Performance of Five Serological Tests in the Diagnosis of Visceral and Cryptic Leishmaniasis: A Comparative Study

Introduction: Leishmaniasis is a major health problem and its diagnosis still represents a challenge. Since consistent evidence on the comparison of serological methods is lacking, our work aims to compare five serological tests for the diagnosis of visceral and asymptomatic leishmaniasis in southern France, a region where leishmaniasis is endemic. Methodology: Serum samples from 75 patients living in Nice, France were retrospectively analyzed. They included patients affected by visceral leishmaniasis (VL; n = 25), asymptomatic carriers (AC; n = 25) and negative controls (n = 25). Each sample was tested using two immunochromatographic tests (ICT; IT LEISH® and TruQuick IgG/IgM®), an indirect fluorescent antibody test (IFAT) and two Western Blotting (WB; LDBio BIORAD® and an in-house method). Results: Diagnosis of VL with IFAT and TruQuick® showed the highest diagnostic performance parameters. IFAT had 100% sensitivity and specificity, while TruQuick had 96% sensitivity and 100% specificity. Finally, the two tests showed high accuracy (100% for IFAT and 98% for TruQuick) for the AC group. WB LDBio® was the only method able to detect Leishmania latent infection, with a sensitivity of 92%, and a specificity of 100%, with a Negative Predictive Value (NPV) of 93%. This performance is reflected in the high accuracy of the test. Conclusions: The data obtained with TruQuick® supports its application in the rapid diagnosis of leishmaniasis in endemic areas, a feature not shown by IFAT despite its high diagnostic performance. Regarding the diagnosis of asymptomatic leishmaniasis, the best results were obtained with WB LDBio®, confirming previous studies

Primary hepatic lymphoma presenting as fulminant hepatic failure with hyperferritinemia: A case report

<p>Abstract</p> <p>Introduction</p> <p>Primary hepatic lymphoma is an unusual form of non-Hodgkin's lymphoma that usually presents with constitutional symptoms, hepatomegaly and signs of cholestatic jaundice. Diffuse hepatic infiltration is uncommon and presentation with acute hepatic failure even more rare. The presence of markedly elevated ferritin levels can complicate the evaluation process and suggest alternative diagnoses.</p> <p>We present the case of a middle-aged woman exhibiting pancytopenia, hyperferritinemia and rapidly deteriorating to develop acute hepatic failure. Her initial clinical picture led to a working diagnosis of adult onset Still's disease with probable hemophagocytic syndrome before her worsening liver function necessitated a percutaneous liver biopsy and establishment of the final diagnosis of primary hepatic lymphoma.</p> <p>Conclusion</p> <p>Primary hepatic lymphoma is an uncommon malignancy and its manifestation as progressive hepatitis or acute fulminant hepatic failure can be difficult to diagnose. The presence of constitutional symptoms, pancytopenia and high ferritin levels can complicate the evaluation process. A liver biopsy early in the course of liver dysfunction may establish the diagnosis without a higher risk of bleeding complications seen once liver failure sets in.</p

Efficacy of trabectedin in metastatic solitary fibrous tumor

Solitary fibrous tumor is a rare tumor type and has an unpredictable course. Local recurrence rate varies between 9 and 19%, and rate of metastatic involvement between 0 and 36 %. It is characterized by a typical architecture and immuno-histochemistry tests. The most important prognostic factor is the complete resection of primary tumor. Treatment of recurrences is not clearly established. If a solitary fibrous tumor is too advanced to allow surgical resection, radiotherapy and chemotherapy may be used. The most often used drugs are doxorubicine and\or ifosfamide. We report the case of man with metastatic solitary fibrous tumor treated with trabectedin, administered at a dose of 1.5 mg/m² every 3 weeks. After 3 cycles, metastases had significantly decreased. Recurrence of the disease was demonstrated 8 months after the start of trabectedin. This case shows that trabectedin is a possible treatment option

Tuberculosis Incidence in Prisons: A Systematic Review

A systematic review by Iacopo Baussano and colleagues synthesizes published research to show that improved tuberculosis (TB) control in prisons could significantly reduce the burden of TB both inside and outside prisons

Methods and timing of biliary drainage for acute cholangitis: Tokyo Guidelines

Biliary drainage is a radical method to relieve cholestasis, a cause of acute cholangitis, and takes a central part in the treatment of acute cholangitis. Emergent drainage is essential for severe cases, whereas patients with moderate and mild disease should also receive drainage as soon as possible if they do not respond to conservative treatment, and their condition has not improved. Biliary drainage can be achieved via three different routes/procedures: endoscopic, percutaneous transhepatic, and open methods. The clinical value of both endoscopic and percutaneous transhepatic drainage is well known. Endoscopic drainage is associated with a low morbidity rate and shorter duration of hospitalization; therefore, this approach is advocated whenever it is applicable. In endoscopic drainage, either endoscopic nasobiliary drainage (ENBD) or tube stent placement can be used. There is no significant difference in the success rate, effectiveness, and morbidity between the two procedures. The decision to perform endoscopic sphincterotomy (EST) is made based on the patient’s condition and the number and diameter of common bile duct stones. Open drainage, on the other hand, should be applied only in patients for whom endoscopic or percutaneous transhepatic drainage is contraindicated or has not been successfully performed. Cholecystectomy is recommended in patients with gallbladder stones, following the resolution of acute cholangitis with medical treatment, unless the patient has poor operative risk factors or declines surgery

Phenotypic Studies of Natural Killer Cell Subsets in Human Transporter Associated with Antigen Processing Deficiency

Peripheral blood natural killer (NK) cells from patients with transporter associated with antigen processing (TAP) deficiency are hyporesponsive. The mechanism of this defect is unknown, but the phenotype of TAP-deficient NK cells is almost normal. However, we noticed a high percentage of CD56bright cells among total NK cells from two patients. We further investigated TAP-deficient NK cells in these patients and compared them to NK cells from two other TAP-deficient patients with no clinical symptoms and to individuals with chronic inflammatory diseases other than TAP deficiency (chronic lung diseases or vasculitis). Peripheral blood mononuclear cells isolated from venous blood were stained with fluorochrome-conjugated antibodies and the phenotype of NK cells was analyzed by flow cytometry. In addition, 51Chromium release assays were performed to assess the cytotoxic activity of NK cells. In the symptomatic patients, CD56bright NK cells represented 28% and 45%, respectively, of all NK cells (higher than in healthy donors). The patients also displayed a higher percentage of CD56dimCD16− NK cells than controls. Interestingly, this unusual NK cell subtype distribution was not found in the two asymptomatic TAP-deficient cases, but was instead present in several of the other patients. Over-expression of the inhibitory receptor CD94/NKG2A by TAP-deficient NK cells was confirmed and extended to the inhibitory receptor ILT2 (CD85j). These inhibitory receptors were not involved in regulating the cytotoxicity of TAP-deficient NK cells. We conclude that expansion of the CD56bright NK cell subtype in peripheral blood is not a hallmark of TAP deficiency, but can be found in other diseases as well. This might reflect a reaction of the immune system to pathologic conditions. It could be interesting to investigate the relative distribution of NK cell subsets in various respiratory and autoimmune diseases

2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe

Entwicklung von Waermedaemmungs-Schichtsystemen fuer die grossflaechige Glasbeschichtung. Teilprojekt: Entwicklung von Schichtsystemen auf Silberbasis und der Prozesstechnologie fuer die Abscheidung von transparenten, leitfaehigen Schichten Abschlussbericht

Im Rahmen des Verbundprojektes 'Entwicklung von Waermedaemmungs-Schichtsystemen fuer die grossflaechige Glasbeschichtung' wurden auf der Basis von Mittelfrequenz-Sputterverfahren Beschichtungsprozesse fuer die transparent leitenden Schichten SnO_2 und ZnO sowie die weiteren als Schutzschicht fuer Waermedaemm (Low E)-Schichtsysteme geeigneten Materialien Si_3N_4 und TiO_2 entwickelt und auf eine Kathodenlaenge von 3750 mm hochskaliert. Der SnO_2-Prozess wurde mit einer Grosskathode von 3550 mm Laenge in der Produktionsanlage des Verbundpartners Sanco erfolgreich erprobt. Auf der Basis von TiO_2 und Si_3N_4 als Schutzschichten wurde ein neuartiges Waermedaemmsystem entwickelt. Das System Glas - TiO_2 - ZnO - Ag - NiCrO_x -Si_3N_4 weist gegenueber herkoemmlichen Systemen eine deutlich verbesserte mechanische Bestaendigkeit auf. Bei einer Lichttransmission von 84,5% liegt der k-Wert bei 1.1 W/m&quot;2K. Es wurden ausserdem Arbeiten zur Entwicklung eines temperbaren Schichtsystems durchgefuehrt. Das System Glas - SnO_2 - NiCrO_x - Ag - NiCrO_x - SnO_2 zeigt nach dem Tempern Farbneutralitaet und sehr gute optische Eigenschaften (k &lt; 1.1 W/m&quot;2 K und T=82,5%). Zur Erhoehung der Wirtschaftlichkeit bei der Abscheidung duenner metallischer Schichten (Silber und Blocker) wurde ein gepulster DC-Sputterprozess realisiert. Ein zusaetzliches Arbeitspaket zur Entwicklung einer Magnetronkathode mit verbesserter Materialausnutzung fuehrte zum Erreichen eines Ausnutzungsgrades von 50% gegenueber 23% bei konventionellen Standard-Grosskathoden. Die Kombination dieser Modifikation mit dem TwinMag &quot;t&quot;r&quot;a&quot;d&quot;e&quot;m&quot;a&quot;r&quot;k besitzt ein hohes Zukunftspotential fuer die industrielle Beschichtungstechnik. (orig.)Within the project 'Development of low emissivity layer systems for large area glass coating' processes for the deposition of SnO_2, ZnO, Si_3N_4 and TiO_2 were developed on the basis of mid frequency magnetron sputtering. The processes have been scaled up to a magnetron length of 3750 mm. The SnO_2 process has been successfully transferred to a production coater (3550 mm magnetron length) located at the project partner Sanco. Based on TiO_2 and Si_3N_4 as protective layers a novel low emissivity system was realized. The system glass - TiO_2 - ZnO - Ag - NiCrO_x - Si_3N_4 exhibits high resistance against mechanical attacks. The k-value is 1.1 W/m&quot;2K at a visible transmission of 84.5%. The project included also investigations with regard to temperable low emissivity systems. For the stack glass - SnO_2 - NiCrO_x - Ag - NiCrO_x - SnO_2 no colour changes and very good optical properties (k &lt; 1.1 W/m&quot;2 K and T=82.5%) have been observed after tempering. In order to decrease costs for deposition of very thin silver and blocker layers a pulsed DC sputter process has been developed. An additional work package was focussed on the development of a magnetron with an enhanced target material utilization. The utilization could be inreased from 23% (which is a typical value for conventional magnetrons used in architectural glass coaters) to a value of 50%. (orig.)SIGLEAvailable from TIB Hannover: F99B617 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman