Tumor necrosis factor alpha and interleukin 6 productions in response to platelet-activating factor in chronic hepatitis B virus infection.

OBJECTIVE: The aim of this study was to determine tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) release in response to platelet-activating factor (PAF) induction in peripheral blood mononuclear cells (PBMCs) from chronic hepatitis B virus (HBV) carriers. METHODS: Subjects were grouped into three subgroups. The mean age was 37 +/- 10 years. Group A (n = 15), group B (n = 10) and group C (n = 9) subjects were HBV serology-negative, had natural immunity after recovery from an acute HBV infection, and were chronic HBV carriers, respectively. RESULTS: Compared with group A, PBMCs from naturally immune subjects and chronic HBV carriers produced significantly higher amounts of TNF-alpha and IL-6 in response to PAF. In chronic HBV carriers, TNF-alpha (1,633.3 +/- 793.7) and IL-6 (2,533.3 +/- 466.3) production was statistically lower than TNF-alpha (2,630.0 +/- 727.3) and IL-6 (3,870.0 +/- 728.4) obtained from naturally immune subjects to HBV. CONCLUSION: Differences of TNF-alpha levels between chronic HBV carriers and naturally immune subjects suggest that TNF-alpha may be a critical mediator of HBV clearance.

Does dexamethasone affect ceftriaxone [corrected] penetration into cerebrospinal fluid in adult bacterial meningitis.

Trough cerebrospinal fluid (CSF) ceftriaxone concentrations were measured daily to investigate the effect of dexamethasone on ceftriaxone penetration into CSF in adult patients with acute bacterial meningitis. Patients were divided into two groups in this double blind randomized study. In group 1 (n=6) patients were given ceftriaxone with dexamethasone whereas in group 2 (n=6) patients were only administered ceftriaxone. Plasma and CSF samples were collected at 24, 48, 72, 96 and 264 h following the study treatments. The trough CSF ceftriaxone concentrations were measured using high performance liquid chromatography (HPLC) and microbiological assay. CSF ceftriaxone concentrations were 3.21 mg/l at 24 h in group 1 and 4.85 mg/l at the same time in group 2 by HPLC. Although microbiological assay results were lower than HPLC the trough CSF ceftriaxone concentrations in dexamethasone group were at least 10(3) times higher than the minimum inhibitory concentrations of the susceptible strains. It was concluded that the ceftriaxone concentration in CSF was adequate and ceftriaxone penetration was not significantly affected by concomitant dexamethasone use in adult patients with acute bacterial meningitis.

Evaluation of Brucella dipstick assay for the diagnosis of acute brucellosis.

The diagnostic value of the dipstick assay was evaluated by comparison with Rose Bengal (RB), serum aglutination tests (SAT) and 2 mercaptoethanol test (2-ME) on consecutive serum samples submitted because of suspicion of brucellosis. Serum samples of 232 patients with suspected brucellosis that were submitted for laboratory confirmation were included in the study. Twelve out of 232 serum samples were detected as positive with the dipstick assay. All of these 12 patients had positive RB and SAT results. In 16 RB positive samples dipstick test was negative. Fifteen of these samples had insignificant (titer<1/160) or borderline (titer 1/160) SAT results and the clinical symptoms of these patients were consistent with chronic brucellosis rather than acute or recent-onset brucellosis. Dipstick assay is an easy-to-perform assay that can be used for the diagnosis of acute brucellosis especially in rural areas where brucellosis is widespread and in settings where well-equipped laboratories are not available.