The Role of Pre-bone Marrow Transplantation Pulmonary Function Test in Predicting Post-transplant Noninfectious Pulmonary Complications.

Background: Pulmonary function test (PFT) is used as a tool for pre-transplant risk assessment and as a predictor of post-transplant outcomes. As there are currently few studies that discuss the role of PFT in bone marrow transplantation (BMT) patients in Saudi settings, and as the number of transplant patients with benign and malignant conditions continues to increase, this study was conducted with the aim of assessing the local practice. Methods: This retrospective cohort study included all adult patients who underwent BMT at Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, between 2014 and 2020. The association between established patient-related risk factors and the incidence of pulmonary complications among autologous and allogeneic groups was assessed. Results: A total of 186 patients were included (autologous = 143; allogenic = 43), of which 115 (61.8%) were male. At the pre-BMT phase, about 30% of the patients had comorbidities and 51% had received two rounds of salvage chemotherapy, while 16.1% had received radiation therapy. In the autologous group, the only PFT parameter that was a significant predictor of post-BMT pulmonary complications was forced vital capacity <80% (P = 0.012), while in the allogenic group, no parameter was significantly associated with pulmonary complications. The patient-related factors that were associated with respiratory distress in the autologous group were lung involvement (P = 0.03) and pre-transplant radiation (P = 0.044). Conclusion: The findings of this study indicated that forced vital capacity <80% was a significant factor in predicting non-infectious complications in the autologous group. Furthermore, lung involvement and pre-transplant radiation were the patient-related factors associated with pulmonary complications.

Risk of meningitis after posterior fossa decompression with duraplasty using different graft types in patients with Chiari malformation type I and syringomyelia: a systematic review and meta-analysis.

Several complications have been reported after the use of grafts for duraplasty following posterior fossa decompression for the treatment of Chiari malformation type I. This study aims to investigate the rate of meningitis after posterior fossa decompression using different types of grafts in patients with Chiari malformation type I and associated syringomyelia. The search was conducted using multiple databases, including PubMed, Scopus, Web of Science, and Embase. Data on the rate of meningitis, syrinx change, and rate of reoperation were extracted and investigated. Quality of evidence was assessed using the Newcastle-Ottawa scale. Nineteen studies were included in the final meta-analysis, encompassing 1404 patients and investigating autografts, synthetic grafts, allografts, and xenografts (bovine collagen, bovine pericardium, and pig pericardium). Autografts were associated with the lowest rate of meningitis (1%) compared to allografts, synthetic grafts, and xenografts (2%, 5%, and 8% respectively). Autografts were also associated with the lowest rate of reoperation followed by xenografts, allografts, and synthetic grafts (4%, 5%, 9%, and 10% respectively). On the other hand, allografts were associated with the highest rate of syrinx improvement (83%) in comparison to autografts and synthetic grafts (77%, and 79% respectively). Autografts were associated with the lowest meningitis, reoperation, and syrinx improvement rates. Furthermore, synthetic grafts were associated with the highest reoperation and xenografts with the highest rate of meningitis, whereas allografts were associated with the best syrinx improvement rate and second-best meningitis rate. Future studies comparing autografts and allografts are warranted to determine which carries the best clinical outcome.

Autologous peripheral blood stem cell mobilization and collection in patients with lymphoma and multiple myeloma: A single-center experience using the plerixa for pre-emptive approach.

OBJECTIVES: To review and assess the efficiency of pre-emptive plerixafor administration for poor mobilization (PM) and to review and assess mobilization efficiency (≥2×106 CD34+ cells/kg) in patients who received autologous stem cell transplantation for lymphoma and multiple myeloma (MM) at the Department of Adult Hematology/Blood Marrow Transplant, Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia, over the past 7 years. METHODS: This retrospective study evaluated all patients with MM and lymphoma undergoing peripheral blood stem cell mobilization and collection at our institution between February 2014 and August 2021. Plerixafor was administered pre-emptively by a plateau of <10 peripheral blood CD34+/µl after chemotherapy-based mobilization or CD34+ of <8/µL on day 4 after mobilization with G-CSF alone. Between peak CD34+ levels of 10-15/µl, plerixafor will be used at the discretion of the treating physician. RESULTS: In total, 215 patients were enrolled. Among them, 80% had peak CD34+ level ≥20/µL, 11% had clear poor mobilization (peak CD34+ levels <10/µL), and 9% had borderline PM (CD34+ between 10-19/µL). Plerixafor was administered pre-emptively in 13% of the patients and 75% of patients with borderline PM were collected without plerixafor, suggesting that plerixafor is not needed if CD34+ >15/µL on the anticipated collection day. Mobilization failed in only one patient (<1%). CONCLUSION: Our data showed that with plerixafor pre-emptive administration, the primary endpoint was achieved for most patients identified with PM, preventing the need for a second mobilization attempt.

Early infection in post-autologous hematopoietic stem cell transplant patients: Princess Noorah Oncology Center experience.

OBJECTIVES: To assess local epidemiology and risk factors for bacterial, fungal, and viral infections among the autologous bone marrow transplant population. METHODS: This study is a retrospective correlational cohort design comprising 150 adult patients who underwent autologous transplants at Princess Noorah Oncology Center, Jeddah, Saudi Arabia between 2014 and 2020. RESULTS: The study findings indicate that bacterial infection prevalence differed significantly across the different disease status pre-salvage as patients with the relapsed disease were more likely to have bacterial infections. The median of engraftment days differed significantly between those who had a bacterial infection and those who did not. Interestingly, previous pneumonia infection had a positive relationship with the number of hospital stays. CONCLUSIONS: Bacterial infections are the dominant type of infection among the autologous patient population. The research reflects authentic practice and reports unique characteristics of autologous transplant patients in terms of the prevalence and types of infection these patients experience.

Evaluation of indigenous Omani alfalfa landraces for morphology and forage yield under different levels of salt stress.

Alfalfa is the major fodder crop of Sultanate Oman, but salinity is a major problem in its cultivation. Therefore, thirty-four alfalfa (Medicago sativa L.) landraces of Oman were evaluated for morphology and forage yield response to different salinity levels viz. 1 (control), 3, 6, 9, and 12 dS m-1 under greenhouse conditions. The experiment was conducted under a completely randomized design. Different alfalfa landraces responded differently to the five salinity levels for plant height, number of branches, number of leaves, leaflet width, leaflet length, forage fresh weight, and forage dry matter yield. Salt stress caused a reduction in growth and dry matter yield of alfalfa landraces with exception of some, which responded positively to the salinity levels of 3 and 6 dS m-1 compared to control for the number of leaves per plant. Moreover, some landraces had better forage fresh weight and dry matter yield at 6 dS m-1 than 3 dS m-1. Alfalfa landraces OMA 257, OMA, 245, OMA 270, OMA 315, OMA 211, OMA 117, OMA 56, OMA 239, OMA 148, OMA 131, OMA 95, OMA 263, OMA 262, OMA 289 and OMA 220 were designated as salt tolerant based on their overall performance across salinity levels of 6, 9 and 12 dS m-1. However, the landraces OMA 305, OMA 100, OMA 211, OMA 148, OMA 60, OMA 248, OMA 9, OMA 88, and OMA 302 collected were sensitive to 6, 9 and 12 dS m-1 salinity stress. The study showed the variation of alfalfa landraces potential for salinity tolerance, and their potential for cultivation in saline areas and/or use in breeding programs aimed to develop salt tolerant alfalfa genotypes.

Neocerebellar Crus I Abnormalities Associated with a Speech and Language Disorder Due to a Mutation in FOXP2.

Bilateral volume reduction in the caudate nucleus has been established as a prominent brain abnormality associated with a FOXP2 mutation in affected members of the 'KE family', who present with developmental orofacial and verbal dyspraxia in conjunction with pervasive language deficits. Despite the gene's early and prominent expression in the cerebellum and the evidence for reciprocal cerebellum-basal ganglia connectivity, very little is known about cerebellar abnormalities in affected KE members. Using cerebellum-specific voxel-based morphometry (VBM) and volumetry, we provide converging evidence from subsets of affected KE members scanned at three time points for grey matter (GM) volume reduction bilaterally in neocerebellar lobule VIIa Crus I compared with unaffected members and unrelated controls. We also show that right Crus I volume correlates with left and total caudate nucleus volumes in affected KE members, and that right and total Crus I volumes predict the performance of affected members in non-word repetition and non-verbal orofacial praxis. Crus I also shows bilateral hypo-activation in functional MRI in the affected KE members relative to controls during non-word repetition. The association of Crus I with key aspects of the behavioural phenotype of this FOXP2 point mutation is consistent with recent evidence of cerebellar involvement in complex motor sequencing. For the first time, specific cerebello-basal ganglia loops are implicated in the execution of complex oromotor sequences needed for human speech.

Effectiveness of adjuvant temozolomide treatment in patients with glioblastoma.

OBJECTIVE: To examine whether adjuvant temozolomide treatment improved glioblastoma patients` survival in a large Canadian cohort. METHODS: We retrospectively studied 364 glioblastoma patients who received different modalities of treatment in 2 Canadian tertiary care centers in Edmonton and Halifax, Canada, between January 2000 and December 2006. The primary outcome was survival following the treatment protocol. RESULTS: The following variables were associated with an increased risk of death: The hazard risk (HR) of on-gross total resection was 0.50 (95% confidence interval [CI]: 0.39-0.64). The HR for the surgery-only group was 5.2 (95% CI: 3.85-7.06). The standard treatment group (surgery, radiation therapy [RT], and temozolomide) had an HR of 0.52 (95% CI: 0.37-0.74). The HR for patients who presented with seizure or whose presentation included seizures was 0.88 (95% CI: 0.55-0.89). Patient entry into trials had an HR of 0.74 (95% CI: 0.57-0.96). Finally, the HR for age was 1.02 (95% CI: 1.01-1.03) for every extra year. CONCLUSION: Concomitant temozolomide with RT and surgery was associated with longer survival compared with RT with surgery alone. We also found that younger age, surgical resection, seizure presence, and entry into trials are important prognostic factors for longer survival.

Monoamine oxidase inhibitors and neuroprotection: a review.

Monoamine oxidase inhibitors have been available for more than 50 years, initially developed as antidepressants but currently used in a variety of psychiatric and neurological conditions. There has been a recent surge of interest in monoamine oxidase inhibitors because of their reported neuroprotective and/or neurorescue properties. Interestingly, it seems that often these properties are independent of their ability to inhibit monoamine oxidase. This review article presents an overview of the neuroprotective/neurorescue properties of these multifaceted drugs and focuses on phenelzine, (-)-deprenyl, rasagiline, ladostigil, tranylcypromine, moclobemide, and clorgyline and their possible neuroprotective mechanisms.

Genetics of primary cerebral gyrification: Heritability of length, depth and area of primary sulci in an extended pedigree of Papio baboons.

Genetic control over morphological variability of primary sulci and gyri is of great interest in the evolutionary, developmental and clinical neurosciences. Primary structures emerge early in development and their morphology is thought to be related to neuronal differentiation, development of functional connections and cortical lateralization. We measured the proportional contributions of genetics and environment to regional variability, testing two theories regarding regional modulation of genetic influences by ontogenic and phenotypic factors. Our measures were surface area, and average length and depth of eleven primary cortical sulci from high-resolution MR images in 180 pedigreed baboons. Average heritability values for sulcal area, depth and length (h(2)(Area)=.38+/-.22; h(2)(Depth)=.42+/-.23; h(2)(Length)=.34+/-.22) indicated that regional cortical anatomy is under genetic control. The regional pattern of genetic contributions was complex and, contrary to previously proposed theories, did not depend upon sulcal depth, or upon the sequence in which structures appear during development. Our results imply that heritability of sulcal phenotypes may be regionally modulated by arcuate U-fiber systems. However, further research is necessary to unravel the complexity of genetic contributions to cortical morphology.

Radiological impact of composite food served at PINSTECH.

To determine radiological impact of composite food served at Pakistan Institute of Nuclear Science and Technology (PINSTECH) on its worker, cooked meals were collected during 2000-2007 and analysed by gamma and beta radiometry techniques for naturally occurring radionuclides and fission fragments. The only measurable radionuclide was naturally occurring (40)K. Its activity range was 40+/-1.5 to 182.4+/-3.8 Bq kg(-1) with cumulative average value of 89.4+/-35.1 Bq kg(-1). Based on annual meals taken by the worker in cafeteria, the measured value gives committed effective dose of 74 microSv and estimated cancer risk factor of 1.5 x 10(-4) that is a minor fraction of the total risk of 5 x 10(-3). It depicts that food served at PINSTECH cafeteria is radiologically safe for consumption.

Peritonitis in patients over the age of 50 years: 98 cases managed surgically.

Generalized peritonitis in patients over the age of 50 years is a common surgical emergency. This is a retrospective analysis of 98 cases managed surgically. Duodenal ulcer perforations, necrotizing enteritis, acute cholecystitis with perforation and small bowel perforations were the common causes. Most of them presented late, and many had associated conditions. Re-look laparotomies had a definite role to play. While there is significant decrease in the number of typhoid and tubercular peritonitis, there appears to be an increase in the incidence of necrotizing enteritis and acute cholecystitis.

Training and assessment of psychomotor skills for performing laparoscopic surgery using BEST-IRIS virtual reality training simulator.

In this article, we present the results of a pilot study that examined the performance of people training on a Virtual Reality based BEST-IRIS Laparoscopic Surgery Training Simulator. The performance of experienced surgeons was examined and compared to the performance of residents. The purpose of this study is to validate the BEST-IRIS training simulator. It appeared to be a useful training and assessment tool.

Granuloma annulare masquerading as molluscum contagiosum-like eruption in an HIV-positive African woman.

A 33-year-old African woman who was HIV positive and being treated with zidovudine and zalcitabine presented with a 4-week history of a generalized pruritic rash superficially resembling molluscum contagiosum. The appearance of the lesions appeared to coincide with a dramatic decrease in her peripheral CD8+, and to a lesser extent, CD4+ T-lymphocyte count. Hematologic investigations revealed anemia with eosinophilia and she had a strongly positive Strongyloides antibody test. The eruption persisted despite appropriate antihelminthic treatment and temporary withdrawal of antiretroviral therapy. Histologic examination showed ill-defined nodules of necrobiotic collagen with surrounding palisading mononuclear cell infiltrate consistent with granuloma annulare. The rash disappeared spontaneously over several weeks.

Direct decay from the superdeformed band to the yrast line in 15266Dy86.

The excitation energy, spin, and parity of the yrast superdeformed band in 152Dy have been firmly established. The evidence comes mainly from the measured properties of a 4011 keV single-step transition connecting the yrast superdeformed level fed by the 693 keV transition to the 27- yrast state. Four additional, weaker, linking gamma rays have been placed as well. The excitation energy of the lowest superdeformed band member is 10 644 keV and its spin and parity are determined to be 24+.

Octupole vibration in superdeformed 152(66)Dy86.

Nine transitions of dipole character have been identified linking an excited superdeformed (SD) band in 152Dy to the yrast SD band. As a result, the excitation energy of the lowest level in the excited SD band has been measured to be 14 238 keV. This corresponds to a 1.3 MeV excitation above the SD ground state. The levels in this band have tentatively been determined to be of negative parity and odd spin. The measured properties are consistent with an interpretation in terms of a rotational band built on a collective octupole vibration.

Synthesis, characterisation and antiamoebic activity of new thiophene-2-carboxaldehyde thiosemicarbazone derivatives and their cyclooctadiene Ru(II) complexes.

Reaction of new thiosemicarbazones (1-4) derived from thiophene-2-carboxaldehyde and cycloalkylaminothiocarbonylhydrazine with [Ru(eta(4)-C8H12)(CH3CN)2Cl2] leads to form complexes (1a-4a) of the type [Ru(eta(4)-C8H12)(TSC)Cl2] (where TSC=thiosemicarbazone). All the compounds have been characterised by elemental analysis, IR, 1H NMR, electronic spectra and thermogravimetric analysis. It is concluded that the thionic sulphur and the azomethine nitrogen atom of the ligands are bonded to the metal ion. In vitro antiamoebic screening against (HK-9) strain of Entamoeba histolytica indicated that the Ru(II) complexes of thiophene-2-carboxaldehyde thiosemicarbazones were found more active than the thiosemicarbazones.

Connections between anterior inferotemporal cortex and superior temporal sulcus regions in the macaque monkey.

We examined the connections between the anterior inferotemporal cortex and the superior temporal sulcus (STS) in the macaque monkey by injecting Phaseolus vulgaris leucoagglutinin (PHA-L) or wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP) into the dorsoanterior and ventroanterior subdivisions of TE (TEad and TEav, respectively) and observing the labeled terminals and cell bodies in STS. We found a clear dichotomy in the connections of the rostral part of STS: the injections into TEad resulted in a dense distribution of labeled terminals and cell bodies in the upper bank of rostral STS, whereas labeling was confined to the lower bank and fundus of rostral STS after injections into TEav. The distribution of labeling in the rostral STS was discontinuous from the distribution of labeling surrounding the injection sites: the lower bank of the rostral STS was spared from labeling in the TEad injection cases, and TEad had only sparse distribution in the TEav injection cases. These results revise the classical view that the lower bank of rostral STS is connected with TE, whereas the upper bank of rostral STS is connected with the parietal, prefrontal, and superior temporal regions (Seltzer and Pandya, 1978, 1991, 1994). The upper bank of the rostral STS is called the superior temporal polysensory area (STP), because it was previously found that neurons there respond to auditory, somatosensory, and visual stimuli. The present results thus suggest that the polymodal representation in STP interacts more with information processing in TEad than TEav. It is also suggested that the information processing in the ventral bank of the rostral STS is distinct from that in TEad, and the former more directly interacts with TEav than TEad.

Divergent backward projections from the anterior part of the inferotemporal cortex (area TE) in the macaque.

The organization of backward projections from the anterior part of the inferotemporal cortex (area TE) to the posterior part of the inferotemporal cortex (area TEO) was studied in the macaque monkey by using the anterograde tracer Phaseolus vulgaris-leucoagglutinin (PHA-L). The objectives of the study were to investigate this backward projection and to compare it with 1) the backward projections that have been described previously in the early sensory areas and 2) the forward projection from area TEO to area TE. After a single iontophoretic injection of PHA-L into area TE in three monkeys, a dense distribution of labeled terminals was observed in area TEO and in the ventral bank of the superior temporal sulcus (area PITd) that adjoined area TEO. A less dense distribution was observed in areas V4, V2, and V1. Clusters of labeled terminals in areas TEO and PITd extended more than 4 mm along the cortical surface. The forward projections from area TEO to area TE also were studied for comparison by reanalyzing two previous cases (Saleem et al. ¿1993 Cerebral Cortex 3:454-464). These projections (from area TEO to area TE) were more focal than the terminations that occurred in area TEO after injections into area TE. Nine single axons projecting from area TE to areas TEO/PITd were reconstructed through serial sections. These showed variable, complex branching patterns with multiple arbors (1-12). Arbors were localized in layers 1-3 for four axons, in layer 1 for one axon, layers 5 and 6 for two axons, and in both layers 1-3 and layers 5-6 for two axons. Axons with horizontally elongated arbors confined to layer 1 were not predominant. The size of the individual arbors of these axons along their long axes tended to be larger (1.56 +/- 1.24 mm) than those of TEO-to-TE forward axons (<0.6 mm). Thus, the authors conclude that, like other backward systems described to date, those from area TE to areas TEO/PITd are divergent. However, single axons have more variable laminar patterns of terminal distribution than those in the other backward systems.

Organization of corticostriatal and corticoamygdalar projections arising from the anterior inferotemporal area TE of the macaque monkey: a Phaseolus vulgaris leucoagglutinin study.

Corticostriatal and corticoamygdalar projections arising from area TE of the macaque monkey were studied by focal injections of the anterograde tracer Phaseolus vulgaris leucoagglutinin into the dorsolateral and ventromedial subdivisions of the anterior TE (TEad and TEav, respectively). This approach yielded several new results. First, the global distributions of labeled terminals revealed that both TEad and TEav projected to the ventrocaudal striatum, including the tail of the caudate nucleus and the adjacent ventral putamen, and the dorsolateral aspect of the deep amygdaloid nuclei. TEav also projected to the medial basal nucleus of the amygdala and the ventral striatum. Second, the reconstructed single axons (n = 18) demonstrated that some axons originating from TEav or TEad projected simultaneously to the ventrocaudal striatum and the dorsolateral aspect of the deep amygdaloid nuclei by giving off collaterals. TEav axons projected to the medial basal nucleus of the amygdala also had collaterals projecting to the perirhinal cortex or area TG. And third, it was revealed that the axons originating from a focal TEav or TEad projected to a restricted territory (3.4-3.6 mm rostrocaudally) in the ventrocaudal striatum with four to six dispersed, rostrocaudally elongated, rod-like modules. Individual axons with multiple arbors innervated many of these modules. These findings add the evidence that the anterior part of TE is anatomically heterogeneous and suggest that the deep amygdaloid nuclei may be functionally dissociated, with the dorsolateral aspect more closely related to the ventrocaudal striatum and the medial basal nucleus more closely related to the perirhinal cortex.

Divergent projections from the anterior inferotemporal area TE to the perirhinal and entorhinal cortices in the macaque monkey.

Area TE is located at the latter part of the ventral visual cortical pathway, which is essential for visual recognition of objects. TE projects heavily to the perirhinal region, which is important for visual recognition memory of objects. To study the organization of projections from TE to the perirhinal (areas 35 and 36) and entorhinal (area 28) cortices, we made focal injections of Phaseolus vulgaris leucoagglutinin (PHA-L) and large injections of biocytin or wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP) into anterior levels of TE in macaque monkeys. Injections of PHA-L into the ventral part of anterior TE (TEav) resulted in labeling of terminals distributed widely in area 36 (approximately one-half of its total extent), although the injection sites were limited to 0.7 mm in width. The labeled terminals tended to be denser in the medial part of area 36. There was less dense but definite labeling in area 35 and the lateral part of area 28. After a single injection of PHA-L or WGA-HRP into the dorsal part of anterior TE (TEad), labeled terminals were confined to a small region at the lateral part of area 36 (less than one-tenth of its total extent). The projections to areas 35 and 28 from TEad were much sparser than those from TEav. The different patterns of projections to the perirhinal and entorhinal cortices, together with previously reported differences in their afferent and other efferent connections, suggest the functional differentiation between TEav and TEad. The divergent projection from TEav to the perirhinal cortex may facilitate the association of different visual features in the perirhinal cortex.