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Background: We compared a conventional empirically derived regimen with a simplified regimen for parenteral artesunate in severe malaria.Methods: This was a randomized, double-blind, placebo-controlled comparison to assess the noninferiority of a simplified 3-dose regimen (given at 0, 24, and 48 hours) compared with the conventional 5-dose regimen of intravenous artesunate (given at 0, 12, 24, 48, and 72 hours) in African children with Plasmodium falciparum malaria with a prespecified delta of 0.2. The total dose of artesunate in each group was 12 mg/kg. The primary end point was the proportion of children clearing ≥ 99% of their admission parasitemia at 24 hours. Safety data, secondary efficacy end points, and pharmacokinetics were also analyzed.Results: In 171 children (per protocol), 78% of the recipients (95% confidence interval [CI], 69%-87%) in the 3-dose group achieved ≥ 99% parasite clearance 24 hours after the start of treatment, compared with 85% (95% CI, 77%-93%) of those receiving the conventional regimen (treatment difference, -7.2%; 95% CI, -18.9% to 4.4%). Dihydroartemisinin was cleared slightly more slowly in those children receiving the higher 3-dose regimen (7.4 vs 8.8 L/h for a 13-kg child; P 5 .008).Conclusions: Pharmacodynamic analysis suggests that 3 doses of artesunate were not inferior to 5 doses for the treatment of severe malaria in children.Clinical Trials Registration: NCT00522132. [ABSTRACT FROM AUTHOR]

Central nervous system tuberculosis remains a clinical diagnostic challenge. The ex vivo Mycobacterium tuberculosis-specific enzyme-linked immunospot assay (ELISPOT) is a novel assay for the rapid detection of M. tuberculosis-specific T-lymphocytes in the peripheral blood. However, when performed on peripheral blood, this assay cannot distinguish between active tuberculosis or latent tuberculosis infection. On the assumption that M. tuberculosis-specific T-lymphocytes migrate to sites of infection, we were able to demonstrate high levels of M. tuberculosis-specific cells by ELISPOT in the cerebrospinal fluid of a patient with tuberculous meningitis and intracerebral tuberculoma four weeks before cerebrospinal fluid culture became positive for M. tuberculosis by culture. [ABSTRACT FROM AUTHOR]

Central nervous system tuberculosis remains a clinical diagnostic challenge. The ex vivo Mycobacterium tuberculosis-specific enzyme-linked immunospot assay (ELISPOT) is a novel assay for the rapid detection of M. tuberculosis-specific T-lymphocytes in the peripheral blood. However, when performed on peripheral blood, this assay cannot distinguish between active tuberculosis or latent tuberculosis infection. On the assumption that M. tuberculosis-specific T-lymphocytes migrate to sites of infection, we were able to demonstrate high levels of M. tuberculosis-specific cells by ELISPOT in the cerebrospinal fluid of a patient with tuberculous meningitis and intracerebral tuberculoma four weeks before cerebrospinal fluid culture became positive for M. tuberculosis by culture. [ABSTRACT FROM AUTHOR]

To estimate the rate of asymptomatic exposure to Bordetella pertussis antigens in the German adult population and to evaluate the stability of antibodies to these antigens, antibody levels against Bordetella antigens and their variability over time were measured in German adult blood donors. One hundred forty-six regular blood donors (41 females, 105 males) were tested repeatedly for antibodies of isotypes IgG and IgA to pertussis toxin, filamentous hemagglutinin (FHA) and pertactin over a period of 2–5 years. Overall, 86% and 56% had IgG or IgA antibodies to pertussis toxin, respectively, 100% and 92% had IgG or IgA antibodies to FHA, respectively, and 83% and 93% had IgG or IgA antibodies to pertactin, respectively. One significant titer increase of both IgG anti-FHA and IgG anti-pertactin, one of IgG anti-FHA, and two of IgA anti-FHA as well as one significant decrease of IgG anti-pertussis toxin were observed during an observation period of 480.5 person-years. Antibody concentrations in men and women were not different. The data show that the level of antibodies to pertussis toxin, FHA, and pertactin remains stable over several years. Furthermore, depending on the definition of serological evidence, the rate of significant increases or decreases suggesting unrecognized exposure to Bordetella antigens was estimated to be between <0.2 and 1.0 per 100 person-years in the population studied. [ABSTRACT FROM AUTHOR]

This report describes investigations carried out on a new type of enamel ('Liberty Coat' Enamel) for steel sheets from continuously cast material. Subsequent to technological tests, EPMA investigations were conducted to study the mechanism of enamel adherence. For this purpose, we employed our Concentration Mapping (CM) technique. In order to obtain representative data, a special evaluation method was used. The results, which are partly in contradiction with statements in the literature, suggest that the concept of enamel adherence reactions should be given further critical consideration. [ABSTRACT FROM AUTHOR]

The most common manifestation of cardiovascular syphilis, a rare diagnosis since the introduction of penicillin, is aortitis of the ascending aorta. Since the majority of patients with uncomplicated aortitis are asymptomatic, early diagnosis is difficult. We report the case of an HIV-positive patient with asymptomatic syphilitic aortitis that was incidentally diagnosed with F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET). We conclude that FDG-PET could become a promising new imaging technique for both diagnosis and follow-up of patients with syphilitic aortitis. [ABSTRACT FROM AUTHOR]

The most common manifestation of cardiovascular syphilis, a rare diagnosis since the introduction of penicillin, is aortitis of the ascending aorta. Since the majority of patients with uncomplicated aortitis are asymptomatic, early diagnosis is difficult. We report the case of an HIV–positive patient with asymptomatic syphilitic aortitis that was incidentally diagnosed with F–18–fluorodeoxyglucose (FDG) positron emission tomography (PET). We conclude that FDG–PET could become a promising new imaging technique for both diagnosis and follow–up of patients with syphilitic aortitis. [ABSTRACT FROM AUTHOR]