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Molecular Diagnostics

Molecular methods: added value for the diagnosis of infectious diseases

Serotyping used to be the golden standard method to distinguish between different types of Escherichia coli. Of the 181 numbered E. coli O antigens, only a small subset is associated with disease in humans. Enteropathogenic E. coli (EPEC) O111 is a classic cause of diarrhoea in children, especially in the developing world. Enterohaemorrhagic E. coli (EHEC) OIII, which typically carries at least one Shiga-toxin gene, is one of the commonest causes of bloody diarrhoea and haemolytic-uremic syndrome in the United States and elsewhere.
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Can molecular techniques contribute to the diagnosis of infective endocarditis?

Molecular biological techniques have dramatically altered the diagnostic procedures for infectious diseases, particularly for blood culture-negative endocarditis (BCNE), the diagnosis of which remains difficult and is often only established after some time. Recently molecular techniques have been developed for the identification of pathogens from heart muscle samples that are difficult to culture or that cannot be cultured under standard conditions. With the exception of some specific tests that can be carried out on serum or blood, these molecular techniques for the diagnosis of BCNE are often carried out on cardiac tissue samples.
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Molecular diagnosis: more than a useful tool in prognosis of prostatitis

Progress in treating prostate cancer has been hampered by the finding that histologically identical cancers exhibit widely varied clinical behaviour. The routine use of serum PSA testing in men at risk for prostate cancer has led to better disease characterisation at presentation, and earlier diagnosis and treatment. Despite this, standard treatment fails in approximately 30% of patients with intermediate risk prostate cancer. An understanding of the molecular abnormalities that define these tumours with a high risk for relapse is needed to help identify more precise biomarkers.
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QA and QC for molecular diagnostics: evaluation is the key to quality

Many current issues that molecular diagnostic laboratories face concern ‘quality’ of the diagnostic service they provide and the impact that this has on the level of patient care. With an increased drive towards ISO (International Standard Organisation) certification to standards such as ISO15189 or equivalent national accreditation programmes, the need for appropriate Quality Assurance (QA) and Quality Control (QC) procedures is essential for optimal and cost-effective patient management.
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