Rapid method for the detection of anti-HCV antibodies in patients with chronic hepatitis C.

OBJECTIVE: to evaluate the usefulness of a simple, rapid, qualitative technique (MedMira Rapid Test) to detect antibodies against hepatitis C virus (HCV) and compare this approach with an immunometric technique in patients with chronic hepatitis C infected with different genotypes. METHODS: anti-HCV antibodies were determined with the MedMira rapid technique and an immunometric method in samples from 138 patients with chronic hepatitis C infected with different HCV genotypes, and in 50 samples from healthy individuals. RESULTS: the MedMira rapid technique detected anti-HCV antibodies in 135 (98%) of 138 serum samples from patients with chronic hepatitis C, whereas the immunometric method gave positive results in all 138 samples. Three of the 138 anti-HCV-positive samples identified with the immunometric method and confirmed by inmunoblotting were repeatedly negative with the MedMira rapid technique. Two of these samples were genotype 1 and the third was not genotyped. All samples from the control group were negative for anti-HCV antibodies by both methods. The sensitivity and specificity of the MedMira rapid technique relative to the immunometric technique were 98% and 100% respectively. CONCLUSION: the MedMira rapid technique is a quick, specific and sensitive method that is easy to use by nonspecialized personnel, and is a good alternative to other, slower methods for the diagnosis of chronic hepatitis C.     

Management of infectious discitis. Outcome in one hundred and eight patients in a University Hospital

Purpose  

The optimal management of pyogenic discitis is not agreed on. We conducted a retrospective, cross-sectional, observational study in which all patients with discitis who attended Hospital San Carlos Madrid from January 1999 to January 2009 were included.     

Evaluation of the Literature: Evidence Assessment Tools for Clinicians

The progressive improvement in the quality of scientific articles has led to an increase in difficulty in reading and interpreting them so that now clinical knowledge and experience must be complemented by methodological, statistical and computer skills. The aim of this article is to offer practitioners the tools, the simplest keys, that will allow them to understand and critically judge the results of scientific studies.The “peer-review” process of a clinical article submitted to a journal is described and the Science Citation Index and the Impact Factor are presented to the reader as essential instruments to evaluate a specific article's impact and the impact of a given journal on the scientific world, respectively. An article should be evaluated on the basis of some key issues which include, at least, an assessment of methodological aspects, a critical analysis of the statistical component and a proper understanding of the clinical impact of the study outcomes.The standard approach for evaluating the quality of individual studies is based on a hierarchical grading system of research design which represents an essential tool to identify the strength of the evidence of an article. Many different biases may affect the reliability of study results. Randomized Control Trials (RCTs) and Systematic Reviews (SRs) are able to minimize the number of biases and thus are at the highest level of the scale of evidence representing the final steps of a treatment's “career.”Finally, moving from research to clinical practice, attention on the clinical impact of study's outcomes is of paramount importance as the literature contains studies (including RCTs) that present statistically significant results but which, from the clinical standpoint, are only relatively or not at all significant. Clinical Practice Guidelines represent a useful tool for practitioners assisting the decision-making process when choosing the most appropriate treatment for their patients.     

Functional biopolymer-based matrices for modulation of chronic wound enzyme activities

Collagen, collagen/hyaluronic acid (HA) and collagen/HA/chitosan (CS) sponges loaded with epigallocatechin gallate (EGCG), catechin (CAT) and gallic acid (GA) were developed and evaluated as active chronic wound dressings. Their physico-mechanical properties, biostability, biocompatibility and ability to inhibit in vitro myeloperoxidase (MPO) and collagenase—major enzymes related with the persistent inflammation in chronic wounds—were investigated as a function of the biopolymer composition and the polyphenolic compound used. The results demonstrated that the molecular weight of HA influences significantly the bulk properties of the obtained materials: higher elastic modulus, swelling ability and biostability against collagenase were measured when HA with higher molecular weights (830 and 2000 kDa) were added to the collagen matrices. The addition of CS and the polyphenols increased further the biostability of the sponges. Preliminary in vitro tests with fibroblasts revealed that the cells were able to adhere to all sponges. Cell viability was not affected significantly by the addition of the polyphenols; however, the presence of CS or high molecular weight HA in the sponge composition was associated with lower cellular viability. Finally, all specimens containing polyphenols efficiently inhibited the MPO activity. The highest inhibition capacity was observed for EGCG (IC₅₀ = 15 ± 1 μM) and it was coupled to the highest extent of binding to the biopolymers (>80%) and optimal release profile from the sponges that allowed for prolonged (up to 3–5 days) effects.