Pure White Cell Aplasia Associated With Long-Term Unprotected Exposure to High Concentrations of Benzalkonium Chloride and 2-Phenoxyethanol.

Pure white cell aplasia (PWCA) is a very rare hematological disorder with a nearly total absence of granulocytes and their precursor cells. While the disease is rarely diagnosed incidentally in otherwise asymptomatic individuals, most patients suffer from sometimes life-threatening infections. Due to its very low incidence, the precise pathomechanism of PWCA still needs to be elucidated. While most cases reported in the literature have been associated with an underlying thymic or autoimmune disease, some other factors including the intake of certain drugs such as antimicrobial agents or immune checkpoint inhibitors have been identified as potential triggers. Since PWCA is commonly refractory to treatment with granulocyte colony-stimulating factors (G-CSF), the main focus lies in identifying and eliminating the underlying trigger. Here, we report a unique case where the development of PWCA in a 56-year-old man with an upper respiratory tract infection has to be attributed to the long-term unprotected exposure to an industrial detergent containing high concentrations of the preservatives benzalkonium chloride (BAC) and 2-phenoxyethanol (2-PE). As a matter of fact, certain hematotoxic potential has been described in the literature for both BAC and 2-PE.

Fatal cases after Omicron BA.1 and BA.2 infection: Results of an autopsy study.

OBJECTIVES: Omicron lineages BA.1/2 are considered to cause mild clinical courses. Nevertheless, fatal cases after those infections are recognized but little is known about risk factors. METHODS: A total of 23 full and three partial autopsies in deceased with known Omicron BA.1/2 infections have been consecutively performed. The investigations included histology, blood analyses, and molecular virus detection. RESULTS: COVID-19-associated diffuse alveolar damage was found in only eight cases (31%). This rate is significantly lower compared with previous studies, including non-Omicron variants, where rates between 69% and 92% were observed. Neither vaccination nor known risk factors were significantly associated with a direct cause of death by COVID-19. Only those patients who were admitted to the clinic because of COVID-19 but not for other reasons had a significant association with a direct COVID-19 -caused death (P >0.001). CONCLUSION: Diffuse alveolar damage still occurred in the Omicron BA.1/BA.2 era but at a considerably lower frequency than seen with previous variants of concern. None of the known risk factors discriminated the cases with COVID-19-caused death from those that died because of a different disease. Therefore, the host's genomics might play a key role in this regard. Further studies should elucidate the existence of such a genomic risk factor.

Nanostructured fibrin agarose hydrogel as a novel haemostatic agent.

Blood loss remains a major concern during surgery and can increase the morbidity of the intervention. The use of topical haemostatic agents to overcome this issue therefore becomes necessary. Fibrin sealants are promising haemostatic agents due to their capacity to promote coagulation, but their effectiveness and applicability need to be improved. We have compared the haemostatic efficacy of a novel nanostructured fibrin-agarose hydrogel patch, with (c-NFAH) or without cells (a-NFAH), against two commercially available haemostatic agents in a rat model of hepatic resection. Hepatic resections were performed by making short or long incisions (mild or severe model, respectively), and haemostatic agents were applied to evaluate time to haemostasis, presence of haematoma, post-operative adhesions to adjacent tissues, and inflammation factors. We found a significantly higher haemostatic success rate (time to haemostasis) with a-NFAH than with other commercial haemostatic agents. Furthermore, other relevant outcomes investigated were also improved in the a-NFAH group, including no presence of haematoma, lower adhesions, and lower grades of haemorrhage, inflammation, and necrosis in histological analysis. Overall, these findings identify a-NFAH as a promising haemostatic agent in liver resection and likely in a range of surgical procedures.

Translational pancreatic cancer research: A comparative study on patient-derived xenograft models.

AIM: To assess the viability of orthotopic and heterotopic patient-derived pancreatic cancer xenografts implanted into nude mice. METHODS: This study presents a prospective experimental analytical follow-up of the development of tumours in mice upon implantation of human pancreatic adenocarcinoma samples. Specimens were obtained surgically from patients with a pathological diagnosis of pancreatic adenocarcinoma. Tumour samples from pancreatic cancer patients were transplanted into nude mice in three different locations (intraperitoneal, subcutaneous and pancreatic). Histological analysis (haematoxylin-eosin and Masson's trichrome staining) and immunohistochemical assessment of apoptosis (TUNEL), proliferation (Ki-67), angiogenesis (CD31) and fibrogenesis (α-SMA) were performed. When a tumour xenograft reached the target size, it was re-implanted in a new nude mouse. Three sequential tumour xenograft generations were generated (F1, F2 and F3). RESULTS: The overall tumour engraftment rate was 61.1%. The subcutaneous model was most effective in terms of tissue growth (69.9%), followed by intraperitoneal (57.6%) and pancreatic (55%) models. Tumour development was faster in the subcutaneous model (17.7 ± 2.6 wk) compared with the pancreatic (23.1 ± 2.3 wk) and intraperitoneal (25.0 ± 2.7 wk) models (P = 0.064). There was a progressive increase in the tumour engraftment rate over successive generations for all three models (F1 28.1% vs F2 71.4% vs F3 80.9%, P < 0.001). There were no significant differences in tumour xenograft differentiation and cell proliferation between human samples and the three experimental models among the sequential generations of tumour xenografts. However, a progressive decrease in fibrosis, fibrogenesis, tumour vascularisation and apoptosis was observed in the three experimental models compared with the human samples. All three pancreatic patient-derived xenograft models presented similar histological and immunohistochemical characteristics. CONCLUSION: In our experience, the faster development and greatest number of viable xenografts could make the subcutaneous model the best option for experimentation in pancreatic cancer.

[Adenoma metanephric: Report of 2 cases and bibliographic review.] / Adenoma metanefrico: presentación de 2 casos y revisión de la literatura.

OBJECTIVE: Two cases of metanephric adenoma are presented, a rare benign renal tumor, and a literature review is done under the current WHO classification (2016). METHODS: Standard histopathological study was performed with hematoxylin-eosin and immunohistochemistry to analyze the expression of WT, Vimentin, Racemase, CK7, CD10 and RCC. RESULTS: Neoplasms of 3 and 4.5 cm, histologically, exhibiting tubulopapillary architecture. There was no evidence of significant nuclear atypia and mitotic figures. Immunohistochemical study showed positive immunoreaction for WT1 and Vimentin in tumor cells. CONCLUSIONS: Two new cases of metanephric adenoma are presented and a review of the literature was performed in order to discuss the prognosis and differential diagnosis of metanephric adenoma. This is a rare tumor and its diagnosis lies on its morphology and its immunohistochemical profile.

Adenoma metanefrico: presentación de 2 casos y revisión de la literatura / Adenoma metanephric: Report of 2 cases and bibliographic review

OBJETIVO: Presentamos 2 casos de adenoma metanéfrico, un tumor renal benigno poco frecuente y realizamos una revisión de la literatura bajo la clasificación actual de la OMS (2016). MÉTODOS: Se realizaron cortes de bloques de parafina para tinción con HE y técnicas inmunohistoquímicas para analizar la expresión de WT, Vimentina, Racemasa, CK7, CD10 y RCC. RESULTADOS: Las neoplasias de 3 y 4,5 cm, histológicamente mostraban arquitectura tubular y papilar. No se evidenció atipia nuclear significativa ni figuras de mitosis. El estudio inmunohistoquímico demostró inmunorreacción positiva de las células tumorales para WT1 y Vimentina. CONCLUSIONES: Presentamos 2 nuevos casos de adenoma metanéfrico y realizamos revisión de la literatura que hay al respecto para discutir la evolución y el diagnóstico diferencial del adenoma metanéfrico. Este es un tumor poco frecuente y su diagnóstico reside en su morfología y perfil inmunohistoquímico

OBJECTIVE: Two cases of metanephric adenoma are presented, a rare benign renal tumor, and a literature review is done under the current WHO classification (2016). METHODS: Standard histopathological study was performed with hematoxylin-eosin and immunohistochemistry to analyze the expression of WT, Vimentin, Racemase, CK7, CD10 and RCC. RESULTS: Neoplasms of 3 and 4.5 cm, histologically, exhibiting tubulopapillary architecture. There was no evidence of significant nuclear atypia and mitotic figures. Immunohistochemical study showed positive immunoreaction for WT1 and Vimentin in tumor cells.CONCLUSIONS: Two new cases of metanephric adenoma are presented and a review of the literature was performed in order to discuss the prognosis and differential diagnosis of metanephric adenoma. This is a rare tumor and its diagnosis lies on its morphology and its immunohistochemical profile

Sellar collision tumor involving a primary fibrosarcoma: Clinical, morphological and immunohistochemical study of a case and review of the literature / Tumor de colisión hipofisario con fibrosarcoma primario: estudio clínico, morfológico e inmunohistoquímico y revisión de la literatura

No disponible