Nitrous oxide encephalography: 5-year experience with 475 pediatric patients.

475 pediatric patients with a variety of neurologic conditions were subjected to encephalography, using N2O as the contrast medium and N2O-halothane as anesthetic agents. This technic is both safe and effective, as reflected by no mortality and satisfactory roentgenograms. By application of the principles of gas physics, postoperative discomfort has been greatly reduced, resulting in a more comfortable convalescence and earlier discharge.     

The accuracy of aspiration cytology in the diagnosis of rejection following orthotopic liver transplantation

Abstract. The role of aspiration cytology (AC) and the total corrected increment (TCI) in the diagnosis of hepatic rejection was assessed in 30 patients following 36 liver transplants. A total of 174 AC specimens were "blindly" evaluated. Patients underwent protocol AC twice weekly and when biochemical or clinical parameters suggested rejection. Hepatic rejection was only confirmed when clinical and biochemical changes were accompanied by positive histological diagnosis. In all, 103 specimens were matched against histology, the remainder assessed against retrospective clinical and biochemical diagnoses. There were 80 cytological diagnoses of rejection, confirmed in 69 specimens, and 94 diagnoses of no rejection, confirmed in 73 specimens. These figures give a sensitivity of 76.7%, a specificity of 86.9% and a positive predictive value of 86.3%. Overall, 39.7% of specimens taken more than 2 months after grafting proved to be incorrectly diagnosed. However, the accuracy was higher in 145 specimens taken within 8 weeks of transplantation, with a sensitivity of 81.3%, a specificity of 90%, a positive predictive value of 89.7% and an accuracy of 85.5%. Although histology remains the gold standard in the diagnosis of acute rejection after hepatic grafting, AC using a TCI with a positive predictive value of 86.3% may prove to be of value in monitoring liver transplant patients in the first 2 months after grafting.     

Pituitary Microadenomas: Diagnostic and Therapeutic Trends

It can be categorically stated that any clinician who treats medical problems in women during the reproductive or the peripubertal years must be aware of risks of pituitary adenomas and available diagnostic and therapeutic modalities. Pituitary adenomas may present during the pubertal period in association with delayed or incomplete development of secondary sexual characteristics. Primary or secondary amenorrhea may be the most obvious clinical abnormality. Patients with menstrual irregularity or secondary amenorrhea are at risk of hyperprolactinemia and pituitary adenomas. At present, the exact risk is unknown. Patients who are at greatest risk appear to be those with hyperprolactinemia, galactorrhea, and amenorrhea. Patients with apparent functional hyperprolactinemia may be harboring small pituitary adenomas. This possibility should be considered when using bromocriptine therapy. Pregnancy in patients with pituitary adenomas may be either normal or complicated by pituitary tumor enlargement, hemorrhage, or visual disturbances. There is no known accurate predictor of individual risk. Patients conceiving spontaneously or after induced ovulation should be followed closely to detect and treat possible pituitary or visual complications, or both, as rapidly as possible, thereby avoiding serious permanent sequelae.     

Sunitinib: a newly approved small-molecule inhibitor of angiogenesis

The advent of targeted therapies has allowed treatment to be directed at signaling pathways integral to tumor growth and survival. Sunitinib (SU11248, sunitinib malate; Pfizer Inc., New York, NY, USA) is a novel oral small-molecule multitargeted receptor tyrosine kinase inhibitor that has demonstrated direct antitumor activity and antiangiogenic action. It targets the vascular endothelial growth factor receptor (VEGFR), platelet derived growth factor receptor (PDGFR), stem-cell factor receptor and Fms-like tyrosine kinase receptor 3 receptor tyrosine-kinases. In January 2006, sunitinib malate was granted approval by the U.S. Food and Drug Administration for the treatment of gastrointestinal stromal tumor after disease progression on, or intolerance to, imatinib mesylate, as well as for the treatment of metastatic renal cell cancer. This review will discuss the development of sunitinib, particularly in acute myeloid leukemia, imatinib-resistant gastrointestinal stromal tumors and renal cell cancer. The review will also discuss ongoing trials with sunitinib in other malignancies such as neuroendocrine tumors and breast cancer, as well as its potential future development in combination therapy with other agents and in other malignancies.     

Confronting the next pandemic--workshop on lessons learned from potency testing of pandemic (H1N1) 2009 influenza vaccines and considerations for future potency tests, Ottawa, Canada, July 27-29, 2010

Please cite this paper as: Hardy et al. (2011) Confronting the next pandemic—Workshop on lessons learned from potency testing of pandemic (H1N1) 2009 influenza vaccines and considerations for future potency tests, Ottawa, Canada, July 27–29, 2010. Influenza and Other Respiratory Viruses 5(6), 438–442.