The tuberculin skin test increases the responses measured by T cell interferon-gamma release assays

RUTI is a vaccine consisting of Mycobacterium tuberculosis bacilli grown in stress conditions that is fragmented, detoxified and liposomed. RUTI was designed to shorten the treatment of latent tuberculosis infection (LTBI) with isoniazid from 9 months to just 1 month, by additional treatment with two inoculations of RUTI 4 weeks apart. During the validation process for monitoring the immunogenicity of administration of RUTI in a Phase I clinical trial, the question arose whether to introduce the tuberculin skin test (TST) in the screening of non-LTBI volunteers. This study was designed to evaluate the effect of TST on subsequent different T-cell interferon-gamma release assay (TIGRA) responses, using a spectrum of M. tuberculosis -related antigens (ESAT-6, CFP-10, 16 kDa, 19 kDa, MPT64, Ag 85B, 38 kDa, hsp65, PPD and BCG). The results showed an increase in post-TST response even in non-LTBI subjects for most antigens tested, as measured both by whole blood assay (WBA) and ELISPOT. Increased ELISPOT response decreased toward pre-TST levels within 1 month whereas the WBA response did not. Taking into account that there is no definitive correlation between TST and TIGRA tests to diagnose LTBI and the feasibility that TST might alter the immune monitoring included in clinical trials, these data suggest that TST determination should be carefully planned to avoid any interference with TIGRA.     

The outcome of cataract surgery measured with the Catquest‐9SF

Purpose: The purpose of this study was to use the Catquest‐9SF to measure cataract surgery outcomes, and to use Rasch analysis to test the psychometric properties of this questionnaire, including its validity and responsiveness. Methods: Patients were recruited as consecutive cataract surgery patients during 1 month at six surgical units in Sweden (via the National Cataract Register). The patients completed the questionnaire before surgery and 3 months after. The Catquest‐9SF data were assessed for fit to the Rasch model using version 3.63.2 of the WINSTEPS software (Winsteps.com, Beaverton, OR, USA). Both preoperative and postoperative questionnaires were included in the analysis. The responsiveness to cataract surgery was calculated as the effect size. Results: Completed questionnaires before and after surgery were received from 846 patients. The Rasch analysis showed that the category thresholds were ordered. All items fit a single overall construct (infit range 0.79–1.40; outfit range 0.74–1.40). The ability to discriminate different strata of person ability was good, with a real patient separation of 2.58 and patient separation reliability of 0.87. The questionnaire showed unidimensionality and was largely free from differential item functioning. The item difficulty was reasonably well targeted to both preoperative and postoperative patient ability. The Catquest‐9SF Rasch score correlated significantly with visual acuity, and cataract surgery resulted in a significant improvement with an effect size of 1.8. Conclusion: The Catquest‐9SF shows excellent psychometric properties, as demonstrated by Rasch analysis. It is highly responsive to cataract surgery, and its brevity (nine items) makes it well suited for use in daily clinical practice.     

新型输送型球囊扩张导管在颅内动脉狭窄治疗中的临床应用研究

目的：探讨新型输送型球囊扩张导管(Fastunnel)在颅内动脉粥样硬化狭窄介入治疗中的应用效果。方法：2021年11月至2022年2月,我们使用新型输送型球囊扩张导管对10例颅内动脉粥样硬化狭窄的患者进行了球囊扩张+支架成形术。收集并分析了患者的基线情况、影像学特点、治疗情况及围手术期情况。结果：男6例,女性4例,平均年龄(62.7±6.7)岁。10例患者均成功接受手术治疗,手术时长为16~65(37.3±18.2)min,治疗过程所受辐射剂量为1381~4901(2643.7±1131.7)mGy,剂量面积乘积(DAP)值为5707~38112(17526.8±10809.5)μGym₂^。围手术期无出血及缺血相关并发症。结论：输送型球囊扩张导管具有较好的安全性,能有效地简化手术步骤、缩短手术时间,对减少患者及医生所受射线剂量。