Acute cytomegalovirus colitis presenting during primary HIV infection: an unusual case of an immune reconstitution inflammatory syndrome.

Severe ulcerous cytomegalovirus pancolitis developed during primary human immunodeficiency virus (HIV) infection in a patient who underwent early combination antiretroviral treatment. This massive inflammatory process led to acute colon perforation. Serological testing demonstrated cytomegalovirus reactivation. Severe immunosuppression caused by primary HIV infection resulted in cytomegalovirus colitis, and initiation of early combination antiretroviral therapy triggered an immune reconstitution inflammatory syndrome potentially leading to colonic perforation.     

Quality of life and sexual functioning in endometrial cancer survivors

Objective

Recent evidence suggests equivalent efficacy in terms of local control for adjuvant vaginal brachytherapy (VBT) compared to external beam radiotherapy after surgery in patients with intermediate-high endometrial cancer. The objective of this study is to compare the quality of life (QoL) and sexual function of women with endometrial cancer that were treated with either surgery alone or surgery in combination with postoperative VBT.

Methods

Women were interviewed at least 5 years after initial treatment for endometrial cancer. QoL was evaluated by using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and the cervical cancer module, CX-24. Sexual function was evaluated by using the Female Sexual Function Index (FSFI). Eligible women had early stage disease, were currently disease-free, and had undergone surgery and adjuvant VBT, but neither external beam radiotherapy nor systemic treatment. This study group were then compared using univariate and multivariate analyses with an age-matched control group comprising of endometrial cancer patients without adjuvant VBT.

Results

Fifty-five patients (29 surgery plus VBT and 26 surgical controls without VBT) were included for analysis. With respect to QoL including, e.g., physical, role, emotional and social functioning and likewise in terms of sexual function univariate and multivariate analyses did not show significant differences between patients with VBT and the controls without VBT of any of the outcome measures.

Conclusion

Adjuvant VBT after surgery does not seem to have a significant impact on quality of life and sexual function in endometrial cancer survivors.     

Nachsorgeuntersuchungen bei gynäkologischen Malignomen

Routine follow-up of patients with gynecologic cancer includes the detection of a recurrence or metastases as well evaluation and therapy of treatment-related problems, reintegration into the daily routine and the assessment of follow-up data. After adjuvant therapy patients should be seen every 3 months during the first 3 years followed by every 6 months until 5 years after diagnosis and thereafter annually. Follow-up is continued until the risk of recurrence is negligible. Palliative patients should be followed-up appropriate to their individual needs and circumstances.     

Musculoskeletal tumors: T1 and T2 relaxation times

The T1 and T2 relaxation times of primary tumors of the musculoskeletal system were calculated in 54 patients. No correlation was found between the relaxation values and the histopathologic type of the tumors. Lipoma had the same relaxation characteristics as normal fat. Otherwise tumors could be differentiated from normal tissue, but there was no significant difference between malignant and benign tumors, and the mean values for the different histopathologic types differed significantly only in a few instances. Hence T1 and T2 measurements are of limited value for histologic characterization of musculoskeletal tumors.     

Antioxidant and antipyretic properties of methanolic extract of Amaranthus spinosus leaves

ObjectiveMethanolic extract of Amaranthus spinosus (A. spinosus) leaves was screened for antioxidant and antipyretic activities.MethodsAntioxidant activity was measured by 1,1-diphenyl-2-picryl-hydrazile (DPPH) free radical scavenging, superoxide anion radical scavenging, hydroxyl free radical scavenging, nitric oxide radical scavenging, 2,2 '-azinobis-3-ethylbenzothiazole-6-sulfonic acid (ABTS) radical scavenging assays and total phenolic content was also determined. Antipyretic activity of methanolic extract of A. spinosus was measured by yeast induced pyrexia method at concentration of 200 and 400 mg/kg using paracetamol as standard drug.ResultsMethanolic extract of A. spinosus showed potent antioxidant activity. The IC 50 value was (87.50 ±3.52) μg/mL, (98.80±1.40) μg/mL, (106.25±0.20) μg/mL, (88.70±0.62) μg/mL and (147.50±2.61) μg/mL for DPPH, superoxide, hydroxyl, nitric oxide and ABTS radical scavenging activities. Methanolic extract of A. spinosus showed significant (P <0.01) antipyretic activity.     

Seroprevalence of cytomegalovirus among pregnant women attending Murtala Mohammed Specialist Hospital Kano,Nigeria

Background

Primary Cytomegalovirus (CMV) infection during pregnancy is a frequent and serious threat to the fetus. As there is no vaccine alternative measures are needed to prevent congenital CMV infection.

Objective

This study determined CMV Immunoglobulin G (IgG) antibody among pregnant women in order to ascertain the immune status of mothers to guide policy makers.

Methods

A semi-structured questionnaire was initially administered to obtain information on demographic details, stage of pregnancy and risk factors. Blood was collected by venipuncture from 180 women attending the antenatal clinic in Murtala Mohammed Specialist Hospital Kano, Kano State, Nigeria. Sera samples were screened using CMV IgG ELISA kit (Dialab, Austria).

Results

Out of 180 pregnant women, 164 (91.1%) were seropositive. Based on stages of pregnancy 6/6(100%), 52/60(86.7%) and 106/114(93.0%) were seropositive among women in the first, second and third trimesters respectively.

Conclusion

Seroprevalence of pregnant women to CMV Ig G is high, hence the need for CMV - IgM screening to know the extent of active infection. There is also need for public enlightenment on the methods of transmission, effective prevention and control strategies.     

Rate of inhibitor development in previously untreated hemophilia A patients treated with plasma‐derived or recombinant factor VIII concentrates: a systematic review

Summary. Background: Different rates of inhibitor development after either plasma‐derived (pdFVIII) or recombinant (rFVIII) FVIII have been suggested. However, conflicting results are reported in the literature. Objectives: To systematically review the incidence rates of inhibitor development in previously untreated patients (PUPs) with hemophilia A treated with either pdFVIII or rFVIII and to explore the influence of both study and patient characteristics. Methods: Summary incidence rates (95% confidence interval) from all included studies for both pdFVIII and rFVIII results were recalculated and pooled. Sensitivity analysis was used to investigate the effect of study design, severity of disease and inhibitor characteristics. Meta‐regression and analysis‐of‐variance were used to investigate the effect of covariates (testing frequency, follow‐up duration and intensity of treatment). Results: Two thousand and ninety‐four patients (1167 treated with pdFVIII, 927 with rFVIII; median age, 9.6 months) from 24 studies were investigated and 420 patients were observed to develop inhibitors. Pooled incidence rate was 14.3% (10.4–19.4) for pdFVIII and 27.4% (23.6–31.5) for rFVIII; high responding inhibitor incidence rate was 9.3% (6.2–13.7) for pdFVIII and 17.4% (14.2–21.2) for rFVIII. In the multi‐way anova study design, study period, testing frequency and median follow‐up explained most of the variability, while the source of concentrate lost statistical significance. It was not possible to analyse the effect of intensity of treatment or trigger events such as surgery, and to completely exclude multiple reports of the same patient or changes of concentrate. Conclusions: These findings underscore the need for randomized controlled trials to address whether or not the risk of inhibitor in PUPs with hemophilia A differs between rFVIII and pdFVIII.