Diagnostic performance of interferon-gamma release assay for diagnosis of tuberculous pericarditis: A meta-analysis.

BACKGROUND: The diagnosis of tuberculous pericarditis is difficult to set, not only for its non-specific clinical presentation, but also for the lack of useful diagnostic tests. We comprehensively evaluate the overall diagnostic accuracy of Interferon-gamma release assays (IGRA) upon tuberculous pericarditis by meta-analysis. METHODS: We searched PubMed, Embase and Cochrane Library database from the earliest available date of indexing through April 30, 2019. The study quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS2) checklist. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-) and constructed summary receiver operating characteristic curves parameters. RESULTS: Across six results from five studies (415 patients), the pooled sensitivity for IGRA methods was 0.94 (95% confidence interval [CI]; 0.87-0.98) with heterogeneity (χ2  = 69.9, P = .01) and a pooled specificity of 0.94 (95% CI; 0.75-0.94) without heterogeneity (χ2  = 41.1, P = .13). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 16.8 (95% CI; 8.0-35.4) and negative likelihood ratio (LR-) of 0.06 (95% CI; 0.03-0.13). The pooled diagnostic odds ratio was 278 (95% CI; 114-6806). CONCLUSIONS: Interferon-gamma release assays demonstrated good sensitivity and specificity for diagnosis of tuberculous pericarditis. At present, the literature regarding remains the use of IGRA for diagnosis of tuberculous pericarditis still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of IGRA test for the diagnosis of tuberculous pericarditis.

Immunohistochemical evaluation of keratins and involucrin in differentiating between palmoplantar pustulosis and pompholyx.

BACKGROUND: Palmoplantar pustulosis (PPP) and pompholyx are chronic diseases characterized by pustules and vesicles on the palms and soles. These disorders often have similar clinicopathological features, which lead to diagnostic difficulties. We aimed to investigate the expression patterns of keratins and involucrin in PPP and pompholyx using immunohistochemical staining. METHODS: Skin biopsies from patients with PPP (n = 40) and pompholyx (n = 22) were immunohistochemically analyzed for Keratin 5, 9, 14, and involucrin expression. RESULTS: K5 expression was higher in PPP than in pompholyx, with diffusely positive expression in the basal, spinous, and granular layers. K14 expression did not differ between groups. K9 expression was observed near the pompholyx vesicle (P = 0.014) and stratum spinosum (P < 0.001) but was almost absent around PPP pustules. Involucrin expression was diffused around the PPP pustules and partially around the pompholyx vesicles, but without statistical significance (P = 0.123). Involucrin expression was elevated in the basal layer of the PPP compared with that in the pompholyx (P = 0.023). CONCLUSION: PPP and pompholyx exhibited distinctive differentiation in the expression of K5, K9, and involucrin.

Biting deterrency of undecanoic acid and dodecanoic acid ester analogs against Aedes aegypti.

BACKGROUND: Mosquitoes remain one of the most significant threats to the health of humans throughout the world. This study was designed to evaluate the biting deterrent effects of a series of ester analogs of undecanoic acid (C:11:0) and dodecanoic acid (C:12:0) against Aedes aegypti (L), (Diptera: Culicidae), the yellow fever mosquito, using Klun and Debboun (K&D) and Ali and Khan (A&K) bioassay systems. RESULTS: In the K&D bioassays, C:11:0 esters methyl undecanoate, propyl undecanoate, butyl undecanoate, and pentyl undecanoate, and the C:12:0 esters methyl dodecanoate, ethyl dodecanoate, propyl dodecanoate, octyl dodecanoate, and dodecyl dodecanoate were most active. All of these esters were as effective as N,N-diethyl-m-toluamide (DEET) and as effective as the parent acids undecanoic acid and dodecanoic acid with biting deterrence index values ranging from 0.80 to 0.99. In the in vitro A&K bioassay undecanoic acid with a minimum effective dose (MED) of 3.125 µg cm-2 was the most active compound and showed higher activity than DEET (MED of 25 µg cm-2 ). The most active synthetic analog was butyl undecanoate with a MED of 12.5 µg cm-2 . The next most active analogs are the methyl ester analogs methyl undecanoate and methyl dodecanoate, both with MED values of 25 µg cm-2 . CONCLUSION: Fatty acid synthetic esters and structural analogs are a promising source of new mosquito repelling compounds and should be investigated further. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.

Projection of future climate change impacts on nonpoint source pollution loads for a forest dominant dam watershed by reflecting future vegetation canopy in a Soil and Water Assessment Tool model.

This study is to assess the future impact of climate change on hydrological behavior considering future vegetation canopy prediction and its propagation to nonpoint source pollution (NPS) loads. The SWAT (Soil and Water Assessment Tool) model was used for the assessment. For a forest dominant ChungjuDam watershed of South Korea, the MIROC3.2hires climate data of SRES A1B and B1 scenarios were adopted and downscaled for the watershed. The future vegetation canopy information was projected by the monthly relationship between Terra MODIS (MODerate resolution Imaging Spectroradiometer) LAI (Leaf Area Index) and temperature. The future predicted LAI increased up to 1.9 in 2080s April and October because of the temperature increase 3.6 degrees C and 5.3 degrees C respectively. By reflecting the future LAI changes, the future estimated percent changes of maximum annual dam inflow, SS, T-N, and T-P were + 42.5% in 2080s A1B,-35.6% in 2020s A1B,+73.7% in 2080s A1B and-21.0% in 2080s B1 scenario respectively. The increase of T-N load was from the increase of subsurface lateral flows and the groundwater recharges by the future rainfall increase. The decrease of T-P load was by decrease of sediment load during wet days because the effect of LAI increase is greater than the increase of rainfall.

Risk Factors for Aseptic Meningitis in Herpes Zoster Patients.

BACKGROUND: Herpes zoster (HZ) is caused by reactivation of latent varicella-zoster virus (VZV) infection. HZ-associated aseptic meningitis, a rare complication of HZ, can require hospitalization and a long treatment period. OBJECTIVE: A retrospective study was performed to identify potential factors associated with HZ-associated aseptic meningitis development. METHODS: We included all outpatients and patients admitted in the neurology and dermatology departments of a single tertiary center, who were diagnosed with HZ for two years. Among 818 patients, 578 patients were eligible for analysis. RESULTS: The demographics and potential risk factors were compared between the uncomplicated HZ group (n=554) and aseptic meningitis group (n=24). Among the potential factors, the dermatological distribution of skin rash and gender showed statistically significantly different between the two groups. Patients with craniocervical distribution of HZ accounted for 87.5% (n=21) of the aseptic meningitis group and 54.3% (n=301) of the uncomplicated HZ group (p=0.043). The aseptic meningitis group had more men (66.7%, n=16) than the uncomplicated HZ group (42.8%, n=237, p=0.033). Patients with craniocervical distribution had an odds ratio (OR) of 5.884 (p=0.001) for developing aseptic meningitis when compared with the other dermatome involvements. Additional logistic regression analysis resulted in a fading between gender difference (p=0.050) and craniocervical involvement having an OR of 5.667 for aseptic meningitis (p=0.006). CONCLUSION: In HZ patients, skin rash with craniocervical distribution and male gender were associated with a higher risk of aseptic meningitis.

Clinical evaluation of 40% urea and 12% ammonium lactate in the treatment of xerosis.

BACKGROUND: Urea and ammonium lactate are used for the treatment of xerosis, with different degrees of success. This study compares the clinical effectiveness of these two agents. OBJECTIVE: To compare the effectiveness and tolerance of a 40% urea topical cream (Carmol 40) from Doak Dermatologics, a subsidiary of Bradley Pharmaceuticals, Inc., and 12% ammonium lactate topical lotion (Lac-Hydrin 12%) from Westwood Squibb, a division of Bristol-Myers Squibb. METHODS: A randomized, double-blind, bilateral paired comparison study was conducted involving 25 men and women who were undergoing treatment for moderate to severe xerosis. The study included evaluations upon initiation of the study, after a 14-day treatment period and treatment follow-up on day 28. RESULTS: Eighteen study participants completed the entire 28-day evaluation period. Evaluation of treatment benefit was based on instrumental measurement of water loss from the skin surface, skin capacitance, skin desquamation, skin roughness, subject self assessment of skin and investigator evaluation. Results indicated that clinical observation ratings by patients and investigators, as well as instrument measures, show differences between the two treatments. Most measures show that improvement is achieved in less time with 40% urea cream than with 12% ammonium lactate lotion. On day 14, the 40% urea cream was superior to the 12% ammonium lactate lotion as measured by skin roughness, fissure reduction, thickness and dryness. DISCUSSION: At day 14 of treatment, 40% urea cream was superior to 12% ammonium lactate for most of the instrumental and clinical assessments.

Disposition of cocaine in skin, interstitial fluid, sebum, and stratum corneum.

The aim of this study was to determine whether or not the skin acts as a reservoir for cocaine. Cocaine-d5 (1 mg/kg) was administered to five nondependent, cocaine-experienced volunteers. Skin tissue, interstitial fluid, sebum, stratum corneum, and plasma were collected for 72 h after drug administration. Cocaine and benzoylecgonine (BE) levels were determined using GC-MS. Cocaine concentrations peaked in plasma at 1 h after administration, with pharmacokinetic parameters (t(1/2), CL, Vd) also in the expected ranges. In skin, cocaine levels peaked around 1.5 h after administration and became undetectable by 6 h. A correlation was found between the plasma and skin AUC for cocaine (R = 0.99, p = 0.006, N = 4). BE was not detected in skin. In interstitial fluid (N = 4), cocaine concentrations peaked around 5 h after drug administration and were undetectable by 24 h. BE peaks varied between 2 and 24 h and were not detectable at 48 h. In sebum, cocaine levels peaked between 3 and 24 h. BE was found in three samples between 12 and 24 h. In stratum corneum, cocaine was measurable in only one sample from one subject. These findings suggest that skin does not act as a reservoir for cocaine. Rather, cocaine appears to be distributed rapidly to the skin and eliminated, following a time course similar to that of plasma.

Comparison of the acute toxicities of novel algicides, thiazolidinedione derivatives TD49 and TD53, to various marine organisms.

Acute toxicity assessments of new algicides, thiazolidinedione derivatives TD49 and TD53, to the marine ecological system were conducted. The toxicity assessments were performed using two of the new International Organization for Standardization (ISO) standard methods employing Ulva pertusa Kjellman and three species representative of the marine ecological system, with the results compared by calculating the 50% effective concentration (EC50), 50% lethal concentration (LC50), no-observed-effect concentration (NOEC), and predicted-no-effect concentration (PNEC). In the acute toxicity assessment using the Kjellman, the EC50, NOEC, and PNEC of TD53 were 1.65 µM, 0.08 µM, and 1.65 nM, and those of TD49 were 0.18 µM, 0.63 µM, and 0.18 nM. In the assessments using Skeletonema costatum, Daphnia magna, and Paralichthys olivaceus fry, the EC50 or LC50 of TD53 were 1.53, 0.61, and 2.14 µM, respectively, indicating that D. magna was the most sensitive. The calculated NOEC and PNEC to D. magna were 0.25 µM and 6.10 nM, respectively. The LC50s (or EC50) of TD49 for the three species were 0.34, 0.68, and 0.58 µM. The NOEC and PNEC to S. costatum, the most sensitive species, were 0.2 µM and 3.4 nM, respectively. The slight difference in the chemical structures of the algicides caused significantly different sensitivities and specificities in the toxicities to the employed species. The results of the toxicity assessments showed that application concentrations for algiciding of red tide blooms were higher than the corresponding PNEC values. Therefore, we suggest that a formulization study of the algicides with high specificity should be conducted to reduce the surrounding ecological toxicity.