Invasive aspergillosis in pediatric oncology patients: a rare event with poor prognosis--case analysis to plan better targeted prophylactic or therapeutic measurement

Despite the implementation of new antifungal drugs, invasive aspergillosis (IA) still remains a considerable challenge in pediatric oncology with a severe mortality. Prophylactic and therapeutic measurement have to be evaluated in these rare but poor prognostic patients. Therefore the entire group of patients at risk of developing IA has to be defined before cooperative prospective trials. In a retrospective analysis including all our patients with malignancies we looked for patients with proven/probable IA. Cases of the period from 2003 to 2008 were analyzed in detail.In the period between 2003 to 2008 24 of 755 patients were affected by proven/ probable IA. Compared to former studies incidence increased from 1.3%in 1980 to 3.4% in 2008. AML patients with or without allogeneic/haploidentical stem cell transplantation were at highest risk (24% and 25% respectively, in comparison to 1% in ALL-patients). Survival after 2 years was 50% for patients with AML and IA. In patients with high risk to develop IA the effect of intensified, intravenous antimycotic prophylaxis has to be proven prospectively in a cooperative and randomized setting.     

Haplotype analysis of two X-chromosome STR clusters in the Pakistani population

Haplotype analysis of closely associated markers has proven to be a powerful tool in kinship analysis especially when X-chromosome short tandem repeats fail to resolve uncertainty in relationship analysis. Microsatellites located on the X chromosome show stronger linkage disequilibrium compared with autosomal microsatellites; hence, it is necessary to estimate the haplotype frequencies directly from population studies as linkage disequilibrium is population-specific. Here, we describe five markers residing in two clusters; cluster I harboring three STR markers DXS6801–DXS6809–DXS6789 and cluster II harboring two STR markers DXS7424–DXS101. A total of 302 male DNA samples of Pakistani descent were analyzed. Theoretically, 847 and 160 different combinations of haplotypes are possible in clusters I and II, but genotyping identified only 129 and 75 haplotypes, respectively. No evidence of linkage disequilibrium was detected, except for the pair (DXS6801–DXS6789), consistent with results obtained with the cluster I in a German population. Our results demonstrate that 83% haplotypes of cluster I and 65% haplotypes of cluster II show <1% frequency in the Pakistani population. This strongly suggests that haplotypes of these two clusters provide a powerful tool for kinship testing and relationship investigations. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users. This study was supported in part by Higher Education Commission and Ministry of Science and Technology Islamabad, Pakistan.     

Neuron source energy on resonance absorption

Four different methods are used to study the neutron slowing down and to evaluate the neutron resonance escape probability in an infinite homogeneous medium containing a heavy resonant nuclide [U238] and a light moderator nuclide [H]. Two statistical methods use the Monte Carlo simulation and two deterministic methods are based on the numerical solutions of the neutron slowing down equation and a corresponding adjoint equation with an appropriate adjoint source.This study has been done for several dilutions and for two neutron source energies (E_s = 676.45 eV and E_s = 2 MeV). The cut-off energy is placed at 2.77 eV.We have found that the direct numerical solution of the neutron slowing down equation does not agree with the other three methods. In order to eliminate this disagreement, we have taken account of some corrections concerning the hydrogen cross-section in the thermal region.     

DPP-IV inhibitors: Beyond glycaemic control?

Dipeptidyl-peptidase-IV (DPP-IV) inhibitors are a new class of oral hypoglycaemic agents recently approved for the management of type 2 diabetes mellitus. Early data suggested that they had a positive impact on the cardiovascular system: treatment appeared to result in improvements in cardiac performance, blood pressure and lipid levels. However, recent clinical findings bring this into question. Our understanding of the physiological actions of these agents is complicated by the fact that DPP-IV has a wide range of substrates in addition to glucagon-like peptide 1. Indeed, DPP-IV inhibition alters concentrations of a wide variety of cytokines and neuropeptides. A deeper understanding of the physiological effects of these drugs as well as their true impact on cardiovascular risk is needed before consideration can be given to extending their use beyond the treatment of diabetes.     

Wrist blood pressure-measuring devices: a comparative study of accuracy with a standard auscultatory method using a mercury manometer

BACKGROUND: In this study, we compared two wrist blood pressure-measuring devices, the Omron RX and the Nissei WS-310, against a mercury manometer. METHOD: A total of 152 subjects attending an out-patient hypertensive clinic were recruited from a randomized blood pressure survey, 87 patients (mean 44.4 +/- 14.5 years of age) being selected according to the Association for the Advancement of Medical Instrumentation/British Hypertension Society standards. Device validation was assessed through the use of sequential same-arm readings compared with readings taken using a mercury sphygmomanometer by the two trained observers. RESULTS: There were no differences between the observers and the monitors for diastolic readings (2.8 +/- 4.8 mmHg for the Omron and 4.2 +/- 6.4 mmHg for the Nissei) according to the Association for the Advancement of Medical Instrumentation standards. The largest standard deviations -- 8.3 mmHg for the Omron and 8.8 mmHg for the Nissei, respectively -- were seen for systolic readings recorded by the observers and the monitors. According to the British Hypertension Society standards, the Omron achieved an A grade for diastolic readings and a B grade for systolic readings within 5 and 10 mmHg. The Nissei monitor achieved an A grade for diastolic readings and a B grade for systolic readings within 5 and 10 mmHg. CONCLUSION: Patients found the wrist oscillometric devices that we tested to be comfortable and easy to use. These devices are appropriate for measuring diastolic blood pressure according to the standards, but the reliability of both devices decreased when measuring systolic blood pressure.