Severe Neurological Toxicity of Immune Checkpoint Inhibitors: Growing Spectrum

Expanding use of immune-checkpoint inhibitors (ICIs) underscores the importance of accurate diagnosis and timely management of neurological immune-related adverse events (irAE-N). We evaluate the real-world frequency, phenotypes, co-occurring immune-related adverse events (irAEs), and long-term outcomes of severe, grade III to V irAE-N at a tertiary care center over 6 years. We analyze how our experience supports published literature and professional society guidelines. We also discuss these data with regard to common clinical scenarios, such as combination therapy, ICI rechallenge and risk of relapse of irAE-N, and corticosteroid taper, which are not specifically addressed by current guidelines and/or have limited data. Recommendations for management and future irAE-N reporting are outlined. ANN NEUROL 2020;87:659–669     

Comparable fMRI activity with differential behavioural performance on mental rotation and overt verbal fluency tasks in healthy men and women

To explicate the neural correlates of sex differences in visuospatial and verbal fluency tasks, we examined behavioural performance and blood-oxygenation-level-dependent (BOLD) regional brain activity, using functional magnetic resonance imaging, during a three-dimensional (3D) mental rotation task and a compressed sequence overt verbal fluency task in a group of healthy men (n=9) and women (n=10; tested during the low-oestrogen phase of the menstrual cycle). Men outperformed women on the mental rotation task, and women outperformed men on the verbal fluency task. For the mental rotation task, men and women activated areas in the right superior parietal lobe and the bilateral middle occipital gyrus in association with the rotation condition. In addition, men activated the left middle temporal gyrus and the right angular gyrus. For verbal fluency, men activated areas in the bilateral superior frontal gyrus, right cingulate gyrus, left precentral gyrus, left medial frontal gyrus, left inferior frontal gyrus, thalamus, left parahippocampal gyrus and bilateral lingual gyrus, and women activated areas in the bilateral inferior frontal gyrus and left caudate. Despite observing task related activation in the hypothesised areas in men and women, no areas significantly differentiated the two sexes. Our results demonstrate comparable brain activation in men and women in association with mental rotation and verbal fluency function with differential performance, and provide support for sex differences in brain–behaviour relationships.     

社区护理人员灾害准备的研究进展

对国内外社区护理人员灾害准备模式、存在的问题、影响因素、培训现状及测量工具进行综述。提出应建立完善的社区护理人员灾害准备培训体系,建立适合我国国情的社区护理人员灾害应对准备模式并建立社区护理人员灾害准备测量工具的区域性常模,旨在为今后提高社区护理人员的灾害准备度提供参考依据。     

Description of <Emphasis Type="Italic">Paratrichodorus pachydermus</Emphasis> (Nematoda: Trichodoridae) from the Czech Republic

A survey has been carried out to study the occurrence and distribution of Paratrichodorus pachydermus nematodes in the Czech Republic in a range of habitats (orchards, forests, vineyards, strawberry and river bank). A total 208 sites were surveyed and 19 sites were found positive for P. pachydermus. This species is a new record for Czech nematofauna.     

Determination of Genetic Diversity of the Morinda tinctoria Population in Historical Mandore Garden

Morinda tinctoria (Rubiaceae) commonly called as ‘Indian Mulberry’ is one of the avenue trees of historically important Mandore garden planted anthropogenically in the past. Objective of this study was to determine the genetic diversity of M. tinctoria population at Mandore garden using Random Amplified Polymorphic DNA and Inter Simple Sequence Repeat Markers. A total of 97 bands were produced from 10 random amplified polymorphic DNA primers (49 bands) and 8 inter simple sequence repeat primers (48 bands). No polymorphic bands were obtained in any accessions using the two methods, which strongly suggested that M. tinctoria of this region appear as identical clones. Monomorphic pattern revealed the clonal plantation of M. tinctoria in this historical garden. This is the first report on use of molecular markers to infer the ancient plantation history. Consequences of genetically monomorphic population under global climate changes are discussed and conservation strategy is proposed.     

Outcome of low birth weight babies with special reference to some maternal factors

Neonatal outcome of 178 low birth weight (LBW) babies in this study was associated with 26.4% neonatal mortality. A significantly higher mortality rate was noted in presence of adverse maternal factors, birth weight less than 1.5 kg, prematurity and respiratory distress at birth. Premature rupture of membranes and leaking (greater than 12 h) were recorded in 75 cases. Significant association was observed for septicemia. Maternal postpartum weight less than 40 kg was associated with higher incidence of neonatal infections than when mother's weight was greater than 45 kg.     

Liver dysfunction in severe birth asphyxia

A total of 46 full term, appropriate for gestational age neonates were included in this study. Out of this, 31 infants had suffered severe birth asphyxia, while 15 normal babies formed the control group. The liver function tests of the asphyxiated group was deranged in 64.52% babies. There was 60% mortality in asphyxiated babies with deranged liver function. The serum levels of transaminases (SGOT, SGPT) and alkaline phosphatase in non-survivors were significantly higher than those of survivors.     

Prevention of renal ischemia-reperfusion-induced injury in rats by picroliv

Picroliv is a potent antioxidant extracted from the roots and rhizome of Picrorhiza kurrooa. It has been shown to impart significant hepatoprotective activities, partly by modulation of free radical-induced lipid peroxidation. Lipid peroxidation and reactive oxygen species are associated with tissue injury in post-ischemic acute renal failure. The efficacy of picroliv was assessed in an in vivo model of renal ischemia-reperfusion injury (IRI) in rats at a dose of 12 mg/kg orally for 7 days. The animals were killed at various times after reperfusion. Increased lipid peroxidation and apoptotic cell number reflected the oxidative damage following renal IRI. Picroliv-pretreated rats exhibited lower lipid peroxidation, improved antioxidant status, and reduced apoptosis, indicating better viability of renal cells. Immunohistochemical studies revealed that picroliv pretreatment attenuated the expression of intercellular adhesion molecule-1 in the glomerular region. These results suggested that picroliv pretreatment protects rat kidneys from IRI, perhaps by modulation of free radical damage and adhesion molecules.