Assessment of the reproducibility of oligoclonal IgM band detection for its application in daily clinical practice.

BACKGROUND: The presence of oligoclonal IgM bands (OCMB) in cerebrospinal fluid (CSF) is an unfavourable prognostic marker in multiple sclerosis. There is no commercial test to investigate OCMB status. However, a sensitive and specific isoelectrofocusing (IEF) and western blot method was described. We aimed to study the inter-centre reproducibility of this technique, a necessary condition for a reliable test to be incorporated into clinical practice. METHODS: The presence of OCMB was analysed by IEF and western blot with prior reduction of pentameric IgM. We assayed the reproducibility of this test in a blinded multicentre study performed in 13 university hospitals. Paired-CSF and serum samples from 52 neurological patients were assayed at every centre. RESULTS: Global analysis rendered a concordance of 89.8% with a kappa value of 0.71. CONCLUSION: These data indicate that OCMB detection by means of IEF and western blot with IgM reduction shows a good interlaboratory reproducibility and thus can be used in daily clinical setting.

Utility of oligoclonal IgG band detection for MS diagnosis in daily clinical practice.

An early and accurate diagnosis of multiple sclerosis (MS) is very important, since it allows early treatment initiation, which reduces the activity of the disease. Oligoclonal IgG band (OCGB) detection is a good ancillary tool for MS diagnosis. However, it was argued that its usefulness was limited by the high interlaboratory variability. In the last years, different techniques for OCGB detection have appeared. We performed a blinded aleatorized multicenter study in 19 Spanish hospitals to assess the accuracy and reproducibility of OCGB detection in this new scenario. We studied cerebrospinal fluid (CSF) and serum samples from 114 neurological patients. Every hospital contributed to the study with triplicated pairs of CSF and serum samples of six patients and analyzed 18 different samples. Global analysis rendered a sensitivity of 92.1%, a specificity of 95.1% and a Kappa value of 0.81. This shows that current techniques for OCGB detection have good accuracy and a high interlaboratory reproducibility and thus, represent a good tool for MS diagnosis. When we analyzed separately the different techniques used for OCGB detection, the highest concordance was observed in western blot with alkaline phosphatase detection (kappa=0.91). This indicates that high sensitivity techniques improve the reproducibility of this assay.

Hipercistinuria / Hypercistinuria

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Hipercistinuria familiar / Family hypercistinuria

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[Comparative study of the efficiency of itraconazole and ketoconazole in the treatment of experimental paracoccidioidomycosis]. / Estudio comparativo de la eficacia del itraconazol y el ketoconazol en el tratamiento de la paracoccidioidomicosis experimental.

A comparative study between ketoconazole and itraconazole in the prophylactic and curative treatment of experimental paracoccidioidomycosis in rats and guinea pigs was carried out. Ninety seven Wistar rats were inoculated intracardiacally with the yeast-phase of P. brasiliensis with the purpose of evaluating the prophylactic treatment. Eighty one guinea pigs were injected intratesticularly with the same microorganism with the aim of studying the healing treatment. Both drugs were administered by gavage once a day. The prophylactic treatment started 3 days before the challenger inoculation and the healing treatment begun 10 days after the challenger inoculation. The animals were divided in four groups: I), control animals to which only the solvents of both drugs were administered; II), those which received ketoconazole 40 mg/kg/day; III), those treated with the same drug 80 mg/kg/day, and IV), animals treated with itraconazole 8 mg/kg/day. Seven to 30 days after starting the healing and prophylactic treatments the results were evaluated. Itraconazole seems to be as effective as ketoconazole at 5 fold lower dosage.

Tratamiento con ketoconazol de la paracoccidioidomicosis diseminada de la rata / Treatment with ketoconazole of disseminated paracoccidioidomycosis of the rat

Se estudió la eficacia del tratamiento preventivo de la paracoccidioido diseminada de la rata Wistar con ketoconazol por vía oral. Se emplearon en total 36 ratas Wistar, macho, de 200g de peso, que fueron divididas en 3 grupos: un grupo control, que no recibió tratamiento, integrado por 15 animales, otro de 5 ratas tratadas con ketoconazol a razón de 40 mg/kg/día y un tercer grupo de 16 animales que recibieron 80 mg/kg/día de ketoconazol. Los tratamientos comenzaron 3 días antes de la inoculación de P. brasiliensis por vía venosa y se prolongaron por 4 semanas. Las autopsias demostraron la presencia de granulomas paracoccidióidicos en los pulmones en 12/15 animales del grupo control, en 3/5 ratas tratadas con 40 mg/kg/día y en sólo 2/16 de las que recibieron 80 mg/kg/día de ketoconazol. Se comprobaron lesiones extrapulmonares en 3/15 animales de grupo control y ninguno de los que fueron tratados con ketoconazol independientemente de la dosis

Tratamiento con ketoconazol de la paracoccidioidomicosis diseminada de la rata / Treatment with ketoconazole of disseminated paracoccidioidomycosis of the rat

Se estudió la eficacia del tratamiento preventivo de la paracoccidioido diseminada de la rata Wistar con ketoconazol por vía oral. Se emplearon en total 36 ratas Wistar, macho, de 200g de peso, que fueron divididas en 3 grupos: un grupo control, que no recibió tratamiento, integrado por 15 animales, otro de 5 ratas tratadas con ketoconazol a razón de 40 mg/kg/día y un tercer grupo de 16 animales que recibieron 80 mg/kg/día de ketoconazol. Los tratamientos comenzaron 3 días antes de la inoculación de P. brasiliensis por vía venosa y se prolongaron por 4 semanas. Las autopsias demostraron la presencia de granulomas paracoccidióidicos en los pulmones en 12/15 animales del grupo control, en 3/5 ratas tratadas con 40 mg/kg/día y en sólo 2/16 de las que recibieron 80 mg/kg/día de ketoconazol. Se comprobaron lesiones extrapulmonares en 3/15 animales de grupo control y ninguno de los que fueron tratados con ketoconazol independientemente de la dosis (AU)