ABSTRACT
BACKGROUND: A novel swine origin influenza virus (S-OIV) is continue to spread worldwide and a global declaration of 2009 influenza pandemic was made by World Health Organization (WHO) June 2009, this along with approaching the winter season at the northern hemisphere, increase the interest to provide a quick, easy, affordable and available point of care testing for S-OIV. OBJECTIVES: To determine the performance of two rapid point-of-care (POC) tests for influenza virus as well as direct fluorescence assay for the detection of the recently emerged a novel swine origin influenza virus (S-OIV). STUDY DESIGN: A total of 143 respiratory samples which was submitted to Pathology and Laboratory Medicine at King AbdulAziz Medical City in Riyadh, Saudi Arabia from June 6th 2009 till June 28th 2009. All samples were tested in parallel using two rapid assays (BD Directigen EZ Flu®) and (TruFlu, Meridian®) as well as (Imagen Flu A/B DFA, Oxoid®) and compare it with RT-PCR. Each test's performed by different team, who were blinded for other team's result. Data gathered and we analyzed the analytical validity of each test. RESULTS: The analytical sensitivity of the two influenza antigen detection tests for S-OIV was very low in comparison with RT-PCR, BD Directigen EZ performance was better than TruFlu test with sensitivities of 20.6% and 9.7% respectively. DFA perform much better than POC tests with sensitivity of 32.35%, specificity of 99.08% and PPV, NPV of 90% and 81.20% respectively. CONCLUSION: The analytical sensitivity of the selected influenza A antigen detection tests for detection of S-OIV was very low, and should not be used to exclude S-OIV, DFA may be used as first line test especially during after hours or weekends, but negative results must confirmed by RT-PCR.
Subject(s)
Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza, Human/diagnosis , Point-of-Care Systems , Virology/methods , Fluorescent Antibody Technique, Direct/methods , Humans , Influenza, Human/virology , Polymerase Chain Reaction/methods , Saudi Arabia , Sensitivity and SpecificityABSTRACT
In this open-label trial, ten male patients with active Behcet's uveitis were enrolled. Initially, two infliximab infusions (5 mg/kg) were given at weeks 0 and 2. The patients continued to receive conventional therapy on recurrence of severe uveitis (RSU) attack. The patients with further attack were regularly given infliximab infusions every 8 weeks. In cases of further RSU attacks, the infusion interval was reduced to 6 weeks. The total follow-up period was 3 years. The patients were monitored for RSU, visual acuity and adverse effects. Reduction in the doses of prednisolone was also monitored. After receiving two infliximab infusions at weeks 0 and 2, three patients remained attack-free and seven patients had another RSU attack between 8th and 47th week. These patients were regularly given infliximab at 8-week intervals. Five out of seven patients remained attack-free. In two patients who had further attack, infusion frequency was increased to 6 weeks. There was a remarkable improvement in visual acuity with no significant adverse reaction except mild respiratory tract infection (two patients), headache (one patient) and mild infusion reaction (one patient). Infliximab is a safe and effective drug for the management of Behcet's uveitis. Selection of optimal dose and frequency of infusion required standardization for individual patient.
