Acute promyelocytic leukemia after whole brain irradiation of primary brain lymphomainan HIV-infected patient

The occurrence of acute promyelocytic leukemia (APL) in HIV-infected patients has been reported in only five cases. Due to a very small number of reported HIV/APL patients who have been treated with different therapies with the variable outcome, the prognosis of APL in the setting of the HIV-infection is unclear. Here, we report a case of an HIV-patient who developed APL and upon treatment entered a complete remission. A 25-years old male patient was diagnosed with HIV-infection in 1996, but remained untreated. In 2004, the patient was diagnosed with primary central nervous system lymphoma. We treated the patient with antiretroviral therapy and whole-brain irradiation, resulting in complete remission of the lymphoma. In 2006, prompted by a sudden neutropenia, we carried out a set of diagnostic procedures, revealing APL. Induction therapy consisted of standard treatment with all-trans-retinoic-acid (ATRA) and idarubicin. Subsequent cytological and molecular analysis of bone marrow demonstrated complete hematological and molecular remission. Due to the poor general condition, consolidation treatment with ATRA was given in March and April 2007. The last follow-up 14 months later, showed sustained molecular APL remission. In conclusion, we demonstrated that a complete molecular APL remission in an HIV-patient was achieved by using reduced-intensity treatment

The Effect of a Paired Lab on Course Completion and Grades in Nonmajors Introductory Biology

This paper explores the effect of a paired lab course on students’ course outcomes in nonmajors introductory biology at the University of Alaska Anchorage. We compare course completion and final grades for 10,793 students (3736 who simultaneously enrolled in the lab and 7057 who did not). Unconditionally, students who self-select into the lab are more likely to complete the course and to earn a higher grade than students who do not. However, when we condition on observable course, academic, and demographic characteristics, we find much of this difference in student performance outcomes is attributable to selection bias, rather than an effect of the lab itself. The data and discussion challenge the misconception that labs serve as recitations for lecture content, noting that the learning objectives of science labs should be more clearly articulated and assessed independent of lecture course outcomes. This paper explores the effect of a paired lab course on students’ course outcomes in introductory biology for nonmajors at the University of Alaska Anchorage (UAA), a large, open-enrollment, 4-year university. We compare outcomes for 10,793 students, 3736 who simultaneously enrolled in the lab and 7057 who did not, and analyze the degree to which they select into the lab on observable characteristics to explore the following research questions: 1. Are students who take a paired lab more likely to complete the lecture component (i.e., receive a final grade as opposed to withdrawing or receiving an Incomplete)? 2. Are students who take a paired lab more likely to receive a higher grade in the lecture component? 3. Does the laboratory experience differently affect course outcomes for students in specific demographic subgroups (e.g., gender, race, high school urbanicity, age, prior academic performance, and socioeconomic status)

Stress fractures of the base of the metatarsal bones in young trainee ballet dancers

Classical ballet is an art form requiring extraordinary physical activity, characterised by rigorous training. These can lead to many overuse injuries arising from repetitive minor trauma. The purpose of this paper is to report our experience in the diagnosis and treatment of stress fractures at the base of the second and third metatarsal bones in young ballet dancers. We considered 150 trainee ballet dancers from the Ballet Schools of "Teatro Alla Scala" of Milan from 2005 to 2007. Nineteen of them presented with stress fractures of the base of the metatarsal bones. We treated 18 dancers with external shockwave therapy (ESWT) and one with pulsed electromagnetic fields (EMF) and low-intensity ultrasound (US); all patients were recommended rest. In all cases good results were obtained. The best approach to metatarsal stress fractures is to diagnose them early through clinical examination and then through X-ray and MRI. ESWT gave good results, with a relatively short time of rest from the patients’ activities and a return to dancing without pain

An extensive quality control and quality assurance (QC/QA) program significantly improves inter-laboratory concordance rates of flow-cytometric minimal residual disease assessment in acute lymphoblastic leukemia: An I-BFM-FLOW-network report

Monitoring of minimal residual disease (MRD) by flow cytometry (FCM) is a powerful prognostic tool for predicting outcomes in acute lymphoblastic leukemia (ALL). To apply FCM-MRD in large, collaborative trials, dedicated laboratory staff must be educated to concordantly high levels of expertise and their performance quality should be continuously monitored. We sought to install a unique and comprehensive training and quality control (QC) program involving a large number of reference laboratories within the international Berlin-Frankfurt-Münster (I-BFM) consortium, in order to complement the standardization of the methodology with an educational component and persistent quality control measures. Our QC and quality assurance (QA) program is based on four major cornerstones: (i) a twinning maturation program, (ii) obligatory participation in external QA programs (spiked sample send around, United Kingdom National External Quality Assessment Service (UK NEQAS)), (iii) regular participation in list-mode-data (LMD) file ring trials (FCM data file send arounds), and (iv) surveys of independent data derived from trial results. We demonstrate that the training of laboratories using experienced twinning partners, along with continuous educational feedback significantly improves the performance of laboratories in detecting and quantifying MRD in pediatric ALL patients. Overall, our extensive education and quality control program improved inter-laboratory concordance rates of FCM-MRD assessments and ultimately led to a very high conformity of risk estimates in independent patient cohorts