Polymorphic and monomorphic HLA-DR determinants on human hematopoietic progenitor cells

The expression of monomorphic Ia-like antigens and polymorphic (allotypic) HLA-DR determinants on CFU-GM, BFU-E, CFU-E, and CFU-GEMM was studied in bone marrow and peripheral blood cells from normal healthy individuals. Using various polyclonal and monoclonal anti-Ia- like antibodies, the presence of HLA-DR backbone antigens was shown on all hematopoietic progenitor cells (HPC) studied, both in complement- dependent cytotoxicity assays and in fluorescence-activated cell sorting (FACS). The expression of allotypic determinants was demonstrated on all HPCs, using the HLA-DR typing sera anti-HLA-DR1, 2, 3, 4, 5, and 7. The Class II antigen MT-2 was also shown on all HPCs, using both monoclonal and alloantisera, whereas the MB-1 (DC-1) determinant could not be demonstrated on HPCs. This might open the possibility of removing MB-1-positive malignant cells from the graft in autologous bone marrow transplantation.     

Quality of the parent-child interaction in young children with type 1 diabetes mellitus: study protocol

Background  

In young children with type 1 diabetes mellitus (T1DM) parents have full responsibility for the diabetes-management of their child (e.g. blood glucose monitoring, and administering insulin). Behavioral tasks in childhood, such as developing autonomy, and oppositional behavior (e.g. refusing food) may interfere with the diabetes-management to achieve an optimal blood glucose control. Furthermore, higher blood glucose levels are related to more behavioral problems. So parents might need to negotiate with their child on the diabetes-management to avoid this direct negative effect. This interference, the negotiations, and the parent's responsibility for diabetes may negatively affect the quality of parent-child interaction. Nevertheless, there is little knowledge about the quality of interaction between parents and young children with T1DM, and the possible impact this may have on glycemic control and psychosocial functioning of the child. While widely used global parent-child interaction observational methods are available, there is a need for an observational tool specifically tailored to the interaction patterns of parents and children with T1DM. The main aim of this study is to construct a disease-specific observational method to assess diabetes-specific parent-child interaction. Additional aim is to explore whether the quality of parent-child interactions is associated with the glycemic control, and psychosocial functioning (resilience, behavioral problems, and quality of life).     

Pacemaker Lead Fracture Due to Twiddler's Syndrome

The authors report a case of pacemaker twiddler's syndrome that led to lead fracture and loss of consciousness. The role of chest X rays in the diagnosis of pacemaker twiddler's syndrome as well as the management of the syndrome is discussed.     

Perceptions on the use of pricing strategies to stimulate healthy eating among residents of deprived neighbourhoods: a focus group study

Background  

Pricing strategies are mentioned frequently as a potentially effective tool to stimulate healthy eating, mainly for consumers with a low socio-economic status. Still, it is not known how these consumers perceive pricing strategies, which pricing strategies are favoured and what contextual factors are important in achieving the anticipated effects.     

High serum 25-hydroxyvitamin D concentration in patients with a recent diagnosis of non-melanoma skin cancer: a case-control study

Background

Sun exposure is critical for vitamin D synthesis and is a major risk factor for the development of non-melanoma skin cancer (NMSC). NMSC is the most common type of cancer in Brazil and coexists with a very high prevalence of vitamin D deficiency.

Objectives

The present study aimed to assess serum 25-hydroxyvitamin D (25[OH]D) concentration in patients with a recent diagnosis of NMSC.

Materials & methods

The serum 25(OH)D concentration of patients with a histological diagnosis of NMSC, made between September 2016 and September 2017, was measured by chemiluminescence up to 60 days after diagnosis and compared to healthy individuals without NMSC matched by age, sex, BMI, and skin phototype.

Results

Forty-one patients with NMSC and 200 healthy controls were evaluated. Most of the patients were men (56.1%) and most had basal cell carcinoma (90.2%). Patients were 67 years old on average (21-87 years) with skin Phototype 2 or 3 (80.6%). Mean serum 25(OH)D concentration inNMSCpatientswas significantly higher than in healthy controls (p<0.001). Most of the patients with NMSC (65.9%) had vitamin D deficiency (25[OH]D <30 ng/mL). No association was identified between histological type, time from diagnosis, or a previous history of skin neoplasm and 25(OH)D measurements.

Conclusion

Patients with recently diagnosed NMSC had significantly higher serum levels of 25(OH)D when compared to healthy controls. On the other hand, most of the NMSC patients were still considered to have vitamin D insufficiency.

     

Stereological evaluation of fibronectin in the periurethral region of the transitional zone from normal human prostates compared with benign prostatic hyperplasia

The aim of this study was to assess the volumetric density (Vv) of the fibronectin in the periurethral region of patients with benign prostatic hyperplasia (BPH) and compare with a control group. Prostatic periurethral tissue samples were obtained from ten patients (age range 65 to 79 years, mean 66) with clinical symptoms of bladder outlet obstruction who had undergone open prostatectomy. The control group samples (periurethral tissue samples from the transitional zone) were collected from prostates obtained during autopsy of accidental death adults of less than 25 years. The volumetric density (Vv) of the fibronectin was determined with stereological methods from 25 random fields per sample using the point-count method with an M-42 grid test system. The quantitative data were analyzed using the Kolmogorov-Smirnov and Mann-Whitney U tests. The Vv in the control and BPH groups was 21.9% ± 1.5% and 29.1 % ± 1.2% in the fibronectin, respectively. BPH tissues presented a significant increase of fibronectin in prostatic periurethral region in the transitional zone that may cause lengthening of the prostatic urethra.     

Interleukin 1 induces human marrow stromal cells in long-term culture to produce granulocyte colony-stimulating factor and macrophage colony- stimulating factor

Pure interleukin 1 (IL 1) was found to stimulate established human bone marrow stromal layers in long-term culture to produce colony- stimulating activity (CSA). Maximal concentrations in the culture medium were reached 24 hours after a single IL 1 pulse. The effect could be neutralized by a specific rabbit anti-IL 1 antiserum. Stromal layers, once stimulated by IL 1, continued to release CSA into the culture medium in the absence of exogenous IL 1. A second IL 1 pulse induced CSA release in an identical manner, as did the primary stimulation, indicating that the CSA released was actively produced. Using specific immunologic assays, both granulocyte colony-stimulating factor (G-CSF) and macrophage CSF (M-CSF) could be identified in the culture supernatants, and production of both factors was inducible by IL 1. Shortly after initiation of the long-term marrow cultures "spontaneous" G-CSF and M-CSF release occurred. The release of G-CSF diminished following addition of the anti-IL 1 antiserum, indicating that endogenous production of IL 1 by stromal cells had contributed to this effect. These results further support the role of IL 1 as an important modulator of CSF production by cells of the hematopoietic microenvironment.     

Treatment of progressive Hodgkin's disease with intensive chemoradiotherapy and autologous bone marrow transplantation

Twenty-six patients with progressive Hodgkin's disease after conventional chemotherapy received intensive chemoradiotherapy and autologous bone marrow transplantation (ABMT); 19 also received additional involved-field radiotherapy. Twenty-one patients [81%, 95% confidence intervals (CI) 61% to 94%] attained complete (n = 18) or partial responses. Ten patients (38%, 95% CI 20% to 59%) are disease- free a median of 4.5 years later (range 3.5 to 7.0 years), including seven patients with continuous complete responses. The likelihood of overall response was not significantly influenced by any clinical or treatment variable examined. However, there was a trend favoring patients with higher Karnofsky scores, and higher scores were associated with attainment of complete responses (P = .06 and P = .02, respectively, Mann-Whitney U test). Both higher Karnofsky scores and shorter durations of disease before transplantation were associated with improved survival in a stepwise Cox multivariate analysis. The chief cause of failure was progression at sites previously involved with Hodgkin's disease. No patient relapsed in the marrow, and two of three patients with a history of marrow involvement with Hodgkin's disease achieved durable complete responses after transplantation. These data suggest that inadequate pretransplant conditioning, and not the reinoculation of occult tumor cells in the autologous marrow, caused most relapses. Fatal treatment-related toxicity occurred in six patients. Three patients died of idiopathic interstitial pneumonitis; each had previously received local mediastinal irradiation before intensive chemoradiotherapy. Intensive chemoradiotherapy and ABMT produces durable responses in some patients with Hodgkin's disease incurable with conventional therapy. Use of such therapies at the first sign of failure with conventional chemotherapy and development of more effective conditioning regimens should further improve results.