Prospective study of diagnostic accuracy in the detection of high-grade prostate cancer in biopsy-naïve patients with clinical suspicion of prostate cancer who underwent the Select MDx test.

OBJECTIVES: This study aimed to externally validate the diagnostic accuracy of the Select MDx test for Significant prostate cancer (Sig PCa) (ISUP > 1), in a contemporaneous, prospective, multicenter cohort with a prostate-specific antigen (PSA) between 3 and 10 ng/ml and a non-suspicious digital rectal examination. METHODS AND PARTICIPANTS: For all enrolled patients, the Select Mdx test, the risk calculator ERSPC3 + DRE, and a prostatic magnetic resonance imaging (MRI) were carried out. Subsequently, a systematic 12-core trans-rectal biopsy and a targeted biopsy, in the case of a prostate imaging-reporting and data system (PIRADS) > 2 lesion (max three lesions), were performed. To assess the accuracy of the Select MDx test in the detection of clinically Sig PCa, the test sensitivity was evaluated. Secondary objectives were specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the curve (AUC). A direct comparison with the ERSPC + DRE risk calculator and MRI were also performed. We also studied the predictive ability to diagnose Sig PCa from the combination of the Select MDx test with MRI using clinical decision-curve analysis. RESULTS: There were 163 patients enrolled after meeting the inclusion criteria and study protocol. The Select MDx test showed a sensitivity of 76.9% (95% CI, 63.2-87.5), 49.6% specificity (95% CI, 39.9-59.2), 82.09% (95% CI, 70.8-90.4) NPV, and 41.67% (95% CI, 31.7-52.2) PPV for the diagnosis of Sig PCa. COR analysis was also performed, which showed an AUC of 0.63 (95% CI, 0.56-0.71). There were no differences in the accuracy of Select MDx, ERSPC + DRE, or MRI. The combination of Select MDX + MRI showed the highest impact in the decision-curve analysis, with an NPV of 93%. CONCLUSION: Our study showed a worse performance for the SelectMdx test than previously reported, within a cohort of patients with a PSA 3-10 ng/ml and a normal DRE, with results similar to those from ERSPC + DRE RC and MRI, but with an improvement in the usual PSA pathway. A combination of the Select Mdx test and MRI could improve accuracy, but studies specifically evaluating this scenario with a cost-effective analysis are needed.

Variation of color with baking time in snacks made with pregelatinized cassava.

Color is an importantaspect when formulating products, as the consumer will evaluate this aspect in the first instance. There is a growing interest in non-wheat producing regions to replace it with local sources of starches. However, the substitution of wheat flour affects characteristics such as texture, flavor, and color of the intermediate and final products. The objective of this work was to determine if the variation of the baking time allows reducing the color difference that the replacement of flour generates by dehydrated cassava puree (DCP). For that, four replacement levels were evaluated using the CIE-L * a * b * and CIE-L * C * H * methodology. The browning index and total color difference (ΔE) between samples with different replacement levels and between different stages of production were also evaluated. It was proved that the decrease in the baking time allowed the development of a similar coloring between snacks made with DCP and those made without substitution. Also, moisture values of less than 5% (dry basis) were obtained in the snacks. The browning index increased with the proportion of DCP in flour and doughs, but not in baked snacks. The pregelatinization of starches could be a mechanism to improve the quality of products with substitutions of wheat flour. PRACTICAL APPLICATION: Color is a critical attribute of foods in consumer acceptance. The accelerated color development that pregelatinized cassava starch produces in the appearance of baked goods can be useful for food development. A quick color development can mean shorter exposure time to heat, which is important for some products with heat-sensitive components. Also, it is interesting to note that the cassava dehydrated puree is a gluten-free product.

The two component adjuvant IC31® potentiates the protective immunity induced by a dengue 2 recombinant fusion protein in mice.

Here we evaluated the suitability of the synthetic adjuvant IC31® to potentiate the protective capacity of PD5 protein (domain III of the envelope protein of dengue 2 virus fused to the carrier protein P64k). Unlike Alum, PD5 mixed with IC31® induced complete protection against virus challenge in mice and increased IFN-γ secretion after in vitro re-stimulation. The induced antibody response was highly specific to the homologous serotype and showed both IgG1 and IgG2a subtypes. IC31® is a promising adjuvant for PD5 recombinant protein based vaccination against dengue. Future work should address the suitability of PD5/IC31® formulations in non-human primate models.

Effect of oral treatment with the essential oil from Chenopodium ambrosioides against cutaneous leishmaniasis in BALB/c mice, caused by Leishmania amazonensis.

BACKGROUND: The aromatic herb Chenopodium ambrosioides is widely known for its antiparasitic activity. The aim of this study was to investigate the antileishmanial effect of Chenopodium oil administered by the oral route at different doses and to compare its action to conventional, clinically used drugs. MATERIALS AND METHODS: BALB/c mice were infected with Leishmania amazonensis and treated with 30, 60, 90, 120, and 150 mg/kg of the essential oil for 15 days. A second experiment was performed to compare the antileishmanial effect of Chenopodium oil with glucantime (28 mg/kg), amphotericin B (1 mg/kg), and pentamidine (4 mg/kg), which were administered daily over 15 days by the intraperitoneal route. RESULTS: Statistically significant differences were observed between BALB/c mice treated with all the doses of the product compared with untreated animals and the mice treated with the vehicle. A dose of 150 mg/kg was the most effective and no macroscopic toxic effects were observed. The size of lesion showed a linear correlation at each point (R > 0.8322), with a 50% effective concentration of 51.4 mg/kg. At 150 mg/kg, the essential oil showed better activity compared with animals treated with glucantime, amphotericin B, and pentamidine. CONCLUSION: C. ambrosioides caused a promising therapeutic effect against cutaneous leishmaniasis caused by L. amazonensis, which could be explored to develop a new alternative treatment for cutaneous leishmaniasis.

El fibrinógeno como factor de riesgo para cardiopatía isquémica / The fibrinogen as a risk factor for the ischemic cardiopathy

En los servicios de medicina interna y Cardiología de Hospital Universitario de Caracas, se investigó en un estudio de 3 años de duración, en el período comprendido entre abril 86 a abril 89, la prevalencia de Cardiopatía Isquémica en relación con los niveles de fibrinógeno. El estudio se basó en la evaluación de 300 pacientes de ambos sexos y deferentes razas, fumadores y no fumadores, en edades comprendidas entre 35 y 65 años inclusive, para el momento de ingreso al protocolo. Se realizó un estudio de análisis de varianza, encontrándose que el grupo de pacientes con un nivel de fibrinógeno alto presentaban una prevalencia de Cardiopatía Isquémica significativamente mayor en el grupo de pacientes con fibrinógeno normal o bajo (p<0,0001), independientemente de si los pacientes presentaban o no hábito tabáquico. Entre el grupo de pacientes fumadores se observó un nivel de fibrinógeno y una prevalancia de Cardiopatía Isquémica mayor, estadísticamente significativa, con respecto a los pacientes fumadores (p<0,0001). En el grupo de pacientes hipertensos presentaron una mayor prevalencia de Cardiopatía Isquémica con respecto a los normotensos, siendo la diferencia estadísticamente significativa (p<0,0001). Los datos estadísticos apuntan en el sentido de que el fibrinógeno es un factor de riesgo que debe tomarce en cuenta para Cardiopatía Isquémica

Descripción de la situación epidemiológica de la tuberculosis en el distrito sanitario de Reyes Departamento del Beni - Bolivia / Tuberculosis epidemiology in a sanitary district of Bolivia, Reyes, department of Beni-Bolivia

El artículo describe la situación epidemiológica de la tuberculosis en un distrito sanitario del Departamento del Beni-Bolivia. El país tiene una de las tasas más altas de tuberculosis en el continente americano y el Beni es uno de los Departamentos, junto con Santa Cruz y Tarija con los índices más altos del país. Los resultados que presentamos son los obtenidos de la evaluación del programa de distrito de Reyes realiada en marzo del año 1999, trás supervisión directa y correccion de los registros e informes del programa de cada centro sanitario del distrito