Bloodless surgery in urologic oncology: A review of hematologic, anesthetic, and surgical considerations.

The urologic oncology patient who refuses blood transfusion can present unique challenges in perioperative blood management. Since blood loss and associated transfusion can be expected in many complex urologic oncology surgeries, a multidisciplinary approach may be required for optimal outcomes. Through collaboration with the hematologist, anesthesiologist, and urologist, various techniques can be employed in the perioperative phases to minimize blood loss and the need for transfusion. We review the risks and benefits of these techniques and offer recommendations specific to the urologic oncology patient.

GISH-based comparative genomic analysis in Urochloa P. Beauv.

The genus Urochloa P. Beauv. [syn. Brachiaria (Trin.) Griseb.] comprises species of great economic relevance as forages. The genomic constitution for the allotetraploid species Urochloa brizantha (cv. Marandu) and Urochloa decumbens (cv. Basilisk) and the diploid Urochloa ruziziensis was previously proposed as BBB1B1, B1B1B2B2 and B2B2, respectively. Evidence indicates U. ruziziensis as the ancestral donor of genome B2 in U. decumbens allotetraploidy, but the origin of the genomes B and B1 is still unknown. There are diploid genotypes of U. brizantha and U. decumbens that may be potential ancestors of the tetraploids. The aim of this study was to determine the genomic constitution and relationships between genotypes of U. brizantha (2x and 4x), U. decumbens (2x and 4x) and U. ruziziensis (2x) via genomic in situ hybridization (GISH). Additionally, chromosome number and genome size were verified for the diploid genotypes. The diploids U. brizantha and U. decumbens presented 2n = 2x = 18 chromosomes and DNA content of 1.79 and 1.44 pg, respectively. The GISH analysis revealed high homology between the diploids U. brizantha and U. decumbens, which suggests relatively short divergence time. The GISH using genomic probes from the diploid accessions on the tetraploid accessions' chromosomes presented similar patterns, highlighting the genome B1 present in both of the tetraploids. Based on GISH results, the genomic constitution was proposed for the diploid genotypes of U. brizantha (B1B1) and U. decumbens (B1'B1') and both were pointed as donors of genome B1 (or B1'), present in the allotetraploid genotypes.

Axicabtagene ciloleucel (KTE-C19), an anti-CD19 CAR T therapy for the treatment of relapsed/refractory aggressive B-cell non-Hodgkin's lymphoma.

Adoptive T-cell immunotherapy is a rapidly growing field and is shifting the paradigm of clinical cancer treatment. Axicabtagene ciloleucel (axi-cel) is an anti-CD19 chimeric antigen receptor T-cell therapy that was initially developed at the National Cancer Institute and has recently been commercially approved by the US Food and Drug Administration for relapsed or refractory aggressive non-Hodgkin's lymphomas including diffuse large B-cell lymphoma and its variants. The ZUMA-1 Phase I and II clinical trials formed the basis of the US Food and Drug Administration approval of this product, and we discuss the particulars of the clinical trials and the pharmacology of axi-cel. In addition, we review the CD19 chimeric antigen receptor T-specific toxicities of cytokine release syndrome and neurotoxicity, which remain the challenges to the safe delivery of this important therapy for aggressive B-cell lymphomas with poor prognosis.

Babesia microti infection and hemophagocytic lymphohistiocytosis in an immunocompetent patient.

Babesiosis is a rare and potentially severe tick-borne illness endemic to the Northeastern and upper Midwestern regions of the USA. Hemophagocytic lymphohistiocytosis is an uncommon condition resulting from over-activation of the immune system. The first known case of babesiosis and hemophagocytic lymphohistiocytosis in an immunocompetent patient is reported here.

Bioaccumulation and effects of lanthanum on growth and mitotic index in soybean plants.

Rare earth elements such as lanthanum (La) have been used as agricultural inputs in some countries in order to enhance yield and improve crop quality. However, little is known about the effect of La on the growth and structure of soybean, which is an important food and feed crop worldwide. In this study, bioaccumulation of La and its effects on the growth and mitotic index of soybean was evaluated. Soybean plants were exposed to increasing concentrations of La (0, 5, 10, 20, 40, 80, and 160 µM) in nutrient solution for 28 days. Plant response to La was evaluated in terms of plant growth, nutritional characteristics, photosynthetic rate, chlorophyll content, mitotic index, modifications in the ultrastructure of roots and leaves, and La mapping in root and shoot tissues. The results showed that the roots of soybean plants can accumulate sixty-fold more La than shoots. La deposition occurred mainly in cell walls and in crystals dispersed in the root cortex and in the mesophyll. When La was applied, it resulted in increased contents of some essential nutrients (i.e., Ca, P, K, and Mn), while Cu and Fe levels decreased. Moreover, low La concentrations stimulated the photosynthetic rate and total chlorophyll content and lead to a higher incidence of binucleate cells, resulting in a slight increase in roots and shoot biomass. At higher La levels, soybean growth was reduced. This was caused by ultrastructural modifications in the cell wall, thylakoids and chloroplasts, and the appearance of c-metaphases.

Synthesis of naphtho[2,3-a]phenoxazinium chlorides: structure-activity relationships of these heterocycles and benzo[a]phenoxazinium chlorides as new antimicrobials.

Synthesised functionalised naphtho[2,3-a]phenoxazinium chlorides revealed great fluorescence with maximum emission wavelengths between 630 and 676 nm, in ethanol and water at physiological pH. Naphtho[2,3-a]phenoxazines, as well as a series of benzo[a]phenoxazines, were evaluated against Saccharomyces cerevisiae, in a broth microdilution assay. This family of compounds exhibited antifungal activity depending both on the substituents of the heterocycle nucleus as well as on its size. The best activities were obtained for four-ring systems, and particularly for 5,9-diaminobenzo[a]phenoxazines with R=Me, R(1)=H and R(2)=Et. As for R(3) substitution, the greatest efficiency was obtained for R(3)=(CH(2))(3)Cl, with a MIC of 3.75 microM. The linkage of different amino acids to the functional group of the 5-amino position of diaminobenzo[a]phenoxazinium moiety resulted in compounds with diverse antimicrobial efficiencies, depending on the polar character of the amino acid, on its linkage position and on the size of the alkyl chain linker.

Comportamento Violento e disfunção cerebral: estudo de homicidas no Rio de Janeiro / Violent Behavior and brain dysfunction: study of murderers in Rio de Janeiro

Objetivos: Estudar a correlação entre disfunção cerebral e psicopatia em homicidas. Métodos: Foram separados em dois grupos (psicopatas e não-psicopatas) 29 homicidas "normais" (não-psicóticos), detidos em uma delegacia policial e escolhidos aleatoriamente, com base no HARE PCL-R (escala de avaliação de psicopatia). Ambos os grupos foram submetidos a testagem neuropsicológica, sendo empregados testes voltados para atividade em lobo frontal (Trail Making Test A e B, e subtests do WAIS [Mosaico, Semelhanças e Símbolos Numéricos]). Resultados: Dos homicidas, 15 foram considerados psicopatas e 14, não psicopatas. O subteste Mosaico, do WAIS, constituiu-se em discriminador entre os dois grupos pela presença significativa de resultados negativos em não psicopatas (X2=5,37;G.L.=1;P<0,05). Como a prevalência de diagnósticos de dependência/abuso de álcool/drogas foi maior entre os psicopatas, conclui-se que esse fator não influiu significativamente na melhor performance neuropsicológica desse grupo. Conclusões: Há evidências de correlação entre disfunção cerebral frontal e comportamento homicida em não psicopatas. Sugere-se o emprego sistemático do PCL-R em populações forenses violentas, com o objetivo de atingir uma melhor depuração dos grupos estudados

Comportamento violento e disfuncao cerebral: estudo de homicidas no Rio de Janeiro

Objetivos: Estudar a correlacao entre disfuncao cerebral e psicopatia em homicidas. Metodos: foram separados em dois grupos (psicopatas e nao-psicopatas) 29 homicidas 'normais' (nao-psicoticos), detidos em uma delegacia policial e escolhidos aleatoriamente, com base no HARE PCL-R (escala de avaliacao de psicopatia). Ambos os grupos foram submetidos a testagem neuropsicologica, sendo empregados testes voltados para atividade em lobo frontal (Trail Making Test A e B, e subtestes do WAIS [Mosaico, Semelhancas e Simbolos Numericos]). Resultados: Dos homicidas, 15 foram considerados psicopatas e 14, nao-psicopatas. O subteste Mosaico, do WAIS, constituiu-se em discriminador entre os dois grupos pela presenca significativa de resultados negativos em nao-psicopatas (x2=5,37; G.L>=1; P<0,05). Como a prevalencia de diagnosticos de dependencia/abuso de alcool/drogasn foi maior entre os psicopatas, conclui-se que esse fator nao influiu significativamente na melhor performance neuropsicologica desse grupo. Conclusoes: Ha evidencias de correlacao entre disfuncao cerebral frontal e comportamento homicida em nao-psicopatas. Sugere-se o emprego sistematico do PCL-R em populacoes forenses violentas, com o objetivo de atingir uma melhor depuracao dos grupos estudados.

Rapid diagnosis of amniotic fluid embolism.

Acute respiratory failure developed in a 19-year-old primigravida 7 hours after undergoing cesarean section. The diagnosis of amniotic fluid embolism was established by viewing fragments of vernix caseosa in a pulmonary artery blood sample. Forty-eight hours after the cytologic diagnosis had been made, amniotic fluid material was no longer present in pulmonary arterial blood. The patient underwent supportive care in an intensive care setting and recovered completely.