Performance of a New Rapid Point-of-Care Test for Infliximab Levels in Patients with Inflammatory Bowel Disease: A Comparison to ELISA.

BACKGROUND: Therapeutic drug monitoring of infliximab levels in patients with inflammatory bowel disease (IBD) optimizes patients' treatment. The reference technique is based on enzyme-linked immunosorbent assay (ELISA) although point of care (POC) assays are being developed. AIMS: To assess the performance of a new rapid immunochromatographic POC assay (Promonitor Quick IFX) compared with ELISA technique to measure infliximab levels in patients with IBD. METHODS: A prospective, observational, unicentric study was performed on capillary blood samples from patients with IBD before infliximab infusion (trough levels). Infliximab levels and anti-infliximab antibodies were measured using the ELISA technique (Promonitor IFX) and the POC assay. Correlation between both techniques was assessed by Pearson's coefficient. Quantitative differences were evaluated by Bland-Altman analysis. Samples were stratified according to infliximab therapeutic ranges (< 3 µg/mL, 3-8 µg/mL, and > 8 µg/mL). RESULTS: A total of 135 experimental samples were assessed. Infliximab levels showed a high correlation between POC and ELISA tests (r = 0.84, P < 0.001). The mean difference between tests was 1.46 µg/mL (P < 0.001), being minimal for concentrations < 8 µg/mL. POC and ELISA assays showed an overall concordance of 87.4%. Most samples were in the same therapeutic range, which lead to equivalent therapeutic decisions. POC and ELISA assays detected the presence of anti-infliximab antibodies in 2.2% and 3.7% of the samples, respectively. CONCLUSIONS: POC assay results in blood samples from patients with IBD were comparable to those obtained with the reference ELISA technique. The POC assay could be considered for routine testing based on its ease of use and rapidity.

Simple Synthesis of Biocompatible Stable CeO2 Nanoparticles as Antioxidant Agents.

Cerium oxide (IV) nanoparticles offer a high redox ability, while maintaining nontoxicity and high stability. Thus, dispersed nanoceria is a promising candidate as antioxidant material for human cells. In this work, we report on a fast and simple one-pot process that yield a final nanoparticle size of 2-4 nm in polar solvents such as water and alcohols. High boiling point solvents, namely, benzyl alcohol and triethylene glycol, are used to obtain high crystalline nanoparticles by thermal and microwave activation. Transmission electron microscopy investigations prove the narrow size distribution of the CeO2 nanoparticles and show that the shape can be tuned from spherical to cubic using an appropriate precursor. The main objective of this work is to produce nanoparticles, which are well-defined, biocompatible, and stable in highly concentrated colloidal solutions (up to 90 mM) for a long period of time to study their behavior as antioxidant agents in human cells under oxidative stress.

Impact of Iron Mining Activity on the Endophytic Fungal Community of Aspilia grazielae.

Aspilia grazielae (J. U. Santos) is an endemic plant species in Morro do Urucum in the Pantanal wetland (Brazil). A. grazielae is used for the restoration of areas impacted by iron mining activities. This study evaluates the diversity (composition, value and abundance) of endophytic fungal communities, considering parts of the plant and soil condition. The leaves and roots of A. grazielae were collected from native vegetation areas (NVA) and recovery areas (RCA) in Morro do Urucum. Illumina sequencing technology was used to investigate variation in endophytic fungal biodiversity. The operational taxonomic units detected in NVA ranged from 183 to 263 (leaf) and 115 to 285 (root), while RCA samples ranged from 200 to 282 (leaf) and 156 to 348 (root). Ascomycota phylum was the most common species among all plant samples. The most significant classes identified were Lecanoromycetes and Dothideomycetes that differed significantly (p ≤ 0.05) according to their plant hosts and soil stress. The relative abundance of Pestalotiopsis (Sordariomycetes class) and Stereocaulon (Lecanoromycetes class) genera was influenced by the iron mining activities according to the leaf samples analysed. However, the abundance and wealth of endophytic fungal communities in A. grazielae from RCA were evidence that could explain their high resilience to environmental disturbances and the source-sink dynamics of fungal propagules.

Asistencia primaria y especializada en pacientes con insuficiencia arterial aguda / Specialized and primary care in patients with acute arterial insufficiency

Se efectuó un estudio descriptivo y observacional de los pacientes con insuficiencia arterial aguda de las extremidades, ingresados en el Servicio de Angiología del Hospital Clinicoquirúrgico Docente "Dr. Ambrosio Grillo Portuondo" de Santiago de Cuba, desde enero del 2008 hasta abril del 2011, con vistas a observar la evolución de estos en cuanto a un diagnóstico precoz y tratamiento oportuno. Todos los integrantes de la serie presentaron los síntomas clásicos de la afección; sin embargo, a la mayoría no se le realizó el examen de los pulsos arteriales en la atención primaria de salud y a pesar de que más de 50 % de estos fue atendido en las 4 primeras horas de iniciado el cuadro clínico, el mayor número recibió asistencia especializada de 9 a 24 horas después de manifestarlo. De igual manera, primaron el grupo etario de 61 y más años, la procedencia urbana, la ateroesclerosis obliterante (sola o unida a otras enfermedades) como la entidad clínica más asociada y la cirugía revascularizadora como proceder inicial. Un importante porcentaje de aquellos que fueron intervenidos antes de las 8 horas salvó la extremidad, pero los que recibieron tratamiento quirúrgico pasadas las 24 horas del inicio agudo fueron amputados.

A descriptive and observational study was carried out in patients with acute arterial insufficiency of the limbs, admitted to the Angiology Department of "Dr. Ambrosio Grillo Portuondo" Clinical Surgical Teaching Hospital of Santiago de Cuba, from January 2008 to April 2011, with the purpose of monitoring their progress as for an early diagnosis and treatment. All the members of the series had the classic symptoms of the condition, but the majority did not undergo the examination of arterial pulses in the primary health care, and although more than 50% of them were treated at the first 4 hours after the onset of symptoms, most of them received specialized care between 9 and 24 hours of its manifestation. Similarly, age group of 61 years and over, urban origin, obliterating atherosclerosis (alone or combined with other diseases) prevailed as the clinical entity most associated and surgical revascularization as an initial procedure. A significant percentage of those who were operated before 8 hours saved the limb, but those that were operated after 24 hours of acute onset were amputees.

Fracturas Craneales Evolutivas en niños, manejo y tratamiento quirúrgico

Se realizó un estudio retrospectivo entre los años 1990 y 1995 en el Hospital pediátrico Baca Ortiz de Quito, Ecuador, de una rara complicación del trauma craneal infantil. El cuadro clínico se caracteriza por la presencia de una masa pulsatil que se palpa a nivel de la línea de fractura, acompañada ocasionalmente de crisis convulsivas y cefalea. El diagnóstico se realizó en clínicas y el seguimiento con RX simple de cráneo y tomografía axial computarizada, en los que se observa el defecto óseo y un quiste leptmeningeo. Se plantea su tratamiento con invaginación del prolapso, plastia dural y reparación del defecto óseo con material sintético.