Microbial contamination of hematopoietic progenitor cell grafts-incidence, clinical outcome, and cost-effectiveness: an analysis of 735 grafts

BACKGROUND: Screening of progenitor cell grafts (marrow, peripheral blood, and cord blood) for microbial contamination is required by the standards of AABB. Clinical sequelae from infusion of these contaminated grafts, however, is uncommon. STUDY DESIGN AND METHODS: A retrospective analysis of 735 consecutive marrow and peripheral blood progenitor cell harvests between 1998 and 2003 was performed. Analysis included incidence, clinical outcome, and cost outcomes of positive blood cultures and antibiotic therapy. RESULTS: Thirty-three of 735 (4.5%) harvests were contaminated. The incidence of microbial contamination varied with the source of the graft (4 of 26 [15%] were cord blood, 8 of 177 [4.5%] were marrow, and 21 of 532 [3.9%] were peripheral blood). Coagulase-negative Staphylococcus (n=22) and Propionibacterium acnes (n=8) were most frequently isolated. Potentially pathogenic organisms were isolated in 6 of 735 (0.81%) grafts (methicillin-sensitive Staphylococcus aureus, 4; methicillin-resistant S. aureus, 1; and Enterobacter cloacae, 1). The estimated total cost of surveillance was approximately $81,585. The cost of vancomycin therapy in 4 patients who received prophylactic antibiotic therapy was approximately $10,000. No adverse sequelae followed infusion of contaminated grafts. CONCLUSION: Clinical sequelae following infusion of microbially contaminated progenitor cells is extremely rare. Prophylactic empiric antibiotics may be unnecessary. Routine microbial surveillance of progenitor cell grafts is a low-yield procedure.     

Progressive systemic sclerosis in childhood: a report of three cases

Systemic sclerosis is unusual in childhood. We describe three children who presented with diffuse hidebound skin associated with gastrointestinal and pulmonary abnormalities. Cardiac and renal dysfunctions, which are often encountered in these patients, were notably absent in our cases.     

Pregnancy in a Rare Case of Intracranial Rosai Dorfman Disease (RDD)

The Journal of Obstetrics and Gynecology of India -     

The effect of different fiber reinforcements on flexural strength of provisional restorative resins: an in-vitro study

PURPOSE

The aim of this study was to compare the flexural strength of polymethyl methacrylate (PMMA) and bis-acryl composite resin reinforced with polyethylene and glass fibers.

MATERIALS AND METHODS

Three groups of rectangular test specimens (n = 15) of each of the two resin/fiber reinforcement were prepared for flexural strength test and unreinforced group served as the control. Specimens were loaded in a universal testing machine until fracture. The mean flexural strengths (MPa) was compared by one way ANOVA test, followed by Scheffe analysis, using a significance level of 0.05. Flexural strength between fiber-reinforced resin groups were compared by independent samples t-test.

RESULTS

For control groups, the flexural strength for PMMA (215.53 MPa) was significantly lower than for bis-acryl composite resin (240.09 MPa). Glass fiber reinforcement produced significantly higher flexural strength for both PMMA (267.01 MPa) and bis-acryl composite resin (305.65 MPa), but the polyethylene fibers showed no significant difference (PMMA resin-218.55 MPa and bis-acryl composite resin-241.66 MPa). Among the reinforced groups, silane impregnated glass fibers showed highest flexural strength for bis-acryl composite resin (305.65 MPa).

CONCLUSION

Of two fiber reinforcement methods evaluated, glass fiber reinforcement for the PMMA resin and bis-acryl composite resin materials produced highest flexural strength.

Clinical implications

On the basis of this in-vitro study, the use of glass and polyethylene fibers may be an effective way to reinforce provisional restorative resins. When esthetics and space are of concern, glass fiber seems to be the most appropriate method for reinforcing provisional restorative resins.     

Novel 5-(1-aryl-1H-pyrazol-3-yl)-1H-tetrazoles as glycogen phosphorylase inhibitors: An in vivo antihyperglycemic activity study

In this study, we report the ring transformation of 3-arylsydnone into 1-aryl-1H-pyrazole-3-carbonitriles via [3 + 2] cycloaddition with acrylonitrile. 1-Aryl-1H-pyrazole-3-carbonitrile underwent [2 + 3] cycloaddition with sodium azide to afford 5-(1-aryl-1H-pyrazol-3-yl)-1H-tetrazoles which were further subjected to N-alkylation with aryl/heteroaryl alkyl halides to afford 1,5- and 2,5-disubstituted tetrazoles. Furthermore, the title compounds were screened for in vivo antihyperglycemic activity using albino Wistar rats of either sex. Compounds 4a , 6b , 7a , 7b , 8b , and 9b showed maximum fall in the blood glucose levels in streptozotocin-induced diabetic rats after 5–7 days of administration. In support of antidiabetic activity, we also performed the experimental in vivo studies, namely, effect of compounds on enzymes (serum glutamic oxaloacetic transaminase, serum glutamic-pyruvic transaminase, creatinine, urea, and total protein), antihyperlipidemic, and histopathology. Moreover, the molecular docking study has been performed for potent molecules among the series with glycogen phosphorylase as target enzyme, and this study corroborated the experimental in vivo results.