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haematological emergencies

Joana M Murad, David J Graber, Charles L Sentman
Chimeric antigen receptors (CAR)-T cell therapy has recently made promising advances towards treatment of B-cell malignancies. This approach makes use of an antibody-derived single chain variable fragment (scFv)-based CAR to target the CD19 antigen. Currently scFvs are the most common strategy for creation of CARs, but tumor cells can also be targeted using non-antibody based approaches with designs focused on the interaction between natural receptors and their ligands. This emerging strategy has been used in unique ways to target multiple tumor types, including solid and haematological malignancies...
June 2018: Best Practice & Research. Clinical Haematology
Eric Wong, Joanne E Davis, Andrew Grigg, Jeff Szer, David Ritchie
Relapse of haematological malignancies after allogeneic haematopoietic stem cell transplant is a major cause of mortality. The immunological mechanisms that may lead to disease relapse may include immunological immaturity prior to reconstitution of the allogeneic immune system, tumour antigen downregulation or promotion of T-cell exhaustion by interactions with the tumour microenvironment. Current therapeutic strategies for post-transplant relapse are limited in their efficacy and alternative approaches are required...
June 14, 2018: Bone Marrow Transplantation
Prajwal Dhakal, Manoj P Rai, Modina Thrasher, Mukta Sharma
Tumour lysis syndrome (TLS) is an oncological emergency. It is caused by cellular death occurring secondary to cancer therapy or spontaneously in rapidly dividing tumours. More common in haematological malignancies, it has also been reported in solid tumours. Out of 14 cases of small cell lung cancer (SCLC) with TLS, only three cases of spontaneous TLS have been reported in literature to date. Here we report a case of SCLC presenting as a spontaneous TLS.
June 13, 2018: BMJ Case Reports
Blair Crewther, Konrad Witek, Piotr Zmijewski, Zbigniew Obmiński
D-aspartic acid (DAA) is promoted as a testosterone (T) enhancing supplement via mechanisms involving the hypothalamic-pituitary-gonadal (HPG) axis. Here we investigated the short-term effects of DAA on serum biomarkers of the HPG-axis in male climbers. Using a single-blinded, placebo-controlled design, 16 climbers were randomly assigned to either a DAA (3 g·d-1 ) or placebo (3 g·d-1 ) supplement for two weeks. The reverse treatment commenced after a two-week washout, with all conditions administered in a balanced manner...
June 12, 2018: International Journal of Sport Nutrition and Exercise Metabolism
Winfried V Kern, Susanne Weber, Markus Dettenkofer, Klaus Kaier, Hartmut Bertz, Michael Behnke, Maja Weisser, Tim Götting, Andreas F Widmer, Christian Theilacker
OBJECTIVES: Antibacterial chemoprophylaxis with fluoroquinolones (FQPx) has been commonly used in cancer patients with neutropenia, but its efficacy has been challenged by the emergence of fluoroquinolone resistance. METHODS: The impact of FQPx on bloodstream infections (BSI) during neutropenia after high-dose chemotherapy for haematologic malignancies was evaluated through a multicenter hospital infection surveillance system for the period 2009 to 2014. RESULTS: Among 8,755 patients (4,223 allogeneic [allo-] HSCT, 3602 autologous [auto-] HSCT, 930 high-dose chemotherapy for acute leukemia [HDC]), 5,302 (61%) had received FQPx...
June 5, 2018: Journal of Infection
Bruno Cornelis, David Blinder, Bart Jansen, Liesbet Lagae, Peter Schelkens
The development of portable haematology analysers receives increased attention due to their deployability in resource-limited or emergency settings. Lens-free in-line holographic microscopy is one of the technologies that is being pushed forward in this regard as it eliminates complex and expensive optics, making miniaturisation and integration with microfluidics possible. On-chip flow cytometry enables high-speed capturing of individual cells in suspension, giving rise to high-throughput cell counting and classification...
May 28, 2018: Optics Express
Kung-Hao Liang, Sang Hoon Ahn, Hye Wong Lee, Ya-Hui Huang, Rong-Nan Chien, Tsung-Hui Hu, Kwang-Huei Lin, Christopher Sung-Huan Yeh, Chao-Wei Hsu, Chih-Lang Lin, Tai-Long Pan, Po-Yuan Ke, Ming-Ling Chang, Chau-Ting Yeh
Liver cirrhotic patients suffer from a seemingly unpredictable risk of hepatocellular carcinoma (HCC). Here, an HCC risk score R (0 ≦ R ≦ 1) was derived from commonly tested haematological and biochemical parameters. In the score-derivation Taiwanese cohort (144 cirrhosis versus 48 HCC-remission patients), the score had an area-under-the-curve (AUC) of 0.70 (95% confidence interval [CI], 0.61-0.78, P < 0.001). When validated in a Korean cohort (78 cirrhosis versus 23 HCC-remission patients), the AUC was 0...
June 5, 2018: Scientific Reports
Mohd H Abdul-Aziz, Elicia Driver, Jeffrey Lipman, Jason A Roberts
Some special patient populations (e.g. critically ill, burns, haematological malignancy, post-major surgery, post-major trauma) have characteristics that lead to higher rates of failure and mortality associated with infection. Choice of effective antibiotics and optimised doses are challenging in these patients that are commonly infected by multi-drug resistant pathogens Areas covered: A review of the importance of diagnosis and the place of newer microbiological methods (e.g. whole genome sequencing) to ensure rapid transition from empiric to directed antibiotic therapy is provided...
June 4, 2018: Expert Opinion on Drug Metabolism & Toxicology
Jorge Cortes, Alexander E Perl, Hartmut Döhner, Hagop Kantarjian, Giovanni Martinelli, Tibor Kovacsovics, Philippe Rousselot, Björn Steffen, Hervé Dombret, Elihu Estey, Stephen Strickland, Jessica K Altman, Claudia D Baldus, Alan Burnett, Alwin Krämer, Nigel Russell, Neil P Shah, Catherine C Smith, Eunice S Wang, Norbert Ifrah, Guy Gammon, Denise Trone, Deborah Lazzaretto, Mark Levis
BACKGROUND: Old age and FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutations in patients with acute myeloid leukaemia are associated with early relapse and poor survival. Quizartinib is an oral, highly potent, and selective next-generation FLT3 inhibitor with clinical antileukaemic activity in relapsed or refractory acute myeloid leukaemia. We aimed to assess the efficacy and safety of single-agent quizartinib in patients with relapsed or refractory acute myeloid leukaemia...
May 30, 2018: Lancet Oncology
Robert M O'Connell, Michael R Boland, Jeremiah O'Driscoll, Abdelmonim Salih, Mayilone Arumugasamy, Thomas N Walsh, Michael J Allen, David J Beddy
BACKGROUND: Acute pancreatitis is a commonly encountered emergency but accurately predicting that subset of patients who will become systemically unwell has proven difficult. Simple haematological prognostic markers, such as red cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR), could identify such patients. The aim of this study was to assess the usefulness of RDW and NLR measured on admission as predictors of mortality and intensive care (ICU) or high dependency unit (HDU) admission in patients with acute pancreatitis...
May 25, 2018: International Journal of Surgery
Oana Roxana Scripcă, Cristina Pădurariu, Neacșu Gheorghe Boricean, Loredana Botoș
A 42-year-old woman, without a specific medical history presented at the Department of Emergency Ophthalmology accusing marked decrease of vision for the left eye (VA 1/ 100). The eye examination revealed an optic neuropathy with multiple retinal hemorrhages at the level of both eyes, but more acutely on the left eye. The brain computer tomography (CT) excluded the suspicion of increasing intracranial pressure. The common blood tests such as complete blood count (CBC), erythrocyte sedimentation rate, and inflammatory markers raised a high suspicion of a malignant haematological disease...
January 2018: Romanian Journal of Ophthalmology
Dina Stroopinsky, Hasan Rajabi, Myrna Nahas, Jacalyn Rosenblatt, Maryam Rahimian, Athalia Pyzer, Ashujit Tagde, Akriti Kharbanda, Salvia Jain, Turner Kufe, Rebecca K Leaf, Eleni Anastasiadou, Michal Bar-Natan, Shira Orr, Maxwell D Coll, Kristen Palmer, Adam Ephraim, Leandra Cole, Abigail Washington, Donald Kufe, David Avigan
Acute myeloid leukaemia (AML) is an aggressive haematological malignancy with an unmet need for improved therapies. Responses to standard cytotoxic therapy in AML are often transient because of the emergence of chemotherapy-resistant disease. The MUC1-C oncoprotein governs critical pathways of tumorigenesis, including self-renewal and survival, and is aberrantly expressed in AML blasts and leukaemia stem cells (LSCs). However, a role for MUC1-C in linking leukaemogenesis and resistance to treatment has not been described...
May 15, 2018: Journal of Cellular and Molecular Medicine
Alice Nentwig, Marina L Meli, Johanna Schrack, Iris M Reichler, Barbara Riond, Corinne Gloor, Judith Howard, Regina Hofmann-Lehmann, Barbara Willi
BACKGROUND: Cytauxzoonosis is an emerging tick-borne disease of domestic and wild felids. Cytauxzoon felis induces severe and often fatal disease in domestic cats. In Europe, clinical and subclinical infections caused by Cytauxzoon sp. are described. We report the first cases of Cytauxzoon sp. infection in domestic cats in Switzerland. METHODS: Clinical and laboratory data and results of PCR analyses were collected from Cytauxzoon sp. PCR-positive cats and the cats followed for up to 851 days...
May 10, 2018: Parasites & Vectors
Yang Jun Kang, Sang-Joon Lee
Haemorheologically impaired microcirculation, such as blood clotting or abnormal blood flow, causes interrupted blood flows in vascular networks. The biophysical properties of blood, including blood viscosity, blood viscoelasticity, haematocrit, red blood bell (RBC) aggregation, erythrocyte sedimentation rate and RBC deformability, have been used to monitor haematological diseases. In this review, we summarise several techniques for measuring haemorheological properties, such as blood viscosity, RBC deformability and RBC aggregation, using in vitro microfluidic platforms...
May 9, 2018: Analyst
Ananya Tupaki-Sreepurna, Anupma Jyoti Kindo
Fusarium is an emerging human opportunistic pathogen of growing importance, especially among immunosuppressed haematology patients due to an increased incidence of disseminated infections over the past two decades. This trend is expected only to continue due to the advances in medical and surgical technologies that will prolong the lives of the severely ill, making these patients susceptible to rare opportunistic infections. Production of mycotoxins, enzymes such as proteases, angio-invasive property and an intrinsically resistant nature, makes this genus very difficult to treat...
January 2018: Indian Journal of Medical Microbiology
Debra A Howell, Ruth I Hart, Alexandra G Smith, Una Macleod, Russell Patmore, Gordon Cook, Eve Roman
BACKGROUND: Pathways to myeloma diagnosis can be prolonged, and are often preceded by multiple GP consultations and emergency presentation. This is the first qualitative study to examine events leading to diagnosis by asking patients about their experiences during this time. METHODS: Set within a UK population-based cohort, semi-structured interviews were conducted with 20 myeloma patients with varying characteristics and pathways, 12 of whom invited their relatives to take part...
2018: PloS One
Shinsuke Takeda, Masahiro Tatebe, Atsushi Sakai, Hitoshi Hirata
Acute compartment syndrome (ACS) is a surgical emergency that requires urgent fasciotomy to prevent irreversible sequelae. We report two cases of unidentified ACS, which did not result from traumatic injuries such as fractures or crush injury, iatrogenic injury or diseases such as haematological malignancies. Both patients complained of severe pain and swelling of their extremity. No bite marks, blisters or skin necrosis was noted. They also complained of marked symptoms of third cranial nerve injury, including divergent squint and diplopia...
April 1, 2018: BMJ Case Reports
M Ortac, Y Pazır, A Kadıoğlu
Priapism is a urological emergency that needs early intervention and may lead to irreversible cavernosal damage. Ischaemic priapism is the most common type, which is frequently idiopathic and commonly associated with haematological diseases, medications or recreational drugs. Synthetic cannabinoids (SCs) have been increasingly used all over the world, particularly among young-adult population. SCs can cause severe adverse effects on several organ systems. However, there are no studies in the literature which have stated the possible relationship between using of SCs and priapism...
April 1, 2018: Andrologia
Msj Wilson, P Maniam, A Ibrahim, N Makaram, S R Knight, P Patil
Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Materials and methods Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015...
March 15, 2018: Annals of the Royal College of Surgeons of England
Mathilde Quidet, Fahed Zairi, Eileen Boyle, Thierry Facon, Marie-Hélène Vieillard, François Machuron, Jean-Paul Lejeune, Richard Assaker
BACKGROUND: Multiple myeloma spinal involvement can lead to bone fractures and neurologic impairment that can severely alter quality of life. The role of surgery is controversial, given its high morbidity, and the lack of evidence. We hereby aim to evaluate efficacy and safety of surgery in the management of symptomatic spinal lesions in patients with multiple myeloma. METHODS: We included all patients operated on for a myeloma-related spinal lesion in our institution between 2007 and 2015...
March 9, 2018: World Neurosurgery
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