Efficacy and Feasibility of Allogeneic Hematopoietic Stem-Cell Transplantation in the Treatment of Refractory Acute Myeloid Leukemia

Background

Refractory acute myeloid leukemia (AML) includes AML includes failure of disease to respond to standard induction chemotherapy, relapse within 6 months after first CR, and 2 or more relapses. The outcome of these patients is usually very poor; only a small proportion can be rescued by allogenic hematopoietic stem-cell transplantation (allo-HSCT). The aim of this study was to evaluate the efficacy and feasibility of allo-HSCT in patients with refractory AML.

Preparation of magnetic dye affinity adsorbent and its use in the removal of aluminium ions

Aluminium has recently been considered as a causative agent in dialysis encephalopathy, osteodystrophy, and anemia occuring in hemodialysis patients. The aim of this study is to prepare magnetic poly(2-hydroxyethylmethacrylate) (mPHEMA) adsorbent and to investigate it's useability for the removal of Al(III) ions from drinking and dialysis water. Magnetic PHEMA beads in a size range 80-120 microm were produced by a dispersion polymerization technique. Then Alizarin Red was covalenlty attached onto the mPHEMA beads. Al(III) adsorption from aqueous solutions was examined by batch system. mPHEMA beads were characterized by swelling tests, electron spin resonance (ESR), scanning electron microscopy (SEM), and elemental analysis. Important results obtained in this study are as follows: the swelling ratio of mPHEMA beads was 34%. The presence of magnetite in the polymeric structure was confirmed by ESR. The mPHEMA beads have a spherical shape and porous structure. Alizarin Red loading was 135.8 micromol g(-1) polymer. The maximum Al(III) adsorption was 722 micromol g(-1) polymer at pH 5.0. Non-specific Al(III) adsorption was about 23 micromol g(-1) polymer under the same conditions. High desorption ratios (98%) were achieved by using 0.1 M HNO3. It was possible to reuse the beads without significant loss of Al(III) adsorption capacity.     

Mental health of adolescents associated with sexual and reproductive outcomes: a systematic review

ObjectiveTo systematically review the literature on the mental health of adolescents associated with sexual and reproductive outcomes, and compare the mental health outcomes with that of other age groups.MethodsWe searched seven databases for relevant peer-reviewed articles published between 1 January 2010 and 25 April 2019. Our inclusion criteria required that the study included age-disaggregated data on adolescents, and focused and assessed mental health outcomes associated with pregnancy or sexually transmitted infections. We extracted data on the specific health event, the mental health outcome and the method of measuring this, and comparisons with other age groups.FindingsAfter initially screening 10 818 articles by title and abstract, we included 96 articles in our review. We observed that a wide-ranging prevalence of mental ill-health has been reported for adolescents. However, most studies of mental health during pregnancy did not identify an increased risk of depression or other mental disorders among adolescents compared with other age groups. In contrast, the majority of studies conducted during the postpartum period identified an increased risk of depression in adolescents compared with other age groups. Three studies reported on mental health outcomes following abortion, with varying results. We found no studies of the effect of sexually transmitted infections on mental health among adolescents.ConclusionWe recommend that sexual and reproductive health services should be accessible to adolescents to address their needs and help to prevent any adverse mental health outcomes.     

Comparison of randomized preemptive dexketoprofen trometamol or placebo tablets to prevent withdrawal movement caused by rocuronium injection

Rocuronium is a non-depolarizing neuromuscular blocking agent which is associated with injection pain and induces withdrawal movement of the injected hand or arm or generalized movements of the body after intravenous injection. The aim of this randomized study was to compare the efficacy of pretreatment with oral dexketoprofen trometamol (Arvelles^®; Group A) with placebo (Group P) without tourniquet to prevent the withdrawal response caused by rocuronium injection. The study cohort comprised 150 American Society of Anaesthesiologists class I–III patients aged 18–75 years who were scheduled to undergo elective surgery with general anesthesia. The patients response to rocuronium was graded using a 4-point scale [0 = no response; 1 = movement/withdrawal at the wrist only, 2 = movement/withdrawal involving the arm only (elbow/shoulder); 3 = generalized response]. The overall incidence of withdrawal movement after rocuronium injection was significantly lower in Group A (30.1 %) than in Group P (64.6 %) (p < 0.001). The incidence of score 0 withdrawal movements was higher in Group A (69.9 %) than in Group P (35.4 %), that of score 1 withdrawal movements was similar between groups (Group A 21.9 %; Group B 26.1 %) (p = 0.560) and that of score 2 withdrawal movements was lower in Group A (8.2 %) than in Group P (38.5 %) (p < 0.001). There were no score 3 withdrawal movements in either group (p > 0.05). These results demonstrate that the preemptive administration of dexketoprofen trometamol can attenuate the degree of withdrawal movements caused by the pain of the rocuronium injection.     

Treatment Outcomes of Long-Pulsed Nd: YAG Laser for Two Different Subtypes of Rosacea

Background: A variety of lasers have been used for the treatment of rosacea. However, treatment of this condition with long-pulsed neodymium-doped yttrium aluminium garnet laser has not been reported yet. Objective: To assess the efficacy and safety of long-pulsed neodymium-doped yttrium aluminium garnet laser in two different subtypes (erythematotelangiectatic and papulopustular) of rosacea. Methods: A total of 66 patients were enrolled in the study. All of the patients were treated with long-pulsed neodymium-doped yttrium aluminium garnet laser with 3- to 4-week intervals. Rosacea severity score was assessed by using photographs. Improvement in severity was defined as the percentage reduction in severity scores from baseline to the end of treatment. Patients were also asked about their own opinions of improvement at the end of the treatment. Side effects were also documented. Results: Good to excellent improvement was achieved in up to 50 percent of the patients in the erythematotelangiectatic and papulopustular groups. Percent improvement of global severity was significantly greater in the erythematotelangiectatic patients than in the papulopustular patients. The majority of patients from both groups noted a significant improvement of the lesions. Hypopigmented atrophic scars were seen in two patients. Conclusion: The long-pulsed neodymium-doped yttrium aluminium garnet laser is a safe and effective treatment for vascular and inflammatory lesions of rosacea.Rosacea is a chronic inflammatory cutaneous disorder with periods of exacerbations and remissions. Clinical findings are characterized by flushing, erythema, telangiectasia, papules, and pustules. There are four recognized subtypes—erythematotelangiectatic (ETR), papulopustular (PPR), phymatous, and ocular.1 Although angiogenic and sebaceous factors have been implicated in the etiopathology of the disease, it remains unclear. Vascular abnormalities, dermal matrix degeneration, environmental factors, and microorganisms may have a potential role in the development of rosacea.2Rosacea may significantly affect patients’ lives, leading to considerable psychological and social distress over appearance. Therefore, management of this condition is very important. There is no definite cure. Electrosurgery and lasers can be used to decrease vascular lesions.3 Topical and/or oral antibiotics can be used to suppress the inflammatory lesions. Although these methods are moderately successful in controlling symptoms, relapse usually occurs shortly after the cessation of therapy.4,5Many types of lasers and light devices have been increasingly used in the treatment of rosacea. However, the role of long-pulsed neodymium-doped yttrium aluminium garnet (Nd:YAG) laser in this condition has not been well-studied. In this study, the authors assessed the efficacy of long-pulsed Nd:YAG laser in treating patients with two different subtypes (ETR and PPR patients) of rosacea.     

Influence of liver pathology on markers of postmortem brain tissue quality

Background: Postmortem brain tissue provides an important resource to investigate various brain disorders, including those resulting from the effects of alcohol abuse. Unlike the traditionally recognized confounders to tissue quality (e.g., coma, hypoxia), our understanding of the effects of liver disease is incomplete. The aim of this study was to determine the effects of liver pathology, and in particular cirrhosis resulting in hepatic encephalopathy (HE), on 2 postmortem brain tissue quality markers, brain pH and RNA integrity. Methods: We measured tissue quality markers in a cohort of alcohol abuse and control cases collected by the NSW Tissue Resource Centre. Cerebellar tissue was used to evaluate both brain pH and RNA quality (as indicated by the RNA integrity number: RIN). A histological assessment was performed on each case to exclude coexisting pathologies (e.g., cerebrovascular disease, hypoxic encephalopathy, neurodegenerative disease) and to assess the presence or absence of HE. Autopsy reports were reviewed for liver pathology and toxicology. Results: Analysis revealed that cases of alcohol abuse had a lower mean (±SD) brain pH, 6.46 (±0.3) as compared with the control mean 6.64 (±0.2). The mean RIN for the alcohol abuse group was 6.97 (±1.3) and controls 7.66 (±0.5). The severity of liver pathology affected both brain pH (p < 0.0001) and RIN (p < 0.0001). The comparison between cirrhotic cases highlighted increased degradation of RNA in cases with cirrhosis resulting in HE (p = 0.0095). A similar effect was seen on brain pH (p = 0.0019). Conclusions: The results show that the presence of cirrhosis and, more so, HE reduces the pH and RIN of postmortem brain tissue.