Travelling with cystic fibrosis: Recommendations for patients and care team members

There are no European Guidelines on issues specifically related to travel for people with cystic fibrosis (CF). The contributors to these recommendations included 30 members of the ECORN-CF project. The document is endorsed by the European Cystic Fibrosis Society and sponsored by the Executive Agency of Health and Consumers of the European Union and the Christiane Herzog Foundation.The main goal of this paper is to provide patient-oriented advice that complements medical aspects by offering practical suggestions for all aspects involved in planning and taking a trip. The report consists of three main sections, preparation for travel, important considerations during travel and at the destination, and issues specific to immunocompromised travellers. People with CF should be encouraged to consult with their CF centre prior to travel to another country. The CF centre can advise on the necessary preparation for travel, the need for vaccinations, essential medications that should be brought on the trip and also provide information relating to CF care in the region and plan of action in case of an emergency.     

A strategy to prevent substance abuse in an academic anesthesiology department

Substance abuse is the most serious occupational safety issue associated with the practice of anesthesiology, with an incidence as high as 1% per year of training. The Cleveland Clinic's Anesthesiology Institute approached the process from the perspective of active prevention, including specific mandatory education programs for all department personnel on a recurring basis, strengthened procedures for the detection and prevention of diversion of controlled substances, enhanced skill building for detection of impairment, and implemented a multi-faceted drug testing program, including random and “for cause” urine screens, for prevention and early detection of abused anesthetic drugs and other substances of abuse. After 18 months of preparation, a Substance Abuse Prevention Protocol was created, which has been fully implemented as of September 1, 2007.     

Cytotoxic and mutagenic evaluation of extracts from plant species of the Miconia genus and their influence on doxorubicin-induced mutagenicity: An in vitro analysis

The Miconia genus, a plant widely used for medicine, occurs in tropical America and its extracts and isolated compounds have demonstrated antibiotic, antitumoral, analgesic and antimalarial activities. However, no study concerning its genotoxicity has been conducted and it is necessary to determine its potential mutagenic effects to develop products and chemicals from these extracts. This study assessed the cytotoxicity, mutagenicity and the protective effects of methanolic extracts from Miconia species on Chinese hamster lung fibroblast cell cultures (V79). The cytotoxicity was evaluated using a clonogenic assay. Cultures exposed to the extract of Miconia albicans up to a concentration of 30 μg/mL, M. cabucu up to 40 μg/mL, M. albicans up to 40 μg/mL and M. stenostachya up to 60 μg/mL exhibited a cytotoxic effect on the cells. The clonogenic assay used three non-cytotoxic concentrations (5, 10 and 20 μg/mL) to evaluate mutagenicity and antimutagenicity of the extracts. Cultures were treated with these three extract concentrations (mutagenicity test) or the extract associated with doxorubicin (DXR) (antimutagenicity test) in three protocols (pre-, simultaneous and post-treatments). Distilled water and DXR were used as negative and positive controls, respectively. In the micronucleus (MN) test, a significant reduction was observed in MN frequency in cultures treated with DXR and extracts compared to those receiving only DXR; a significant reduction was also observed for the presence of mutagenicity in all treatments. This study confirmed the safe use of Miconia extracts at the concentrations tested and reinforced the therapeutic properties previously described for Miconia species by showing their protective effects on doxorubicin-induced mutagenicity.     

Schwere Soforttypallergie nach Verzehr roher Paprika

We report on a patient with rare anaphylaxis after ingestion of raw bell pepper. A complex cluster of sensitization including grass and birch pointed out a possible pollen-associated food allergy. We suggest that the severe reaction is due to cross-reactivity towards Bet v 1. Western blot showed binding of the patient’s serum to an 11 kDa protein, which has not been described yet and might be a new allergenic structure of the bell pepper plant or a fragment of the Bet v 1-homologous bell pepper protein.     

Basal Cell Carcinoma Arising in a Cleft Lip Repair Scar

BACKGROUND: A case of basal cell carcinoma (BCC) developing in the repair scar of a cleft lip is presented. OBJECTIVE: Primary BCCs arising in surgical scars are very rare and no known reported cases exist of a BCC developing in a surgically repaired cleft lip scar. METHODS: A 69-year-old white man presented with a 5 mm primary BCC on his upper lip at the site of his cleft lip repair scar. The diagnosis was made by a tangential biopsy that showed an ulcerated BCC. RESULTS: Review of the medical literature indicates that a scar may be an independent risk factor for developing BCC. CONCLUSION: BCC may rarely arise in a cleft lip repair scar.     

Evaluation of Nod-Like Receptor (NLR) Effector Domain Interactions

Members of the Nod-like receptor (NLR) family recognize intracellular pathogens and recruit a variety of effector molecules, including pro-caspases and kinases, which in turn are implicated in cytokine processing and NF-κB activation.     

Wiederbelebung bei Hypothermie und Ertrinken

Circulatory arrest in accidental hypothermia is a special challenge for the emergency physician, starting with the difficulty of diagnosis because of bradycardia and hypotonia. Extracorporal circulation is the standard method of rewarming in deep hypothermia with circulatory arrest. When not available, conservative rewarming with forced air, warmed infusions and ventilator gas, dialysis, peritoneal and pleural lavage are alternatives that have been successful. These conservative methods are also effective in cases of hypothermia with sustained perfusion although there is no accordance about the optimal method of rewarming these patients. In hospital the decision whom to take on extracorporal circulation or to terminate resuscitative efforts must remain individualized. Elevated serum potassium levels and prolonged activated clotted time indicate patients in whom deleterious hypoxia has preceded the protective effects of hypothermia. A submersion time of victims in icewater up to 66 min has been survived. In asystolic avalanche victims, a time of >45 min in absence of an air pocket is a good triage criteria for preclinical declaration of death.     

Blood stem cell transplantation in pediatric oncology]

Large-dose chemotherapy (LDCT) with auto- and allogenic transplantation of blood stem cells (BSC) in pediatric oncology remains so far the last hope for many patients. The number of such procedures made in Europe increases by 10% every year. At the same time many issues of the place and role of transplantation in pediatric oncology remains unclear. Based on 240 sessions of cytopheresis, the author show that BSC can be sampled from severe pretreated patients despite the drug therapy regimen. The efficacy of G-KSF and GM-KSF used to stimulate BSC secretion is similar. After LDCT with BSC autotransplantation, the relapse-free survival rates in patients with Ewing's sarcoma and acute myeloblast-cell leukemia were 55.4 and 44.4%, respectively (in the first and second remissions). Consolidation as LDCT with BSC autotransplantation without cleansing the material from malignant cells is not a sufficient therapeutical measurement in disseminated neuroblastoma. Whether partial compatible related BSC transplantation can be possible made after non-myeloablative preparation regimens is shown.