Ciprofloxacin prophylaxis for patients undergoing high-dose chemotherapy and autologous stem cell transplantation (ASCT) - a single-center experience.

PURPOSE: The objective of the study was to evaluate the efficacy of ciprofloxacin prophylaxis for patients undergoing high-dose chemotherapy followed by autologous stem cell transplantation (ASCT). MATERIALS AND METHODS: The data of 104 patients transplanted at the Department of Hematology Medical University of Lodz between 2005 and 2008 were analyzed. The cohort was divided into two groups depending on the administered ciprofloxacin prophylaxis. Conditioning regimens did not differ significantly among the groups. Multiple myeloma was the main indication for ASCT in both groups. RESULTS: Ciprofloxacin prophylaxis resulted in a statistically significant reduction of duration of intravenous (IV) antibiotic treatment in the group with prophylaxis (p=0.01). The trend has been observed towards lower prevalence of infectious episodes in the prophylaxis group. Positive blood cultures were similar in both groups with no significant resistance to ciprofloxacin. CONCLUSION: These data demonstrate that ciprofloxacin prophylaxis is beneficial for patients treated with ASCT following high dose chemotherapy regimen, in terms of the intravenous antibiotics usage. This advantage directly translates into economic benefit and may also induce less bacterial resistance due to less exposure to antibiotics.

Novel and emerging drugs for acute myeloid leukemia: pharmacology and therapeutic activity.

For the last twenty years, significant progress in Molecular and Cellular Biology has resulted in a better characterization and understanding of the biology and prognosis of acute myeloid leukemia (AML). These achievements have provided new opportunities for the development of innovative, more effective therapies. Novel agents potentially useful in the treatment of patients with AML include new formulations of established drugs, newer nucleoside analogs, molecular target drugs, monoclonal antibodies and other agents. Three newer nucleoside analogs, clofarabine, troxacitabine and sapacitabine have been recently investigated in patients with AML. Two methylation inhibitors, 5-azacyticline and decitabine are pyrimidine nucleoside analogs of cytidine which can be incorporated into RNA and/or DNA. Lower doses of these agents are active in AML and have been extensively investigated, especially in secondary AML and AML in elderly patients. Tipifarnib and lonafarnib are orally available farnesyltransferase inhibitors with in vitro and in vivo activity against AML. In recent years, FLT3 inhibitors, lestaurinib, tandutinib and PKC 412 have been developed and tested in AML. The preclinical observations and clinical studies indicate that FLT3 inhibitors are promising agents in the treatment of FLT3 mutated AML patients, especially when used in combinations with chemotherapy. Several newer MDR inhibitors, including valspodar (PSC-833) and zosuquidar trihydrochloride have been also tested for the treatment of relapsed AML. This article reviews the various classes of AML targets and drugs that are under early phase clinical evaluation, especially those that are likely to enter clinical practice in the near future.

The concept for integration of thermal imaging systems with personal protective equipment.

Work in difficult conditions resulting from limited visibility in conjunction with restricted movement and complexity of performed operations involves high risk. The hazard can be reduced significantly through rapid provision of information on the risks people are exposed to under certain working conditions. Their reactions - classified as improper - result most often under stress, in particular when acting in limited visibility conditions. This article shall treat of reduced visibility understood as lack of visibility resulting from dim light, as opposed to the problem of obstructed view, which is not discussed here.

UV protective textile clothing for workers exposed to natural and artificial UV radiation.

Some amounts of ultraviolet radiation are beneficial for humans but excessive exposure can cause many negative health effects to the skin and eyes and also can affect the immune system. Exposed area of skin should be covered by working clothes with low UVR transmission. It concerns both exposure to natural UV or prolonged exposure to artificial UV. This article presents some aspects of UV protective textile clothing for workers exposed to natural and artificial UV radiation. This article presents results of selected textile samples transmittances and calculated UPF and new proposed AUPF, which describes protective properties against UV of textiles. The UPF and AUPF differs substantially between each other, what is related both to the weighting factors of erythema and actinic efficiency functions and spectral range of these functions. UV protection by clothing depends on a large variety of factors, such as type of fiber, color or moisture content. Contrary to popular opinion, however, some fabrics provide insufficient ultraviolet (UV) protection.

Increased responsiveness to toll-like receptor 4 stimulation in peripheral blood mononuclear cells from patients with recent onset rheumatoid arthritis.

BACKGROUND: Cell signaling via Toll-like receptors (TLRs) leads to synovial inflammation in rheumatoid arthritis (RA). We aimed to assess effects of TLR2 and TLR4 stimulation on proinflammatory cytokine production by peripheral blood mononuclear cells (PBMCs) from patients with recent-onset RA, osteoarthrosis (OA), and healthy control (HC). METHODS: PBMCs were stimulated with LPS, biglycan and cytokine mix. Cytokines were analyzed in supernatants with ELISA. Expression of toll-like receptors mRNA in leukocytes was analyzed using real-time qPCR. RESULTS: PBMCs from RA patients spontaneously produced less IL-6 and TNFalpha than cells from OA and HC subjects. LPS increased cytokines' production in all groups. In RA patients increase was dramatic (30 to 48-fold and 17 to 31-fold, for respective cytokines) compared to moderate (2 to 8-fold) in other groups. LPS induced 15-HETE generation in PBMCs from RA (mean 251%) and OA patients (mean 43%), although only in OA group, the increase was significant. TLR2 and TLR4 gene expressions decreased in response to cytokine mix, while LPS enhanced TLR2 expression in HC and depressed TLR4 expression in OA patients. CONCLUSION: PBMCs from recent-onset RA patients are overresponsive to stimulation with bacterial lipopolysaccharide. TLR expression is differentially regulated in healthy and arthritic subjects.

Photofragmentation of SiF4 upon Si 2p and F 1s core excitation: cation and anion yield spectroscopy.

We have studied the fragmentation dynamics of core-excited SiF4 by means of soft-x-ray photoexcitation and partial positive and negative ion yield measurements around the Si L2,3-shell and F K-shell ionization thresholds. All detectable ionic fragments are reported and we observe significant differences between the various partial ion yields near the Si 2p threshold. The differences are similar to our previous results from CH3Cl showing more extended fragmentation in correspondence to transitions to Rydberg states. At variance with smaller systems, we observe negative ion production in the shape resonance region. This can be related to the possibility in a relatively large system to dissipate positive charge over several channels.

Low-energy nondipole effects in molecular nitrogen valence-shell photoionization.

Observations are reported for the first time of significant nondipole effects in the photoionization of the outer-valence orbitals of diatomic molecules. Measured nondipole angular-distribution parameters for the 3sigma(g), 1pi(u), and 2sigma(u) shells of N2 exhibit spectral variations with incident photon energies from thresholds to approximately 200 eV which are attributed via concomitant calculations to particular final-state symmetry waves arising from (E1)multiply sign in circle(M1,E2) radiation-matter interactions first-order in photon momentum. Comparisons with previously reported K-edge studies in N2 verify linear scaling with photon momentum, accounting in part for the significantly enhanced nondipole behavior observed in inner-shell ionization at correspondingly higher momentum values in this molecule.

Anion and cation-yield spectroscopy of core-excited SF6.

We report an extensive study on total and partial-ion-yield spectroscopy around both the S 2p and F 1s thresholds in SF(6). All positive and negative single-ion channels have been measured. Below the F 1s threshold we detect a large variation in relative intensity of the resonant structures according to the specific channel monitored, indicating selective fragmentation. Above threshold, at variance with previous cases described by us, we detect high-intensity structures related to shape resonances not only in the cation channels but also for the anions. We discuss the applicability and limits of a model we have developed for the analysis of shape resonances in anion yields as a function of molecular size.

Nondipole effects in the photoionization of xe 4d5/2 and 4d3/2: evidence for quadrupole satellites.

Measurements of nondipole parameters in spin-orbit-resolved Xe 4d photoionization demonstrate dynamical differences arising from relativistic effects. The experimental data do not agree with relativistic random-phase approximation calculations of single ionization dipole and quadrupole channels. It is suggested that the discrepancy is due to the omission of multiple-excitation quadrupole channels, i.e., quadrupole satellite transitions.

Nearest-neighbor-atom core-hole transfer in isolated molecules.

A new phenomenon sensitive only to next-door-neighbor atoms in isolated molecules is demonstrated using angle-resolved photoemission of site-selective core electrons. Evidence for this interatomic core-to-core electron interaction is observable only by measuring nondipolar angular distributions of photoelectrons. In essence, the phenomenon acts as a very fine atomic-scale sensor of nearest-neighbor elemental identity.

Dramatic nondipole effects in low-energy photoionization: experimental and theoretical study of Xe 5s.

The Xe 5s nondipole photoelectron parameter gamma is obtained experimentally and theoretically from threshold to approximately 200 eV photon energy. Significant nondipole effects are seen even in the threshold region of this valence shell photoionization. In addition, contrary to previous understanding, clear evidence of interchannel coupling among quadrupole photoionization channels is found.

Practical application of ergonomic settings of typical computerised workstations.

The goal of the study was to check, with regard to ergonomics, workstations equipped with visual display terminals in selected enterprises. Over 180 workstations were tested in 3 enterprises. Most workstations were equipped with computers. The ergonomics of both the parameters of the basic components of the workstation (i.e., a chair and a desk, and the position of the computer at the workstation and its screen with respect to windows) and lighting fittings were analysed. Typical mistakes in the layout of a workstation were chairs inappropriate for computer work, as well as broken chair adjustment mechanisms, which qualified chairs for repair or replacement. Wrong positioning of monitors on the desk and with regard to windows and lighting fittings was also noted.

[Surgical treatment of GnRH secretory hypothalamic hamartomas causing precocious puberty]. / Leczenie chirurgiczne GnRH wydzielniczej postaci hamartoma podwzgórga wywolujacej przedwczesne pokwitanie plciowe.

Hypothalamic hamartomas (HHs) are benign lesions often associated with central precocious puberty. Resection of HHs has been recommended as a treatment option for selected cases, however recent reports stressed the role of effective medical management with a long-acting GnRH agonist. This paper describes incomplete response to the initial GnRH therapy and results of total resection of HHs. Five children two boys and three girls with physical signs of puberty at a mean age of 20.2 months (range 5-36 months) have been treated at our institution. All children had a pedunculated mass below the tuber cinereum. Two children were initially treated with GnRH agonist and had received follow-up care for 11 and 12 months respectively. These patients had incomplete regression of endocrinological disturbances to prepubertal level. Both patients were subsequently operated on. All five children underwent total surgical removal of HHs. The hamartomas were excised through pterional approach. Postoperatively two children showed transient third nerve palsy and one diabetes incipidus. There was no permanent disability due to surgical intervention. The clinical and biochemical symptoms and signs of precocious puberty completely regressed postoperatively including two cases treated initially with GnRH analog. The children have been followed for 1 to 6 years and no recurrence of puberty was observed. Surgical excision of pedunculated HHs is still a valuable option in the treatment of precocious puberty in small children. This alternative should be considered if the initial GnRH therapy failed to suppress++ puberty and reduce bone age advancement.

Incomplete masculinisation of XX subjects carrying the SRY gene on an inactive X chromosome.

46,XX subjects carrying the testis determining SRY gene usually have a completely male phenotype. In this study, five very rare cases of SRY carrying subjects (two XX males and three XX true hermaphrodites) with various degrees of incomplete masculinisation were analysed in order to elucidate the cause of sexual ambiguity despite the presence of the SRY gene. PCR amplification of 20 Y chromosome specific sequences showed the Yp fragment to be much longer in XX males than in true hermaphrodites. FISH analysis combined with RBG banding of metaphase chromosomes of four patients showed that in all three true hermaphrodites and in one XX male the Yp fragment was translocated onto a late replicating inactive X chromosome in over 90% of their blood lymphocytes. However, in a control classical XX male with no ambiguous features, the Yp fragment (significantly shorter than in the XX male with sexual ambiguity and only slightly longer than in XX hermaphrodites) was translocated onto the active X chromosome in over 90% of cells. These studies strongly indicate that inactivation on the X chromosome spreading into a translocated Yp fragment could be the major mechanism causing a sexually ambiguous phenotype in XX (SRY+) subjects.

Luminance of the surround and visual fatigue of VDT operators.

Luminance distribution in the visual field is considered as one of causal factors with a significant influence on visual fatigue, especially for intensive and extended Video Display Terminal (VDT) work. The aim of the study was to define visual fatigue of VDT operators for different values of surrounding luminance. Experiments were carried out in laboratory conditions under 3 lighting conditions. Only 1 lighting parameter--the luminance of the wall behind the display (surrounding luminance)--changed. Visual fatigue was measured both by a subjective evaluation of different visual complaints (asthenopic symptoms) and by objective measurements of changes in the following visual functions: accommodation, convergence, habitual horizontal phoria, critical fusional frequency (CFF), and visual acuity. The same experiments were done for CRT (Cathode Ray Tube) and LCD TFT (Liquid Crystal Display with Thin Film Transistor) screens. The results of the study have shown that there was no significant influence of the value of surrounding luminance on the asthenopic symptoms for either type of screen. A general tendency towards bigger visual complaints for LCD TFT than for CRT participants was found. An objective evaluation of visual fatigue demonstrated a tendency towards bigger changes in visual functions with an increase of surrounding luminance for both screens. Statistical analysis of the results has shown that surrounding luminance influences significantly the reduction of the accommodation amplitude (significance level <.05).

Heterogeneity of urinary steroid profiles in children with adrenocortical tumors.

The excretory patterns of urinary steroids determined by capillary gas chromatography in 11 children (aged 0.8-16.5 years) with adrenocortical tumors were established. In 8 patients the predominant clinical feature was virilization, in 3 others, Cushing's syndrome. In 5 patients (3 carcinoma, 2 adenoma) very high excretion of 3 beta-hydroxy-5-ene steroids was observed. In 2 others (adenomas) only moderately elevated excretion of 11 beta-hydroxyandrosterone was found. In 1 patient (adenoma) pregnanediol dominated in the steroid profile, accompanied by moderately elevated 3 beta-hydroxy-5-ene steroids. Out of 3 Cushingoid patients (1 carcinoma, 2 adenomas), 1 presented an atypical urinary steroid pattern for hypercortisolemia, without 5 alpha-reductase and 11 beta-hydroxysteroid dehydrogenase deficiencies. Neither the urinary steroid pattern nor tumor size alone were reliable indicators of tumor malignancy, as evaluated by a pathological examination and subsequent metastasis-free survival.