No alteration in NK function or zeta chain expression in NK and T cells of cervical cancer patients

OBJECTIVE: To investigate in vitro natural killer (NK) cell activity and expression of signal-transducing zeta chains in patients with cervical cancer. PATIENTS AND METHODS: Experiments were performed with frozen lymphocytes from patients at all disease stages and from healthy controls. Thawed NK were activated by overnight incubation in interferon-gamma (IFN-gamma); activity against two target cell lines was assessed by 4-h (51)Cr release assay. Targets chosen were K562, an erythroleukemic cell line, and a cervical carcinoma cell line designated 808. T and NK cell zeta chain expression was measured by flow cytometry. RESULTS: Patients' NK were found to be as cytotoxic as those of normal controls against cell lines K562 and 808. Patient T and NK cells did not show significant down-regulation of the zeta chain. CONCLUSIONS: We have found no evidence to suggest that loss of zeta chains is a mechanism for immunocompromise in patients with cervical carcinoma. IFN-recoverable patient NK activity is not reduced compared to matched controls. This may be clinically relevant since NK are active against cells exhibiting class I human leukocyte antigen (HLA) down-regulation and many cervical cancers show loss of HLA.     

Effect of HbS in the determination of HbA(2) with the TOSOH HLC-723G7 analyzer and the HELENA Beta-Thal Quik column kit

OBJECTIVES: The analytical performance of the TOSOH HLC-723G7 hemoglobin HPLC analyzer and the effect of the presence of HbS in the determination of HbA(2) using HPLC and manual column methods. DESIGN AND METHODS: The performance characteristics of the TOSOH HLC-723G7 analyzer in the determination of HbA(2) were compared to those of the HELENA Beta-Thal Quik column. The effect of HbS presence in the samples was quantified using the HELENA SAS-MX alkaline gel electrophoresis kit as the reference method. RESULTS: Within-run and between-run CVs for HbA(2) were better for the TOSOH HPLC analyzer than for the HELENA manual column method. The presence of HbS in the samples produces a strong positive bias in the %HbA(2) values when using both the HPLC and manual column methods, compared to the alkaline electrophoresis gel. CONCLUSION: Both the TOSOH HPLC and the manual column are reliable methods for %HbA(2) determination when no HbS is detectable in the samples. When HbS is present, the gel electrophoresis method gives more accurate results.     

History of human papillomavirus, warts and cancer: what do we know today?

Human papillomavirus has been a cause of infection in humans for thousands of years. The history of papillomaviruses, knowledge of their causative role in benign and malignant disease, and their structural characteristics have led to the development of vaccines to prevent cervical and anogenital cancers. Many questions remain unanswered before HPV vaccines can be optimised; however, the concept of virtual eradication of cervical cancer is not impossible, and remains a realistic aspiration.     

Launch and preliminary analysis of Hospital de La Princesa's inter-specialists biological therapies unit

We herein describe an inter-specialists unit for the monitoring and management of biological therapies and analyze the utilization of biological agents across specialties and diseases. Protocols and therapeutic objectives, as well as outcomes and protocol deviations, are shared and discussed periodically between specialists. All patients treated at one centre with any biological treatment from January 2000 by rheumatology, gastroenterology, dermatology, or neurology, regardless diagnosis, are identified by Clinical Pharmacy and included in an ongoing database that detects use and outcome. The drugs, survival, and reasons for discontinuation differ significantly across specialties. This approach has helped us recognizing the challenges and size of the problem of sharing expensive medications across specialties, and has served as a starting point to contribute to the better use of these compounds.     

Pneumococcal antimicrobial resistance: therapeutic strategy and management in community-acquired pneumonia

Streptococcus pneumoniae has been consistently shown to represent the most frequent causative agent of community-acquired pneumonia (CAP) and pneumococcal antibiotic resistance towards different families of antibiotics continues to be a much-debated issue. Microbial resistance causes a great deal of confusion in choosing an empirical treatment for pneumonia and this makes it necessary to know which factors actually determine the real impact of antimicrobial resistance on the outcome of pneumococcal infections. Several different aspects have to be taken into account when analyzing this matter, such as the study design, the condition of the patient at the time of diagnosis, the choice of the initial antimicrobial regimen (combination or monotherapy) and the pharmacokinetic/pharmacodynamic variables of the chosen antibiotic. It is generally accepted that in the treatment of beta-lactam-resistant pneumococcal infections, the use of standard antipneumococcal beta-lactam agents is unlikely to impact negatively on the outcome of CAP when appropriate agents are given in sufficient doses. As a general rule, for infections with penicillin-sensitive strains, penicillin or an aminopenicillin in a standard dosage will be effective; in the cases of strains with intermediate resistance, beta-lactam agents are still considered appropriate treatment although higher dosages are recommended; finally, infections with isolates of high-level penicillin resistance should be treated with alternative agents such as the third-generation cephalosporins or the new antipneumococcal fluoroquinolones. In areas of high prevalence of high-level macrolide resistance, empirical monotherapy with a macrolide is not optimal for the treatment of hospitalised patients with moderate or moderately-severe CAP. Fluoroquinolones are considered to be excellent antibiotics in the treatment of pneumococcal CAP in adults, but their general recommendation has been withheld due to fears of a widespread development of resistance. Most international guidelines recommend combination therapy (beta-lactam plus a macrolide) for the treatment of hospitalised patients with CAP.