Combined toxic effects of cadmium and environmental microplastics in Aphanius fasciatus (Pisces, Cyprinodontidae).

Microplastics (MPs), plastic particles smaller than 5 mm in diameter, have received extensive attention as new environmental pollutants with still unexplored potential ecological risks. The main objective of the present study is to see if the concomitant exposure to MPs and Cd is more toxic than that to MPs or Cd separately in Aphanius fasciatus. Immature female were exposed to Cd and/or MPs for 21 days, and the subsequent effects were monitored by a combination of biochemical, histological and molecular toxicity markers. Exposure to Cd, but not to MPs, increased metallothioneins content and mRNA levels of the metallothioneins gene MTA both in liver and gills. In addition, we observed a significant oxidative stress response at histological, enzymatic (Catalase and Superoxide dismutase), non-enzymatic (proteins sulfhydryl and malondialdehyde) and gene expression levels to both toxicants in both tissues, particularly in gills, but no clear evidence for interaction between the two factors. Our results indicate a major effect of MPs on gills at different organizational levels. Finally, exposure to both MPs and Cd induced spinal deformities, although bone composition was only altered by the latter, whereas MTA mRNA bone levels were only increased realtive to controls in doubly-exposed samples. Interestingly, the simultaneous use of both pollutants produced the same effects as Cd and MPs alone, probably due to reduced bioavailability of this heavy metal.

Heparin infusion in simultaneous pancreas and kidney transplantation reduces graft thrombosis and improves graft survival.

INTRODUCTION: Thrombosis of the pancreas after transplantation is the most common cause of relaparotomy and resultant graft loss. There is currently no standard protocol consistently proven to prevent thrombosis following transplantation. Our objective was to determine whether our protocol of post-operative low-dose intravenous (IV) heparin infusion would prevent graft thrombosis without additional complications in our patients. METHODS: A total of 66 simultaneous pancreas kidney (SPK) transplants were performed at our institution from 2004 to 2014. Patients were divided into 2 retrospective cohort groups. Group 1 patients received only acetylsalicylic acid (ASA) 81 mg/d started on post-operative day 1. Group 2 patients received IV heparin infusion beginning in the recovery room at a rate of 500 IU/h for the first 24 hours, reduced by 100 IU/h every day to stop on day 5, and then received ASA 81 mg/d afterward. Outcome and complication rates were compared between the two groups for 5 years post-transplant. RESULTS: We observed a significant reduction in graft thrombosis and graft loss with (0/29) patients in the heparin group vs (7/33) 25.7% from the non-heparin (P<.01) with no differences in complication rates. CONCLUSIONS: We present a heparin infusion protocol which may help prevent graft thrombosis and graft loss in SPK transplantation.

Interdigitating dendritic cell sarcoma of the duodenum with rapidly fatal course: a case report and review of the literature.

Interdigitating dendritic cell sarcoma is an extremely rare malignancy derived from antigen-presenting cells. Dendritic cells constitute a heterogeneous group of cells, which includes Langerhans cells, dermal dendrocytes, follicular dendritic cells, and interdigitating dendritic cells present in lymphoid and nonlymphoid organs. We report the case of a 36-year-old woman who presented with epigastric pain, projectile vomiting, and significant weight loss. Upper gastrointestinal endoscopy showed a duodenal lesion; a biopsy of the lesion was taken and was diagnosed as sarcoma. She underwent a Whipple procedure. A final diagnosis of interdigitating dendritic cell sarcoma was made, with liver and peripancreatic lymph node involvement. The patient deteriorated rapidly and died 4 months later. Although interdigitating dendritic cell sarcoma of the duodenum is extremely rare, we think it should be included in the differential diagnosis of unusual spindle cell tumors with a rich lymphocytic infiltrate.