The relationship between the use of tumor necrosis factor antagonists and onset of granulomatous infection was examined using data collected through the Adverse Event Reporting System of the US Food and Drug Administration for January 1998-September 2002. Granulomatous infections were reported at rates of approximately 239 per 100,000 patients who received infliximab and approximately 74 per 100,000 patients who received etanercept (P<.001). Tuberculosis was the most frequently reported disease, occurring in approximately 144 and approximately 35 per 100,000 infliximab-treated and etanercept-treated patients, respectively (P<.001). Candidiasis, coccidioidomycosis, histoplasmosis, listeriosis, nocardiosis, and infections due to nontuberculous mycobacteria were reported with significantly greater frequency among infliximab-treated patients. Seventy-two percent of these infection occurred < or =90 days after starting infliximab treatment, and 28% occurred after starting etanercept treatment (P<.001). These data indicate a risk of granulomatous infection that was 3.25-fold greater among patients who received infliximab than among those who received etanercept. The clustering of reports shortly after initiation of treatment with infliximab is consistent with reactivation of latent infection.

No abstract

Although infliximab and etanercept share tumor necrosis factor (TNF) as a common therapeutic target, accumulating data indicate that infliximab (an anti-TNF monoclonal antibody) poses a greater risk of reactivation of latent granulomatous infections than does etanercept (a soluble TNF receptor). Similarly, infliximab is effective for the treatment of chronic granulomatous inflammatory conditions (e.g., Crohn disease) for which etanercept is ineffective. The ability of infliximab to disrupt established granulomas may be distinct from its ability to neutralize soluble TNF. Further research to elucidate the mechanism of the antigranuloma activity of infliximab is warranted.

No abstract

We present a simple, rapid method for detecting short DNA sequences that combines a novel isothermal amplification method (EXPAR) with visual, colorimetric readout based on aggregation of DNA-functionalized gold nanospheres. The reaction is initiated by a trigger oligonucleotide, synthetic in nature for this proof-of-principle study, which is exponentially amplified at 55 degrees C and converted to a universal reporter oligonucleotide capable of bridging two sets of DNA-functionalized gold nanospheres. This reaction provides >10(6)-fold amplification/conversion in under 5 min. When combined with a solution containing DNA nanospheres, the bridging reporter causes nanosphere aggregation. The resulting color change from red to dark purple or blue is enhanced through spotting the solution onto a C18 reversed-phase thin-layer chromatography plate. The reaction can easily be adapted for detection of different trigger oligonucleotides using the same set of DNA nanospheres. It permits detection of as low as 100 fM trigger oligonucleotide in under 10 min total assay time, with minimal reagent consumption and requirement for instrumentation. We expect that combining this simple, versatile assay with trigger generation from a genomic target DNA sequence of interest will be a powerful tool in the development of rapid and simple point-of-care molecular diagnostic applications.

Rapid, accurate and high-throughput sizing and quantification of particulate matter (PM) in air is crucial for monitoring and improving air quality. In fact, particles in air with a diameter of ≤2.5 μm have been classified as carcinogenic by the World Health Organization. Here we present a field-portable cost-effective platform for high-throughput quantification of particulate matter using computational lens-free microscopy and machine-learning. This platform, termed c-Air, is also integrated with a smartphone application for device control and display of results. This mobile device rapidly screens 6.5 L of air in 30 s and generates microscopic images of the aerosols in air. It provides statistics of the particle size and density distribution with a sizing accuracy of ~93%. We tested this mobile platform by measuring the air quality at different indoor and outdoor environments and measurement times, and compared our results to those of an Environmental Protection Agency–approved device based on beta-attenuation monitoring, which showed strong correlation to c-Air measurements. Furthermore, we used c-Air to map the air quality around Los Angeles International Airport (LAX) over 24 h to confirm that the impact of LAX on increased PM concentration was present even at >7 km away from the airport, especially along the direction of landing flights. With its machine-learning-based computational microscopy interface, c-Air can be adaptively tailored to detect specific particles in air, for example, various types of pollen and mold and provide a cost-effective mobile solution for highly accurate and distributed sensing of air quality.

No abstract

Multidetector CT angiography offers accurate and valuable preoperative assessment of surgical resectability of pancreatic ductal adenocarcinoma. Liver and peritoneal metastases and vascular invasion still remain important pitfalls in preoperative evaluation.