Rapid Plasma Research Articles

Comparison of the standard Q syphilis antibody rapid diagnostic test to gold standards for yaws detection in children.

Yaws remains a public health problem in Indonesia, and it is the largest contributor to Yaws cases in Southeast Asia. Yaws is caused by bacterial infection of Treponema pallidum subspecies pertenue, mainly affecting the skin and bones. An estimated 75% of new cases were found in children under 15. The diagnosis of yaws is based on clinical findings with serological confirmation. Rapid diagnostic tests (RDT) have been developed to diagnose Yaws faster and simpler and can thus be used in areas with limited resources. In this study, sensitivity and specificity of the solid phase immunochromatographic assay of Standard Q Syphilis Antibody (Ab) RDT was performed compared to Treponema Pallidum Haemagglutination Assay (TPHA Plasmatec®) and Rapid Plasma Reagin (RPR) in 195 children with yaws age 2-15 years in Halmahera Barat, Maluku. There were 116 children with clinical symptoms representative of yaws, but only 13 were serologically positive. The scar was the most commonly found lesion, and the most affected regions were the legs. The sensitivity and specificity of RDT compared to TPHA were 93.3% and 99.4%, respectively. The sensitivity and specificity of RDT compared to RPR were 100% and 98.4%, respectively. Based on the excellent performance of this test, this study suggests that Standard Q Syphilis Ab RDT examination can be used as a screening test. However, unusual clinical findings, like scars in RDT reactive patients, indicated that RPR is still required to confirm the diagnosis of yaws.

Prevalence of syphilis infection among migrant workers in Qatar: a nationwide cross-sectional survey

ObjectivesScant data are available on syphilis infection within migrant populations worldwide and in the population of the Middle East and North Africa region. This study investigated the prevalence of both...

Management of detected syphilis in pregnancy adheres to guideline recommendations, but the crisis of congenital syphilis persists.

Infectious syphilis among women of reproductive age continues to rise in many countries including Australia, with a resultant increase in congenital syphilis. In response, new guidelines for management of syphilis in pregnancy were published in Queensland, Australia in 2018. This study evaluates the management of women diagnosed with syphilis in pregnancy in South-East Queensland (SEQ) after release of this guideline. This retrospective review of notification data identified women in SEQ who had a positive syphilis serology during pregnancy, without evidence of adequate treatment prior to the pregnancy, between January 2019 and December 2021 inclusive. Maternal demographics and pregnancy details including syphilis staging, testing and management were extracted, with management assessed against the 2018 Queensland syphilis in pregnancy guideline. Of the 42 women identified, 79% were diagnosed in the first or second trimester, 69% had early-stage syphilis at the time of diagnosis and 86% were asymptomatic at the time of diagnosis. All, including the eight (19%) Aboriginal and/or Torres Strait Islander women identified, completed stage-appropriate treatment with penicillin, 83% completed treatment four weeks prior to delivery and 60% achieved a four-fold reduction in rapid plasma reagin at time of delivery. Our findings suggest compliance with syphilis in pregnancy management recommendations has improved in SEQ since release of the 2018 guidelines. However, congenital syphilis rates continue to rise; further initiatives addressing barriers to timely testing and management of syphilis in pregnancy are urgently needed at both healthcare system levels and for individual women.

Kinetics of RPR Decline in Pregnant Persons Treated for Syphilis in Pregnancy and Their Infants.

Congenital syphilis is a re-emerging infectious threat in areas of North America. The purpose of this study was to quantitatively describe the rate of decline of nontreponemal (rapid plasma reagin, RPR) titers in pregnant persons with syphilis and their infants. In a retrospective review, we included 120 pregnant persons with 563 reactive RPR measurements (median 5, range 2 to 11 per person) and 35 infants with 81 RPR measurements (median 2, range 2 to 6 per infant). First-order decay, second-order decay, and a mathematical model representing functional FcRn-mediated antibody recycling were fitted to individual patient RPR trajectories. The RPR titers decreased with a median half-life of 39 days (IQR 28-59) and 27 days (IQR 17-41) in birthing parents and infants, respectively. The half-life varied with the initial RPR titer, suggesting that the kinetics of RPR decline was not first-order. A mathematical model accounting for saturable antibody recycling explained the longevity of RPR reactivity, predicted the observed non-linear kinetics, and fit the empiric data well. In summary, RPR titers decline with a half-life of roughly one month; however, the elimination does not follow first-order kinetics. Saturable antibody recycling may explain the prolonged and non-linear elimination of nontreponemal antibodies.

Enhanced Oxygen Evolution Reaction Performance of NiMoO4/Carbon Paper Electrocatalysts in Anion Exchange Membrane Water Electrolysis by Atmospheric-Pressure Plasma Jet Treatment.

NiMoO4 was grown on carbon paper (CP) by a hydrothermal method. A rapid and high-temperature atmospheric-pressure plasma jet (APPJ) process was used to generate more oxygen-deficient NiMoO4 on the CP surface to serve as an electrode material for the oxygen evolution reaction (OER). After 60 s of APPJ treatment, the overpotential of the electrode at 100 mA/cm2 decreased to 790 mV and that at 10 mA/cm2 decreased to 368 mV. Additionally, the charge transfer resistance decreased from 2.8 to 1.2 Ω, indicating that APPJ treatment effectively reduced the electrode overpotential and impedance. The effect of NiMoO4/CP/APPJ-60 s on the anion exchange membrane water electrolysis (AEMWE) system was also tested. At a system temperature of 70 °C and current density of 100 mA/cm2, the energy efficiency reached 95.1%, and the specific energy consumption decreased from 4.02 to 3.83 kWh/m3. These results demonstrate that the APPJ-treated NiMoO4/CP electrode can effectively enhance the OER performance in water electrolysis and improve the energy efficiency of the AEMWE system. This approach shows promise in replacing precious metal electrodes, thereby potentially reducing the cost and providing an environmentally friendly alternative.

Improving the detection of congenital syphilis: reviewing test utility and adherence to recommendations

Western Australia (WA) has experienced a resurgence of congenital syphilis. Appropriate microbiology testing of the neonate is recommended to confirm infection, including syphilis immunoglobulin M (IgM), rapid plasma reagin (RPR) paired with a maternal sample, and polymerase chain reaction (PCR) on placenta and nasal swabs. We examined the performance of microbiology tests in confirmed congenital syphilis cases and the adherence to testing recommendations in those assessed as high risk. We reviewed the microbiology results of confirmed congenital syphilis cases in WA between 1 January 2018 and 31 December 2023. In addition, microbiology testing of neonates from metropolitan Perth identified as being at a high risk of congenital syphilis between 1 January 2021 and 31 October 2023 was reviewed. Eighteen congenital syphilis cases were identified; data were unavailable for a case born interstate. Of the 17 included cases, the case fatality rate was 35% (6/17; five stillbirths and one perinatal death). Placenta tissue PCR was positive in all stillbirths. Of the 12 live births, 83% were symptomatic at delivery. Perinatal testing was performed in 11 live births (11/12); IgM was detected in 55% (6/11). Placenta tissue PCR was positive in 88% (7/8 tested). Nasal swab PCR was positive in 57% (4/7 tested) of cases. There were 22 neonates classified as being at a high risk for congenital syphilis infection; all had IgM and RPR testing. Syphilis PCR was performed on placenta tissue samples in 64% (14/22) and on nasal swabs in 64% (14/22) of cases. Comprehensive microbiological testing, including syphilis IgM and placenta tissue PCR, is required to confirm congenital syphilis infection. Continuous evaluation of testing will be crucial for individual case detection and monitoring of the ongoing outbreak. Given the risk of incomplete specimen collection, our data support ​the adoption of a risk-based approach for neonates at risk of congenital syphilis, with management guided by maternal serology and treatment history.

Concomitant primary and secondary syphilis: a case series from a reference center in Mexico

Primary syphilis is characterized by the presence of a chancre and secondary syphilis by the presence of syphilis. The presence of chancres within secondary syphilis have been reported, however, this form of presentation is rare. Patients with synchronous diagnosis of primary and secondary syphilis were included. They underwent a reverse sequence algorithm for syphilis diagnosis with a rapid syphilis test, if positive, a rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) tests were performed. A total of 15 patients were included. All were men. In primary syphilis, penile chancre predominated in 13 patients (86.6%), and one (6.7%) was in the tongue. In secondary syphilis syphilitic roseola was the most common type of presentation in 10 patients (66.6%), followed by the palmoplantar plaques in 6 patients (40%) and condyloma lata in 2 patients (13.3%). One patient presented alopecia in a “moth-eaten” pattern and this presentation coexisted with a condyloma lata and the palmoplantar plaques. Other patient presented with syphilitic roseola, palmoplantar plaques and condyloma lata. Clinical presentation as coexistent primary-secondary syphilis will become more frequent. First contact physicians and dermatologists would have to take more in consideration infrequent and atypical clinical forms of this disease.

A Complex Case of Extrahepatic Biliary Obstruction: Syphilitic abdominal lymphadenitis

Abstract Introduction/Objective Syphilis, a sexually transmitted disease that is caused by spirochete Treponema pallidum, can vary widely in presentation. Infective lymphadenitis due to syphilis have been reported before in cervical and inguinal lymph nodes.Here we present an interesting case of syphilitic lymphadenitis with unusual presentation and location. Methods/Case Report A 30-year-old male with no past medical history presented with epigastric pain, fever, jaundice, weight loss, and night sweats. Computed tomography imaging revealed a 4.1 cm solid mass at the porta hepatis with involvement of perihepatic lymph nodes, raising suspicion of malignancy. All serological tumor markers were negative. The patient underwent ERCP with biliary drainage to relieve obstructive jaundice. Bile duct brushing and liver biopsy at that time were non-diagnostic. Later the patient underwent laparoscopic lymph node excision. Histological examination of the lymph node showed intact follicular architecture with an increase in plasma cells and sinus histiocytes, without evidence of carcinoma or lymphoma cells. Flow cytometry on the lymph node showed polytypic B-cells and antigenically normal T-cells with CD4: CD8 ratio of 0.5 showing relatively excess of CD8 positive cytotoxic cells. Positive staining for Treponema pallidum with appropriate control highlighted micro-organisms suggestive of secondary syphilitic infection. This evidence was later supported by positive rapid plasma reagin (RPR) test. He subsequently tested positive for Human immunodeficiency virus (HIV-1). Results (if a Case Study enter NA) NA Conclusion In summary, appropriate histologic and serological testing lead to timely diagnosis in this case. This case contributes to the limited literature on syphilitic lymphadenitis and reports the first documented case of isolated intra- abdominal lymph node involvement.

Electroformation of Giant Unilamellar Vesicles from Damp Films in Conditions Involving High Cholesterol Contents, Charged Lipids, and Saline Solutions.

Giant unilamellar vesicles (GUVs) are frequently used as membrane models in studies of membrane properties. They are most often produced using the electroformation method. However, there are a number of parameters that can influence the success of the procedure. Some of the most common conditions that have been shown to have a negative effect on GUV electroformation are the presence of high cholesterol (Chol) concentrations, the use of mixtures containing charged lipids, and the solutions with an elevated ionic strength. High Chol concentrations are problematic for the traditional electroformation protocol as it involves the formation of a dry lipid film by complete evaporation of the organic solvent from the lipid mixture. During drying, anhydrous Chol crystals form. They are not involved in the formation of the lipid bilayer, resulting in a lower Chol concentration in the vesicle bilayer compared to the original lipid mixture. Motivated primarily by the issue of artifactual Chol demixing, we have modified the electroformation protocol by incorporating the techniques of rapid solvent exchange (RSE), ultrasonication, plasma cleaning, and spin-coating for reproducible production of GUVs from damp lipid films. Aside from decreasing Chol demixing, we have shown that the method can also be used to produce GUVs from lipid mixtures with charged lipids and in ionic solutions used as internal solutions. A high yield of GUVs was obtained for Chol/1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) samples with mixing ratios ranging from 0 to 2.5. We also succeeded in preparing GUVs from mixtures containing up to 60 mol% of the charged lipid 1-palmitoyl-2-oleoyl-sn-glycero-3-phospho-L-serine (POPS) and in NaCl solutions with low ionic strength (<25 mM).

Macular Star and Neuroretinitis with Optic Disk Edema

Neuroretinitis is an inflammatory disorder of the eye presenting with unilateral visual loss, optic disc edema, and subsequent formation of a macular star. Neuroretinitis can be classified as idiopathic, infectious and recurrent. Following a detailed patient history, essential work-up should include Bartonella antibody titers, the rapid plasma reagin (RPR) test, the tuberculin skin test, ACE and lysozyme levels, and a two-view chest X-ray. Among infectious etiologies of neuroretinitis, cat scratch disease caused by Bartonella henselae is the most frequently observed, accounting for two-thirds of cases. Recurrent neuroretinitis is characterized by poorer visual recovery and visual field loss. Patients should be informed about the possibility of recurrence to prevent severe vision loss.

Congenital Syphilis With Multiple Bone Fractures

We report a rare case of multiple fractures occurring in a 3-month-old boy with congenital syphilis (CS). His mother was diagnosed by a gynecologist with syphilis on a screening test before his birth. After birth, a serological panel revealed positive rapid plasma reagin and treponema pallidum hemagglutination assay test results. On the first visit, his left humerus was broken. Whole-body screening radiographs showed multiple fractures of both distal radii and the right first metatarsal. Immobilization was performed with a plastic splint, and callus formation of his humerus was seen after 3 weeks. CS cases have been increasing both in Japan and abroad in recent years. Orthopaedic surgeons should not forget the possibility of CS as a differential for fractures, especially in infants younger than 3 months born to syphilis-infected mothers.

Clinical and Laboratory Characteristics, Diagnosis, and Treatment of Patients with Neurosyphilis in Emergency Department: A Retrospective Study of 12 Patients.

Syphilis, caused by Treponema pallidum, presents a diagnostic challenge due to its diverse clinical manifestations. Neurosyphilis has seen a resurgence in recent years, particularly among men who have sex with men and those living with HIV. Diagnosis of neurosyphilis in emergency settings is challenging due to its varied neurological presentations. This study aims to serve as a reference for dermatologists and neurologists in diagnosing and treating neurosyphilis. This retrospective study analyzed patients who presented with neuropsychiatric symptoms and were ultimately diagnosed with neurosyphilis. These patients were collected from the emergency department in Peking Union Medical College Hospital between January 2018 and November 2023. The medical history, clinical symptoms, laboratory examinations, cranial MRI characteristics, and treatment regimens of these patients were investigated. Among the included 12 neurosyphilis patients, memory deterioration was observed in 8 out of the 12 neurosyphilis patients. Diagnosis often resulted in delays, with misdiagnoses mainly including Alzheimer's disease, stroke, and epilepsy. Neuroimaging revealed various abnormalities, predominantly affecting ventricular and temporal regions. Treatment with penicillin-based regimens varied in compliance, with only a minority of patients adhering to guidelines. Treatment outcomes were inconsistent, with some patients experiencing irreversible neurological damage and fluctuating serum rapid plasma reagin (RPR) titers. Diagnosis of neurosyphilis in the emergency department remains challenging, necessitating awareness of its varied neurological presentations. Enhanced diagnostic strategies are imperative to accelerate treatment initiation and improve outcomes for affected individuals.

Enhancing Differential Diagnosis Related to Oxidative Stress, Nitrous Oxide, and Nutrition by Rapid Plasma Homocysteine Measurement.

Historically used as a marker for inherited disorders, the current interest in plasma homocysteine measurement lies in its ability to provide valuable information about the metabolic and nutritional status of patients. Specifically, nitrous oxide (N2O) abuse can lead to functional vitamin B12 deficiency by oxidation and increase oxidative stress, resulting in elevated plasma homocysteine levels, which mimic neurological conditions such as Guillain-Barré syndrome. Rapid identification of hyperhomocysteinemia is crucial for timely intervention and avoiding costly, unnecessary treatments. This study evaluates the performance of a rapid immunoassay technique (Snibe) compared to mass spectrometry (LC-MS/MS) for measuring plasma homocysteine levels in patients with nitrous oxide abuse and non-inherited caused of elevated homocysteine, aiming to enhance differential diagnosis related to oxidative stress. 235 patients from Lille University Hospital were included. EDTA blood samples were collected and analyzed using both rapid immunoassay (Snibe) and LC-MS/MS. Neurological assessment was performed using the peripheral neuropathy disability (PND) score. Firstly, significant elevations in plasma homocysteine levels were observed in patients abusing nitrous oxide measured by LC-MS/MS. Secondly, the immunoassay provided rapid results, essential for early clinical decision-making, but tended to underestimate high values compared to LC-MS/MS. A good correlation was found between the methods for low and moderate values. The immunoassay tended to underestimate high-value samples compared to LC-MS/MS, which is a common problem with the competitive methodology. The rapid immunoassay technique is effective for initial screening and early intervention, aiding in the differential diagnosis of conditions related to oxidative stress. Therefore, it is recommended to use the CLIA method for initial screening and confirm with mass spectrometry if there are abnormal samples. Integrating both techniques can enhance diagnostic accuracy and improve patient outcomes.

Rapid oxygen plasma treatment of tin oxide layers for improving the light stability of perovskite solar cells

Surface treatment of SnO2 as an electron transport layer is essential for improving charge transport and device performance in the fabrication of perovskite solar cells. In this study, oxygen plasma with a controlled ion–radical composition ratio was used for rapid surface treatment to clean the surface of SnO2, and its performance was compared with that of the conventional UV–ozone treatment. Consequently, the plasma treatment succeeded in increasing the processing speed up to 40 times faster than that required for the conventional UV–ozone pretreatment. Furthermore, plasma pretreatment improved the photostability of solar cells.

Posterior Segment Manifestations of Syphilis and Correlation With Serologic Markers of Infection.

Retrospective analysis correlating serologic titers of ocular syphilis with posterior segment manifestations. This study consisted of 40 patients (80 eyes imaged, 68 affected) with positive rapid plasma reagin (RPR) and Treponema Pallidum immunoglobulin G. We collected demographic and presentation data including HIV status, absolute CD4 count, RPR, cerebrospinal fluid-venereal disease research laboratory (CSF-VDRL) test, and retinal zone. We categorized imaging into syphilitic outer retinopathy (SOR), acute syphilitic posterior placoid chorioretinopathy, retinitis/chorioretinitis (RC), and papillitis. Multivariate analysis correlated HIV status, RPR, and VDRL titers with posterior segment findings and zone. Mean age of 42.8 ± 10.7 years, with 70% male patients. Presenting visual acuity (logMAR) 0.66 ± 0.74 did not correlate with RPR, nor was it associated with papillitis, RC, or acute syphilitic posterior placoid chorioretinopathy. Higher RPR (≥ 1:128) positively associated with SOR (P = 0.031) and zone 1 (odds ratio [OR], 1.62; P = 0.02), but negatively associated with zone 2 (OR 0.35; P = 0.005). HIV positivity increased RC odds (OR, 4.45; P = 0.047). Higher RPR correlated with SOR and zone 1, whereas HIV positivity correlated with RC. [Ophthalmic Surg Lasers Imaging Retina 2024;55:511-516.].

Prevalence and risk factors of curable sexually transmitted and reproductive tract infections and malaria co-infection among pregnant women at antenatal care booking in Kenya, Malawi and Tanzania: a cross-sectional study of randomised controlled trial data

ObjectivesMalaria and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are associated with adverse pregnancy outcomes. This study reports the prevalence and risk factors of curable STIs/RTIs, STI/RTI co-infection and...

Formulation and in-vitro anticancer activity of nilotinib immediate release and ibrutinib sustained release pellets

Background: Blood cancer is a significant contributor to mortality rates worldwide, and its prevalence is projected to rise on a global scale. This trend places considerable strain on healthcare systems and necessitates the expedited development of innovative treatments by pharmaceutical firms to remain competitive. Conventional pellets produce rapid plasma drug levels, but they might cause side effects, decrease effectiveness, and lead to poor therapeutic management. Ibrutinib and Nilotinib are employed to treat leukemia patients. Methodology: The current research aims to formulate, characterize, and anticancer effect of Nilotinib immediate release (NIR) and Ibrutinib sustained release (ISR) seal sugar-coated pellets. Micrometric properties estimated the characterization of the drug pellets, and surface morphology was estimated using scanning electron microscopy. Drug excipient compatibility studies, stability studies, and in-vitro drug release were accessed. Result &amp; Discussion: The results of pellet formulations FNI-1 to FNI-5 showed that FNI-5 formulations showed 100±6.0 µm size and possessed excellent mechanical strength for giving pellets a good self-life; also, due to the higher drug content up to 99%, FNI-5 was the best suited for pellet formulation and because NIR showed 99.18 ± 2.12 drug release at 2h and ISR 99.03±3.74% up to 12h so that anticancer concentration maintained for prolonged period. The standard dose for cytotoxicity against the THP-1 cell line of Nilotinib was found to be 200 mg, and the maintenance oral dose of Ibrutinib was 140mg, with four times the intake of the drug up to 560 mg. In an in vitro study in FNI-5 (final formulation), the dose of Ibrutinib was reduced to 420 mg. Conclusion: A synergistic effect of Ibrutinib and nilotinib drugs was observed in the inhibition of cancer cell growth, with an IC50 value of 4.585 µg/mL

Green, mild, and rapid plasma synthesis of nitrogen/amino-cofunctionalized MWCNTs-supported Pd catalyst in solution for boosting formic acid dehydrogenation

Developing Pd catalysts with high catalytic activity and stability for formic acid dehydrogenation still remains a great challenge. Herein, a nitrogen/amino-cofunctionalized MWCNTs-supported Pd catalyst (Pd/MWCNTs-AP) was prepared in solution by a green, mild, and fast plasma technology. At 333 K reaction temperature, the turnover frequency (8415 h−1) over Pd/MWCNTs-AP for formic acid dehydrogenation was 1.26 and 5.16 times of those using Sigma-Aldrich Pd/C and thermal reduction prepared Pd/MWCNTs-AH, respectively. Impressively, the activity of Pd/MWCNTs-AP was not reduced during the six reaction cycles. In contrast, after the sixth cycle, the volume of gas produced using Sigma-Aldrich Pd/C decreased to 48 % of the initial volume. The results of structural characterization showed that Pd/MWCNTs-AP possessed ultrasmall-sized Pd, high Pd/C and N/C atomic ratios, and abundant –OH, facilitating the breakage of C–H and O–H bonds in formic acid to produce H and thus H2. Therefore, Pd/MWCNTs-AP exhibited excellent catalytic performance for formic acid dehydrogenation.

Sexually transmitted infections and migration in Uganda: a population-based study

ObjectivesMigration is associated with increased risk of HIV infection in Africa, but evidence about non-HIV sexually transmitted infection (STI) burden among African migrants is limited.MethodsWe used data from the Sexually...

Higher rates of laboratory-confirmed cases of syphilis in Western Canadian blood donors compared with Eastern Canadian blood donors following a period of societal re-opening.

There is a growing infectious syphilis outbreak in Western Canada. Although blood donors are screened for syphilis risks, some blood donors will still be confirmed test-positive for syphilis. This study compares the characteristics of confirmed test-positive syphilis donations in both Western Canada and Eastern Canada, November 2022-August 2023. Donors were defined as Western or Eastern Canadian. Blood donations were tested for syphilis using the PK-TP assay (Beckman Coulter PK7300 Automated Microplate System). Confirmatory Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) assays were performed by one of two reference laboratories. An RPR titre ≥1:8 was used as a proxy for possible infectious syphilis. Rates of laboratory-confirmed syphilis were higher in Western (n = 43, 13.4/100,000 donations) versus Eastern donors (n = 19, 4.7/100,000 donations; Fisher's exact test, two-sided, p ≤ 0.0001). Most syphilis confirmations were in first-time donors (Western Canada n = 31/43, 72.1%, Eastern Canada 12/19, 63.2%). Although rates of laboratory-confirmed syphilis were higher in Western versus Eastern donors, Western donors did not have higher rates of infectious syphilis. Further studies might assess whether donors with laboratory-confirmed syphilis understood pre-donation screening questions or were completely unaware of a past infection.