Validation of Calprotectin As a Novel Biomarker For The Diagnosis of Pleural Effusion: a Multicentre Trial

Discriminating between malignant pleural effusion (MPE) and benign pleural effusion (BPE) remains difficult. Thus, novel and efficient biomarkers are required for the diagnosis of pleural effusion (PE). The aim of this study was to validate calprotectin as a diagnostic biomarker of PE in clinical settings. A total of 425 patients were recruited, and the pleural fluid samples collected had BPE in 223 cases (53.7%) or MPE in 137 patients (33%). The samples were all analysed following the same previously validated clinical laboratory protocols and methodology. Calprotectin levels ranged from 772.48 to 3,163.8 ng/mL (median: 1,939 ng/mL) in MPE, and 3,216-24,000 ng/mL in BPE (median: 9,209 ng/mL; p < 0.01), with an area under the curve of 0.848 [95% CI: 0.810-0.886]. For a cut-off value of </= 6,233.2 ng/mL, we found 96% sensitivity and 60% specificity, with a negative and positive predictive value, and negative and positive likelihood ratios of 96%, 57%, 0.06, and 2.4, respectively. Multivariate analysis showed that low calprotectin levels was a better discriminator of PE than any other variable [OR 28.76 (p < 0.0001)]. Our results confirm that calprotectin is a new and useful diagnostic biomarker in patients with PE of uncertain aetiology which has potential applications in clinical practice because it may be a good complement to cytological methods

Hepatic safety of antibiotics used in primary care

Antibiotics used by general practitioners frequently appear in adverse-event reports of drug-induced hepatotoxicity. Most cases are idiosyncratic (the adverse reaction cannot be predicted from the drug's pharmacological profile or from pre-clinical toxicology tests) and occur via an immunological reaction or in response to the presence of hepatotoxic metabolites. With the exception of trovafloxacin and telithromycin (now severely restricted), hepatotoxicity crude incidence remains globally low but variable. Thus, amoxicillin/clavulanate and co-trimoxazole, as well as flucloxacillin, cause hepatotoxic reactions at rates that make them visible in general practice (cases are often isolated, may have a delayed onset, sometimes appear only after cessation of therapy and can produce an array of hepatic lesions that mirror hepatobiliary disease, making causality often difficult to establish). Conversely, hepatotoxic reactions related to macrolides, tetracyclines and fluoroquinolones (in that order, from high to low) are much rarer, and are identifiable only through large-scale studies or worldwide pharmacovigilance reporting. For antibiotics specifically used for tuberculosis, adverse effects range from asymptomatic increases in liver enzymes to acute hepatitis and fulminant hepatic failure. Yet, it is difficult to single out individual drugs, as treatment always entails associations. Patients at risk are mainly those with previous experience of hepatotoxic reaction to antibiotics, the aged or those with impaired hepatic function in the absence of close monitoring, making it important to carefully balance potential risks with expected benefits in primary care. Pharmacogenetic testing using the new genome-wide association studies approach holds promise for better understanding the mechanism(s) underlying hepatotoxicity

Avances y perspectivas de investigaci?n en biodiversidad y su uso en el territorio colectivo del Bajo Calima

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Development of a novel nano-biomaterial for biomedical applications.

The technological development of biodegradable nanoparticles for drug delivery in medical diagnostics and therapies is addressing increasing efforts to make safer, affordable and more bio-efficient polymeric materials. The preparation via the solvent displacement method of a novel polymeric nanomaterial with new spherical and narrow sizes dispersion is described. It was achieved by choosing the best amount of PLDLA-co-TMC, PEO-PPO-PEO and an adequate acetone:methanol volume ratio, using the factorial design 23 and Box-Behnken experiment design. This new material was loaded with finasteride, the chosen drug model, and its delivery dynamic was determined by the HPLC method. Results revealed that an optimal formulation of PLDLA-co-TMC nanoparticles was found to be composed of 20 mg PLDLA-co-TMC; 37.5 mg PEO-PPO-PEO and a volume acetone:methanol ratio 2.2:0.3. The formulation of this novel biomaterial showed a high encapsulation efficiency of finasteride, controlled release profile along 24 h, without burst effect in the first 4 h, nanometric sizes, spherical shapes, close polydispersity, negative surface charge, unimodal particle size distribution and relatively high thermal stability of the polymer matrix PEO-PPO-PEO/PLDLA-co-TMC. These results support the fabrication of technologically advanced nanoparticles based on high molecular weight PLDLA-co-TMC and their use in the nano-controlled drug release in biomedical applications