A new HCV core antigen assay based on disassociation of immune complexes: an alternative to molecular biology in the diagnosis of early HCV infection

BACKGROUND: An EIA based on immune complex disassociation of nucleocapsid proteins of HCV has been developed to detect and quantify HCV core antigen. STUDY DESIGN AND METHODS: To evaluate whether this new assay (trak-C, Ortho Clinical Diagnostics) could be an alternative to NAT during the window period, its sensitivity in this context was assessed, and its performance was compared with that of a first-generation HCV core antigen assay dedicated to the blood screening (HCV core antigen ELISA). Studied populations included nine HCV RNA-positive, HCV antibody-negative blood donors and 23 hemodialysis patients who underwent an HCV seroconversion. From these individuals, 81 samples (23 HCV RNA-negative and 58 HCV RNA-positive) sequentially collected during the phase before seroconversion were tested. RESULTS: The nine blood donor samples were positive for the presence of HCV core antigen by the trak-C, and 6 of 8 tested were positive for the presence of HCV core antigen by blood screening ELISA. In the hemodialysis cohort, the 23 HCV RNA-negative samples were negative with the two HCV core antigen assays. Among the 58 HCV RNA-positive samples, 46 of 57 (80.7%) tested were positive for the presence of HCV core antigen with the blood screening assay, and 57 of 58 (98.2%) were positive for the presence of HCV core antigen with the trak-C. The mean delays in detecting HCV infection between trak-C and the appearance of HCV antibodies, between HCV RNA testing and trak-C, and between trak-C and HCV core antigen ELISA were 58.2, 0.24, and 3.33 days, respectively. CONCLUSION: Trak-C was more sensitive than the blood screening assay and had similar performance to HCV RNA assay in the window period. Trak-C could constitute an alternative to NAT for the diagnosis of HCV infection during the window period, especially when molecular biology procedures cannot be implemented.     

Weakly inhomogeneous media tomography

Our objective is to develop an ultrasonic scanner for breast imaging. High resolution is obtained by using wide-band spherical waves transmitted and measured in the near field zone (i.e., close to the skin) all around the organ. The tomographic approach that we adopt allows us to use low central frequency waves (3-7 MHz) that are suitable for good penetration while maintaining high resolution and contrast. The procedure is thus suitable for early detection of tumors and increases the chances of total recovery. The novelty of the present reconstruction procedure is that it associates the signals acquired in transmission to the data measured in reflection over a large aperture. This enables us to correct the phase aberration induced by weak inhomogeneities whose sizes might be several wavelengths. Numerical tests based on Finite Difference Time Domain (FDTD) simulations demonstrate the greater fidelity of the reconstruction.     

Nocardia veterana isolated from ascitic fluid of a patient with human immunodeficiency virus infection

Nocardia veterana is a recently characterized species within the genus Nocardia, and only three human clinical isolates have been reported for this species. We describe a case of ascitic fluid infection in an immunocompromised patient due to N. veterana. To our knowledge, this is the first report of a Nocardia sp. strain from ascitic fluid and the fourth report of N. veterana isolated from human samples. Chemotaxonomic methods showed the strain to belong to the genus Nocardia, and identification to the species level was done by 16S ribosomal DNA gene sequencing. The antibiotic susceptibility profile of N. veterana is reported here for the second time. The strain was deposited in the Collection of the Pasteur Institute and in the Culture Collection of the University of G?teborg (CIP 107497 and CCUG 46576). The corresponding 16S ribosomal DNA gene sequence is available from the GenBank database under accession number AY149599. A phylogenetic analysis was conducted and showed that N. veterana was most closely related to the recently characterized species Nocardia africana rather than to Nocardia vaccinii, as previously reported.     

Long-term adiposity changes are related to a glucocorticoid receptor polymorphism in young females

Male and female preadolescents and adolescents who participated in phase 1 of the Québec Family Study, and who were retested about 12 yr later, were recruited and subdivided on the basis of a genetic variant within the intron 2 of the glucocorticoid receptor (GRL IVS2-BclI). The increase in sc adiposity over the 12-yr follow-up period in the 4.5/2.3 genotype female subgroup was more than twice that observed in the 4.5/4.5 and the 2.3/2.3 genotype subgroups (P < 0.01). The statistical significance of this difference was essentially unchanged after adjusting for changes, over time, in percent dietary energy as fat, alcohol consumption, and participation in vigorous physical activity. In male subjects, the same trend was found, but it did not reach statistical significance. In conclusion, this study suggests that a significant interaction effect exists between variation in the glucocorticoid receptor gene and body fat gain in female subjects experiencing the transition between adolescence and adulthood. Further research will, however, be necessary to characterize the lifestyle factors promoting fat accumulation, over time, among genetically susceptible individuals.     

Dose density and dose intensity in the treatment of breast cancer

Since 10 years, high-dose chemotherapy has been evaluated for the treatment of breast cancer in numerous randomized clinical trials. Preliminary results of some of these studies have shown an advantage in relapse-free survival in both metastatic and high-risk breast cancer. Although follow-up is short in most of the studies, no impact on overall survival has been detected. Based on available results, high-dose chemotherapy cannot be proposed either in metastatic or in high-risk breast cancer patients outside a clinical trial. Conversely, two randomized trials have demonstrated that dose-dense scheduled chemotherapy with G-CSF support, containing an anthracycline, cyclophosphamide and paclitaxel, improves clinical outcomes compared with the same regimen administered every 3 weeks. These results establish dose-dense scheduled chemotherapy containing an anthracycline and paclitaxel as an option for the adjuvant treatment of positive lymph nodes breast cancer patients. Data are not sufficient to conclude in the neoadjuvant and metastatic setting. High-dose chemotherapy and dose-dense chemotherapy seem to increase the pathological complete response rate in inflammatory breast cancer. However, prospective and comparative survival data are lacking.