Autoantibodies against tumour suppressor protein p53 in pleural effusions of patients with tuberculosis pleurisy.

BACKGROUND: Autoantibodies against the p53 proteins (p53 Abs) can be detected in the serum, ascites, saliva and pleural effusions of various malignant patients. It is suggested that p53 Abs in pleural effusions might have some value for tumour diagnosis, prognosis or monitoring. The present study investigated the prevalence of p53 Abs in the pleural effusions of 90 patients with various diseases. METHODS: Patients with suspicious pleural effusions in chest film received thoracocentesis and their pleural effusions were collected. The presence of p53 Abs in effusion was detected by immunoblotting. Differences of p53 Abs with respect to the patient's age, gender, white blood cell count, lactate dehydrogenase, total proteins and adenosine deaminase scores were calculated by chi2-test. RESULTS: p53 Abs were detected in 14.4% (13/90) of our patients, with prevalences of 10.5% (6/57) and 21.2% (7/33) among patients with benign and malignant diseases, respectively. Notably, 16.1% (5/31) of patients with tuberculosis pleurisy were positive for p53 Abs. These five patients had no history of cancer and, so far, have had no manifestations related to tumorigenesis. CONCLUSIONS: As far as we know, this is the first report regarding the detection of p53 Abs in pleural effusions from patients with tuberculosis pleurisy.

A comparative study of cefepime versus ceftazidime as empiric therapy of febrile episodes in neutropenic patients.

An open-label, randomized comparative study was conducted to evaluate the efficacy and safety of cefepime (2.0 g q. 8 h) and ceftazidime (2.0 g q. 8 h) in the empiric therapy of febrile neutropenic patients. A total of 45 eligible febrile episodes were randomized (1:1) to be treated with the study regimen. Nineteen febrile episodes treated with cefepime and 22 febrile episodes treated with ceftazidime were evaluable for efficacy. The two groups were comparable in terms of age, sex, height, weight, underlying neoplasm, number of pretherapy neutrophil, duration of neutropenia and types of infections. The overall therapeutic success rate of the cefepime group (53%) was comparable to the ceftazidime group (50%). It did not differ significantly (95% confidence interval: -0.28 to 0. 34, p = 0.85). Eighty-eight percent of pathogens in each group were bacteriologically eradicated. The safety profile was similar in both groups. No patients in either group discontinued the therapy because of adverse events. None (0%) of the cefepime patients and 2 (9%) of the ceftazidime patients died of infection. The results of this study suggest that cefepime is an effective and safe agent in the empiric therapy of febrile episodes in neutropenic patients.

Diagnostic value of an automatic hematology analyzer in patients with hematologic disorders.

The Sysmex SE-9000 is a newly designed automatic hematology analyzer that provides complete blood counts and white-cell differential counts. Few reports in the literature, however, discuss the sensitivity and specificity of this type of automatic analyzer, especially in patients with hematologic illnesses. This study compared differences between hematologist assessments and measurements made by the SE-9000 analyzer of differential counts, immature granulocytes, atypical lymphocytes, nucleated red cells, and platelet counts. Significant differences were found between manual and apparatus counting of neutrophils, lymphocytes, and monocytes but not of eosinophils and basophils. Atypical lymphocytes and nucleated red cell could not be counted accurately, and when platelet counts fell below 20 x 10(9)/L, accurate assessments were not possible. We conclude that not even the Sysmex SE-9000 can provide unflawed results and any suspicious blood report should be rechecked by an experienced hematologist.