Clinicopathological spectrum of mycosis fungoides

Cutaneous lymphomas represent a heterogeneous group of T-, NK- and B-cell neoplasms, with mycosis fungoides (MF) being the most common subtype. MF has a plethora of clinicopathological manifestations. Many variants of this lymphoma differ substantially from the 'classical' Alibert-Bazin disease and are therefore sometimes referred to as 'atypical' forms of the disease. This review addresses the whole clinicopathological spectrum of mycosis fungoides with respect to epidemiology, clinical, histopathological, immunophenotypic and genotypic features and the clinical course and prognosis of its variants: classical, erythrodermic, follicular, syringotropic, bullous/vesicular, granulomatous, poikilodermic, hypo- and hyperpigmented, unilesional, palmoplantar, hyperkeratotic/verrucous, vegetating/papillomatous, ichthyosiform, pigmented purpura-like, pustular and mucosal involvement in MF.     

Use of the experimental-psychological methods for evaluation of psychomotor performance of the flying personnel with functional disorders and diseases of the central nervous system

The study of mental performance of the flying personnel during medical expertise with respect to complex sensory-motor and logical operations has shown that changes of psychic activity in subjects with early symptoms of cerebral atherosclerosis are more marked than those in subjects with CNS functional disorders. They involve difficulties in attention control, delay in motor responses, deterioration in associative processes. These subjects prove less suitable for flying work: 71% of the pilots examined were grounded by the medical expertise.     

A multiplex polymerase chain reaction microarray assay to detect bioterror pathogens in blood

Heightened concern about the dangers of bioterrorism requires that measures be developed to ensure the safety of the blood supply. Multiplex detection of such agents using a blood-screening DNA microarray is a sensitive and specific method to screen simultaneously for a number of suspected agents. We have developed and optimized a multiplex polymerase chain reaction microarray assay to screen blood for three potential bioterror bacterial pathogens and a human ribosomal RNA gene internal control. The analytical sensitivity of the assay was demonstrated to be 50 colony-forming units/ml for Bacillus anthracis, Francisella tularensis, and Yersinia pseudotuberculosis (surrogate for Yersinia pestis). The absence of any false-positives demonstrated high analytical specificity. Screening B. anthracis-infected mouse blood samples and uninfected controls demonstrated effectiveness and specificity in a preclinical application. This study represents proof of the concept of microarray technology to screen simultaneously for multiple bioterror pathogens in blood samples.     

Priming by a novel universal influenza vaccine (Multimeric-001)—A gateway for improving immune response in the elderly population

Background

A new vaccine, “Multimeric-001” (M-001) has been recently developed, containing conserved, common linear influenza epitopes that activate both cellular and humoral arms of the immune system against a wide variety of influenza A and B strains. Apart from its direct action, M-001 is an attractive candidate for priming immune responses to seasonal influenza vaccine for the elderly population. The current clinical study was designed to assess M-001's standalone and priming action in participants over 65 years old. Evaluation of standalone action is based on induction of cell mediated immunity (CMI), since M-001 alone does not induce hemagglutinin inhibition (HAI) antibodies.

Methods

This was a two-center, randomized, placebo-controlled study. 120 participants were randomized 1:1:1:1 into four groups to receive either two sequential non-adjuvanted or a single non-adjuvanted or a single adjuvanted intramuscular injection of 500 mcg M-001 (treatment), or one placebo (saline) injection, before receiving the trivalent inactivated influenza vaccine (TIV). Due to visual differences between placebo and treatment the study was partially blinded. HAI was evaluated at baseline and 3 weeks after standard TIV vaccination as a measure of M-001's efficacy. CMI responses were evaluated in a subset (10/group) of the participants. Participants were monitored for safety throughout the study.

Results

Overall the treatment was well-tolerated and safe, though sample sizes allowed only limited statistical analysis. M-001 priming resulted in enhanced seroconversion towards all three TIV strains, compared to priming with placebo. Significant elevation of influenza-specific CMI was observed following immunization with M-001 alone.

Conclusions

The standalone and priming actions of M-001 were demonstrated in elderly participants despite the limitations of small population size and pre-existing HAI antibody titers in some participants. As a standalone vaccine, M-001 induced significant CMI to multiple strains and as a primer, M-001 enhanced HAI responses. Larger scale studies are warranted.

ClinicalTrials.gov registry number

NCT01419925.     

The effects of enfuvirtide therapy on body composition and metabolic parameters over 48 weeks in the TORO body imaging substudy*

Objective

The aim of the study was to compare the metabolic and morphological effects of enfuvirtide plus an optimized background (OB) regimen vs. OB alone (control group) in treatment‐experienced patients in the T‐20 vs. Optimized Regimen Only (TORO) studies.

Methods

Body composition and metabolic changes were investigated in patients over 48 weeks, based on fasting chemistries, body weight, and other anthropometric measurements. Dual‐energy X‐ray absorptiometry (DEXA) and computed tomography (CT) scans were performed in a patient subgroup (n=155) at baseline and at weeks 24 and 48.

Results

At week 48, mean changes from baseline were similar between treatment groups for glucose, insulin, C‐peptide, total cholesterol, low‐density lipoprotein (LDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, high‐density lipoprotein (HDL) cholesterol and triglyceride levels. The enfuvirtide group experienced a significant increase in body weight [mean change from baseline +0.99 kg; 95% confidence interval (CI) +0.54, +1.44] and, in those who had body scans, there was a significant increase in truncal fat (by DEXA: median change +419.4 g; 95% CI+71.3, +767.5) and total fat [visceral adipose tissue (VAT)+subcutaneous adipose tissue (SAT) by single‐slice abdominal CT scan: median change +25.5 cm²; 95% CI+8.9, +42.0] over 48 weeks; significant increases in these parameters were not seen in the control group. There was no significant change in truncal:peripheral fat ratio in either the enfuvirtide or the control group.

Conclusion

The addition of enfuvirtide to an OB regimen does not appear to have unfavourable effects on fat distribution or metabolic parameters.     

The estimation of elasticity and viscosity of soft tissues in vitro using the data of remote acoustic palpation

The presented study revealed the significant dependence of displacement magnitude and strain relaxation on phantom elasticity and viscosity. It has been shown that simultaneous analysis of temporal behavior and magnitude of shear strain induced by the radiation force of focused ultrasonic beam gives the necessary data for quantitative estimation of tissue shear modulus because of the known functional dependencies of displacement on local viscosity and elasticity. As a result, the simplest calibration procedure of acoustic radiation force-based methods is performed and algorithm for separate reconstruction of tissue elasticity and viscosity is proposed. These findings were tested, in particular, using the data obtained for specially prepared phantoms containing calf liver and muscle tissue in vitro. The observed complex character of shear strain relaxation and noise in some tissue phantoms and tissues in vitro reduces the preciseness of viscoelastic properties estimation.     

Surgical treatment of varicose veins of the lower extremities in a polyclinic]

The authors discuss the results of 40 operations carried out in the outpatient clinic for varicosity of the lower limb veins. The number of complications did not exceed that in operations performed in the inpatient clinic. The home conditions, the absence of a possible intrahospital infection, and the increased motor activity help in rapid rehabilitation of the patients. The period of working disability is significantly reduced.