Objective:To determine the current use and potential acceptance (by tuberculosis experts worldwide) of novel rapid tests for the diagnosis of tuberculosis that are in line with World Health Organization target product profiles. Methods:A multilingual survey was disseminated online between July and November of 2016. Results:A total of 723 individuals from 114 countries responded to the survey. Smear microscopy was the most commonly used rapid tuberculosis test (available to 90.9% of the respondents), followed by molecular assays (available to 70.7%). Only a small proportion of the respondents in middle- and low-income countries had access to interferon-gamma-release assays. Serological and lateral flow immunoassays were used by more than a quarter (25.4%) of the respondents. Among the respondents who had access to molecular tests, 46.7% were using the Xpert assay overall, that proportion being higher in lower middle-income countries (55.6%) and low-income countries (76.6%). The data also suggest that there was some alignment of pricing for molecular assays. Respondents stated they would accept novel rapid tuberculosis tests if available, including molecular assays (acceptable to 86.0%) or biomarker-based serological assays (acceptable to 81.7%). Simple biomarker-based assays were more commonly deemed acceptable in middle- and low-income countries. Conclusions:Second-generation molecular assays have become more widely available in high- and low-resource settings. However, the development of novel rapid tuberculosis tests continues to be considered important by tuberculosis experts. Our data also underscore the need for additional training and education of end users.
The trinuclear complex [(‘S2’){Ni(PMe3)}2Fe(CO)(‘S2’)2] (1) {‘S2’2– = 1,2‐benzenedithiolate(2–)} has been reported as a structural as well as functional model for [NiFe] hydrogenases since it contains key structural features of the [NiFe] hydrogenase active site, and is oxidized by protons to give [1]+ and H2. Complex 1 formed as an unexpected product from the reaction of [Fe(CO)2(‘S3’)]2 {‘S3’2– = bis(2‐mercaptophenyl) sulfide(2–)} and [Ni(PMe3)2(‘S2’)]. Both the iron and nickel centers of 1 are chelated by ‘S2’ donors, but not with any ‘S3’ ligand. In order to understand this reaction, the new precursor [Fe(CO)2(siS3)]2 (2) {siS32– = bis(2‐mercapto‐3‐trimethylsilylphenyl) sulfide(2–)} was synthesized. Compound 2 readily loses its CO ligand to give [Fe(CO)(siS3)]2 (3), which consists of two 16 valence electron fragments and could be isolated in the solid state. Conversion of 3 to 2 is feasible with gentle bubbling of CO gas for about 2 min. Treatment of 2 with [Ni(PMe3)2(‘S2’)] resulted exclusively in the formation of complex 1, which confirms that all three ‘S2’ ligands in 1 originate from [Ni(PMe3)2(‘S2’)]. Therefore, an alternative synthesis of 1, which does not involve any ‘S3’ ligand, has been developed. Density functional theory (DFT) calculations suggest that the oxidation states of the metal centers are FeII and NiII and do not change upon oxidation of 1 to [1]+. The unpaired electron in [1]+ is located to a large extent on the nickel atoms and the adjacent thiolate donor functions. The charge, however, is distributed over the whole cluster, main parts residing on the ‘S2’ ligands. Preliminary constant potential coulometric measurements indicate that 1 mediates the reduction of protons to dihydrogen at a mild potential (–0.48 V vs. NHE). Based upon these experimental and theoretical results, plausible mechanisms for this reduction are briefly discussed. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007)
Introducción: existen métodos como “Interferon-Gamma-Release-Assay” (IGRAs) para diagnóstico de Tuberculosis Latente (TBL). En México hay pocos datos de prevalencia de TBL utilizando IGRAs en población de riesgo ocupacional. Objetivos: describir la prevalencia de TBL confirmada por IGRAs y Tuberculina (TST); cuantificar y correlacionar los niveles de interferón gama (IFN-γ) y quimiocina IP-10 en población del Instituto Nacional de Enfermedades Respiratorias (INER) en Ciudad de México. Material y métodos: estudio descriptivo, de enero 2016 a mayo 2017, en 84 sujetos de alto riesgo (neumólogos y residentes) y 11 de bajo riesgo (personal administrativo). Se midieron niveles de IFN-γ e IP-10 en sangre y se aplicó TST. Se diagnosticó TBL si TST≥10 mm, IFN-γ ≥20 pg/mL e IP-10≥500 pg/mL. El análisis fue descriptivo y analítico utilizando GraphPad v.5. Valores de p<0.05 fueron considerados significativos. Fue avalado por el Comité de Investigación. Resultados: se evaluaron 40 hombres y 44 mujeres (grupo alto riesgo) y 6 hombres y 5 mujeres (grupo bajo riesgo). La media de edad en cada grupo fue 28 y 37 años con IMC en 25 y 21,5 kg/m2. La prevalencia de TBL fue 31% con IGRAs y 32% con TST en grupo alto riesgo, 0 y 18% en bajo riesgo. El tamaño promedio de TST, IFN-γ e IP-10 fueron mayores en grupo alto riesgo. La correlación de IFN-γ e IP-10 fue buena (r=0,85; p<0,0001). Conclusión: la prevalencia de TBL en población de riesgo ocupacional varía según el método diagnóstico y existe correlación de IFN-γ y quimiocinas.
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