[99m]tc-ubiquicidin [29-41], a promising radiopharmaceutical to differentiate orthopedic implant infections from sterile inflammation

Ubiquicidin [UBI] [29-41] is a synthetic cationic antimicrobial peptide that preferentially binds to bacterial cell membrane at the site of infection. We aimed to assess diagnostic value of [99m]Tc-UBI [29-41] as a radiopharmaceutical in differentiation of bacterial infection from sterile inflammation in suspected orthopedic implants. Nine patients suspected for orthopedic implant infection, all males with the mean age of 41.6 +/- 20.9 years, were studied. A dose of 10 MBq/Kg [range: 555-740 MBq] [99m]Tc-UBI [29-41] was injected intravenously. A dynamic study followed by static whole body imaging at 30, 60 and 120 min post-radiotracer injection was acquired. Periprosthetic tissue culture was considered the closest test to a gold standard for diagnosing infections and scintigraphic scans were categorized as true- or false-positive and true- or false-negative, considering the bacterial culture as the gold standard. No adverse reaction was observed during or after the radiotracer injection days. There were five true positive, four true negative and no false positive and false negative scans. Sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] were all calculated as 100%. We found a high diagnostic accuracy for [99m]Tc-UBI [29-41] scintigraphy in differentiation of bacterial infection from sterile inflammation in suspected orthopedic implants. Therefore, [99m]Tc-UBI [29-41] scintigraphy might be potentially recommended as a safe and promising imaging modality in these settings. However, further studies on a larger number of patients and different pathologies are still needed

Immunological correlates of adult onset idiopathic generalized tonic-clonic epilepsy before and after sodium valproate treatment

To investigate possible immunological humoral correlates innewly diagnosed adult-onset generalized tonic-clonic epilepsy among Iranian patients before and after sodiumvalproate treatment. 72 adult patients with newly diagnosed idiopathic generalized tonic-clonic epilepsy were recruited. Serum antinuclear antibodies [ANA], anti-cardiolipin antibodies [aCL], anti-dsDNAantibodies, total serumimmunoglobulins [IgM, IgG, IgA] and C3 and C4 complements were determined before and after 12 months of therapy with sodiumvalproate. Similar parameters were also measured in 32 age and sex-matched healthy volunteers. Patients group had a significantly greater level of IgG class aCL [30.6%versus 12.4%, P = 0.004] and anti-dsDNAantibodies [23.9%versus 0%, P = 0.001] when compared with healthy volunteers, however, ANAtitre was relatively the same in both groups. Sodiumvalproate significantly decreased anti-dsDNAantibodiles [P= 0.002], IgM concentrations [P = 0.034], and increased the number of ANApositive patients [P = 0.002]. Changes in serumlevel of autoantibodies in patients with new onset idiopathic generalized convulsion were found to be high. These abnormalities are associated with both seizure disorders per se and also antiepileptic drugs.We suggest that in epileptic patients with an autoimmune basis, administration of anti-epileptic drugs having modulatory effects on immune systemshould be considered