Diagnostic efficiency of different amphetamine screening tests - the search for an optimal cutoff

Increased use of designer drugs (amphetamines and amphetamine-like substances) raises the need for fast screening tests in urine in clinical settings, workplace and drug rehabilitation. Immunological assays currently used are subject to unwanted crossreactivities, partly depending on the cutoff concentrations used. The values recommended in Europe and the USA are 500 and 1000 ng/ml, respectively. In Switzerland, the recommended concentration of 300 ng/ml results in a high rate of false-positive urine samples and expensive, time-consuming confirmation testing. Using the Abbott Axsym analyzer, we found numerous false positives from patients in rehabilitation centers due to concomitant medication. Therefore, the diagnostic sensitivity and specificity of the Abbott test at different cutoff concentrations and the sensitivity of the Roche Cobas Integra, Beckman Synchron and Biosite Triage point-of-care test were examined. HPLC Bio-Rad Remedi was chosen as the method of higher hierarchical order. The specificity of the Axsym analyzer (300 ng/ml) was 86%. At 500 ng/ml or 1000 ng/ml the specificity was increased to 99 or 100%, respectively, while the sensitivity only decreased from 97 to 91 or 81%, respectively. In summary, the cutoff concentration for amphetamine screening tests should not be below 500 ng/ml to avoid a high rate of false-positive result

Procalcitonin: Importance for the diagnosis of bacterial infections

In contrast to calcitonin which is primarily synthesized in the thyroid, procalcitonin is a prohormone which is synthesized in many different tissues of infected organs. To diagnose mild, localized, or early infections an assay needs to have a functional assay sensivity of approximately 0.02μg/L. We demonstrated that procalcitonin modifies the outcome of respiratory infections with regard to minimizing the use of antibiotics and duration of antibiotic treatment. High concentrations, especially over time, indicate high risk of a severe outcome. In this respect, procalcitonin is superior to other infection markers, such as C-reactive protein. High procalcitonin levels can also be found in non-bacterial diseases, such as malaria, severe trauma, burns, and medullar carcinoma of the thyroid. Procalcitonin, as a marker, has improved the diagnosis of bacterial infections. However, procalcitonin needs to be used in conjunction with other laboratory markers, clinical examination, and medical histor

Procalcitonin und seine Bedeutung für die Diagnose bakterieller Infektionen

Procalcitonin ist das Pro-Hormon von Calcitonin. Im Gegensatz zu Calcitonin, welches primär in der Schilddrüse gebildet wird, wird Procalcitonin bei einer bakteriellen Infektion im Körper von allen infizierten parenchymatösen Organen produzier

Dugodosežzni učinci i stranost u nukleonu

We discuss the calculation of the strange magnetic radius of the proton in chiral perturbation theory. In particular, we investigate the low-energy component of the loop integrals involving kaons. We separate the chiral calculation into a low-energy part and a high-energy component through use of a momentum space separation scale. This separation shows that most of the chiral calculation comes from high energies where the effective field theory treatment is not valid. The resulting lowenergy prediction is in better agreement with dispersive treatments. Finally, we briefly discuss magnetic moments and show how our techniques can help resolve an old puzzle in understanding the magnetic moments of the proton and Σ+.Raspravljamo o računanju stranog magnetskog polumjera protona u kiralnoj teoriji smetnje. Posebice, istražujemo niskoenergijsku sastavnicu kaonskih petljanih integrala. Razdvajamo kiralni račun u niskoenergijski dio i visokoenergijsku sastavnicu primjenom razdvajajuće ljestvice impulsnog prostora. To razdvajanje pokazuje da kiralni račun većim dijelom daje doprinos na visokim energijama za koje efektivna teorija polja nije dobra. Predviđanje za niske energije je u boljem skladu s disperzivnim računom. Na kraju, kratko raspravljamo magnetske momente i pokazujemo kako naše metode mogu riješiti stari problem razumijevanja magnetskih momenata protona i Σ+

Effective control of persistent hyperparathyroidism with cinacalcet in renal allograft recipients

Background. Cinacalcet rapidly normalizes serum calcium and reduces intact parathyroid hormone (PTH) levels in renal transplant patients with hypercalcaemia and persistent hyperparathyroidism. The aim of this study is to evaluate the 6 months efficacy of cinacalcet and the effect of cinacalcet withdrawal on serum calcium and PTH in such patients. Furthermore, the impact of cinacalcet on bone turnover and quality of life was assessed. Methods. Twelve renal allograft recipients with hypercalcaemia due to persistent hyperparathyroidism were treated with cinacalcet for 26 weeks. Cinacalcet was then withdrawn to check for recurrence of hypercalcaemia. Results. Cinacalcet maintained normocalcaemia in all patients from week 4 to 26, and PTH significantly decreased and remained suppressed. Serum phosphate increased, whereas the serum calcium-phosphate product remained unchanged. The excretion of calcium and phosphate in the 24 h urine had tendency to decrease. After cinacalcet was withdrawn, hypercalcaemia recurred rapidly and PTH increased to baseline values. Renal function remained stable, proteinuria was unchanged and no allograft rejection was observed. During treatment with cinacalcet, total and bone-specific alkaline phosphatase increased, whereas the urinary deoxypyridinoline-creatinine ratio did not change significantly, suggesting enhanced bone formation. Quality of life assessed at weeks 10 and 26 remained unchanged compared with baseline. Conclusions. In conclusion, continued treatment with cinacalcet is required to maintain long-term normocalcaemia and to suppress the enhanced PTH production in renal transplant recipients with persistent hyperparathyroidis

Coronary CT FFR vs Invasive Adenosine and Dobutamine FFR in a Right Anomalous Coronary Artery.

We present the management of an anomalous coronary artery originating from the opposite sinus of Valsalva with comprehensive diagnostic workup including noninvasive coronary computed tomography (CT) derived fractional flow reserve (FFR) and invasive dobutamine-volume challenge-FFR/intravascular ultrasound. After surgical operation, treatment success was quantified by anatomical and functional analysis in postoperative CT. (Level of Difficulty: Advanced.)

Eikonal phase matrix, deflection angle, and time delay in effective field theories of gravity

The eikonal approximation is an ideal tool to extract classical observables in gauge theory and gravity directly from scattering amplitudes. Here we consider effective theories of gravity where in addition to the Einstein-Hilbert term we include non-minimal couplings of the type $R^3$, $R^4$ and $FFR$. In particular, we study the scattering of gravitons and photons of frequency $\omega$ off heavy scalars of mass $m$ in the limit $m\gg \omega \gg |\vec{q}\,|$, where $\vec{q}$ is the momentum transfer. The presence of non-minimal couplings induces helicity-flip processes which survive the eikonal limit, thereby promoting the eikonal phase to an eikonal phase matrix. We obtain the latter from the relevant two-to-two helicity amplitudes that we compute up to one-loop order, and confirm that the leading-order terms in $\omega$ exponentiate \`{a} la Amati, Ciafaloni and Veneziano. From the eigenvalues of the eikonal phase matrix we then extract two physical observables, to 2PM order: the classical deflection angle and Shapiro time delay/advance. Whenever the classical expectation of helicity conservation of the massless scattered particle is violated, i.e. the eigenvalues of the eikonal matrix are non-degenerate, causality violation due to time advance is a generic possibility for small impact parameter. We show that for graviton scattering in the $R^4$ and $FFR$ theories, time advance is circumvented if the couplings of these interactions satisfy certain positivity conditions, while it is unavoidable for graviton scattering in the $R^3$ theory and photon scattering in the $FFR$ theory. The scattering processes we consider mimic the deflection of photons and gravitons off spinless heavy objects such as black~holes.Comment: 38 pages. v2: published version, small typos corrected, reference adde

Visualizing dimensionality reduction of systems biology data

One of the challenges in analyzing high-dimensional expression data is the detection of important biological signals. A common approach is to apply a dimension reduction method, such as principal component analysis. Typically, after application of such a method the data is projected and visualized in the new coordinate system, using scatter plots or profile plots. These methods provide good results if the data have certain properties which become visible in the new coordinate system and which were hard to detect in the original coordinate system. Often however, the application of only one method does not suffice to capture all important signals. Therefore several methods addressing different aspects of the data need to be applied. We have developed a framework for linear and non-linear dimension reduction methods within our visual analytics pipeline SpRay. This includes measures that assist the interpretation of the factorization result. Different visualizations of these measures can be combined with functional annotations that support the interpretation of the results. We show an application to high-resolution time series microarray data in the antibiotic-producing organism Streptomyces coelicolor as well as to microarray data measuring expression of cells with normal karyotype and cells with trisomies of human chromosomes 13 and 21

Exploring the host factors affecting asymptomatic Plasmodium falciparum infection: insights from a rural Burkina Faso study.

BACKGROUND Asymptomatic Plasmodium falciparum parasitaemia forms a reservoir for the transmission of malaria disease in West Africa. Certain haemoglobin variants are known to protect against severe malaria infection. However, data on the potential roles of haemoglobin variants and nongenetic factors in asymptomatic malaria infection is scarce and controversial. Therefore, this study investigated the associations of iron homeostasis, inflammation, nutrition, and haemoglobin mutations with parasitaemia in an asymptomatic cohort from a P. falciparum-endemic region during the high transmission season. METHODS A sub-study population of 688 asymptomatic individuals (predominantly children and adolescents under 15 years, n = 516) from rural Burkina Faso previously recruited by the NOVAC trial (NCT03176719) between June and October 2017 was analysed. Parasitaemia was quantified with conventional haemocytometry. The haemoglobin genotype was determined by reverse hybridization assays targeting a selection of 21 HBA and 22 HBB mutations. Demographics, inflammatory markers (interleukins 6 and 10, hepcidin), nutritional status (mid upper-arm circumference and body mass index), and anaemia (total haemoglobin, ferritin, soluble transferrin receptor) were assessed as potential predictors through logistic regression. RESULTS Malaria parasites were detected in 56% of subjects. Parasitaemia was associated most strongly with malnutrition. The effect size increased with malnutrition severity (OR = 6.26, CI95: 2.45-19.4, p < 0.001). Furthermore, statistically significant associations (p < 0.05) with age, cytokines, hepcidin and heterozygous haemoglobin S were observed. CONCLUSIONS According to these findings, asymptomatic parasitaemia is attenuated by haemoglobin S, but not by any of the other detected genotypes. Aside from evidence for slight iron imbalance, overall undernutrition was found to predict parasitaemia; thus, further investigations are required to elucidate causality and inform strategies for interventions