be kept ready before carrying out the test.(Type 1 hypersensitivity reaction)
Interpretation: Sensitive patients develop large wheal measuring 5 cm or more with formation of pseudopodia like projection within 30 minutes occuring at injection site, considered positive result.(immediate hypersensitivity) .
No reaction in the control arm.
Disadvantage: It has low sensitivity (60-80%)
and gives false positive results in cross reactive cestode infections.
It is no longer used nowadays and replaced largely by the serological tests.
Less reliable than imaging technique.
Laboratory diagnosis of H. Pylori infection, Ola ElgaddarOla Elgaddar
A short presentation for the different laboratory techniques used in diagnosing Helicobacter Pylori infection. A special focus is given for the diagnostic performance of every test.
casoni test is an immediate hypersensitivity skin test previously used in the diagnosis of hydatid disease.
Intradermal injection of 0.2ml of hydatid fluid collected from animal/human cyst which is sterilized by seitz filtration OR membrane filtration.
equal volume of saline(control) injected on the other forearm and observation made for next 30 min and after 1 to 2 days.
As a precaution anaphylactic tray must be kept ready before carrying out the test.(Type 1 hypersensitivity reaction)
Interpretation: Sensitive patients develop large wheal measuring 5 cm or more with formation of pseudopodia like projection within 30 minutes occuring at injection site, considered positive result.(immediate hypersensitivity) .
No reaction in the control arm.
Disadvantage: It has low sensitivity (60-80%)
and gives false positive results in cross reactive cestode infections.
It is no longer used nowadays and replaced largely by the serological tests.
Less reliable than imaging technique.
D dimer test and sample collection procedure anjalatchi
Normally D-dimer levels are undetectable or detectable at very low levels, but they rise sharply when the body breaks down clots. D-dimer tests help in ruling out pulmonary embolisms in hospitalised Covid-19 patients
Autoimmune hemolytic anemia (or autoimmune haemolytic anaemia; AIHA) occurs when antibodies directed against the person's own red blood cells (RBCs) cause them to burst (lyse), leading to insufficient plasma concentration.
Hello everyone!!
This is a presentation regarding Hemolytic anaemia. I hope you get enough information according to your needs from the same. This will be helpful for students or people in the field of medical. Students can take this as reference for their mini projects or presentations.
I hope this will be beneficial for many people.
Thank You!
A presentation made by Dr Gauhar Mahmood Azeem on the interpretations of a simple CBC and the information it can give us, Various conditions which may cause derangement are mentioned,
One test can save your life. Know what a D Dimer test is, why you should have it, who should get it, and where can you get tested as well as get your results fast. If you want to read more about the D Dimer test, just click the link below.
Visit: https://www.labfinder.com/labexams/d-dimer-test/ and get tested now!
D dimer test and sample collection procedure anjalatchi
Normally D-dimer levels are undetectable or detectable at very low levels, but they rise sharply when the body breaks down clots. D-dimer tests help in ruling out pulmonary embolisms in hospitalised Covid-19 patients
Autoimmune hemolytic anemia (or autoimmune haemolytic anaemia; AIHA) occurs when antibodies directed against the person's own red blood cells (RBCs) cause them to burst (lyse), leading to insufficient plasma concentration.
Hello everyone!!
This is a presentation regarding Hemolytic anaemia. I hope you get enough information according to your needs from the same. This will be helpful for students or people in the field of medical. Students can take this as reference for their mini projects or presentations.
I hope this will be beneficial for many people.
Thank You!
A presentation made by Dr Gauhar Mahmood Azeem on the interpretations of a simple CBC and the information it can give us, Various conditions which may cause derangement are mentioned,
One test can save your life. Know what a D Dimer test is, why you should have it, who should get it, and where can you get tested as well as get your results fast. If you want to read more about the D Dimer test, just click the link below.
Visit: https://www.labfinder.com/labexams/d-dimer-test/ and get tested now!
PATHOGENESIS OF BRONCHIECTASIS BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MED...Prof Dr Bashir Ahmed Dar
Dr Bashir Ahmed Dar associate professor medicine chinkipora sopore kashmir presently working in malaysia speaks about bronchiectasis.Bronchiectasis which is defined as the irreversible dilatation of the cartilage-containing airways bronchi or bronchioles.
The Top Skills That Can Get You Hired in 2017LinkedIn
We analyzed all the recruiting activity on LinkedIn this year and identified the Top Skills employers seek. Starting Oct 24, learn these skills and much more for free during the Week of Learning.
#AlwaysBeLearning https://learning.linkedin.com/week-of-learning
Staphylococcus aureus,a bunch of grapes
commonly found on the skin or in the nose of even healthy individuals
cause skin infections but can cause pneumonia, heart valve infections, and bone infections.
Evasion of the host immune response by Mycobacterium tuberculosisRichard Bautista
PowerPoint slides for a presentation on some of the methods and mechanisms used by Mycobacterium tuberculosis to evade host immune responses. The presentation was given on Monday, April 25, 2016, for the Advanced Microbial Physiology and Biochemistry course at Middle Tennessee State University.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
3. What is Sputum ?
• Sputum is mucus that is coughed up from the
lower airways.
• (Phlegm, mucus)
Sputum definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms
4. Types Of Sputum
• Bloody
• Rusty colored
• Purulent
• Foamy white
• Frothy pink
Sputum Color is the Key to Treating Acute COPD Exacerbations
17. Possible Infections
• Bacterial(pneumonia, whooping cough,
Legionnaire's disease, an atypical pneumonia,
parrot fever, TB, otitis media,
bronchitis, sinusitis, laryngitis )
• Fungal (Aspergillosis, Blastomycosis,
Coccidioidomycosis, Cryptococcus,
Histoplasmosis )
• Viral (In combination with certain bacteria)
18. Possible Bacterial Pathogens
• Streptococcus pneumoniae
• Staphylococci
• Hemophilus influenzae
• Members of the family Enterobacteriaceae
• Some pseudomonads
• Moraxella catarrhalis
• Mycobacterium tuberculosis
22. Streptococcus pneumoniae
• cause of bacterial pneumonia
• organisms are arranged in pairs and are
lancet shaped
• surrounded by a large capsule
• organisms are reported as Gram positive
cocci in pairs.
23.
24. Staphylococcus aureus
• They are usually round or slightly oval cocci
which occur singly in small clusters.
• Report these organisms as Gram positive
cocci in pairs and clusters.
25.
26.
27. Haemophilus influenzae
• The presence of many very tiny
pleomorphic Gram negative rods is strongly
suggestive of Hemophilus influenzae.
• They should be reported as small,
pleomorphic Gram negative rods.
33. Pseudomonas sp.
• Pseudomonads are usually long slender
Gram negative rods.
• Like Enterobacteriaceae, their morphology
is not sufficiently typical to be able to
characterize them on a Gram smear.
38. Mycobacterium Tuberclosis
•M. tuberculosis is characterized
by granulomas containing Langhans giant
cells, which have a "horseshoe" pattern of
nuclei.
•Organisms are identified by their red color on
acid-fast staining.
39.
40. Yeast
• Yeasts and pseudohyphal elements are
frequently seen.
• Small numbers.
• Increased numbers are often seen in patients
who are immuno-logically compromised and in
those who have been extensively treated with
antibiotics.
• These patients often have oral candidiasis.
• Yeasts are much larger than bacteria. Notice
the size difference between the yeast and the
gram negative rods.
41. Viral Infection
• Viruses are a common cause of pneumonia.
For a viral culture, sputum is mixed with
commercially-prepared animal cells in a test
tube. Characteristic changes to the cells
caused by the growing virus help identify the
virus. The time to complete a viral culture
varies with the type of virus. It may take from
several days to several weeks.
42. Media Culture used for sputum
• Mac Conkey Agar
• Chocolate Agar
• Blood Agar
49. Mucus
• "Mucus is incredibly important
for our bodies, It is the oil in the
engine. Without mucus, the
engine seizes."
Explains Michael M. Johns, III, MD, director of the
Emory Voice Center and assistant professor of
otolaryngology -- head and neck surgery at Emory
University.
50. References
• Sputum definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms
• Clinical Microbiology procedures handbook, American Society for Microbiology 2nd Ed. 2007 update
• Richard F.LeBlond. Diagnostics_expectoration. US: McGraw-Hill Companies, Inc. ISBN 0-07-140923-8.
• Richard F.LeBlond. Diagnostics_expectoration. US: McGraw-Hill Companies, Inc. ISBN 0-07-140923-8.
• Sputum Color is the Key to Treating Acute COPD Exacerbations
• Mawas F, Ho MM, Corbel MJ (January 2009). "Current progress with Moraxella catarrhalis antigens as vaccine
candidates". Expert Rev Vaccines 8 (1): 77–90. doi:10.1586/14760584.8.1.77.PMID 19093775.
• Yu S, Gu XX (June 2007). "Biological and Immunological Characteristics of Lipooligosaccharide-Based Conjugate
Vaccines for Serotype C Moraxella catarrhalis". Infect. Immun. 75 (6): 2974–80.doi:10.1128/IAI.01915-
06. PMC 1932890. PMID 17371852
• Winstanley, T.G. and R.C. Spencer. “Moraxea catarrkar: antibiotic susceptibility with special reference to
trimethoprim.” Journal of Antimicrobial Chemotherapy 18, no. 3 (1986): 425-426.
• Helminen, Merja E., Isobel Maciver, Jo L. Latimer, Julia Klesney-Tait, Leslie D. Cope, Maria Paris, George H.
McCracken, Jr., and Eric J. Hansen. “A Large, Antigenically Conserved Protein on the Surface of Moraxella
catarrhalis Is a Target for Protective Antibodies.” The Journal of Infectious Diseases 170, no. 4 (1994): 867-872.
• h Melendez, Philipp R. and Royce H. Johnson. “Bacteremia and Septic Arthritis Caused by Moraxella catarrhalis.”
Reviews of Infectious Diseases 13, no. 3 (1991): 428-429.
• Maciver, Isobel, Manaswat Unhanand, George H. McCracken Jr., and Eric J. Hansen. “Effect of Immunization on
Pulmonary Clearance of Moraxella Catarrhalis in an Animal Model.” The Journal of Infectious Diseases 168, no. 2
(1993): 469-472.
51. • Kuhnert P; Christensen H (editors). (2008).Pasteurellaceae: Biology, Genomics and Molecular Aspects. Caister Academic
Press. ISBN 978-1-904455-34-9.
• Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 396–401. ISBN 0-8385-8529-9.
• Slack, MP; et al. (1998). "Enhanced surveillance of invasive Haemophilus influenzae disease in England, 1990 to 1996:
impact of conjugate vaccines.". Pediatr Infect Dis J. 17 (9 suppl): S204–7. PMID 9781764.
• Behrman, Richard E.; Robert M Kliegman and Hal B. Jenson (2004). Nelson Tratado de Pediatría. Elsevier. p. 904. ISBN 84-
8174-747-5. Retrieved 2009-09-11.
• Puri J, Talwar V, Juneja M, Agarwal KN, Gupta HC (1999). "Prevalence of antimicrobial resistance among respiratory isolates
of Haemophilus influenzae". Indian Pediatr 36 (10): 1029–32. PMID 10745313.
• Levine OS, Schuchat A, Schwartz B, Wenger JD, Elliott J; Centers for Disease Control (1997). "Generic protocol for
population-based surveillance of Haemophilus influenzae type B". World Health Organization. WHO/VRD/GEN/95.05.
• John TJ, Cherian T, Steinhoff MC, Simoes EA, John M (1991). "Etiology of acute respiratory infections in children in tropical
southern India". Rev Infect Dis 13: Suppl 6:S463–9.PMID 1862277.
• Kennedy WA, Chang SJ, Purdy K, LE T, Kilgore PE, Kim JS et al. (2007). "Incidence of bacterial meningitis in Asia using
enhanced CSF testing: polymerase chain reaction, latex agglutination and culture". Epidemiol Infect 135 (7): 1217–
26. doi:10.1017/S0950268806007734.PMC 2870670. PMID 17274856.
• Pericone, Christopher D., Overweg, Karin, Hermans, Peter W. M., Weiser, Jeffrey N. (2000). "Inhibitory and Bactericidal
Effects of Hydrogen Peroxide Production by Streptococcus pneumoniae on Other Inhabitants of the Upper Respiratory
Tract". Infect Immun 68 (7): 3990–3997.doi:10.1128/IAI.68.7.3990-3997.2000. PMC 101678.PMID 10858213.
• Lysenko E, Ratner A, Nelson A, Weiser J (2005). "The role of innate immune responses in the outcome of interspecies
competition for colonization of mucosal surfaces". PLoS Pathog 1 (1):
e1. doi:10.1371/journal.ppat.0010001.PMC 1238736. PMID 16201010.
• Chang CM, Lauderdale TL, Lee HC, et al. (August 2010)."Colonisation of fluoroquinolone-resistant Haemophilus influenzae
among nursing home residents in southern Taiwan". J. Hosp. Infect. 75 (4): 304–
8.doi:10.1016/j.jhin.2009.12.020. PMID 20356651.
Editor's Notes
Phlegm is in essence a water-based gel consisting of glycoproteins, immunoglobulins, lipids and other substances. Important part of the normal defense mechanism of the lungsProduced by goblet cells which line the bronchiSpreads in a thin, even layer over the tissue surfacesProvides a transport system for the removal of foreign bodies from the respiratory tractIn many disease states, an excess of mucus is produced and is expectoratedCells and bacteria become enmeshed in the mucus and it is this combination of material that is known as sputumSputum:One of the most common types of specimen submitted to the laboratory for bacterial examination. Difficult to obtain because of contamination with saliva.Even specimens collected by bronchoscopy or through an endotracheal tube may be mixed with oropharyngeal secretions.Many of the bacteria which are known to cause lower respiratory tract infections may be present in the oropharynx as part of the normal flora e.g., staphylococci, pneumococci, and gram negative rods. The examination of a direct smear from the specimen can be very helpful in diagnosing respiratory infections and in determining the usefulness of the information provided by the culture.
. The colour can provide hints as to effective treatment in Chronic Bronchitis Patients:
Equipment requiredThe equipment needed to prepare the smears consists of two slides (preferably ones with frosted ends) a package of sterile swabs, a pencil a Bunsen burner. Label the two slides with the patient’s name, the date of collection, and the specimen accession number.
Specimens may be primarily clear and slightly viscid with flecks of white or greenish material embedded. These are specimens that consists mainly of saliva with a small amount of material that may be sputum. The flecks should be selected.
The sample to be used may be drawn up the side of the container with the swab to make selection easier. Mucus can be "cut" with the swab by drawing the swab against the side of the container and thus separating off part of the mucus. Merely dipping the swab into the specimen will not usually provide the best sample.
Fix the smear by passing it through a Bunsen flame several times. Do not allow the smear to be in contact with the flame for more than one second at a time. 5 or 6 passes through the flame is sufficient. The slide should be warm, not hot, to the touch.Stain one of the smears using the Gram stain procedure. Sputum smears are usually thicker than most other types of smear and often need more decolorization than usual. Decolorize until all or most of the blue color is removed
Mucus is easily seen under low power magnification. It forms long irregularly shaped strands which may have cells and bacteria embedded in it.
The etiology of bacterial infections cannot be diagnosed solely by the Gram stain morphology of the organisms in a direct smear. However, the morphology of some organisms is sufficiently characteristic that a tentative diagnosis can be made on the basis of the smear .
Mucus is easily seen under low power magnification. It forms long irregularly shaped strands which may have cells and bacteria embedded in it.
Hemophilusinfluenzaeoften stains very weakly and tends to blend into the background material in the smear and it is easy to overlook them. On this slide, they are most clearly seen as intracellular organisms in the poly with a 4-lobed nucleus. Look for more amongst the background material. Pleomorphism (cytology): variability in the size and shape of cells and/or their nuclei
Clinical Significance : These bacteria are known to cause otitis media,[2][3] bronchitis, sinusitis, and laryngitis. Elderly patients and long-term heavy smokers with chronic pulmonary disease should be aware that M. catarrhalis is associated with bronchopneumonia, as well as exacerbations of existing chronic obstructive pulmonary disease (COPD).It has also been known to cause infective exacerbations in adults with chronic lung disease, and it is an important cause in acute sinusitis, maxillary sinusitis, bacteremia, meningitis, conjunctivitis, acute purulent irritation ofchronic bronchitis, urethritis, septicemia (although this is rare), septic arthritis (which is also a rare occurrence), as well as acute laryngitis in adults and acute otitis media in children.[6][7] M. catarrhalis is an opportunistic pulmonary invader, and causes harm especially in patients who have compromised immune systems or any underlying chronic disease
Phlegm is in essence a water-based gel consisting of glycoproteins, immunoglobulins, lipids and other substances. Important part of the normal defense mechanism of the lungsProduced by goblet cells which line the bronchiSpreads in a thin, even layer over the tissue surfacesProvides a transport system for the removal of foreign bodies from the respiratory tractIn many disease states, an excess of mucus is produced and is expectoratedCells and bacteria become enmeshed in the mucus and it is this combination of material that is known as sputumSputum:One of the most common types of specimen submitted to the laboratory for bacterial examination. Difficult to obtain because of contamination with saliva.Even specimens collected by bronchoscopy or through an endotracheal tube may be mixed with oropharyngeal secretions.Many of the bacteria which are known to cause lower respiratory tract infections may be present in the oropharynx as part of the normal flora e.g., staphylococci, pneumococci, and gram negative rods. The examination of a direct smear from the specimen can be very helpful in diagnosing respiratory infections and in determining the usefulness of the information provided by the culture.