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Clinical microbiologists are engaged in the field of diagnostic microbiology to determine whether pathogenic microorganisms are present in clinical specimens collected from patients with suspected infections. If microorganisms are found, these are identified and susceptibility profiles, when indicated, are determined. During the past two decades, technical advances in the field of diagnostic microbiology have made constant and enormous progress in various areas, including bacteriology, mycology, mycobacteriology, parasitology, and virology. The diagnostic capabilities of modern clinical microbiology laboratories have improved rapidly and have expanded greatly due to a technological revolution in molecular aspects of microbiology and immunology. In particular, rapid techniques for nucleic acid amplification and characterization combined with automation and user-friendly software have significantly broadened the diagnostic arsenal for the clinical microbiologist. The conventional diagnostic model for clinical microbiology has been labor-intensive and frequently required days to weeks before test results were available. Moreover, due to the complexity and length of such testing, this service was usually directed at the hospitalized patient population. The physical structure of laboratories, staffing patterns, workflow, and turnaround time all have been influenced profoundly by these technical advances. Such changes will undoubtedly continue and lead the field of diagnostic microbiology inevitably to a truly modern discipline. Advanced Techniques in Diagnostic Microbiology provides a comprehensive and up-to-date description of advanced methods that have evolved for the diagnosis of infectious diseases in the routine clinical microbiology laboratory. The book is divided into two sections. The first techniques section covers the principles and characteristics of techniques ranging from rapid antigen testing, to advanced antibody detection, to in vitro nucleic acid amplification techniques, and to nucleic acid microarray and mass spectrometry. Sufficient space is assigned to cover different nucleic acid amplification formats that are currently being used widely in the diagnostic microbiology field. Within each technique, examples are given regarding its application in the diagnostic field. Commercial product information, if available, is introduced with commentary in each chapter. If several test formats are available for a technique, objective comparisons are given to illustrate the contrasts of their advantages and disadvantages. The second applications section provides practical examples of application of these advanced techniques in several "hot" spots in the diagnostic field. A diverse team of authors presents authoritative and comprehensive information on sequence-based bacterial identification, blood and blood product screening, molecular diagnosis of sexually transmitted diseases, advances in mycobacterial diagnosis, novel and rapid emerging microorganism detection and genotyping, and future directions in the diagnostic microbiology field. We hope our readers like this technique-based approach and your feedback is highly appreciated. We want to thank the authors who devoted their time and efforts to produce their chapters. We also thank the staff at Springer Press, especially Melissa Ramondetta, who initiated the whole project. Finally, we greatly appreciate the constant encouragement of our family members through this long effort. Without their unwavering faith and full support, we would never have had the courage to commence this project

INTRODUCTION: Mediastinal parathyroid adenomas are a rare condition. AIM: Analysis of epidemiological data, clinical manifestation of mediastinal parathyroid adenoma (MPA), including imaging modalities, and therapeutic approach to this condition. MATERIAL AND METHODS: A retrospective study of documented cases of mediastinal parathyroid adenoma that were managed at our Department of Thoracic Surgery of the Military Teaching Hospital Mohammed V, between January 2010 and December 2019. RESULTS: During a 9-year period in our department, 21 documented cases of MPA were treated surgically. Patients ranged in age from 20 to 69 years, with a mean age of 45 years, and there was no gender predominance. The most frequently reported manifestations were osteoarticular, with bone pain in 66.6% (14/21), pathological fractures in 28.5% (6/21), and osteoporosis in 23.8% (5/21). Cervical ultrasound, MIBI scintigraphy and cervico-thoracic computed tomography scan were performed respectively in 28.5% (n = 06/21), in 47.6% (n = 10/21) and 100% (n = 21), and allowed positive diagnosis of MPA. All patients benefited from resection surgery, through a classical transverse cervicotomy which was extended in some cases to the manubrium, and in only one case treated with thoracotomy. CONCLUSIONS: Management of mediastinal parathyroid adenoma is based on the diagnosis imaging assessment step, usually by MIBI scintigraphy. Surgical ablation is a radical treatment. Peroperative hormonal evaluation is mainly recommended.

Clear cell acanthoma represent a benign solitary epidermal tumor of the clear glycogen containing epithelial cells, which is quite common in dermatologic practice. The etiology of this tumor formation is not known exactly at the moment. Clinically, the lesion appears as a single reddish papule or papule-nodule and the characteristic of this lesion is represented by a peripheral scaling collarette. Although solitary lesions represent the most common form of presentation of the acanthoma with clear cells, less than thirtieth cases of multiple clear cell acanthoma, from two up to four hundred lesions, have been described in the medical literature to date. The diagnosis based on clinical features frequently needs to be supported using a dermoscopy exam and, in most cases, a histopathology exam is required. The treatment consists is complete removal (standard surgical excision, cryotherapy, electrofulguration alone, carbon dioxide laser or shave removal or curettage followed by electrofulguration). For the cases with multiple lesions, cryotherapy, or topical 5- fluorouracil are preferred. We present the case of a 62-year-old male patient, presented to our Dermatology Department for multiple asymptomatic rounded papules and multiple exophytic nodular tumor formations (approximate fifteen), on the lower extremities, which had occurred approximately two years previously and gradually increased in number.

In mid-March 2015, a mother and her teenage daughter and son from Syria presented to a Syrian American Medical Society (SAMS) refugee clinic in the Beqaa Valley in Lebanon with the chief complaints of hair loss together with weakness and numbness of their lower extremities. They reported that on March 1, a military foe of their relative had given him several boxes of Middle Eastern cookies which were consumed by over 20 members of their families and neighbors. Soon after the consumption, most members of the households developed symptoms including abdominal pain, nausea, vomiting, and constipation. Later, many of the affected individuals, including the three who presented to the clinic, had pain and weakness in the extremities, skin lesions, and hair loss. Two subjects died inside Syria of kidney failure. In this report, we describe the diagnostic challenges faced until the arrival to the diagnosis of thallium intoxication and the therapeutic obstacles to getting adequate therapy. We also report the results of a survey sent to all subjects in the affected households and discuss the context of lawlessness that led to this intoxication and perhaps other cases.

It is undeniable that the increasing costs in healthcare are a concern. Although technological advancements have been made in healthcare systems, the return on investment made by governments and payers has been poor. The current model of care is unsustainable and is due for an upgrade. In developed nations, a law of diminishing returns has been noted in population health standards, whilst in the developing world, westernized chronic illnesses, such as diabetes and cardiovascular disease have become emerging problems. The reasons for these trends are complex, multifactorial and not easily reversed. Personalized medicine has the potential to have a significant impact on these issues, but for it to be truly successful, interdisciplinary mass collaboration is required. We propose here a vision for open-access advanced analytics for personalized cardiac diagnostics using imaging, electrocardiography and genomics.

It is undeniable that the increasing costs in healthcare are a concern. Although technological advancements have been made in healthcare systems, the return on investment made by governments and payers has been poor. The current model of care is unsustainable and is due for an upgrade. In developed nations, a law of diminishing returns has been noted in population health standards, whilst in the developing world, westernized chronic illnesses, such as diabetes and cardiovascular disease have become emerging problems. The reasons for these trends are complex, multifactorial and not easily reversed. Personalized medicine has the potential to have a significant impact on these issues, but for it to be truly successful, interdisciplinary mass collaboration is required. We propose here a vision for open-access advanced analytics for personalized cardiac diagnostics using imaging, electrocardiography and genomics.

Interdependencies of attitudes towards vignettes of mentally ill patients and the professional approach of medical students measured by means of diagnostic assessments and therapeutic distance were studied. First, the findings indicate that the attitudes towards the vignettes depended on the behavioral characteristics of each patient presented in the vignettes. Thus, the levels on four attitudinal subscales were different for each of the patients. Second, the two variables of the professional approach of the students towards the patients, i.e., the diagnostic assessment and the therapeutic distance, were dependent on the attitudes towards the patients. The findings indicate that the more disturbed a patient is, and the less he is diagnosed as mentally ill, the more he is rejected from treatment, and the more negative the students' attitudes are towards him.

According to increasing use of clinical facilities such as MRI to diagnose diseases around the world, it is important to know that to what extent these facilities are used based on the existing indications. Accurate history taking and physical examination are essential and first step in requesting para-clinical measures. It is also very important in interpreting the spine MRI findings in patients with back pain. Therefore, it seems necessary to examine physicians' attention to history taking and physical examination before applying MRI to enact rules for optimal use of existing facilities. A total of 195 outpatients referred to the Imaging Center of Shahid Sadoughi Hospital in Yazd for spine MRI were selected by easily and convenience sampling method. The data were collected using a structured interview. Of 195 patients referred, 17.5% (n = 31) and 8.2% (n = 16) reported that the physician was not aware of the main complaint duration and the exact pain localization, respectively, and 31% of patients had not been examined by the physician. Based on the results of this research, inattention of some physicians to accurate history taking and physical examination is one of the reasons for aberrant spine MRI. Accordingly, lack of attention to the absence of clinical signs consistent with the results of MRI can create a chain of futile diagnostic and therapeutic measures as well as financial and psychological burden on the patients.The results showed that solving the problem of aberrant requests for MRI requires fundamental and comprehensive planning to develop national guidelines, inclusion of these guidelines in educational system of medical students and doctors, encouraging patients to ask physicians about the reason for applying MRI and its impact on diagnostic and therapeutic processes, and finally national legislation and insurance to monitor and reduce requests without indications.