The INNO-LiPA
Rif.TB (R) line-probe assay (LPA) detects rifampin (RMP) resistance and may accelerate the time to effective MDR-TB treatment.
OBJECTIVE: To determine the impact of LPA on time to diagnosis, High Content Screening initiation of treatment, sputum culture conversion and treatment outcome.
DESIGN: From October 2004 to September 2006, we performed LPA and drug susceptibility testing (DST) using BACTEC and Lowenstein-Jensen (LJ) media among all individuals at risk for MDR-TB compared to a 2003 cohort of 48 MDR-TB patients detected by BACTEC.
RESULTS: In a total of 107 sputum smear-positive individuals at risk for MDR-TB, Mycobacterium tuberculosis was isolated from 85; 23 were RMP-resistant on LJ compared to 22 on LPA (96% sensitivity). There was a significant difference in the mean time between specimen collection and LPA result (10.0 days) and BACTEC DST result (17.0 days, P = 0.0005) in the LPA cohort. The LPA cohort achieved culture conversion a median of 105 days after treatment initiation vs. a median of 88.5 days (P = 0.54) in the BACTEC cohort. There was no difference in the proportion achieving culture conversion JPH203 (P = 0.54) or in treatment outcome (P = 0.65).
CONCLUSION: LPA accelerated
empiric treatment, but did not reduce the time to culture conversion or improve the rate of culture conversion or treatment outcome.”
“AimTo study the effect of blocking the inflammatory cascade with interleukin-6
receptor antibody (anti-IL-6R) on feto-maternal outcomes in a rat model.
MethodsPregnant Sprague-Dawley rats (n=38) were injected intraperitoneally (day 22) (control, anti-IL-6R 30g/kg, lipopolysaccharide [LPS] 250g/kg or 500g/kg alone or combined with anti-IL-6R) followed Belnacasan supplier by preterm caesarian performed 12h later. Resuscitated pups (n=179) were given to surrogate mothers. Primary outcomes were maternal and pup mortality.
ResultsFifty percent of pregnant rats died after LPS 500g/kg+anti-IL-6R injection but none in other groups. Neonatal mortality at 24h was 63% and 86% in LPS 500g/kg and LPS 500g/kg+anti-IL-6R groups, respectively (P<0.05). Surviving pups in the latter group presented a severe growth deficit compared to the LPS 500g/kg group (P<0.01) and showed no difference with controls for open field testing. Maternal cytokine analysis after LPS 500g/kg+anti-IL-6R injection showed a tendency for increased IL-1 production (P=0.06).
ConclusionParadoxically, the association of pregnancy, inflammation and anti-IL-6R increases the inflammatory effects of LPS.”
“Background: Retrospective single-center studies have shown that measures of mechanical dyssynchrony before cardiac resynchronization therapy (CRT), or acute changes after CRT, predict response better than QRS duration.