Results Of Laboratory Assays Research Articles

Establishment of Pathogenicity Test Method for Macrophomina phaseolina Causing Soybean Charcoal Rot

The establishment of a laboratory assay and a greenhouse assay was conducted for evaluating the pathogenicity of Macrophomina phaseolina causing soybean charcoal rot established. In the laboratory assay, microsclerotia and hyphae were used as inoculum. In the laboratory assays using microsclerotia as an inoculum, disease incidences of M. phaseolina NSW17-108 and HSM17-034 were higher at 35°C than 25°C. Of the two isolates NSW17-108 and HSM17-034, the disease incidence of HSM17-034 isolated from diseased sesame is higher than that of NSW17-108 isolated from diseased soybean. When the mycelia of M. phaseolina were used as an inoculum, the disease incidence of NSW17-108 and HSM17-034 at 35°C exceeded 80% even after only 5 days of inoculation. Even at 25°C, furthermore, that of HSM17-034 exceeded 80% 5 days later. In the pathogenicity assays at a greenhouse, toothpicks where microsclerotia were produced or microsclerotia harvested from potato dextrose agar medium were used as an inoculum. In all greenhouse assays, M. phaseolina NSW17-108 and HSM17-034 showed 40–60% of disease incidences 35–65 days after inoculation with the pathogen, depending on the inoculation method. Between the two isolates, the pathogenicity of HSM17-034 was stronger than that of NSW17-108, and this result was consistent with laboratory assay results. Since the laboratory and greenhouse test methods tested in this study have different advantages and disadvantages depending on each test method, it is thought that the test method that can meet the purpose of the study should be selected and used.

Reduced amino acid alphabet-based encoding and its impact on modeling influenza antigenic evolution

Currently, vaccination is one of the most efficient ways to control and prevent influenza infection. Vaccine production largely relies on the results of laboratory assays, including hemagglutination inhibition and microneutralization assays, which are time-consuming and laborious. Viruses can escape from the immune response that results in the need to revise and update vaccines biannually. The hemagglutination inhibition assay can measure how effectively antibodies against a reference strain bind and block an antigen of the test strain. Various computer-aided models have been developed to optimize candidate vaccine strain selection. A general problem in modeling of antigenic evolution is the representation of genetic sequences for input into the research model. Our motivation stems from the well-known problem of encoding genetic information for modeling antigenic evolution. This paper introduces a two-fold encoding approach based on reduced amino acid alphabet and amino acid index databases called AAindex. We propose to apply a simplified amino acid alphabet in modeling of antigenic evolution. A simplified alphabet, also called a sub-alphabet or reduced amino acid alphabet, implies to use the 20 amino acids being clustered and divided into amino acid groups. The proposed encoding allows to redefine mutations termed for amino acid groups located in reduced alphabets. We investigated 40 reduced amino acid sets and their performance in modeling antigenic evolution. The experimental results indicate that the proposed reduced amino acid alphabets can achieve the performance of the standard alphabet in its accuracy. Moreover, these alphabets provide deeper insight into various aspects of the relationship between mutation and antigenic variation. By checking identified high-impact sites in the Influenza Research Database, we found that not only antigenic sites have a significant influence on antigenicity, but also other amino acids located in close proximity. The results indicate that all selected non-antigenic sites are related to immune responses. According to the Influenza Research Database, these have been experimentally determined to be T-cell epitopes, B-cell epitopes, and MHC-binding epitopes of different classes. This highlighted a caveat: while simulating antigenic evolution, the model should consider not only the genetic information on antigenic sites, but also that of neighboring positions, as they may indirectly impact antigenicity. Additionally, our findings indicate that structural and charge characteristics are the most beneficial in modeling antigenic evolution, which is in agreement with previous studies.

Evaluation of Mosquito Attractant Candidates Using a High-Throughput Screening System for Aedes aegypti (L.), Culex quinquefasciatus Say. and Anopheles minimus Theobald (Diptera: Culicidae).

Simple SummaryTrapping mosquitoes can enhance its capture rate by adding attractants such as carbon dioxide or human hosts’ odor-mimicking synthetic blends. Various olfactometers exist to test mosquitos’ behavior, but high-throughput screening system (HITSS)—one of the diffusion assays—has not been applied to developing lures. In this study, six different newly prepared chemical lure candidates (Kasetsart University (KU)-lures) were tested for diurnal Aedes aegypti, nocturnal Culex quinquefasciatus and nocturnal Anopheles minimus, using the HITSS assay. Results showed species-specific different lure preferences; the diurnal species were attracted to KU-lure #1 (29.7%), while both of the nocturnal species preferred KU-lure #6 (68.3% and 74.3% for Cx. quinquefasciatus and An. minimus, respectively). In addition, the selected lure candidates clearly demonstrated dose-dependent reversal responses for each Ae. aegypti and Cx. quinquefasciatus. Our results indicate that the HITSS assay distinguishes potential species-specific lure candidates. In addition, the HITSS assay was equally effective in determining the host-seeking behavior in pyrethroid-resistant and -susceptible strains. Further studies are needed to determine the accuracy of the HITSS assay in large-scale semi-field screen house tests using commercial traps.Several types of olfactometers have been used to evaluate mosquito responses to agents that mimic natural volatiles that repel or attract. The Y-tube olfactometer has been widely used to study repellents and attractants, while the high-throughput screening system assay has only been used to study repellents. Whether the high-throughput screening system assay is suitable for evaluating attractants is unknown. We evaluated the responses to four lactic-acid-based mixtures and two non-lactic-acid-based chemical lure candidates using the high-throughput screening system (HITSS) for three mosquito species (laboratory strains and field populations of both Aedes aegypti (L.) and Culex quinquefasciatus Say.; laboratory strain of Anopheles minimus Theobald) under laboratory-controlled conditions. HITSS assay results showed that KU-lure #1 elicited the greatest percent attraction for pyrethroid-resistant and -susceptible Ae. aegypti. KU-lure #6 elicited the strongest attractive response for pyrethroid-susceptible and -resistant Cx. quinquefasciatus and pyrethroid-susceptible An. minimus. The response to the lures from each species was independent of the pyrethroid susceptibility status (Ae. aegypti, p = 0.825; Cx. quinquefasciatus, p = 0.056). However, a significant difference in attraction to KU-lure #6 was observed between diurnal and nocturnal mosquitoes (Cx. quinquefasciatus vs. Ae. aegypti, p = 0.014; An. minimus vs. Ae. aegypti, p = 0.001). The laboratory-level HITSS assay effectively selects potential lure candidates. Because the host-seeking behavior differs between mosquito species, further studies are needed to develop species-specific attractants. Additional studies in semi-field screen houses using commercial traps are necessary to evaluate the accuracy of these laboratory assay results.

Retrospective analysis of patients with non-tuberculous mycobacteria from a primary hospital in Southeast China

To achieve a comprehensive understanding of the characteristics of patients with non-tuberculous mycobacteria (NTM), patients with NTM between January 2016 and June 2019 were recruited from a primary hospital. NTM were identified based on the MBP64 protein assay. The clinical records and laboratory assay results were retrospectively reviewed. A total of 204 patients with NTM were included in the final analysis. The patients with multiple isolations were more likely accompanied with chronic obstructive pulmonary disease (COPD) (p = 0.029) and arthritis (p = 0.049), but showed a lower percentage of positive T-spot results (p = 0.022). In addition, patients with multiple isolations showed a higher rate of positive acid-fast staining results and their symptom duration was more likely longer than 30 days (p = 0.019). Patients with a positive response in T-spot assay showed a higher proportion of nodular manifestation on computed tomography (CT) than those with a negative response. Compared with male patients with NTM, female patients showed lower rates of positive acid-fast staining results (p = 0.03), but were more likely accompanied with COPD (p < 0.0001). The positive acid-fast staining results were closely associated with pulmonary cavities and tuberculosis antibody. Patients with different NTM isolation frequencies were closely associated with coexisting diseases and examination results.

Serum peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 in combination with C-reactive protein and white blood cell as novel predictors for infants with community-acquired pneumonia

The aim of this study was to investigate the predictive value of peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (Pin1) with C-reactive protein (CRP) and white blood cell (WBC) count for community-acquired pneumonia (CAP) in infants. A total of 84 hospitalized infants with CAP and 69 healthy infants were included in this study. The clinical manifestations and laboratory assay results of infants were recorded. Serum Pin1 level was estimated by enzyme-linked immunosorbent assay. The median serum Pin1 concentration in infants with CAP was significantly higher than that in controls (1.44 vs. 0.21 ng/mL, P &lt; 0.0001). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of the combination Pin1, CRP and WBC (Pin1 + CRP + WBC, 0.943) was higher than Pin1, CRP, WBC alone or the combination of Pin1 and CRP ( P &lt; 0.05). The sensitivity of Pin1 + CRP + WBC (94.0%) was higher than that of Pin1, CRP, WBC alone, or any two combined ( P &lt; 0.05). Pin1 + CRP + WBC also had a high negative predictive value (91.4%). Moreover, serum Pin1 alone had a high specificity (97.0%) and excellent positive predictive value (96.6%) for infants with CAP, which were higher than WBC, Pin1 and WBC in combination, CRP and WBC in combination, and Pin1 + CRP + WBC ( P &lt; 0.05). Therefore, serum Pin 1 was highly expressed in infants with CAP and can singly or in combination with CRP and WBC represent promising novel predictors for infants with CAP.

Detection and seed transmission of Bermudagrass phytoplasma in maize in Turkey

AbstractDuring 2017, maize cultivation areas in the provinces of Adana and Kahramanmaraş (Turkey) were surveyed to inspect maize plants with symptoms similar to those associated with of phytoplasma disease, that is, yellowing, short internodes and small corncobs. Thirty fields were inspected and two hundred samples from symptomatic and asymptomatic plants were collected, together with insects considered as potential vectors of phytoplasmas. All samples were assayed by polymerase chain reaction (PCR) and subsequently analysed by restriction fragment length polymorphism and sequencing to identify the phytoplasmas detected in the plant material and insects. Results of laboratory assays and phylogenetic analyses showed that the Bermudagrass white leaf phytoplasma ('Candidatus Phytoplasma cynodontis') was present in both maize plants and seeds, showing 99% sequence identity with other reported phytoplasma strains from GenBank, whereas no PCR amplifications were obtained from tested insects. The seeds of infected plants, sown in an insect‐proof screenhouse, produced plantlets that were found PCR‐positive for the Bermudagrass white leaf phytoplasma, indicating its seed transmission.

Threshold-stimulated kallikrein activity distinguishes bradykinin- from histamine-mediated angioedema.

The lack of specific biomarkers makes the diagnosis of hereditary angioedema (HAE) with normal levels of C1-inhibitor (C1INH) protein (HAE-nl-C1INH) and idiopathic non-histaminergic angioedema (INHA) difficult. Confirming or excluding these diagnoses is a significant challenge for clinicians evaluating patients with angioedema. To develop a reliable biomarker that would aid the diagnosis of HAE-nl-C1INH and INHA. A total of 154 consecutive patients referred for angioedema at a single centre were enrolled and evaluated. Subjects were clinically phenotyped based on clinical history and response to treatment by clinicians blinded to laboratory assay results. Plasma kallikrein activity was measured by the cleavage of the fluorometric substrate Z-Phe-Arg-AMC-HCL in plasma samples stimulated exvivo with submaximal doses of dextran sulphate. Stimulated plasma kallikrein activity (mean relative fluorescence units/min±SD) was significantly increased in both HAE-nl-C1INH (1804±600) and INHA (1579±371) subjects compared to non-swelling controls (171±46) and histaminergic angioedema (133±30) subjects. Using a threshold cut-off based on the normal controls, HAE-nl-C1INH and INHA subjects could be differentiated from histaminergic angioedema subjects with high sensitivity (negative predictive value 86%-89%) and specificity (positive predictive value 80%-100%). The stimulated kallikrein activity assay allows differentiation of bradykinin- from histamine-mediated angioedema. The assay could feasibly be considered as a potential clinical tool for the diagnosis of bradykinin-mediated angioedema.

Data visualizations to detect systematic errors in laboratory assay results.

The measurement of concentrations of drugs and endogenous substances is widely used in basic and clinical pharmacology research and service tasks. Using data science‐derived visualizations of laboratory data, it is demonstrated on a real‐life example that basic statistical exploration of laboratory assay results or advised standard visual methods of data inspection may fall short in detecting systematic laboratory errors. For example, data pathologies such as generating always the same value in all probes of a particular assay run may pass undetected when using standard methods of data quality check. It is shown that the use of different data visualizations that emphasize different views of the data may enhance the detection of systematic laboratory errors. A dotplot of single data in the order of assay is proposed that provides an overview on the data range, outliers and a particular type of systematic errors where similar values are wrongly measured in all probes.

Review of the Economic and Ethnobotany of the Family Nyctaginaceae

In the course of work on the taxonomy and agronomy of Mirabilis expansa (Ruiz and Pav.) Standl. (Nyctaginaceae), it became clear that there is no thorough published review of the medicinal and other useful aspects of the family. This work illustrates the history and potential for use for Nyctaginaceae at the generic level world-wide. Several genera in this family have well documented potential as sources of medication, food, dye, lumber and adhesives. Abronia, Boerhavia, and Mirabilis are reported most often for positive laboratory assay results. Pisonia and Neea have both been used as sources of lumber in the tropics. In addition, Bougainvillea and Mirabilis have been utilized for floriculture. Included, is an updated analysis of the historical confusion between medicinal Mirabilis jalapa L. and medicinal Jalap in the Convolvulaceae, and the disagreements over taxonomic names in both families which have contributed to this error and detracted from its resolution. Known invasive issues for some Nyctaginaceae species are discussed, having economic impact on agriculture. A recommendation is made that highly variant expression in Nyctaginaceae taxa makes them strong candidates for investigation of polyploidy and epigenetic patterns, important for better understanding evolution and development in plants.

"Candidatus Liberibacter solanacearum" Associated With the Psyllid, Bactericera maculipennis (Hemiptera: Triozidae).

The psyllid Bactericera maculipennis (Crawford) (Hemiptera: Triozidae) often cohabits field bindweed (Convolvulus arvensis, Solanales: Convolvulaceae) and other plants with the congeneric psyllid, Bactericera cockerelli (Šulc), in the Pacific Northwestern United States. Bactericera cockerelli is a vector of "Candidatus Liberibacter solanacearum," the pathogen associated with zebra chip disease of potato (Solanales: Solanaceae). Because B. maculipennis and B. cockerelli both naturally occur on certain plants, we surveyed B. maculipennis adults collected from Washington and Idaho for presence of "Ca. L. solanacearum" to determine whether this psyllid also harbors this pathogen. Liberibacter was present in 30% of field-collected B. maculipennis and in 100% of colony-reared psyllids. Sequences of 16S rDNA and microsatellite markers revealed that "Ca. L. solanacearum" from B. maculipennis was closely related to Liberibacter haplotype B from B. cockerelli. Results of laboratory assays demonstrated that Liberibacter can be transmitted between B. cockerelli and B. maculipennis on plants within the Convolvulaceae. Potato plants challenged with Liberibacter-infected B. maculipennis did not become infected, apparently because potato is not a suitable host for the psyllid. We therefore conclude that B. maculipennis is not a direct threat to potato production, despite its association with Liberibacter. We are the first to report that "Ca. L. solanacearum" is associated with a psyllid other than B. cockerelli in North America. Results of our study demonstrate the importance of understanding the complete ecology of psyllids-including interactions with other psyllids on non-crop hosts-in predicting what crops or regions are potentially susceptible to the spread of Liberibacter.

Meta-analysis identifies tumor necrosis factor-alpha and interleukin-1 beta as diagnostic biomarkers for bacterial and aseptic meningitis.

Meningitis is a complex and severe acute infectious disease of the central nervous system and is caused mainly by bacteria and viruses. However, the distinction between aseptic and bacterial meningitis can be difficult for clinicians because the symptoms and the results of laboratory assays are often similar and overlapping, particularly when the use of antibiotics is administered prior to examining the cerebrospinal fluid. We determined the accuracy of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) for the differential diagnosis between bacterial and aseptic meningitis. A comprehensive search was performed for papers published from January 1989 to July 2013. Prospective or retrospective studies and cerebrospinal fluid (CSF) TNF-α and/or IL-1β cytokine concentrations for differential diagnosis distinguishing bacterial from aseptic meningitis were included. A statistical analysis was performed using Revman and Meta-Disc. This systematic review showed that TNF-α has a sensitivity of 80.5%, specificity of 94.9%, diagnostic odds ratio (DOR) of 71.7, and area under the curve (AUC) = 0.942; IL-1β showed a sensitivity of 86.0%, specificity of 92.3%, DOR of 53.5, and AUC = 0.975. Therefore, TNF-α and IL-1β are useful markers for the prediction of the bacterial meningitis and levels may represent an accurate method that is useful for the differentiation between bacterial and aseptic meningitis.

Overview of Heparin-Induced Thrombocytopenia. Diagnosis and Treatment in Europe with an Emphasis on France

Although the prevalence of heparin-induced thrombocytopenia (HIT) has decreased these last years in France with the widespread use of low molecular weight heparins, HIT remains an important severe prothrombotic disease that needs to be diagnosed and treated adequately. HIT is caused by IgG antibodies that bind to modified platelet factor 4 and induce platelet and monocyte activation with increased thrombin generation. Venous and arterial thromboses are therefore frequent in HIT, explaining why substituting heparin with a potent alternative anticoagulant such as danaparoid sodium, lepirudin, or argatroban is necessary in every affected patient. However, the management of these drugs is difficult, and the diagnosis of HIT always has to be assessed on both clinical criteria and laboratory tests that detect heparin-dependent antibodies in the patient's blood (antigen assays and platelet activation tests). When the clinical probability of HIT is high, the first requirement is to discontinue heparin, without waiting for the results of laboratory assays. The choice of the alternative anticoagulant is then driven by several criteria. Danaparoid (mainly anti-Xa) is often preferred in cases of isolated thrombocytopenia, and lepirudin (anti-IIa) is preferred when surgery is required due to its shorter half-life. But with these two drugs the risk of overdosage is high in patients with renal failure. Argatroban (anti-IIa) is thus a useful drug in critically ill patients because of its hepatobiliary excretion. Unfortunately, argatroban is not available in many European countries including France.

Comparative in situ and laboratory sediment bioassays with juvenile Mercenaria mercenaria

Sediment toxicity assays were conducted with juvenile Mercenaria mercenaria to compare the results of laboratory assays and in situ deployments. Juvenile clams were deployed for one week at a variety of degraded and undegraded sites in Charleston Harbor, South Carolina. USA, during the summers of 1998, 1999, and 2000. Parallel laboratory assays were conducted with sediments collected from the deployment sites. Mortality and a sublethal endpoint, seed clam growth rate, were used to compare toxicity between reference and degraded sites. Growth rates of field-deployed clams tended to be higher than growth rates for laboratory assays, especially at the reference sites. Field studies indicated a higher potential for toxicity than did the laboratory studies at degraded sites. These studies suggest that laboratory assays may underestimate potential sediment toxicity at degraded sites. However, field growth rates may be affected by natural environmental factors (e.g., pH, dissolved oxygen, and salinity), so regression normalization techniques were used to distinguish the effects of these variables from those of contaminants.

Effects of bacterial films on attachment of barnacle ( Balanus improvisus Darwin) larvae: laboratory and field studies

The influence of surface-associated bacteria and extracellular materials (ECM) produced by the bacteria during culturing on attachment (settlement) of Balanus improvisus (Darwin) cyprids was examined. The effects of three species of gram-negative bacteria, Deleya marina Corbel et al., Baumann et al., Alteromonas macleodii Baumann et al., and Pseudomonas fluorescens Migula, on attachment of barnacle cyprids were tested in week-long laboratory assays. Cells and ECM of each bacterial species decreased attachment of cyprids to polystyrene surfaces and increased attachment of cyprids to glass, compared to control untreated surfaces. The effect of D. marina on settlement of larvae onto polystyrene was also examined in field assays. In contrast to results of laboratory assays, greater attachment of B. improvisus cyprids in the field occurred on polystyrene with adsorbed ECM than on untreated surfaces. In addition, bryozoan larvae settled in greater numbers on polystyrene surfaces to which D. marina cells were attached.

Laboratory assessment of von Willebrand factor: differential influence of prolonged ambient temperature specimen storage on assay results.

The laboratory assessment of von Willebrand factor (VWF) is typically performed at specialist laboratory sites, particularly when performed as a battery of laboratory tests in a thorough workup for the diagnosis of von Willebrand's disease (VWD). In these cases, specimens could derive from a variety of off-site sources, including smaller laboratories, and general clinical practitioners. Because of the potential for lack of control by the specialist laboratory over the method of specimen handling and transport from these sources, and recent VWF methodological advances, we investigated the effect of prolonged ambient temperature specimen storage on laboratory assay results. Thus, specimens were collected from 10 separate individuals, and each variably processed to provide an ideal ('control') plasma specimen, and additional specimens that were then stored at ambient temperature for up to 7 days. Specifically, specimens were stored either as whole blood, or as separated plasma, and VWF tested in isolated plasma, post 24 h, post 48 h and post 7 days storage. Three separate laboratory assays for VWF were performed; (i) a standard 'antigen' (antisera-ELISA-based) assay (VWF:Ag), (ii) a standard ristocetin-dependent-platelet-agglutination procedure (VWF:RCof) and (iii) a more recently described ELISA-based functional collagen-VWF binding assay (VWF:CBA). Results can be summarized as follows, (i) Plasma storage: there was no (statistically significant) change in VWF:Ag or VWF:RCof assay results over the 7-day storage period; however, there was a small but statistically significant fall (P= 0.009) in VWF:CBA assay results after 7 days storage of plasma. (ii) Whole blood storage: there was no (statistically significant) change in VWF:Ag, VWF:CBA or VWF:RCof assay results over the 7-day storage period, although the data suggested a trend towards increasing VWF:Ag over time. As a result of the change in assayed VWF:CBA following prolonged plasma storage, a similar small but statistically significant (P= 0.009) change (increase) in the VWF:Ag to VWF:CBA ratio was observed. This ratio has previously been determined to be useful in the differential diagnosis of VWD subtypes, with high VWF:Ag to VWF:CBA ratios potentially indicative of Type 2 VWD. Fortunately, the absolute magnitude of the altered ratio following prolonged plasma storage is unlikely in practice to affect the diagnosis of VWD in most testing cases. Nevertheless, there will be occasional borderline normal cases in whom the change in VWF:CBA, or in the calculated VWF:Ag to VWF:CBA ratio, may otherwise influence a clinical diagnosis of VWD. Caution is therefore suggested in the interpretation of laboratory-derived VWF data, particularly if the specimen is derived as an off-site referral.

Improvement of Comparability and Compatibility of Laboratory Assay Results in Life Sciences Comments and Resolutions

"Improvement of Comparability and Compatibility of Laboratory Assay Results in Life Sciences Comments and Resolutions." Scandinavian Journal of Clinical and Laboratory Investigation, 51(sup205), pp. 141–142

Toxicity of Vertical Sediments in the Trenton Channel, Detroit River, Michigan, to Chironomus Tentans (Insecta: Chironomidae)

The objective of this study was to determine the effects of sediment from various sediment core depths on survival and weight gain of larvae of the dipteran midge, Chironomus tentans, during 10-d laboratory exposures. Sediment cores were collected from 12 sites in the Trenton Channel of the Detroit River in 1987 and sectioned into 5-cm intervals to a depth of 25 cm. Percent reductions in larval weight gain, relative to that in control sediment, were calculated for each interval. Two sites were classified as very toxic, three sites as toxic, three sites as slightly toxic, and four sites as good quality benthic habitat. The utility of sediment core toxicity profiling and the C. tentans bioassay for three-dimensional sediment quality assessment are discussed, as well as comparisons between the results of laboratory assays and field surveys of benthic macroinvertebrates. The assay results are used to estimate the volume of toxic sediment at eight sites and determine the costs of dredging and disposal of the toxic sediments. Preliminary estimates of remedial actions were developed to achieve several levels of mitigation of the toxicity of sediment to macrozoobenthic populations in the Trenton Channel.

Flurbiprofen in the treatment of acute gout: A comparison with indomethacin

The relative efficacy and safety of flurbiprofen (Ansaid, Upjohn) and indomethacin were compared in 29 patients with monoarticular gouty arthritis of less than 48 hours' duration. A loading dose of 400 mg of flurbiprofen or 200 mg of indomethacin was administered for 24 hours, followed by 200 mg of flurbiprofen per day or 100 mg of indomethacin per day for a maximum of five days. Based on global assessment of improvement, at least 50 percent of patients in both treatment groups showed improvement within 24 hours. There were statistically significant improvements in pain, swelling, erythema, and skin temperature in both groups of patients within 48 hours of treatment. By 72 hours, the proportion of patients with improvement in the flurbiprofen group was equal to or greater than the proportion in the indomethacin group for all clinical efficacy parameters. At the end of treatment, eight of 15 patients in the indomethacin group and five of 14 patients in the flurbiprofen group were asymptomatic. There were no statistically significant differences between indomethacin and flurbiprofen in the percentage of asymptomatic patients at the end of treatment. Side effects were mild in both groups. No clinically significant between-treatment differences were noted in vital signs or in the results of laboratory assays.