A preliminary investigation of Beta-hCG expression in patients with osteosarcoma

There are eight reported cases in the literature of osteosarcomas secreting β-hCG. Our primary aim was to investigate the rate of β-hCG expression in osteosarcoma and attempt to understand the characteristics of osteosarcomas that secrete β-hCG. We reviewed 37?histopathology slides (14 biopsies and 23 surgical specimens) from 32 patients with osteosarcoma. The slides were retrospectively stained for β-hCG expression. Patient and tumour characteristics, including age, gender, tumour location, subtype, proportion of necrosis, presence of metastases and recurrence were recorded. A total of five of the 32?tumours were found to be positive for β-hCG expression (one strongly and four weakly). This incidence of this expression was found in tumours with poor histological response to neoadjuvant chemotherapy. The use of β-hCG expression as a diagnostic, prognostic or follow-up marker is questionable and needs further investigation with a larger sample size.     

Impact of high-dose inotropic donor support on early myocardial necrosis and outcomes in cardiac transplantation

Nixon JL, Kfoury AG, Brunisholz K, Horne BD, Myrick C, Miller DV, Budge D, Bader F, Everitt M, Saidi A, Stehlik J, Schmidt TC, Alharethi R. Impact of high‐dose inotropic donor support on early myocardial necrosis and outcomes in cardiac transplantation.
Clin Transplant 2011 DOI: 10.1111/j.1399‐0012.2011.01504.x.
© 2011 John Wiley & Sons A/S. Abstract: Background: Cardiac donors routinely require vasoactive agents for circulatory stability after brain death. Nevertheless, inotropes have been associated with direct cardiac toxicity. Our study evaluated whether the use of high‐dose inotropic support in potential donors was associated with increased early myocardial necrosis (MN) and worse clinical outcomes after cardiac transplantation. Methods: The UTAH Cardiac Transplant Program (UCTP) and Intermountain Donor Services databases were queried for records between 1996 and 2009. The high‐dose donor inotropic support (HDIS) group was defined as patients on dopamine >10 μg/kg/min. The incidence of early MN, intensive care unit (ICU) length of stay, length of ventilator support, and mortality was evaluated. Results: Two hundred and forty‐four recipients undergoing transplant met study criteria. The average donor age was 27 yr. The incidence of MN in the HDIS (n = 29) and non‐HDIS (n = 204) groups was 14.8% and 6.7%, respectively, OR 2.67. Total ischemic time, ventilator support time, ICU stay, and actuarial survival were similar between both groups. Conclusion: The use of high‐dose inotropic support to maintain donor stability appears to have a higher trend for early post‐transplant MN without an impact on clinical outcomes. With the current growing shortage of organ donors, it appears reasonable to use donors on high‐dose inotropic support.     

Estimation of Etofenprox Residues in Tomato Fruits by QuEChERS Methodology and HPLC–DAD

Etofenprox residues were estimated by employing standardized QuEChERS technique in tomato following one application of Trebon^® 20 % EC. The average recoveries of etofenprox on tomato for fortification levels 0.01, 0.1 and 0.5 mg/kg were observed to be 87.5 %, 89.7 % and 92.2 %, respectively, with relative standard division of 3.50, 4.11 and 3.20. The LOQ for tomato was found to be 0.01 mg/kg. The average initial deposit of etofenprox on tomato was observed to be 0.783 mg/kg, at single application rate. This etofenprox residue dissipated below its LOQ of 0.01 after 15 days at a single dosage. Half-life of etofenprox was observed to be 2.15 days, at the recommended dosage. These data could provide guidance for the proper and safe use of this pesticide on tomato in Egypt.     

Dissipation of Chlorantraniliprole in Tomato Fruits and Soil

The main objective of this study was to understand the residue and persistence behaviour of new insecticide chlorantraniliprole in tomato fruit and soil samples. Its residue was analyzed by HPLC and it dissipated in tomato fruit and soil following first order kinetics. The results showed half life (t_1/2) value of 3.30 and 3.66 days for chlorantraniliprole in tomato fruit and soil, respectively. According to maximum residue limit (MRL) the pre-harvest interval (PHI) of chlorantraniliprole on tomato was 8-days after the treatment.     

Infections chez l’immunodéprimé

Chronic obstructive pulmonary disease (COPD) is characterized by acute exacerbations (AECOPD) which can be life-threatening and contribute to the progressive decline of lung function and deterioration of quality of life.Management of severe AECOPD requiring intensive care unit (ICU) admission is usually based on ventilatory support (mainly by non-invasive ventilation), pharmacologic treatment of bronchial obstruction, and treatment of triggering agents. Systemic corticosteroids and antibiotics are frequently prescribed, based on trials that usually excluded patients requiring ventilatory support. Extrapolation of these trial results to patients requiring ventilator support is not straightforward given the burden of antibiotic resistance in the ICU and the specific adverse effects of corticosteroids in ICU patients including neuromyopathy and sepsis. Few studies have recently evaluated systemic corticosteroids in AECOPD patients requiring ventilatory support: they reached contradictory results regarding intermediate outcomes (ventilation duration, length of stay, and so on) or hard endpoints like ICU mortality. These studies have however consistently highlighted the high risk of developing potentially severe corticosteroids’ side effects. Only one study evaluated systematic antibiotic administration in AECOPD patients requiring ventilatory support. This study suggested that beneficial effects of antibiotics stem from an effect of selective digestive decontamination preventing ventilatory-associated pneumonia. The majority of patients included in that study had invasive mechanical ventilation either at admission or in the 6 h following mechanical ventilation, rendering hazardous any extrapolation to current ventilatory management of such patients who are usually ventilated non-invasively.     

Effects on erythropoiesis of alemtuzumab-containing reduced intensity and standard conditioning regimens

Haemopoietic cell transplantation (HCT) with reduced-intensity conditioning (RIC) has been associated with delayed disappearance of host anti-A and anti-B isohaemaglutinins and hindrance of donor erythropoiesis in major ABO mismatched transplants. Erythroid recovery, disappearance of recipient type and appearance of donor-type isohaemaglutinins was compared in 84 patients undergoing RIC and 50 patients with standard-conditioning (SCo) HCT. All patients received alemtuzumab as part of their conditioning. The incidence of immune-mediated anaemia and red cell transfusion usage were also compared. Immune factors affecting post-transplant erythroid kinetics showed little variance between different conditioning regimens. Disappearance of recipient isohaemaglutinins and emergence of donor red cells proceeded at similar rates in RIC and SCo transplants; the effects of ABO mismatch were marginal. Pure red cell aplasia, alloimmune haemolysis and autoimmune haemolytic anaemia were not more common in RIC transplants. We believe that alemtuzumab played a critical role in dampening immune reactions of both the host and the donor. Patients in both conditioning groups had similar post-transplant erythroid burst-forming unit (BFU-E) counts; BFU-E chimaerism analysis showed that 90–100% progenitors were of donor origin. However, transfusion requirements were significantly higher in the SCo group, due at least partly to earlier onset of bone marrow hypoplasia.     

Activity of Eravacycline against Enterobacteriaceae and Acinetobacter baumannii,Including Multidrug-Resistant Isolates,from New York City

Eravacycline demonstrated in vitro activity against a contemporary collection of more than 4,000 Gram-negative pathogens from New York City hospitals, with MIC₅₀/MIC₉₀ values, respectively, for Escherichia coli of 0.12/0.5 μg/ml, Klebsiella pneumoniae of 0.25/1 μg/ml, Enterobacter aerogenes of 0.25/1 μg/ml, Enterobacter cloacae 0.5/1 μg/ml, and Acinetobacter baumannii of 0.5/1 μg/ml. Activity was retained against multidrug-resistant isolates, including those expressing KPC and OXA carbapenemases. For A. baumannii, eravacycline MICs correlated with increased expression of the adeB gene.