A Pantetheinase-Resistant Pantothenamide with Potent,On-Target,and Selective Antiplasmodial Activity

Pantothenamides inhibit blood-stage Plasmodium falciparum with potencies (50% inhibitory concentration [IC₅₀], ∼20 nM) similar to that of chloroquine. They target processes dependent on pantothenate, a precursor of the essential metabolic cofactor coenzyme A. However, their antiplasmodial activity is reduced due to degradation by serum pantetheinase. Minor modification of the pantothenamide structure led to the identification of α-methyl-N-phenethyl-pantothenamide, a pantothenamide resistant to degradation, with excellent antiplasmodial activity (IC₅₀, 52 ± 6 nM), target specificity, and low toxicity.     

Transgender health care in Germany: Participatory approaches and the development of a guideline

Health care of individuals who experience their gender not, not completely and/or not continuously in line with their sex assigned at birth has been organized for a long time in an area of conflict between the right for self-determination of transgender individuals and the fear of incorrect decisions among mental health professionals. The German Standards for the Treatment and Diagnostic Assessment of Transsexuals, published in 1997, were an attempt to regulate this area of conflicts within the German health system. Meanwhile, in view of the seventh version of the international Standards of Care published by the World Professional Association for Transgender Health (WPATH) as well as based upon recent judgments of the Federal Constitutional Court in Germany, the German standards must be exigently revised. In consequence, the Deutsche Gesellschaft für Sexualforschung (DGfS, German Society for Sex Research) has begun to substitute the above-mentioned standards with an evidence-based guideline aiming at an improvement of the service quality. This article introduces the history of transgender care in Germany, describes the background and the procedures of the current guideline development, and discusses how participatory approaches might improve the health care situation for transgender peeople in Germany.     

Stent thrombosis following the STAR technique in a complex RCA chronic total occlusion.

Four drug-eluting stents were deployed in the right coronary artery (RCA) of a symptomatic young woman who presented with a chronic total occlusion (CTO) of the RCA. The occlusion was successfully crossed using the recently described STAR technique. However, the patient died suddenly 15 hr later. Autopsy demonstrated a long segment of subintimal stenting in the proximal and mid RCA that was intraluminal in the distal vessel. Acute stent thrombosis in the subintimal stents was responsible for sudden death. This case highlights the potential risk of performing extensive subintimal stenting for CTO.     

Benefits and risks of immediately sequential bilateral cataract surgery: a literature review

Immediately sequential bilateral cataract surgery (ISBCS) is a highly contended issue in ophthalmology, mainly due to the risk of bilateral endophthalmitis and financial penalties that many ophthalmologists face when performing simultaneous cataract surgeries. The purpose of this review is to understand the current status of the knowledge of ISBCS, mainly its benefits and risks and how they compare with the standard of care, delayed sequential bilateral cataract surgery. Evidence, although limited, increasingly supports ISBCS for providing faster rehabilitation, improved visual outcomes, and cost and time savings. Evidence does not support the fear of bilateral endophthalmitis resulting from the simultaneous procedure. However, stronger and greater evidence is needed before ISBCSs can be considered the standard of care. Where ISBCS can potentially create the most beneficial impact is in public eye health programmes in developing countries, but this has not yet been explored.     

Immunophenotyping does not improve predictivity of the local lymph node assay in mice

The local lymph node assay (LLNA) is a regulatory accepted test for the identification of skin sensitizing substances by measuring radioactive thymidine incorporation into the lymph node. However, there is evidence that LLNA is overestimating the sensitization potential of certain substance classes in particular those exerting skin irritation. Some reports describe the additional use of flow cytometry‐based immunophenotyping to better discriminate irritants from sensitizing irritants in LLNA. In the present study, the 22 performance standards plus 8 surfactants were assessed using the radioactive LLNA method. In addition, lymph node cells were immunophenotyped to evaluate the specificity of the lymph node response using cell surface markers such as B220 or CD19, CD3, CD4, CD8, I‐A^κ and CD69 with the aim to allow a better discrimination above all between irritants and sensitizers, but also non‐irritating sensitizers and non‐sensitizers. However, the markers assessed in this study do not sufficiently differentiate between irritants and irritant sensitizers and therefore did not improve the predictive capacity of the LLNA. Copyright © 2014 John Wiley & Sons, Ltd.     

FDG‐PET/CT is a pivotal imaging modality to diagnose rare intravascular large B‐cell lymphoma: case report and review of literature

Intravascular large B‐cell lymphoma (IVLBCL) remains a diagnostic challenge, because of non‐specific findings on clinical, laboratory, and imaging studies. We present a case in which 18F‐fluorodeoxyglucose (FDG)‐positron emission tomography (PET)/computed tomography was particularly useful to suspect the diagnosis, to detect unexpected locations, to guide contributive biopsy, and to assess the response to treatment. In case of initial negative results, FDG‐PET should be repeated in the course of clinical evolution. In the presence of neurological or hormonal symptoms without brain magnetic resonance imaging abnormality, FDG‐PET brain slices could depict additional pituitary and/or brain hypermetabolisms. We discuss the potential interests of FDG‐PET in IVLBCL by a literature review. Copyright © 2014 John Wiley & Sons, Ltd.