Adenosine deaminase activity in tuberculous and malignant pleural effusions

Measurement of pleural adenosine deaminase activity (ADA) is a useful diagnostic tool for tuberculous pleurisy, but false-positive findings from non-tuberculous effusions have been reported. In order to improve diagnostic value of ADA it is recommended to estimate activity of both ADA1 and ADA2 izoenzymes or 2'-deoxyadenosine/adenosine activity ratio. In order to evaluate ADA as a diagnostic parameter total ADA, with adenosine as a substrate, and 2'-deoxyadenosine/adenosine activity ratio were measured in tuberculous and malignant pleural effusions. Altogether, 26 pleural exudates (11 tuberculous and 15 malignant) were selected. ADA either with adenosine or 2'-deoxyadenosine was determined by colorimetric method of Giusti. Each pleural fluid sample was diluted prior to the assay(1:8)to avoid enzyme inhibition which was observed in nondiluted pleural effusions. The ADA level reached the diagnostic cut-off set for tuberculous effusions (40 U/L) in every 11 tuberculous exudates with the mean value of 85,3±47,1U/L; in 9 of these the 2'-deoxyadenosine/adenosine ratio was less than 0,45. In the malignant group of patients, no one ADA level exceed 40 U/L, being estimated at 10,6±7,7 U/L (

Pleural fluid interferon-gamma (IFN-γ) measurement as a diagnostic tool in tuberculous pleurisy

Wstęp: Mimo że gruźlicze zapalenie opłucnej stanowi jedną z częstszych przyczyn obecności płynu w jamie opłucnej, rozpoznanie choroby nie należy jednak do łatwych. Najważniejsze znaczenie diagnostyczne mają badania histologiczne i mikrobiologiczne bioptatów opłucnej. Prowadzi się także liczne badania nad innymi markerami gruźliczego zapalenia opłucnej. Celem badania była ocena przydatności oznaczania stężenia interferonu gamma (IFN-&#947;) w płynie opłucnowym jako metody diagnostycznej gruźliczego zapalenia opłucnej. Materiał i metody: Badaną grupę stanowiło 94 chorych z płynem w opłucnej (44 kobiety i 50 mężczyzn, w wieku od 18 do 95 lat, średnia 59 &#177; 18 lat). U wszystkich wykonano punkcję opłucnej i badanie właściwości fizykochemicznych płynu (m.in. stężenie białka, aktywność dehydrogenazy mleczanowej [LDH, lactate dehydrogenase]). Dokonano także oceny całkowitej liczby komórek w płynie i ich składu odsetkowego. O innych badaniach diagnostycznych decydowały przesłanki kliniczne i wyniki badania płynu. Podstawę rozpoznania gruźliczej etiologii wysięku stanowiły: 1) dodatni wynik hodowli płynu lub bioptatu opłucnej lub 2) stwierdzenie ziarniny gruźliczopodobnej w bioptatach przy jednoczesnym wykluczeniu innych chorób mogących stanowić jej przyczynę. Stężenie IFN-&#947; w płynie opłucnowym oznaczano metodą ELISA (Quantikine Human IFN-&#947; Immunoassay, R&D Systems, USA). Wyniki: Gruźlicze wysiękowe zapalenie opłucnej rozpoznano u 28 osób. Wśród chorych z niegruźliczym płynem w opłucnej wyróżniono następujące podgrupy: wysięk nowotworowy (n = 35), wysięk parapneumoniczny/ropniak opłucnej (n = 20), przesięk w przebiegu niewydolności serca (n = 5) i inne rzadsze przyczyny płynu (n = 6). Średnie stężenie IFN-&#947; było znamiennie wyższe u chorych z wysiękiem gruźliczym niż w pozostałej grupie chorych (614,1 &#177; 324,5 vs. 15,1 &#177; 36,0 pg/ml, p < 0,0001). Przyjmując jako wartość odcinającą stężenie równe 100 pg/ml, czułość i swoistość testu dla rozpoznania gruźliczej etiologii wysięku wyniosły odpowiednio 100% i 98,5%. Wniosek: Stężenie IFN-&#947; okazało się bardzo swoistym i czułym markerem pozwalającym na rozróżnienie gruźliczego wysięku w opłucnej od płynów o innej etiologii.Introduction: Tuberculosis is one of the most common causes of pleural effusion (PE). However, the diagnosis of tuberculous pleurisy still remains difficult. Since M. tuberculosis isolation rates in tuberculous effusions are relatively low the histological and microbiological studies of pleural biopsy samples are usually required to confirm the diagnosis. Several biological markers have been proposed to enhance the effectiveness of diagnosing patients with tuberculous pleurisy. The study was undertaken to evaluate the diagnostic accuracy of pleural fluid IFN-&#947; concentration in differentiation between tuberculous pleural effusion (TPE) and non-tuberculous pleural effusion (nTPE). Material and methods: 94 patients (50 M and 44 F, mean age 59 &#177; 18, range 18-95 years) with PE were studied. All subjects underwent diagnostic thoracenthesis and extensive laboratory pleural fluid evaluation. Tuberculous pleural effusion was diagnosed in: 1) patients with positive pleural fluid or pleural biopsy culture and 2) patients with granulomas in the pleural biopsy specimen, after exclusion of other granulomatous diseases. IFN-&#947; level in pleural fluid was measured with commercially available immunoenzymatic assay (Quantikine Human IFN-&#947; Immunoassay, R&amp;D Systems, USA). Results: Tuberculous pleural effusion was diagnosed in 28 pts. The non-tuberculous pleural effusion group consisted of 66 pts, including 35 with malignant PE, 20 with parapneumonic effusion or pleural empyema, 5 with pleural transudates due to heart failure, and 6 with miscellaneous causes of PE. The mean concentration of IFN-g was significantly higher in TPE than in nTPE (614.1 &#177; 324.5 vs. 15.1 &#177; 36.0 pg/ml, p < 0.0001). At the cut-off value of 100 pg/ml the sensitivity and specificity of the test were 100% and 98,5% respectively. Conclusion: The pleural fluid concentration of IFN-&#947; was found to be highly sensitive and specific marker of tuberculous pleurisy

Assessment of zinc content in selected skin protective formulations by means of the ASA method

W poniższej pracy badano zawartość cynku w wybranych preparatach ochronnych. W trakcie eksperymentu przebadano 8 produktów deklarujących w swoim składzie jego obecność. Pięć z nich to kremy stosowane do ochrony przeciwsłonecznej marki Emolium, Pharmaceris oraz Ziaja, szósty z nich to krem Be Blemish ze SKIN79, siódmy to fluid mineralny marki Avene, zaś ósmy to balsam regenerujący z La Roche-Posay. Po przeprowadzeniu mineralizacji mikrofalowej analizowanych próbek w badanych roztworach oznaczono zawartość jonów cynku przy zastosowaniu metody płomieniowej absorpcyjnej spektrometrii atomowej. Zgodnie z deklaracjami producentów cynk wykryto w każdym z ośmiu preparatów. Uzyskane wartości są zgodne z normami przyjętymi przez Komisję Unii Europejskiej. Żaden z preparatów nie przekracza tych norm.The study examinated the content of zinc in selected protective formulations. During experiment eight products were tested, all of them declared zinc in their composition. Five of them are sunscreens from Emolium, Pharmaceris and Ziaja, the sixth is the Be Blemish cream from SKIN79, the seventh is Avene mineral fluid, and the eighth is the regenerating balm from La Roche-Posay. After the mineralization of the analyzed samples in the obtained solutions, the concentration of zinc ions was determinated by means of flame atomic absorption spectrometry. According to the producers declarations, zinc was detected in each of eight preparations. The values obtained are in accordance with the standards adopted by the Commission of the European Union. None of the preparations exceeds these standards

Adenosine Deaminase Activity in Tuberculous and Malignant Pleural Effusions

Measurement of pleural adenosine deaminase activity (ADA) is a useful diagnostic tool for tuberculous pleurisy, but false-positive findings from non-tuberculous effusions have been reported. In order to improve diagnostic value of ADA it is recommended to estimate activity of both ADA1 and ADA2 izoenzymes or 2′-deoxyadenosine/adenosine activity ratio. In order to evaluate ADA as a diagnostic parameter total ADA, with adenosine as a substrate, and 2’-deoxyadenosine/adenosine activity ratio were measured in tuberculous and malignant pleural effusions. Altogether, 26 pleural exudates (11 tuberculous and 15 malignant) were selected. ADA either with adenosine or 2’-deoxyadenosine was determined by colorimetric method of Giusti. Each pleural fluid sample was diluted prior to the assay (1:8) to avoid enzyme inhibition which was observed in nondiluted pleural effusions. The ADA level reached the diagnostic cut-off set for tuberculous effusions (40 U/L) in every 11 tuberculous exudates with the mean value of 85.3 ± 47.1 U/L; in 9 of these the 2′-deoxyadenosine/adenosine ratio was less than 0.45. In the malignant group of patients, no one ADA level exceed 40 U/L, being estimated at 10.6 ± 7.7 U/L (p &lt; 0.001). In 10 of these 15 exudates the 2′-deoxyadenosine/adenosine ratio was undetectable, in four it was less than 0.45 and only in one it was over 0.45.We concluded that ADA measured by the Giusti method proceeded by the dilution 1:8 of the pleural effusion samples very good differentiates tuberculous from malignant pleurisy, without the necessity to determine the 2′-deoxyadenosine/adenosine ratio The investigation needs to be continued on the more numerous groups of patients

Pleural Fluid Interferon-Gamma (IFN-γ) Measurement as a Diagnostic Tool in Tuberculous Pleurisy

Introduction: Tuberculosis is one of the most common causes of pleural effusion (PE). However, the diagnosis of tuberculous pleurisy still remains difficult. Since M. tuberculosis isolation rates in tuberculous effusions are relatively low the histological and microbiological studies of pleural biopsy samples are usually required to confirm the diagnosis. Several biological markers have been proposed to enhance the effectiveness of diagnosing patients with tuberculous pleurisy. The study was undertaken to evaluate the diagnostic accuracy of pleural fluid IFN-γ concentration in differentiation between tuberculous pleural effusion (TPE) and non-tuberculous pleural effusion (nTPE). Material and methods: 94 patients (50 M and 44 F, mean age 59 ± 18, range 18–95 years) with PE were studied. All subjects underwent diagnostic thoracenthesis and extensive laboratory pleural fluid evaluation. Tuberculous pleural effusion was diagnosed in: (1) patients with positive pleural fluid or pleural biopsy culture and (2) patients with granulomas in the pleural biopsy specimen, after exclusion of other granulomatous diseases. IFN-γ level in pleural fluid was measured with commercially available immunoenzymatic assay (Quantikine Human IFN-γ Immunoassay, R&amp;D Systems, USA). Results: Tuberculous pleural effusion was diagnosed in 28 pts. The non-tuberculous pleural effusion group consisted of 66 pts, including 35 with malignant PE, 20 with parapneumonic effusion or pleural empyema, 5 with pleural transudates due to heart failure, and 6 with miscellaneous causes of PE. The mean concentration of IFN-γ was significantly higher in TPE than in nTPE (614.1 ± 324.5 vs. 15.1 ± 36.0 pg/ml, p &lt; 0.0001). At the cut-off value of 100 pg/ml the sensitivity and specificity of the test were 100% and 98.5% respectively. Conclusions: The pleural fluid concentration of IFN-γ was found to be highly sensitive and specific marker of tuberculous pleurisy

Efficacy, durability, and safety of intravitreal faricimab up to every 16 weeks for neovascular age-related macular degeneration (TENAYA and LUCERNE): two randomised, double-masked, phase 3, non-inferiority trials

Background: Faricimab is a bispecific antibody that acts through dual inhibition of both angiopoietin-2 and vascular endothelial growth factor A. We report primary results of two phase 3 trials evaluating intravitreal faricimab with extension up to every 16 weeks for neovascular age-related macular degeneration (nAMD). Methods: TENAYA and LUCERNE were randomised, double-masked, non-inferiority trials across 271 sites worldwide. Treatment-naive patients with nAMD aged 50 years or older were randomly assigned (1:1) to intravitreal faricimab 6·0 mg up to every 16 weeks, based on protocol-defined disease activity assessments at weeks 20 and 24, or aflibercept 2·0 mg every 8 weeks. Randomisation was performed through an interactive voice or web-based response system using a stratified permuted block randomisation method. Patients, investigators, those assessing outcomes, and the funder were masked to group assignments. The primary endpoint was mean change in best-corrected visual acuity (BCVA) from baseline averaged over weeks 40, 44, and 48 (prespecified non-inferiority margin of four letters), in the intention-to-treat population. Safety analyses included patients who received at least one dose of study treatment. These trials are registered with ClinicalTrials.gov (TENAYA NCT03823287 and LUCERNE NCT03823300). Findings: Across the two trials, 1329 patients were randomly assigned between Feb 19 and Nov 19, 2019 (TENAYA n=334 faricimab and n=337 aflibercept), and between March 11 and Nov 1, 2019 (LUCERNE n=331 faricimab and n=327 aflibercept). BCVA change from baseline with faricimab was non-inferior to aflibercept in both TENAYA (adjusted mean change 5·8 letters [95% CI 4·6 to 7·1] and 5·1 letters [3·9 to 6·4]; treatment difference 0·7 letters [-1·1 to 2·5]) and LUCERNE (6·6 letters [5·3 to 7·8] and 6·6 letters [5·3 to 7·8]; treatment difference 0·0 letters [-1·7 to 1·8]). Rates of ocular adverse events were comparable between faricimab and aflibercept (TENAYA n=121 [36·3%] vs n=128 [38·1%], and LUCERNE n=133 [40·2%] vs n=118 [36·2%]). Interpretation: Visual benefits with faricimab given at up to 16-week intervals demonstrates its potential to meaningfully extend the time between treatments with sustained efficacy, thereby reducing treatment burden in patients with nAMD