A novel blood-based assay for treatment monitoring of tuberculosis.

OBJECTIVES: A novel 3-gene host transcriptional signature (GBP5, DUSP3 and KLF2) has been validated for tuberculosis (TB) treatment monitoring using laboratory-based RNA sequencing platforms. The signature was recently translated by Cepheid into a prototype cartridge-based test that can be run on the GeneXpert instrument. In this study, we prospectively evaluated the change in the expression of the cartridge-based 3-gene signature following treatment initiation among pulmonary TB patients who were microbiologically cured at the end of treatment. RESULTS: The 3-gene signature expression level (TB score) changed significantly over time with respect to baseline among 31 pulmonary TB patients. The greatest increase in TB score occurred within the first month of treatment (median fold-increase in TB score: 1.08 [IQR 0.54-1.52]) and plateaued after 4 months of treatment (median TB score: 1.97 [IQR: 1.03-2.33]). The rapid and substantial increase of the TB score in the first month of treatment holds promise for the early identification of patients that respond to TB treatment. The plateau in TB score at 4 months may indicate early clearance of disease and could direct treatment to be shortened. These hypotheses need to be further explored with larger prospective treatment monitoring studies.

Diagnostic Accuracy Study of a Novel Blood-Based Assay for Identification of Tuberculosis in People Living with HIV.

A nonsputum triage test to rule out tuberculosis (TB) disease is a WHO high-priority diagnostic, and a combinatory score based on a 3-gene host signature has shown promise in discriminating TB from other illnesses. We evaluated the accuracy of an early-prototype cartridge assay ("Xpert MTB Host Response" or Xpert-MTB-HR-Prototype) of this 3-gene signature on biobanked blood samples from people living with HIV (PLHIV) against a comprehensive microbiological reference standard (CMRS) and against Xpert MTB/RIF on the first sputum sample alone. We depict results based on performance targets set by the WHO in comparison with a laboratory-based C-reactive protein (CRP) assay. Of 201 patients included, 67 were culture positive for Mycobacterium tuberculosis The areas under the concentration-time curve (AUCs) for Xpert-MTB-HR-Prototype were 0.89 (confidence interval [CI], 0.83 to 0.94) against the CMRS and 0.94 (CI, 0.89 to 0.98) against Xpert MTB/RIF. Considering Xpert-MTB-HR-Prototype as a triage test (at the nearest upper value of sensitivity to 90%), specificities were 55.8% (CI, 47.2 to 64.1%) compared to the CMRS and 85.9% (CI, 79.3 to 90.7%) compared to Xpert MTB/RIF as confirmatory tests. Considering Xpert-MTB-HR-Prototype as a stand-alone diagnostic test, at a specificity near 95%, the test achieved a sensitivity of 65.7% (CI, 53.7 to 75.9%), while the CRP assay achieved a sensitivity of only 13.6% (CI, 7.3 to 23.4%). In this first accuracy study of a prototype blood-based host marker assay, we show the possible value of the assay for triage and diagnosis in PLHIV.

Relación entre los métodos clínico y de Moyers-Jenkins para la evaluación del apiñamiento dentario / Relationship between the clinical and Moyers-Jenkins methods for the evaluation of dental crowding

Se realizó un estudio descriptivo y transversal de 29 modelos de yeso de la arcada inferior que presentaron algún grado de apiñamiento, los cuales pertenecían a pacientes ingresados en el Departamento de Ortodoncia de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, desde octubre hasta diciembre del 2013, a fin de determinar la correspondencia entre los métodos clínico y de Moyers-Jenkins para la evaluación del apiñamiento dentario. Entre las variables analizadas figuraron: métodos de evaluación del apiñamiento, tipo de dentición y grado de apiñamiento dentario. Al analizar los 2 métodos predominaron los afectados con discrepancia severa; sin embargo, la mayoría de los que fueron evaluados como discrepancia ligera por el primero resultaron sin discrepancia al aplicar el segundo. Existió mayor precisión entre ambos métodos en las discrepancias moderada y severa(AU)

A descriptive and cross-sectional study of 29 plaster cast of the lower arch that presented a degree of crowding was carried out, which belonged to patients admitted in the Orthodontics Department of Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, from October to December, 2013, in order to determine the correspondence among the clinical and Moyers-Jenkins methods for the evaluation of dental crowding. Among the analyzed variables there were: methods of evaluation of crowding, teething type and degree of dental crowding. When analyzing the 2 methods those affected with severe discrepancy prevailed; however, most of those that were evaluated as slight discrepancy by the first method were without discrepancy when applying the second one. Higher precision existed between both methods in the moderated and severe discrepancies(AU)

Relación entre los métodos clínico y de Moyers-Jenkins para la evaluación del apiñamiento dentario / Relationship between the clinical and Moyers-Jenkins methods for the evaluation of dental crowding

Se realizó un estudio descriptivo y transversal de 29 modelos de yeso de la arcada inferior que presentaron algún grado de apiñamiento, los cuales pertenecían a pacientes ingresados en el Departamento de Ortodoncia de la Clínica Estomatológica Provincial Docente "Mártires del Moncada" de Santiago de Cuba, desde octubre hasta diciembre del 2013, a fin de determinar la correspondencia entre los métodos clínico y de Moyers-Jenkins para la evaluación del apiñamiento dentario. Entre las variables analizadas figuraron: métodos de evaluación del apiñamiento, tipo de dentición y grado de apiñamiento dentario. Al analizar los 2 métodos predominaron los afectados con discrepancia severa; sin embargo, la mayoría de los que fueron evaluados como discrepancia ligera por el primero resultaron sin discrepancia al aplicar el segundo. Existió mayor precisión entre ambos métodos en las discrepancias moderada y severa.

A descriptive and cross-sectional study of 29 plaster cast of the lower arch that presented a degree of crowding was carried out, which belonged to patients admitted in the Orthodontics Department of "Mártires del Moncada" Teaching Provincial Stomatological Clinic in Santiago de Cuba, from October to December, 2013, in order to determine the correspondence among the clinical and Moyers-Jenkins methods for the evaluation of dental crowding. Among the analyzed variables there were: methods of evaluation of crowding, teething type and degree of dental crowding. When analyzing the 2 methods those affected with severe discrepancy prevailed; however, most of those that were evaluated as slight discrepancy by the first method were without discrepancy when applying the second one. Higher precision existed between both methods in the moderated and severe discrepancies.

Mucocele bilateral de la glándula de Bartholin / Bilateral mucocele of the Bartholin's gland

Se presenta el primer caso en Venezuela de mucocele bilateral de la glándula de Bartholin. Se hace una revisión de la literatura en cuanto a la frecuencia y probable causa de esta patología