Delayed onset interstitial nephritis following multiple wasp stings

A wasp sting rarely causes delayed / late onset hypersensitivity reaction. Although unknown, the mechanism of such a delayed hypersensitivity reaction is thought to be an immunologically mediated, type III hypersensitivity reaction with the deposition of immune complexes and activation of the complement system. We present here the case of a seven year-old girl with acute interstitial nephritis following multiple wasp stings. To the best of our knowledge, this is the first such report of delayed presentation in a child from India.

Trabectedin plus pegylated liposomal doxorubicin in relapsed ovarian cancer delays third-line chemotherapy and prolongs the platinum-free interval

BACKGROUND

OVA-301 is a large randomized trial that showed superiority of trabectedin plus pegylated liposomal doxorubicin (PLD; CentoCor Ortho Biotech Products L.P., Raritan, NJ, USA). over single-agent PLD in 672 patients with relapsed ovarian cancer, particularly in the partially platinum-sensitive subgroup [platinum-free interval (PFI) of 6-12 months]. This superiority has been suggested to be due to the differential impact of subsequent (platinum) therapy.

PATIENTS AND METHODS

a detailed analysis of subsequent therapies and survival outcomes in the overall population and in the subsets according to platinum sensitivity was therefore conducted.

RESULTS

similar proportions of patients received subsequent therapy in each arm (76% versus 77%), including further platinum-based regimens (49% versus 55%). Patients in the trabectedin/PLD arm received subsequent chemotherapy at a later time (median delay 2.5 months versus PLD arm). Overall survival from subsequent platinum was significantly prolonged in the partially platinum-sensitive disease subset (hazard ratio = 0.63; P = 0.0357).

CONCLUSION

the superiority of trabectedin/PLD over single-agent PLD in OVA-301 cannot be explained by differences in the extent or nature of subsequent therapies administered to these patients. On the other hand, these exploratory analyses support the hypothesis that the enhanced survival benefits in the partially platinum-sensitive subset might be due to an extended PFI leading to longer survival with subsequent platinum.

Trabectedin plus pegylated liposomal doxorubicin in relapsed ovarian cancer: outcomes in the partially platinum-sensitive (platinum-free interval 6-12 months) subpopulation of OVA-301 phase III randomized trial

BACKGROUND

OVA-301 is a large randomized trial that showed superiority of trabectedin plus pegylated liposomal doxorubicin (PLD) over PLD alone in relapsed ovarian cancer. The optimal management of patients with partially platinum-sensitive relapse [6-12 months platinum-free interval (PFI)] is unclear.

PATIENTS AND METHODS

within OVA-301, we therefore now report on the outcomes for the 214 cases in this subgroup.

RESULTS

Trabectedin/PLD resulted in a 35% risk reduction of disease progression (DP) or death [hazard ratio (HR) = 0.65, 95% confidence interval (CI), 0.45-0.92; P = 0.0152; median progression-free survival (PFS) 7.4 versus 5.5 months], and a significant 41% decrease in the risk of death (HR = 0.59; 95% CI, 0.43-0.82; P = 0.0015; median survival 23.0 versus 17.1 months). The safety of trabectedin/PLD in this subset mimicked that of the overall population. Similar proportions of patients received subsequent therapy in each arm (76% versus 77%), although patients in the trabectedin/PLD arm had a slightly lower proportion of further platinum (49% versus 55%). Importantly, patients in the trabectedin/PLD arm survived significantly longer after subsequent platinum (HR = 0.63; P = 0.0357; median 13.3 versus 9.8 months).

CONCLUSION

This hypothesis-generating analysis demonstrates that superior benefits with trabectedin/PLD in terms of PFS and survival in the overall population appear particularly enhanced in patients with partially sensitive disease (PFI 6-12 months).

Interface exchange coupling in Co nanoparticles dispersed in a Mn matrix

The structural and magnetic properties of 1.8 nm Co particles dispersed in a Mn matrix by co-depositing pre-formed mass-selected Co clusters with an atomic vapour of Mn onto a common substrate have been studied by using EXAFS (extended x-ray absorption fine structure), XMCD (x-ray magnetic circular dichroism), magnetometry, and theoretical modelling. At low Co volume fraction (5%) Co@Mn shows a significant degree of alloying and the well-defined particles originally deposited become centres of high Co concentration CoMn alloy that evolves from pure Co at the nanoparticle centre to the pure Mn matrix within a few nm. Each inhomogeneity is a core-shell particle with a Co-rich ferromagnetic core in contact with a Co-depleted antiferromagnetic shell. The XMCD reveals that the Co moment localized on the Co atoms within the Co-rich cores is much smaller than the ferromagnetic moment of the Co nanoparticles deposited at the same volume fraction in Ag. Electronic structure calculations indicate that the small magnitude of the core Co moment can be understood only if significant alloying occurs. Monte Carlo modelling replicates the exchange bias (EB) behaviour observed at low temperature from magnetometry measurements. We ascribe EB to the interaction between the ferromagnetic Co-rich cores and the antiferromagnetic Mn-rich shells.

Probing atomic structure in magnetic core/shell nanoparticles using synchrotron radiation

Core/shell Fe/Cu and Fe/Au nanoparticles were prepared directly by deposition from the gas phase. A detailed study of the atomic structure in both the cores and shells of the nanoparticles was undertaken by means of extended absorption fine structure (EXAFS) measurements. For Fe/Cu nanoparticles, a Cu shell ∼ 20 monolayers thick appears similar in structure to bulk Cu and is sufficient to cause the structure in the Fe core to switch from body centred cubic (bcc; as in bulk Fe) to face centred cubic. This is not the case for thinner Cu shells, 1-2 monolayers in thickness, in which there is a considerable contraction in nearest-neighbour interatomic distance as the shell structure changes to bcc. In Fe/Au nanoparticles, the crystal structure in the Fe core remains bcc for all Au thicknesses although there is some stretching of the lattice. In thin Au shells ∼ 2 monolayers thick, there is strong contraction in interatomic distances. There does not appear to be significant alloying at the Fe/Au interface.

Spatial repartition and genetic relationship of green and albino individuals in mixed populations of Cephalanthera orchids

Several green orchids of the Neottieae tribe acquire organic carbon both from their mycorrhizal fungi and from photosynthesis. This strategy may represent an intermediate evolutionary step towards mycoheterotrophy of some non-photosynthetic (albino) orchids. Mixed populations of green and albino individuals possibly represent a transient evolutionary stage offering opportunities to understand the evolution of mycoheterotrophy. In order to understand the emergence of albinos, we investigated patterns of spatial and genetic relationships among green and albino individuals in three mixed populations of Cephalanthera damasonium and one of C. longifolia using spatial repartition and Amplified fragment length polymorphism (AFLP) markers. Two of these populations were monitored over two consecutive flowering seasons. In spatial repartition analyses, albino individuals did not aggregate more than green individuals. Genetic analyses revealed that, in all sampled populations, albino individuals did not represent a unique lineage, and that albinos were often closer related to green individuals than to other albinos from the same population. Genetic and spatial comparison of genets from the 2-year monitoring revealed that: (i) albinos had lower survival than green individuals; (ii) accordingly, albinos detected in the first year did not correspond to the those sampled in the second year; and (iii) with one possible exception, all examined albinos did not belong to any green genet from the same and/or from the previous year, and vice versa. Our results support a scenario of repeated insurgence of the albino phenotypes within the populations, but unsuccessful transition between the two contrasting phenotypes. Future studies should try to unravel the genetic and ecological basis of the two phenotypes.

Body image distortion change during inpatient treatment of adolescent girls with restrictive anorexia nervosa

Body image distortion is one core symptom of anorexia nervosa. However, little is known concerning its fluctuation over time. This paper pursues two objectives: (1) to assess body image distortion change during inpatient treatment of adolescent girls with restrictive anorexia nervosa (n=10), and (2) to identify associations between this change and the change observed to other measures of eating and weight-related disorders. A Quantification of Body Image Distortion computerized tool (Q-BID) and paper-and-pencil questionnaires were used at both beginning and end of inpatient treatment. Pearson correlations and linear regression analyses were conducted to identify associations between body image distortion change and the change observed to other measures of eating and weight-related disorders. The results indicate that all adolescents experienced a body image distortion change. This change corresponds to a body image distortion decrease for 70% of them. The body image distortion change measure was highly correlated with the change observed in the score to the Eating Attitude Test (EAT-26) and to the Eating Disorder Examination Questionnaire (EDEQ-4) during the inpatient treatment. These two measures of change indeed explained 88.4% of the body image distortion change variance in the multivariate model. We concluded that the Q-BID is an interesting tool for the assessment of body image distortion change. More research is needed concerning the correlates of this outcome in order to elaborate appropriate interventions for both clinical and community settings.

Socio-economic inequalities in suicide attempts and suicide mortality in Québec, Canada, 1990-2005

OBJECTIVES

Little research has evaluated changes in the association between area deprivation and suicidal behaviour over time. This study investigated patterns in suicide attempts and suicide mortality according to material deprivation in the province of Québec, Canada between 1990 and 2005.

STUDY DESIGN

Ecological analysis.

METHODS

Data on suicide attempts were extracted from the hospital discharge summary database (n=47,516) and data on suicides were extracted from the Québec death file (n=20,851). Gender- and age-specific (10-24, 25-44, 45-64 and > or = 65 years) suicide attempt and mortality rates were calculated for four time periods (1990-1993, 1994-1997, 1998-2001 and 2002-2005) for the entire Québec population aged 10 years and older residing in 162 communities ranked by decile of material deprivation. Absolute and relative measures of inequality were calculated to summarize differences between the most and least materially deprived areas. Commonly used methods of suicidal behaviour were examined.

RESULTS

Differentials in suicide attempt hospitalization between the most and least deprived areas were present for all age groups, and these decreased slightly among males and increased among females over time. Inequalities in suicide attempts were greatest among young adults (age 25-44 years) for both genders, and were smallest among the elderly (> or = 65 years). For suicide mortality, differentials increased among females but not males; these differentials were greatest among males and 25-44 year olds, and smallest among the elderly. Differentials in commonly used methods were evident for poisoning hospitalizations in both genders and for hanging deaths among males.

CONCLUSIONS

In Québec, differences in suicide attempts and mortality between the most and least materially deprived areas persisted or even increased over time. Inequalities were more pronounced for suicide attempts than for suicide mortality, and were greatest among adults of working age. Strategies to reduce socio-economic differences in suicidal behaviour may be important.

Ozone nucleolysis for management of pain and disability in prolapsed lumber intervertebral disc. A prospective cohort study

SUMMARY

The prevalence rate of low back pain in a number of studies ranged from 22% to 65% in one year, and lifetime prevalence ranged from 11% to 84%. Over the years many percutaneous minimally invasive therapeutic modalities have evolved. Intradiscal oxygen-ozone therapy has also showed promising results. We undertook a prospective cohort study to evaluate the therapeutic outcome of oxygen-ozone therapy on patients with lumber disc herniation in the Indian population. After obtaining ethical committee and investigational review board permission, 53 consecutive patients complying with selection criteria were treated with a single session of oxygenozone therapy. All presented with clinical signs of lumber nerve root compression supported by CT and MRI findings. All patients received 3-7 ml of ozone-oxygen mixture at an ozone concentration of 29-32 mc/ml of oxygen. Therapeutic outcome was assessed after three weeks, three months, six months, one year and two years on a visual analog scale and Oswestry low back pain disability questionnaire. Pain intensity was significantly reduced following treatment (VAS baseline 7.58-/+0.86, after three weeks 2.75-/+1.42 and after two years 2.64-/+2.14). Similarly the Oswestry disability index showed a remarkable improvement in the functional status of the patients (p<0.05). No major complication was observed in this case series. Oxygen-ozone treatment is highly effective in relieving low back pain due to lumber disc herniation.

Case report: Rhodococcus erythropolis osteomyelitis in the toe

The Rhodococcus species rarely cause musculoskeletal infections, with only two cases reported in the literature. We report the case of a 53-year-old woman who had an infection develop after first metatarsophalangeal joint fusion. A year after surgery, she continued to have pain and swelling with nonunion. She underwent revision of the arthrodesis and tissue samples from surgery revealed Rhodococcus erythropolis. The patient's symptoms improved with oral antibiotics. One year after the revision surgery, the fusion had united. We believe this is the first report of a case of a musculoskeletal infection caused by Rhodococcus erythropolis.

The effect of parity on placental weight and birth weight: Interaction with placental alkaline phosphatase polymorphism

The effect of parity on placental weight and birth weight is examined through a series of birth records from an Indian population in Calcutta. Placental weight and birth weight increase with parity, the maximum increment occurring between parities 1 and 2. This is compatible with a hypothesis of sensitization of the mother to foetal, paternally derived, antigens. The three common placental alkaline phosphatase enzymic genotypes have no effect on determining foetal development.