Transient renal enlargement in pediatric hematopoietic cell transplant recipients

Age‐dependent renal length tables are routinely used when interpreting pediatric ultrasound. Standard renal length tables may not be accurate for HCT patients due to treatment effects on kidney size. The purpose of this study was to determine whether renal size changes from expected lengths based on age after HCT in the absence of other markers of renal disease. Four hundred and fifty renal measurements were made on 101 patients who underwent HCT between 2006 and 2010. Renal length was measured at 1–90 days pre‐HCT and at 0–30, 31–90, 91–180, and 181+ days post‐HCT. Values were compared with normal renal length tables. Average post‐HCT renal lengths were greater than established normative renal length data within every age group. Age‐adjusted average renal lengths measured at 0–30 and 31–90 days post‐transplantation were significantly larger than pre‐HCT renal lengths, with relative increases of 6.9% (4.5, 9.4; p < 0.001) and 3.9% (1.4, 6.4; p = 0.003), respectively. Average renal length did not differ significantly after 90 days post‐transplantation. HCT patients may have larger kidneys in the absence of renal disease. Awareness of the potential phenomenon of transient renal enlargement following HCT can prevent misdiagnosis and eliminate unnecessary diagnostic evaluations, interventions, anxiety, resource allocation, and financial costs.     

Zapobieganie zakażeniom meningokokowym – jak stosować obecnie dostępne szczepionki

Authors have presented the current recommendations for the prevention of meningococcal infections. The epidemiological situation in Poland has been described and the use of currently available meningococcal vaccines has been discussed. The chemoprophylaxis for close contacts of all people with invasive meningococcal disease has been also presented.     

The role of vision in Parkinson's disease locomotion control: free walking task

The current study addressed the role of visual information in the control of locomotion in people with Parkinson's disease. Twelve healthy individuals and 12 mild to moderate Parkinson's disease patients were examined while walking at self-selected velocities, under three visual sampling conditions: dynamic (normal lighting), static (static visual samples) and voluntary visual sampling. Subjects wore liquid crystal glasses for visual manipulation. Outcome measures included spatial-temporal parameters, braking and propulsive impulses, number of samples and total duration of voluntary visual samples. Interaction between groups and visual conditions was not observed for kinematic parameters or braking and propulsive impulses. There were no significant differences between groups for voluntary visual sampling variables. These findings suggest that the visual control of locomotion in Parkinson's disease patients was similar to that observed in controls. Furthermore, Parkinson's disease patients were not more dependent on visual information than healthy individuals for the locomotion control.     

Factors associated with place of death of cancer patients in the Mexico City Metropolitan area

Objective To improve the care of cancer patients by understanding the factors associated with the place of death. Patients and methods We conducted a retrospective study of death certificates registered in Mexico during 2003. Adult cases were included if the underlying cause of death was cancer, death location was in the Mexico City Metropolitan Area (MCMA), and information was available on sociodemographic characteristics and place of death (home or medical unit). Main results Of the 10,561 cases meeting the inclusion criteria, 54% died at home. More women (55%) than men died of cancer and at a younger age (63 vs 64 years, respectively; p < 0.001). Multivariate analysis indicated that patients diagnosed with leukemia and lymphoma were 3.6 times more likely to die in hospitals than patients diagnosed with other cancers (p < 0.001). Compared with patients who died at home, patients who died in hospitals were significantly more educated, younger, and residents of counties with more hospital beds density (p < 0.001, p < 0.001, and p = 0.003, respectively). Certificates for in-hospital deaths were more likely to be signed by other physician or health professional than were those for at-home deaths (p < 0.001). Cases with usual residency located outside the study area were 27 times more likely to die in hospitals than were metropolitan-area residents (p < 0.001). Conclusions Patients dying at home tended to be of older age, less educated, diagnosed with prostate, urinary tract or gastrointestinal cancers, and residents of the MCMA. Health planners should consider determinants of place of death when allocating hospital or home-based palliative care units.     

Overexpressed cyclin D3 contributes to retaining the growth inhibitor p27 in the cytoplasm of thyroid tumor cells

The majority of thyroid carcinomas maintain the expression of the cell growth suppressor p27, an inhibitor of cyclin-dependent kinase-2 (Cdk2). However, we find that 80% of p27-expressing tumors show an uncommon cytoplasmic localization of p27 protein, associated with high Cdk2 activity. To reproduce such a situation, a mutant p27 devoid of its COOH-terminal nuclear-localization signal was generated (p27-NLS). p27-NLS accumulates in the cytoplasm and fails to induce growth arrest in 2 different cell lines, indicating that cytoplasm-residing p27 is inactive as a growth inhibitor, presumably because it does not interact with nuclear Cdk2. Overexpression of cyclin D3 may account in part for p27 cytoplasmic localization. In thyroid tumors and cell lines, cyclin D3 expression was associated with cytoplasmic localization of p27. Moreover, expression of cyclin D3 in thyroid carcinoma cells induced cytoplasmic retention of cotransfected p27 and rescued p27-imposed growth arrest. Endogenous p27 also localized prevalently to the cytoplasm in normal thyrocytes engineered to stably overexpress cyclin D3 (PC-D3 cells). In these cells, cyclin D3 induced the formation of cytoplasmic p27-cyclin D3-Cdk complexes, which titrated p27 away from intranuclear complexes that contain cyclins A-E and Cdk2. Our results demonstrate a novel mechanism that may contribute to overcoming the p27 inhibitory threshold in transformed thyroid cells.