Variations in non-pharmacological anti-infective measures in childhood leukemia - results of an international survey

Background Standardization in clinical practice may lead to improved outcomes. Unfortunately, little is known about the variability of non-pharmacological anti-infective measures in children with cancer. DESIGN AND METHODS: A web-based survey assessed institutional recommendations regarding restrictions of social contacts, pets and food and instructions on wearing face masks in public for children with standard- risk acute lymphoblastic leuk emia and acute myeloid leukemia during intensive chemotherapy. RESULTS: A total of 336 institutions in 27 countries responded to the survey (range, 1-76 institutions per country; overall response rate 61%). Most institutions recommend that patients with acute myeloid leukemia avoid indoor public places and daycare, kindergarten and school, whereas recommendations for patients with acute lymphoblastic leukemia differ considerably by institution. In terms of restrictions related to pets, there was a wide variability between institutions for both acute lymphoblastic and acute myeloid leukemia patients. Most, but not all institutions do not allow children with either acute lymphoblastic or acute myeloid leukemia to eat raw meat, raw seafood or unpasteurized milk. Whereas most institutions do not routinely recommend that patients with acute lymphoblastic leukemia wear face masks in public, advice on this matter varies for patients with acute myeloid leukemia. Conclusions The survey demonstrates that there is a wide variation in recommendations on non-pharmacological anti-infective measures between different institutions, countries and continents. This information may be used to encourage harmonization of supportive care practices and future clinical trials.     

Visual hallucinations of autobiographic memory and asomatognosia: a case of epilepsy due to brain cysticercosis

The current study describes the case of a woman with symptomatic epilepsy due to brain cysticercosis acquired during childhood. During her adolescence, she developed seizures characterized by metamorphopsia, hallucinations of autobiographic memory and, finally, asomatognosia. Magnetic brain imaging showed a calcified lesion in the right occipitotemporal cortex, and positron emission tomography imaging confirmed the presence of interictal hypometabolism in two regions: the right parietal cortex and the right lateral and posterior temporal cortex. We discuss the link between these brain areas and the symptoms described under the concepts of epileptogenic lesion, epileptogenic zone, functional deficit zone, and symptomatogenic zone.     

Blockade of CXCR1/2 chemokine receptors protects against brain damage in ischemic stroke in mice: Ischemia and Reparixin

OBJECTIVE:

Ischemic stroke may result from transient or permanent reductions of regional cerebral blood flow. Polymorphonuclear neutrophils have been described as the earliest inflammatory cells to arrive in ischemic tissue. CXCR1/2 receptors are involved in the recruitment of these cells. However, the contribution of these chemokine receptors during transient brain ischemia in mice remains poorly understood. In this work, we investigated the effects of reparixin, an allosteric antagonist of CXCR1/2 receptors, in a model of middle cerebral artery occlusion and reperfusion in mice.

METHODS:

C57BL/6J male mice treated with reparixin or vehicle were subjected to a middle cerebral artery occlusion procedure 1 h after the treatment. Ninety minutes after ischemia induction, the monofilament that prevented blood flow was removed. Twenty-four hours after the reperfusion procedure, behavioral changes, including motor signs, were analyzed with the SmithKline/Harwell/Imperial College/Royal Hospital/Phenotype Assessment (SHIRPA) battery. The animals were sacrificed, and brain tissue was removed for histological and biochemical analyses. Histological sections were stained with hematoxylin and eosin, neutrophil infiltration was estimated by myeloperoxidase activity and the inflammatory cytokine IL-1β was measured by ELISA.

RESULTS:

Pre-treatment with reparixin reduced the motor deficits observed in this model of ischemia and reperfusion. Myeloperoxidase activity and IL-1β were reduced in the reparixin-treated group. Histological analysis revealed that ischemic injury was also attenuated by reparixin pre-treatment.

CONCLUSIONS:

Our results suggest that the blockade of the CXCR1/2 receptors by reparixin promotes neuroprotective effects by reducing the levels of polymorphonuclear infiltration in the brain and the tissue damage associated with middle cerebral artery occlusion and reperfusion.     

Myxovirus resistance,osteopontin and suppressor of cytokine signaling 3 polymorphisms predict hepatitis C virus therapy response in an admixed patient population: comparison with IL28B

OBJECTIVES:

Suppressor of cytokine signaling 3, myxovirus resistance protein and osteopontin gene polymorphisms may influence the therapeutic response in patients with chronic hepatitis C, and an association with IL28 might increase the power to predict sustained virologic response. Our aims were to evaluate the association between myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 gene polymorphisms in combination with IL28B and to assess the therapy response in hepatitis C patients treated with pegylated-interferon plus ribavirin.

METHOD:

Myxovirus resistance protein, osteopontin, suppressor of cytokine signaling 3 and IL28B polymorphisms were analyzed by PCR-restriction fragment length polymorphism, direct sequencing and real-time PCR. Ancestry was determined using genetic markers.

RESULTS:

We analyzed 181 individuals, including 52 who were sustained virologic responders. The protective genotype frequencies among the sustained virologic response group were as follows: the G/G suppressor of cytokine signaling 3 (rs4969170) (62.2%); T/T osteopontin (rs2853744) (60%); T/T osteopontin (rs11730582) (64.3%); and the G/T myxovirus resistance protein (rs2071430) genotype (54%). The patients who had ≥3 of the protective genotypes from the myxovirus resistance protein, the suppressor of cytokine signaling 3 and osteopontin had a greater than 90% probability of achieving a sustained response (p<0.0001). The C/C IL28B genotype was present in 58.8% of the subjects in this group. The sustained virological response rates increased to 85.7% and 91.7% by analyzing C/C IL28B with the T/T osteopontin genotype at rs11730582 and the G/G suppressor of cytokine signaling 3 genotype, respectively. Genetic ancestry analysis revealed an admixed population.

CONCLUSION:

Hepatitis C genotype 1 patients who were responders to interferon-based therapy had a high frequency of multiple protective polymorphisms in the myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 genes. The combined analysis of the suppressor of cytokine signaling 3 and IL28B genotypes more effectively predicted sustained virologic response than IL28B analysis alone.     

Inhibition of mineral loss at the enamel/sealant interface of fissures sealed with fluoride- and non-fluoride containing dental materials in vitro

Objective. In this in vitro study we evaluated the enamel mineral loss effect of fluoride-containing and non-fluoride-containing materials at different distances from the sealant margin, and verified the fluoride-releasing capability of these materials. Material and methods. Extracted molars were randomly assigned into nine groups (n=12): Concise (C), FluroShield (F), Helioseal Clear Chroma (H), Vitremer (V), Fuji II-LC (FII), Ketac Molar (KM), Fuji IX (FIX), Single Bond (SB), and Clearfil Protect Bond (CF). All groups were subjected to thermo and pH cycling. Enamel mineral loss was evaluated by cross-section micro-hardness analysis at distances: ?100?µm, 0?µm, 100?µm, 200?µm. The mineral loss data were analyzed using a multi-factor ANOVA with split-plot design, and fluoride-released data were submitted to ANOVA and Tukey tests. Results. FIX demonstrated a lower mineral loss than C, F, and H, but did not differ from the SB, CF, V, FII, and KM groups, which also demonstrated no difference among them. C, F, H, and V presented the highest mineral loss, with no difference among them. V did not differ from the other groups (p>0.05). Regarding the different distances from the sealant margin, ?100?µm presented the lowest mineral loss. FIX showed the highest fluoride release on the 7th and 14th days of evaluation, while CF showed high fluoride release only on the 7th day. Conclusion. Resin sealant did not prevent enamel mineral loss, contrary to glass-ionomer cement, which showed the highest capacity for fluoride release. It is not exclusively the presence of fluoride in a material's composition that indicates its capability to interfere with the development of enamel caries-like lesions.     

Biofilm formation on denture liners in a randomised controlled in situ trial

ObjectivesThis randomised clinical trial assessed how biofilm development and composition is affected by time and denture material type in denture wearers with and without denture stomatitis.MethodsSpecimens of acrylic resin (control) and denture liners (silicone-based or acrylic resin based, depending on the experimental phase) were inserted into the surface intaglio of 30 denture wearers. Biofilm was formed in two phases of 21 days, and counts of viable micro-organisms in the accumulating biofilm were determined after 7, 14 and 21days of biofilm formation. Data were analysed by three-way ANOVA followed by Tukey test to assess differences among health condition (healthy or with denture stomatitis), materials and time point.ResultsNon-albicans Candida species counts were higher in diseased patients with silicone-based denture liners (p = 0.01). Denture stomatitis patients showed higher mutans streptococci counts after 7 days (p = 0.0041).ConclusionsLonger biofilm formation time periods did not result in differences on biofilm composition. The denture liners evaluated in this study accumulate greater amount of biofilm, and therefore their use should be carefully planned.Clinical significanceThe silicone-based denture liner tested should be used cautiously in patients with denture stomatitis as it showed increased non-albicans species counts, known to be difficult to treat.