Lupus syndrome with neutropenia following minocycline therapy - a case report

An 18-year-old patient is described who presented with febrile neutropenia and hepatitis caused by minocycline therapy. This rare complication of minocycline-induced lupus syndrome is discussed here.

Dielectric function of ZnTe nanocrystals by spectroscopic ellipsometry

We have studied the optical properties of ZnTe nanocrystals (ZnTe-nc) by spectroscopic ellipsometry. The ZnTe-nc are embedded in a SiO2 matrix by an ion implantation technique. Two doses of 1 x 10(16) and 5 x 10(15) cm(-2) of tellurium and zinc ions are implanted in a 250 nm thick SiO2 layer thermally grown on silicon with respective implantation energies of 180 and 115 keV. Subsequent thermal treatments at 800 degrees C lead to the formation of ZnTe-nc. Their sizes are characterized by transmission electron microscopy. The ZnTe-nc obtained with the 1 x 10(16) cm(-2) dose are self-organized into two layers parallel to the surface. Their mean radius ranges between 4-17 nm and 7-17 nm. The ZnTe-nc obtained with the 5 x 10(15) cm(-2) dose are self-organized into one layer with a mean radius between 4-17 nm. A critical points (CPs) dispersion model is used to extract the optical responses of the ZnTe-nc. The optical properties such as the dielectric function and the second derivative of the dielectric function are presented and analyzed. The dielectric function spectra reveal distinct structures attributed to band gap and optical transitions at higher energy. The correlation between the optical responses and the size of the nanocrystals is also given.

Double burden of underweight and overweight among children (10-19 years of age) of employees working in Indian industrial units

BACKGROUND

Along with the existing problem of underweight, overweight in children is increasing in the developing world. However, there is little information on its magnitude and pattern in the Indian context. We aimed to study the pattern and correlates of overweight in Indian children and adolescents.

METHODS

A total of 3750 children in the age group of 10-19 years, who were family members of randomly selected employees from 10 different industrial sites in India, were surveyed using an interviewer-administered questionnaire.

RESULTS

The prevalence of underweight was highest in peri-urban areas (30.2% and 53.2% according to Indian and international criteria, respectively). In urban and highly urban areas, the prevalence of underweight was 14.1% and 9.8%, respectively, according to the Indian criteria, and 27.1% and 19.2%, respectively, according to international criteria. The proportion of overweight children was highest in the highly urban category (19.1% and 13.4% according to Indian and international criteria, respectively). The level of urbanization (OR 3.1 and 4.7 for overweight in urban and highly urban areas, respectively, compared with peri-urban areas, p < 0.001), physical activity (OR 0.4, p < 0.001, in children with physical activity score > or = 75th percentile compared with a score < or = 75th percentile) and frequency of meals outside the home (OR 12, p < 0.001, if > 25% weekly meals taken outside the home compared with < 25% of weekly meals outside home) were significant predictors of overweight.

CONCLUSION

There is a double burden of underweight and overweight among Indian children and adolescents.

Intramural hematoma of the aorta: delayed pericardial tamponade

Intramural hematoma of the aorta is a fatal disorder that remains poorly characterized. Recently, it has been accepted as a variant form of aortic dissection, where blood accumulates within the aortic media without the presence of an intimal tear. Clinically, it may present somewhat similar to dissection, and although optimal therapy remains controversial, current opinion supports surgery as the preferred method of treatment for intramural hematomas that involve the ascending aorta and aortic arch.

Female-male differences at various clinical steps of tuberculosis management in rural Bangladesh

A registry data-based study of 3,600 patients systematically drawn from out-patient clinic, laboratory and tuberculosis (TB) treatment registers (1200 from each) examined female-male differences at various clinical steps of TB management and compared selective indicators with published results. Female-to-male ratios (FMR) declined at the following clinical steps: respiratory patients seeking out-patient care (0.81), TB suspects submitting sputum for testing (0.52) and smear-positive test results (0.38), but the decline ceased at treatment initiation (0.41). Compared to 1997, the FMR in 2000 had decreased for out-patient clinics and sputum submission for testing, but had increased for smear-positive test results and treatment initiation. More female than male patients who underwent treatment achieved cure (93% vs. 89%). Lower female representation at the different clinical steps of TB management persists.

Tumor stroma as a target in cancer

Solid tumors are composed of the malignant cell itself (most commonly a carcinoma) and supporting cells that comprise the stroma. Significant stromal components include the extracellular matrix, supporting fibroblasts, vessels comprised of endothelium, pericytes and in some cases vascular smooth muscle, lymphatics and usually a major leukocyte infiltration. Indeed, macrophages may constitute up to 50% of the viable cells within the tumor. For many years, researchers have concentrated almost exclusively on the malignant carcinoma and looked for ways to either selectively kill or restrict its growth. In recent years the frustrating lack of advances in cytotoxic cancer therapy provoked a search for more novel strategies and foremost amongst these were anti-angiogenesis and vascular targeting. The purpose of this article is to illustrate how the stroma is now being pursued as an anti-cancer target. The article will briefly touch on anti-angiogenics that are now entering the clinic but concentrate on recent studies looking at vascular disrupting agents, stromal tumor fibroblasts and macrophages. Target identification is illustrated by the search for tumor endothelial markers. Finally, we draw attention to efforts to develop a cancer vaccine. The genetic instability and variation found in carcinoma cells made vaccination in the past a near impossibility. In contrast, genetically stable tumor endothelium with its unique accessibility to blood borne agents, together with recent advances in immunotherapy means that the possibility of a cancer vaccine now takes on a reality not previously recognised.

Attenuation and protective efficacy of an O-antigen-deficient mutant of Francisella tularensis LVS

Francisella tularensis is a zoonotic, Gram-negative coccobacillus that causes tularemia in humans and animals. F. tularensis subspecies tularensis (type A) and F. tularensis subspecies holarctica (type B) are antigenically similar and more virulent than Francisella novicida in humans. The genetic locus that encodes the LPS O antigen was found to be substantially different between the type B live vaccine strain (LVS) and F. novicida. One LVS-specific gene with homology to a galactosyl transferase was selected for allelic replacement using a sacB-chloramphenicol expression suicide plasmid, and recombinants were screened for colony morphology on Congo red agar that matched that of F. novicida. Two mutants (WbtI(S187Y) and WbtI(G191V)) were isolated that contained substitutions in conserved motifs in the sugar transamine/perosamine synthetase (WbtI) of the O-antigen locus, and the latter mutant was extensively tested and characterized. WbtI(G191V) grew at the same rate as the parent strain in Chamberlain's defined medium, completely lacked O antigen, was serum-sensitive but could grow in a mouse macrophage cell line, had increased resistance to sodium deoxycholate, and was highly attenuated in mice. Complementation of WbtI(G191V) with the wild-type wbtI gene in trans restored normal LPS synthesis, phenotypic properties similar to the parent, and virulence in mice. Immunization with WbtI(G191V) protected mice against a relatively low-dose intraperitoneal challenge with LVS, but was less protective against a high-dose challenge. These results indicate that complete loss of O antigen alters the surface phenotype and abrogates virulence in F. tularensis, but also compromises the induction of full protective immunity against F. tularensis infection in mice.

Antinociceptive activity of Derris uliginosa

The ethanol extract of leaves of Derris uliginosa given by oral route at dose of 250 and 500 mg/kg produced a significant inhibition on acetic acid-induced writhing in mice.

Variance in physician attitudes toward androgen deprivation therapy initiation for biochemical cancer recurrence

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Background: The optimal timing for starting Androgen Deprivation Therapy (ADT) for patients with recurrent prostate cancer (PCa) remains uncertain. In 2004, the American Society of Clinical Oncology deemed the evidence insufficient to recommend early ADT initiation. Recent evidence shows a slight survival benefit to recurrent PCa patients with high risk features; however, early initiation can prematurely reduce patients’ quality of life without providing benefit. This pilot study surveys physician attitudes and practices regarding ADT initiation at a single institution. Methods: Physicians (n=20), including 7 attendings and 13 fellows, who treated biochemically- recurrent PCa patients enrolled in a companion study completed a survey about clinical experience, knowledge of recommendations, and attitudes regarding decisions to start ADT. They also rated the importance of sixteen factors potentially contributing to the decision. Results: Consistent with the ASTRO definition, forty-five percent answered, that three consecutive PSA-rising tests constitute recurrence. For patients with high risk features (Gleason > 7, doubling time < 10 months), 55% said ADT should be started immediately, while only 15% noted that the literature remains unresolved on this issue. For patients without high risk features, 100% would defer ADT. The two factors rated most important in determining ADT initiation timing were PSA doubling time (100%) and patient preferences (95%). Conclusions: Our preliminary data suggest that even within one institution, there is variance in physicians’ definitions of PCa recurrence and the correct treatment strategy. Despite the lack of definitive data on the benefit of early ADT initiation even for high risk patients, over 50% said such patients should start immediately.

No significant financial relationships to disclose.

BH3 mimetic ABT-737 neutralizes resistance to FLT3 inhibitor treatment mediated by FLT3-independent expression of BCL2 in primary AML blasts

FLT3 defines a promising target for the treatment of acute myeloid leukemia (AML). In contrast to their efficacy in cell lines, FLT3-specific inhibitors as single agents have only modest clinical activity in patients with AML. As demonstrated here, overexpression of anti-apoptotic proteins of the BCL2 family leads to resistance against FLT3 inhibitors in a hematopoietic cell line model with activating FLT3 mutations. The susceptibility to FLT3 inhibition could be restored by treatment with the novel BH3 mimetic ABT-737. Primary AML samples tested in our study showed a high expression of BCL2 protein, but not of BCL-xL or MCL1. BCL2 protein levels were not reduced after dephosphorylation of FLT3 and its downstream target STAT5 in patient samples with FLT3 internal tandem duplications. Interestingly, treatment with ABT-737 caused apoptotic cell death in all primary AML samples at submicromolar level and synergized efficiently with FLT3 inhibition in AML samples with activating FLT3 mutations. In contrast to AML cell lines, BCR-ABL transformed human cells showed resistance to ABT-737, which might be due to the induction of MCL1 by BCR-ABL. Inhibition of BCL2 family members might define a novel highly efficient and specific strategy in the combined or monotreatment of AML.

The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh

OBJECTIVE

To investigate the prevalence of selected micronutrient deficiencies amongst anaemic adolescent schoolgirls in rural Bangladesh and to examine their relationship with haemoglobin (Hb) levels.

DESIGN

A cross-sectional study.

SETTING

Girls' high schools in rural areas of Dhaka District in Bangladesh.

SUBJECTS AND METHODS

Three hundred and ten anaemic adolescent girls aged 14-18 years from eight schools participated in the study. Information on personal characteristics and food habits were collected by interview. Parents were asked about their socio-economic conditions. Anthropometric data and blood samples were collected following the interview.

RESULTS

Twenty-eight per cent of the girls had depleted iron stores (serum ferritin <12.0 microg/l), 25% had folic acid deficiency (red blood cell folic acid <317 nmol/l), 89% had vitamin B(2) (erythrocyte glutathione reductase activity coefficient > or =1.4) and 7% had vitamin B(12) deficiencies (serum vitamin B(12) <150 pmol/l). Although the prevalence of vitamins A and C deficiency was very low, a significant proportion had low vitamin A (serum retinol between 0.70 and <1.05 micromol/l) and vitamin C status (plasma ascorbic acid between 11.4-23.0 micromol/l). Frequency of consumption of meat, serum ferritin and vitamin B(2) status were found to be strongly related to Hb by multiple regression analysis. For 1 microg/l change in serum ferritin, there was a 0.13 g/l change in Hb when adjusted for other factors.

CONCLUSIONS

There is coexistence of micronutrient deficiencies among anaemic adolescent girls in rural Bangladesh, although they do not suffer from energy deficiency. Of all micronutrients, only iron and vitamin B(2) concentrations were found to be related to the Hb concentration.

New compounds from Commiphora myrrha (Nees) Engl

Phytochemical investigation of Commiphora myrrha (Nees) Engl. has afforded six new compounds identified as cadina-3-en-15-ol (myrracadinol A) (1), 7, 8-seco-2, 5-dihydroxy-12-acetoxycalam-8-ene (myrracalamene A) (2), 7, 8-seco-2, 3, 5-hydroxy-12-acetoxycalame-8-ene (myrracalamene B) (3), 7, 8-seco-cadin-3, 8-dien-2beta, 12-diol (myrracadinol B) (4), 7, 8-seco-12-hydroxycalam-8-ene (myrracalamene C) (6), 7, 8-seco-cadin-3,7(12)-dien-5alpha,10alpha-diol (myrracadinol C) (7) along with a known compound tria-cont-1-ene (5). Their structures were elucidated on the basis of spectral and chemical analyses.