A LAMP-based assay for the molecular detection of group B Streptococcus.

PURPOSE: Streptococcus agalactiae remains a major pathogen in human health, especially in neonatal infection. Detection in pregnant women is essential to initiate intrapartum antibiotic prophylaxis. This study compared the HiberGene loop-mediated isothermal amplification (LAMP) assay to culture, the reference method, for the detection of group B Streptococcus (GBS) in pregnant women. METHODS: This was a prospective multicenter study conducted in four French hospitals. Three hundred fifty-four non-redundant routine care vaginal swabs were analyzed by both methods, LAMP assay and culture. Clinicians and patients were blinded to the results of the LAMP assay. RESULTS: Three hundred thirty-seven samples presented concordant results, 15 presented discordant results, and 2 were invalid using the LAMP assay (excluded from the study). Compared to culture, the LAMP assay had a sensitivity of 87.7%, a specificity of 98%, a negative predictive value of 97.6%, and a positive predictive value of 89.3%. CONCLUSION: The HiberGene GBS LAMP assay is an easy test that possesses good performances compared with the reference method, culture. It could be used in case of emergency when a quick result is needed.

Red light photodynamic therapy for actinic keratosis using 37 J/cm2 : Fractionated irradiation with 12.3 mW/cm2 after 30 minutes incubation time compared to standard continuous irradiation with 75 mW/cm2 after 3 hours incubation time using a mathematical modeling.

OBJECTIVE AND STUDY DESIGN: Photodynamic therapy (PDT) is an emerging treatment modality for various diseases, especially for dermatological conditions. Although, the standard PDT protocol for the treatment of actinic keratoses in Europe has shown to be effective, treatment-associated pain is often observed in patients. Different modifications to this protocol attempted to decrease pain have been investigated. The decrease in fluence rate seems to be a promising solution. Moreover, it has been suggested that light fractionation significantly increases the efficacy of PDT. Based on a flexible light-emitting textile, the FLEXITHERALIGHT device specifically provides a fractionated illumination at a fluence rate more than six times lower than that of the standard protocol. In a recently completed clinical trial of PDT for the treatment of actinic keratosis, the non-inferiority of a protocol involving illumination with the FLEXITHERALIGHT device after a short incubation time and referred to as the FLEXITHERALIGHT protocol has been assessed compared to the standard protocol. In this paper, we propose a comparison of the two above mentioned 635 nm red light protocols with 37 J/cm2 in the PDT treatment of actinic keratosis: the standard protocol and the FLEXITHERALIGHT one through a mathematical modeling. METHODS: This mathematical modeling, which slightly differs from the one we have already published, enables the local damage induced by the therapy to be estimated. RESULTS: The comparison performed in terms of the local damage induced by the therapy demonstrates that the FLEXITHERALIGHT protocol with lower fluence rate, light fractionation and shorter incubation time is somewhat less efficient than the standard protocol. Nevertheless, from the clinical trial results, the FLEXITHERALIGHT protocol results in non-inferior response rates compared to the standard protocol. CONCLUSION: This finding raises the question of whether the PDT local damage achieved by the FLEXITHERALIGHT protocol (respectively, the standard protocol) is sufficient (respectively, excessive) to destroy actinic keratosis cells. Lasers Surg. Med. 49:686-697, 2017. © 2017 Wiley Periodicals, Inc.

Image Quality Analysis of Photon-Counting CT Compared with Dual-Source CT: A Phantom Study for Chest CT Examinations.

A comparison was made between the image quality of a photon-counting CT (PCCT) and a dual-source CT (DSCT). The evaluation of image quality was performed using a Catphan CT phantom, and the physical metrics, such as the noise power spectrum and task transfer function, were measured for both PCCT and DSCT at three CT dose indices (1, 5 and 10 mGy). Polyenergetic and virtual monoenergetic reconstructions were used to evaluate the performance differences by simulating a Gaussian spot with a radius of 5 mm and calculating the detectability index. The highest iterative reconstruction level was able to decrease the noise by about 70% compared with the filtered back projection using a parenchyma reconstruction kernel. The PCCT task transfer functions remained constant, while those of the DSCT increased with the reconstruction strength level. At monoenergetic 70 keV, a 50% decrease in noise was observed for DSCT with image smoothing, while PCCT had the same 50% decrease in noise without any smoothing. The PCCT detectability index at a reconstruction strength level of two was equivalent to the highest level of ADMIRE 5 for DSCT. The PCCT showed its superiority over the DSCT, especially for lung nodule detection.

Evaluation and validation of the convolution algorithm for Leksell Gamma knife radiosurgery.

The new Leksell Gamma knife convolution algorithm requires evaluation prior to implementation in clinical practice. The superiority of this algorithm, which takes into account tissue electron densities, was evaluated using EBT3 GafChromicTM films within an anthropomorphic phantom. The CIRS anthropomorphic head phantom was chosen for its relevance to validate the convolution algorithm. Absolute dose and dose distributions were measured and compared with the outputs calculated from the Leksell Gamma Plan algorithms (TMR10 and the convolution algorithm). The measured absolute dose and the dose distributions in the homogeneous region of the anthropomorphic phantom were clearly in agreement with the dose distribution computed by the convolution algorithm. In a heterogeneous region where soft tissues contain a medium, such as aluminium, or an air gap, the measured dose profiles drastically changed, and only the convolution algorithm was able to correctly compute the dose to water in water. The convolution algorithm was able to take into account regions with high or very low electron densities such that the measured absolute dose was nearly equal to that computed by the convolution algorithm, with a common accepted dose measurement error of 2%.

Management of Patients with Renal Failure Undergoing Dialysis During 131I Therapy for Thyroid Cancer.

Radioactive iodine (131I) therapy may be used to treat thyroid cancer in end-stage renal disease patients who undergo hemodialysis. Because iodine uses predominantly renal clearance, treatment management in hemodialysis patients may be problematic, and no formal recommendations on hemodialysis currently exist. This work details our experience with treating thyroid cancer with iodine in chronic renal failure patients who require hemodialysis and details the dosimetry results obtained during treatment to ensure that the dose to the bone marrow (BM) was acceptable. Methods: We treated 6 patients in the metabolic radiotherapy unit after thyroid stimulation. Two hemodialysis sessions in the metabolic radiotherapy unit were performed at 42 and 90 h after radiopharmaceutical administration. BM toxicity was estimated with activity measurements from blood samples and with whole-body measurements that were regularly repeated during hospitalization and measured with a γ-counter. The patients underwent thyroid and hematologic monitoring to assess treatment efficacy and therapeutic toxicity in the short, medium, and long term. Results: Whole-body activity was reduced on average by 66.7% (range, 60.1%-71.5%) after the first dialysis session and by 53.3% (range, 30.4%-67.8%) after the second. The mean estimated total absorbed dose to the BM was 0.992 Gy for all patients (range, 0.431-2.323 Gy). We did not observe any significant hematologic toxicity, and the clinical, biologic, and ultrasound test results confirmed the success of ablative treatment for most patients. Conclusion: In hemodialysis patients with thyroid cancer, an 131I activity approximately 30% lower than the nominal dose appears to strike an appropriate balance between absence of BM toxicity and therapeutic efficacy. To avoid overirradiation, we recommend pretherapeutic dosimetry studies for metastatic patients to calculate the amount of activity to be administered. We also recommend dosimetry monitoring during the hemodialysis sessions performed after therapeutic dose administration and under the same conditions.