Evaluation of a novel, rapid antigen detection test for the diagnosis of SARS-CoV-2.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is currently finally determined in laboratory settings by real-time reverse-transcription polymerase-chain-reaction (rt-PCR). However, simple testing with immediately available results are crucial to gain control over COVID-19. The aim was to evaluate such a point-of-care antigen rapid test (AG-rt) device in its performance compared to laboratory-based rt-PCR testing in COVID-19 suspected, symptomatic patients. METHODS: For this prospective study, two specimens each of 541 symptomatic female (54.7%) and male (45.3%) patients aged between 18 and 95 years tested at five emergency departments (ED, n = 296) and four primary healthcare centres (PHC, n = 245), were compared, using AG-rt (positive/negative/invalid) and rt-PCR (positive/negative and cycle threshold, Ct) to diagnose SARS-CoV-2. Diagnostic accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), and likelihood ratios (LR+/-) of the AG-rt were assessed. RESULTS: Differences between ED and PHC were detected regarding gender, age, symptoms, disease prevalence, and diagnostic performance. Overall, 174 (32.2%) were tested positive on AG-rt and 213 (39.4%) on rt-PCR. AG correctly classified 91.7% of all rt-PCR positive cases with a sensitivity of 80.3%, specificity of 99.1%, PPV of 98.3, NPV of 88.6%, LR(+) of 87.8, and LR(-) of 0.20. The highest sensitivities and specificities of AG-rt were detected in PHC (sensitivity: 84.4%, specificity: 100.0%), when using Ct of 30 as cut-off (sensitivity: 92.5%, specificity: 97.8%), and when symptom onset was within the first three days (sensitivity: 82.9%, specificity: 99.6%). CONCLUSIONS: The highest sensitivity was detected with a high viral load. Our findings suggest that AG-rt are comparable to rt-PCR to diagnose SARS-CoV-2 in COVID-19 suspected symptomatic patients presenting both at emergency departments and primary health care centres.

Neurotoxocariasis associated with lower motor neuron disease. Report of one case.

We report a 51-year-old male with a history of palpitations, hepatopathy and hypercholesterolemia, who habitually ate raw goat meat, and developed general fasciculations, muscle cramps in the lower limbs, distal muscle weakness and wasting, without upper motor neuron signs or sensory abnormalities. Diagnostic workup revealed positive antibodies against Toxocara canis in the serum and cerebrospinal fluid. Nerve conduction studies revealed a proximal and distal axonal lesion of motor nerves and needle electromyography was indicative of acute and chronic denervation with giant motor unit action potentials. Despite a therapy with albendazole and riluzole, muscle weakness and wasting further progressed and affected also the respiratory muscles. Followup nerve conduction studies and electromyography confirmed progression of the axonal degeneration. Whether lower motor neuron disease was causally related to neurotoxocariasis or due to a general metabolic defect, remains speculative.

Neurotoxocariasis associated with lower motor neuron disease: report of one case / Neurotoxocariasis asociada a enfermedad de motoneurona inferior: presentación de un caso

We report a 51-year-old male with a history of palpitations, hepatopathy and hypercholesterolemia, who habitually ate raw goat meat, and developed general fasciculations, muscle cramps in the lower limbs, distal muscle weakness and wasting, without upper motor neuron signs or sensory abnormalities. Diagnostic workup revealed positive antibodies against Toxocara canis in the serum and cerebrospinal fuid. Nerve conduction studies revealed a proximal and distal axonal lesion of motor nerves and needle electromyography was indicative of acute and chronic denervation with giant motor unit action potentials. Despite a therapy with albendazole and riluzole, muscle weakness and wasting further progressed and affected also the respiratory muscles. Followup nerve conduction studies and electromyography confrmed progression of the axonal degeneration. Whether lower motor neuron disease was causally related to neurotoxocariasis or due to a general metabolic defect, remains speculative.

Presentamos un hombre de 51 años con una historia de palpitaciones, hepatopatía e hipercolesterolemia que comía habitualmente carne de cabra cruda, que desarrolló un cuadro caracterizado por fasciculaciones generalizadas, calambres musculares en las extremidades inferiores, pérdida de fuerza y atrofa muscular distal, sin signos de lesión de motoneurona superior o alteraciones sensitivas. El laboratorio mostró anticuerpos anti Toxocara canis en suero y líquido cefalorraquídeo. La electromiografía mostró una lesión axonal proximal y distal de nervios motores y denervación con potenciales de acción gigantes en las unidades motoras. A pesar de tratarse con albendazol y riluzona, la debilidad muscular y atrofa continuaron progresando. Una nueva electromiografía confrmó la progresión de la degeneración axonal. La asociación entre esta enfermedad de motoneurona inferior y la neurotoxocariasis, es especulativa.

Epidermal growth factor receptor-targeted immunoliposomes significantly enhance the efficacy of multiple anticancer drugs in vivo.

We previously reported the development of epidermal growth factor receptor (EGFR)-targeted immunoliposomes that bind and internalize in tumor cells which overexpress EGFR and/or mutant EGFR variant III (EGFRvIII), enabling intracellular delivery of potent anticancer agents in vitro. We now describe in vivo proof-of-concept for this approach for the delivery of multiple anticancer drugs in EGFR-overexpressing tumor models. Anti-EGFR immunoliposomes were constructed modularly with Fab' fragments of cetuximab (IMC-C225), covalently linked to liposomes containing probes and/or anticancer drugs. Pharmacokinetic and biodistribution studies confirmed long circulation times (t(1/2) = 21 hours) and efficient accumulation in tumors (up to 15% ID/g) irrespective of the presence of the targeting ligand. Although total accumulations of anti-EGFR immunoliposomes and nontargeted liposomes in EGFR-overexpressing tumors were comparable, only immunoliposomes internalized extensively within tumor cells (92% of analyzed cells versus <5% for nontargeted liposomes), indicating different mechanisms of delivery at the cellular level. In vivo therapy studies in a series of xenograft models featuring overexpression of EGFR and/or EGFRvIII showed the superiority of immunoliposomal delivery of encapsulated drugs, which included doxorubicin, epirubicin, and vinorelbine. For each of these drugs, anti-EGFR immunoliposome delivery showed significant antitumor effects and was significantly superior to all other treatments, including the corresponding free or liposomal drug (P < 0.001-0.003). We conclude that anti-EGFR immunoliposomes provide efficient and targeted drug delivery of anticancer compounds and may represent a useful new treatment approach for tumors that overexpress the EGFR.