Covid-19 / SARS-Cov2 - naučne/medicinske informacije i analize

[NMX]

13 hours ago, zakkturbo said:

Zaboravih da kažem, na tržištu se skoro svakodnevno menjaju cene testova, ali za antitela za 45 uzoraka, uz dozvole i transport, za Srbiju to iznosi oko 1000 eura, ako je test iz Evrope i USA, kineski su oko 300USD.

 

Javlja mi se da ćemo uzeti ove od 1000. Više može da se ugradi prilikom uvoza, distribucije i prodaje 

 

[zakkturbo]

Iskreno, više verujem Euroimmun testovima jer znam da su uradili validaciju, nego nekim kineskim koji se javljaju i daju ponudu za 2000 analiza po ceni od 300 samo zato što su videli u kojoj firmi neko radi. To naravno ne umanjuje bezobrazluk domaćih distributera, pa dozvole za uvoz, carinu.....produži niz.  

[djura.net]

1 hour ago, zakkturbo said:

U lab koje su priključene za rad se ispostavilo da postoji više problema vezanih za PCR dijagnostiku:

- loše uzorkovanje,

- predugo stajanje od uzorkovanja do analize,

- tumačenje dobijenih rezultata, koje se čini da nije baš tako jednostavno.

Pored toga, ježim se od brzinski dobijenih sertifikata za određenu dijagnostiku. 

Gledao sam juce onu doktorku na n1, ona kaze da su testovi tacni oko 60%, odnosi se I na ove iz grla I iz nosa,  a po njoj su najtacniji, preko 70% oni koji se uzimaju kao sto se radi sa testovima na tuberkulozu - ispljuvak iz pluca. Uz to, ovako prakticno svako moze sam da da uzorak na ispitivanje.

[zakkturbo]

Izbegavam gledanje, ali možda bi bilo dobro da pozovu i nekoga ko radi u labu, a ne samo lekare, što se naravno dijagnostilkih testova tiče. Ograđujem se, nisam nikada radila PCR u dijagnostičke svrhe, ali ljudi koji jesu, kažu da su najbolji testovi koji istovremeno analiziraju tri dela virusnog genoma i da se zakljućak donosi na osnovu detekcije sva tri regiona.

[Asterion]

Why Coronavirus Cases Have Spiked in Hong Kong, Singapore and Taiwan

[Asterion]

The Viral ‘Study’ About Runners Spreading Coronavirus Is Not Actually a Study Belgian researchers chose to bypass all standard science publishing protocols to publish research that has been overhyped and isn't well understood.

 

 

[urosg3]

vide se ohrabrujući rezultati od prošle subote, kada je policijski čas počeo u 13 časova, pa je zahvaljujući tome samo 275 novih slučajeva danas.
Sutra če biti još bolje, jer je prošla nedelja imala 24 sata karantin, pa će sigurno biti koji  slučaj manje...

[Asterion]

22 minutes ago, urosg3 said:

vide se ohrabrujući rezultati od prošle subote, kada je policijski čas počeo u 13 časova, pa je zahvaljujući tome samo 275 novih slučajeva danas.
Sutra če biti još bolje, jer je prošla nedelja imala 24 sata karantin, pa će sigurno biti koji  slučaj manje...

 

Izprobava se razne oblike karatine (zavisi od zdr.sistema, ekonomije, kulturloških specifika itd. države). Problem, je, dali postoje dobar know-how (znači testovi, i koliko njih itd.) za pravi feed-back o realnom stanju (šta virus radi u nekoj državi/populaciji).

 

Posle kad se stigne plato, onda ide drugi dio priče. Koliko otovoriti državu, da se ne vrati na stari put pandemije. 

 

Verovatno, če ovako nekako:

1. otvaranje, pa analiza (pračenje brojeva)

if ok (ako pada pod plato), then otvaranje broj 2

else then vračaj na lock-down (onaj jači, početni sa kojim se je postigo plato).

 

I tako napred (koliki je interval svakog tog otvaranja, zavisi od puno faktora), do herd immunitya ili do vakcine. 

 

Krugovi moči, če svakako pritiskati, da se spašava ekonomija, pa če se/se več ulaže puno para u vakcine.

Lepo bi bilo, da se ulaže i još više u testiranje (kvalitet+kvanitet).

 

 

 

 

 

[BojanaCZV]

1 hour ago, urosg3 said:

vide se ohrabrujući rezultati od prošle subote, kada je policijski čas počeo u 13 časova, pa je zahvaljujući tome samo 275 novih slučajeva danas.
Sutra če biti još bolje, jer je prošla nedelja imala 24 sata karantin, pa će sigurno biti koji  slučaj manje...

 

Ja nesto mislim sto vise testova, to vise zarazenih.

 

Mislim da smo duplirali broj testiranih u odnosu na pre 7 dana.

[wwww]

11 hours ago, zakkturbo said:

Iskreno, više verujem Euroimmun testovima jer znam da su uradili validaciju, nego nekim kineskim koji se javljaju i daju ponudu za 2000 analiza po ceni od 300 samo zato što su videli u kojoj firmi neko radi. To naravno ne umanjuje bezobrazluk domaćih distributera, pa dozvole za uvoz, carinu.....produži niz.  

U Nemackoj koriste i jednu foru (ne znam koliko ucestano) koja "stedi" testove:

istovremeno testiraju 10 uzoraka, pa ako taj test bude pozitivan onda urade pojedinacne testove, ako je negativan onda su ustedeli 9 testova.

Naravno, ovo ima smisla ako se radi sire testiranje, a ne samo onih koji imaju simptome (gde je velika verovatnoca da gotovo svaki test bude pozitivan).

 

Znas li da li se u Srbiji koristi test koji je razvijen u Nemackoj i trebalo bi da je na sajtu WHO stvavljen na raspolaganje svima? (nemam pojma ni kako izgleda ni od cega sse sastoji test, ali to ti sigurno znas)

[Plavi Golub]

11 minutes ago, wwww said:

U Nemackoj koriste i jednu foru (ne znam koliko ucestano) koja "stedi" testove:

istovremeno testiraju 10 uzoraka, pa ako taj test bude pozitivan onda urade pojedinacne testove, ako je negativan onda su ustedeli 9 testova.

cool 👍

[zakkturbo]

45 minutes ago, wwww said:

U Nemackoj koriste i jednu foru (ne znam koliko ucestano) koja "stedi" testove:

istovremeno testiraju 10 uzoraka, pa ako taj test bude pozitivan onda urade pojedinacne testove, ako je negativan onda su ustedeli 9 testova.

Naravno, ovo ima smisla ako se radi sire testiranje, a ne samo onih koji imaju simptome (gde je velika verovatnoca da gotovo svaki test bude pozitivan).

 

Znas li da li se u Srbiji koristi test koji je razvijen u Nemackoj i trebalo bi da je na sajtu WHO stvavljen na raspolaganje svima? (nemam pojma ni kako izgleda ni od cega sse sastoji test, ali to ti sigurno znas)

Istu foru su i ovde u nekim ustanovama koristili, pa ako je tzv pul pozitivan, onda ide pojedinačno testiranje. Institutu u kome radim odobreno je serološko testiranje, a pokušaćemo da napravimo i naš test.   

[mladenvzz]

...nositelj posla oko testiranja na koronu u Hrvatskoj je dr Ivan Christian Kurolt

sa Klinike za infektivne bolesti Fran Mihaljević u Zagrebu.Ima nekoliko intervjua

sa njime,pa ako želite više ukucajte njegovo ime.

[handys]

A food safety expert on why you’re unlikely to get the coronavirus from groceries or takeout

 

Vrlo koristan intervju:

 

We don’t have any epidemiology pointing toward food or food packaging as a risk factor for getting Covid-19.

The biology of the virus really points to consumption not being a factor for us. So could the virus be on food? Yes. But am I likely to get sick from it? No, because of all of these factors around biology and epidemiology. Could someone inadvertently put the virus on a package? Yes, absolutely, but I can mitigate that risk by washing my hands.

 

https://www.vox.com/the-goods/2020/4/10/21216586/coronavirus-food-safety-takeout-grocery-stores

 

 

[handys]

 I jedan o citokinima:

 

https://www.knowablemagazine.org/article/health-disease/2020/what-cytokine-storm

[Asterion]

4 hours ago, handys said:

Mozda je ovo vise za nauku, ali mi je delovalo zgodnije ovde posto nije vezano za neke konkretne naucne novosti, prebacite ako je ovde off:

 

Genetics Expert Says Covid-19 May Affect Human Evolution

 

https://m.calcalistech.com/Article.aspx?guid=3806775

 

Mali isecak:

 

 

Did you ever imagine that we would find ourselves in this type of situation?

 

“Absolutely. Moreover I fail to understand how we did not find ourselves in it sooner. Think about it, never before have there been such conditions of proximity. Human society is more urbanized than ever before. In an urban society people are in direct contact with each other on a constant basis, every time they press a button on an elevator. The fact that we have gone 100 years without a pandemic, speaks to the resilience of our immune systems.”

 

Najbolji dio (bar meni):

How can such a primitive virus know not to kill too many people?

 

 

“The people who are transferring the virus most these days are children and the virus knows how to take advantage of them. On the one hand, children’s immune systems are underdeveloped and their immaturity protects them from a deadly phenomenon called Cytokine release syndrome, in which the body produces too many white blood cells. On the other hand, children are in more direct contact with each other, they play and touch and thus serve as a perfect vessel for the transference of the virus to their family members. It is an amazing strategy by the virus: children’s immune systems enable widespread infection, while at the same time not affecting them too violently. Another advantage is that children have many more years to live, so the virus has found itself long-term living arrangements.”

 

 

Will traces of the virus remain with us forever?

 

 

“The chances of that are pretty high. Any disease that attacks us can change our genetics and, in a way, affect evolution. Pandemics influence evolution in two ways. One way is by killing off many people. Those who managed to survive due to a genetic advantage pass it to their offspring. The other way is by actually altering our genetic code. Around 8% of the human genome is made up of the remnants of ancient viruses that spread, infused into human cells, and left their genetic payload within them.

 

 

“There are reports of men who contracted coronavirus and concentrations of it were discovered in their testicles, which means it could reach their offspring. It is possible that the changes to our genetic code are a type of correction that will grant us previously unseen traits, but we will only find out about them in the distant future. When that happens we may be able to understand why some people got sick while others did not. It may be the case that some of the people who died from the virus, particularly the younger ones, had an immune system that was good at coping with germs, but overreacted when it encountered the virus.”

 

 

Is there a difference in how male and female bodies respond to diseases?

 

 

“More men contract Covid-19 than women. People do not understand the differences between the sexes and immediately say it is a result of behavior, that men smoke more or wash their hands less often. This may be partially true, but the fundamental reason is that women have a stronger immune system than men. It is an evolutionary trait, with the goal being that women survive to care for the children.”

 

---

14 hours ago, wwww said:

U Nemackoj koriste i jednu foru (ne znam koliko ucestano) koja "stedi" testove:

istovremeno testiraju 10 uzoraka, pa ako taj test bude pozitivan onda urade pojedinacne testove, ako je negativan onda su ustedeli 9 testova.

Naravno, ovo ima smisla ako se radi sire testiranje, a ne samo onih koji imaju simptome (gde je velika verovatnoca da gotovo svaki test bude pozitivan).

 

Znas li da li se u Srbiji koristi test koji je razvijen u Nemackoj i trebalo bi da je na sajtu WHO stvavljen na raspolaganje svima? (nemam pojma ni kako izgleda ni od cega sse sastoji test, ali to ti sigurno znas)

blue: imunološki testi (verovatno ELISA ili npr. ovaj)

green: genetski testi (RT-PCR)

 

Možda če se moči to još avtomatizirati (blue) ako nije več. 

 

 

Edited April 12, 2020 by Asterion

[Asterion]

Evo našo sam dobar tekst i slike u vezi genetskog dokazivanja virusa:

Quote

As the virus that causes the COVID-19 disease spreads across the world, the IAEA, in partnership with the Food and Agriculture Organization of the United Nations (FAO), is offering its support and expertise to help countries use real time reverse transcription–polymerase chain reaction (real time RT-PCR), one of the most accurate laboratory methods for detecting, tracking, and studying the coronavirus.

But what is real time RT-PCR? How does it work?  And what does it have to do with nuclear technology? Here’s a handy overview of the technique, how it works and a few refresher details on viruses and genetics.

What is real time RT-PCR?

Real time RT-PCR is a nuclear-derived method for detecting the presence of specific genetic material from any pathogen, including a virus. Originally, the method used radioactive isotope markers to detect targeted genetic materials, but subsequent refining has led to the replacement of the isotopic labelling with special markers, most frequently fluorescent dyes. With this technique, scientists can see the results almost immediately while the process is still ongoing; conventional RT-PCR only provides results at the end.

While real time RT-PCR is now the most widely used method for detecting coronaviruses, many countries still need support in setting up and using the technique.

What is a virus? What is genetic material?

A virus is a microscopic package of genetic material surrounded by a molecular envelope. The genetic material can be either DNA or RNA. 

DNA is a two-strand molecule that is found in all organisms, such as animals, plants, and viruses, and it holds the genetic code, or blueprint, for how these organisms are made and develop.

RNA is generally a one-strand molecule that copies, transcribes and transmits parts of the genetic code to proteins so they can synthetize and carry out functions that keep organisms alive and developing. There are different variations of RNA that do the copying, transcribing and transmitting.

Some viruses such as the coronavirus (SARS-Cov2) only contain RNA, which means they rely on infiltrating healthy cells to multiply and survive. Once inside the cell, the virus uses its own genetic code — RNA in the case of the coronavirus — to take control of and ‘reprogramme’ the cells so that they become virus-making factories.  

In order for a virus like the coronavirus to be detected early in the body using real time RT-PCR, scientists need to convert the RNA to DNA. This is a process called ‘reverse transcription’. They do this because only DNA can be copied — or amplified — which is a key part of the real time RT-PCR process for detecting viruses.

Scientists amplify a specific part of the transcribed viral DNA hundreds of thousands of times. Amplification is important so that instead of trying to spot a minuscule amount of the virus among millions of strands of genetic information, scientists have a large enough quantity of the target sections of viral DNA to accurately confirm that the virus is present.

How does real time RT-PCR work with the coronavirus?

A sample is collected from parts of the body where the coronavirus gathers, such as a person’s nose or throat. The sample is treated with several chemical solutions that remove substances, such as proteins and fats, and extracts only the RNA present in the sample. This extracted RNA is a mix of a person’s own genetic material and, if present, the coronavirus’ RNA.

The RNA is reverse transcribed to DNA using a specific enzyme. Scientists then add additional short fragments of DNA that are complementary to specific parts of the transcribed viral DNA. These fragments attach themselves to target sections of the viral DNA if the virus is present in a sample. Some of the added genetic fragments are for building DNA strands during amplification, while the others are for building the DNA and adding marker labels to the strands, which are then used to detect the virus.

The mixture is then placed in a RT-PCR machine. The machine cycles through temperatures that heat and cool the mixture to trigger specific chemical reactions that create new, identical copies of the target sections of viral DNA. The cycle repeats over and over to continue copying the target sections of viral DNA. Each cycle doubles the previous amount: two copies become four, four copies become eight, and so on. A standard real time RT-PCR setup usually goes through 35 cycles, which means that by the end of the process, around 35 billion new copies of the sections of viral DNA are created from each strand of the virus present in the sample.

As new copies of the viral DNA sections are built, the marker labels attach to the DNA strands and then release a fluorescent dye, which is measured by the machine’s computer and presented in real time on the screen. The computer tracks the amount of fluorescence in the sample after each cycle. When the amount goes over a certain level of fluorescence, this confirms that the virus is present. Scientists also monitor how many cycles it takes to reach this level in order to estimate the severity of the infection: the fewer the cycles, the more severe the viral infection is.

Why use real time RT-PCR?

The real time RT-PCR technique is highly sensitive and specific and can deliver a reliable diagnosis as fast as three hours, though usually laboratories take on average between 6 to 8 hours. Compared to other available virus isolation methods, real time RT-PCR is significantly faster and has a lower potential for contamination or errors as the entire process can be done within a closed tube. It continues to be the most accurate method available for detection of the coronavirus.

 

izvor

 

izvor

 

Da podvučem/objasnim jednu stvar/vidik...gornja slika, Problems: contamination and degradation can cause issues:

Ovaj virus je RNA virus. Genom je RNA, kojeg izoluju u laboratoriju. Pošto ljudi imamo (ne samo) na rukama encime koje razdrobe RNA (cepe RNA, zovu se na engleskom RNase) , potrebni su drugačiji uslovi rada ko kod izolacije DNA. U suportnom dođe do toga, da imaš na kraju negativan rezultat (znači iako je virus prisutan, neko malo peksav/ko se ne drži protokola, itd. može zezniti nekom bolesnom od korone život (u  najgorem slučaju), jer na kraju grafu mašine ispiše ravnu liniju (vidi gore sliku negative)).

 

 

 

 

[Asterion]

 

[wwww]

3 hours ago, Asterion said:

---

blue: imunološki testi (verovatno ELISA ili npr. ovaj)

green: genetski testi (RT-PCR)

 

Možda če se moči to još avtomatizirati (blue) ako nije več. 

 

 

Ja sam razumela da se ovo grupisanje 10 uzoraka i testiranje kao jednog odnosi na PCR test (kod identifikovanja zarazenih preko virusa iz brisa grla, ne preko antitela iz krvi), posto se u Nemackoj taj test sada koristi za masovno testiranje stanovnistva (od njega poticu one brojke koje gledamo u sttistikama za zarazene).

 

Valjda ELISA test sada samo koriste za "male kolicine" testiranja, za "naucne" svrhe, za detaljnije proucavanje cega god je sad bittno za prouciti, ne za masovno testiranje stanovnistva, posto je to test na antitela (i sta jos) i koliko sam ja razumela to malo potraje i nije bas automatizovano (to je trenutno problem).

 

(izvini za pojednostavljenje i banalizovanje)

Evo jedan fina slicica:

 

Edited April 12, 2020 by wwww

[wwww]

8 hours ago, Asterion said:

izvor

 

Da podvučem/objasnim jednu stvar/vidik...gornja slika, Problems: contamination and degradation can cause issues:

Ovaj virus je RNA virus. Genom je RNA, kojeg izoluju u laboratoriju. Pošto ljudi imamo (ne samo) na rukama encime koje razdrobe RNA (cepe RNA, zovu se na engleskom RNase) , potrebni su drugačiji uslovi rada ko kod izolacije DNA. U suportnom dođe do toga, da imaš na kraju negativan rezultat (znači iako je virus prisutan, neko malo peksav/ko se ne drži protokola, itd. može zezniti nekom bolesnom od korone život (u  najgorem slučaju), jer na kraju grafu mašine ispiše ravnu liniju (vidi gore sliku negative)).

Sad na vestima ide prilog iz Rusije, kazu da su primetili dosta slucajeva kada je test na covid-19 negativan a ljudi imaju neku neobicnu upalu pluca (dakle, test im nije dovoljno tacan/osetljiv/ispravno uradjen), te su stoga resili da sve ove slucajeve tretiraju kao da imaju covid-19.

[zakkturbo]

WWW divna i jasna sličica za tipove ELISA testova.  

Što se tiče RNaza, jeste tu su, ali se mogu držati pod kontrolom upotrebom reagenasa kao što je RNase away. 

[MetalHead]

On 4/11/2020 at 9:39 PM, wwww said:

U Nemackoj koriste i jednu foru (ne znam koliko ucestano) koja "stedi" testove:

istovremeno testiraju 10 uzoraka, pa ako taj test bude pozitivan onda urade pojedinacne testove, ako je negativan onda su ustedeli 9 testova.

Naravno, ovo ima smisla ako se radi sire testiranje, a ne samo onih koji imaju simptome (gde je velika verovatnoca da gotovo svaki test bude pozitivan).

 

To ima smisla samo ako testiras toliko masovno da obuhvatas i one bez ikakvih simptoma, i da ocekujes nizak procenat zarazenosti.

 

Ili recimo testiras celu zdravstvenu ustanovu (podelis u grupe) gde ocekujes da je vecina ipak zdrava, neka "udaljenija" odeljenja stavis kao jednu grupu a one koji su bili izlozeniji riziku stavis da budu pojedinacno testirani... 

 

 

Postoji jos jedna metoda, matricno testiranje, ne znam da li se bas tako zove ali teorija je sledeca:

Recimo imas uzorke pojedinacnih osoba, njih 25. U Srbiji je do sada u proseku 20% testiranih zaista i zarazeno, ali realno od kad su dosla kosooka braca, povecao se broj testiranja pa je procenat sada oko 10-15% (nisam bas pratio iz dana u dan). Odmah uzimas po vise uzoraka brisa od svake osobe (jeftiniji su stapici od testova).

 

Epruvete sa po 2 brisa od jedne osobe si stavio u matricu 5x5. Neka je 20% zarazeno (sto je mnogo) i kad ih stavis u matricu to izgleda recimo ovako:

Crvenim su oznacene te osobe koje su zarazene (5 od 25). 

 

Onda grupises briseve, stavis ih po 5 u jednu epruvetu, od svake osobe po jedan bris, po redovima (A1+B1+C1+D1+E1 = Grupa 1, itd) i po kolonama (A1+A2+A3+A4+A5 = Grupa A, itd). 

Dakle umesto da uradis 25 testova ti uradis 10 grupisanih. 

 

I s obzirom na pretpostavljenu postavku zarazenih u matrici dobijes ovakve rezultate:

 

Automatski znas da niko iz kolone B i E, kao i reda 4 nije zarazen, odnosno vizuelno ovako:

 

E sad ti ostaje da preostalih 12 (zuto i crveno) jos jednom testiras, pojedinacno, jer da ih stavljas u neku novu matricu nema smisla jer povecavas gustinu zarazenih pa ne dobijas vise ustedu (i ocekivanih 20% je mnogo za ovu metodu ali ima ustede i tako). 

 

Dakle, u ovom primeru umesto da uradis 25 individualnih testova, odradio si 10 grupnih i 12 individualnih, odnosno ustedeo si 3 testa (to je usteda ne samo u parama nego i u vremenu). Jedino sto onaj ko je zarazen, ceka rezulltate nesto duze, da se odrade 2 testa (1 grupni i 1 individualni) na njegovom brisu a ne 1 (individualni). 

 

 

 

Bonus: 

Ovo bi bio najbolji scenario sa 20% zarazenih:

Ne moras nikakve testove da ponavljas, ustedeo si 15 testova.

 

Ovo bi bio najgori scenario sa 20% zarazenih:

Ovde sve moras da ponovis 🙂 da ih preraspodelis ili da ih odmah radis individualno. Sprzio si 10 testova. 

 

 

[Fat Zadd]

U Nemačkoj , ako se dobro sećam podataka, na nivou države, se testira 500 000 osoba.  Jedan od predloga je da se osposobe dodatne labaratorije i ustanove za testiranje, i da se dnevno testira 500 000 osoba...

Meni ove cifre deluju nerealno, i bilo bi dobro ako neko od upucenih može da demantuje ili potvrdi .

2. Pre nedelju-dve su u Hessen-u testirani svi korisnici "staračkih domova" ,  kao i osoblje zaposleno u istima.

[wwww]

ovde ima poredjenje koliko koja zemlja testira (valjda su im ispravni podaci):

https://ourworldindata.org/covid-testing#united-kingdom

To understand the global pandemic, we need global testing – the Our World in Data COVID-19 Testing dataset

 

https://www.nytimes.com/2020/03/13/science/coronavirus-math-mitigation-distancing.html

The Exponential Power of Now

[sasa965]

Hiperbarični postupak  kod covid pacijenata

https://hbot.com/hbot-for-covid-19-pneumonia-and-respiratory-failure/?utm_source=twitter&utm_medium&utm_campaign