Gemcitabine, cisplatin and methylprednisolone (GEM-P) is an effective salvage regimen in patients with relapsed and refractory lymphoma

There is currently no standard salvage chemotherapy regimen in relapsed and refractory lymphoma. Gemcitabine is a novel nucleoside analogue, which acts synergistically with cisplatin both in vitro and in clinical studies. We evaluated the combination of gemcitabine, cisplatin and methylprednisolone (GEM-P) in 41 heavily pretreated patients with relapsed and refractory Hodgkin's and non-Hodgkin's lymphoma. The best-achieved response rate (RR) was 79% (95% CI 64–91), with a complete RR of 21%. In patients with chemo-resistant disease, the RR was 63%. Myelosuppression was the main toxicity, the incidence of Grade 3 or 4 anaemia, neutropenia and thrombocytopenia was 17.1, 61.0 and 53.7% respectively. Only one patient had neutropenic sepsis and none of the patients suffered from haemorrhage. Grade 3 or 4 nonhaematological toxicity was minimal and stem cell mobilisation was not inhibited. GEM-P is an effective salvage regimen and its use prior to autologous stem cell transplant warrants further investigation

Use of ring-expanded diamino- and diamidocarbene ligands in copper catalyzed azide-alkyne "click" reactions

The two-coordinate ring-expanded N-heterocyclic carbene copper­(I) complexes [Cu­(RE-NHC)₂]⁺ (RE-NHC = 6-Mes, 7-<i>o</i>-Tol, 7-Mes) have been prepared and shown to be effective catalysts under neat conditions for the 1,3-dipolar cycloaddition of alkynes and azides. In contrast, the cationic diamidocarbene analogue [Cu­(6-MesDAC)₂]⁺ and the neutral species [(6-MesDAC)­CuCl]₂ and [(6-MesDAC)₂(CuCl)₃] show good activity when the catalysis is performed on water

Physicians using spinal manipulative treatment in The Netherlands: a description of their characteristics and their patients

Background: Various health care professionals apply Spinal Manipulative Treatment (SMT) in daily practice. While the characteristics of chiropractors and manual therapists and the characteristics of their patient populations are well described, there is little research about physicians who use SMT techniques. A distinct group of physicians in The Netherlands has been trained in musculoskeletal (MSK) medicine, which includes the use of SMT. Our objective was to describe the characteristics of these physicians and their patient population. Methods: All registered MSK physicians were approached with questionnaires and telephone interviews to collect data about their characteristics. Data about patient characteristics were extracted from a web-based register. In this register physicians recorded basic patient data (age, gender, the type and duration of the main complaint, concomitant complaints and the type of referral) at the first consultation. Patients were invited to fill in web-based questionnaires to provide baseline data about previous treatments and the severity of their main complaint. Functional impairment was measured with Patient Reported Outcome Measures (PROMs). Results: Questionnaires were sent to 138 physicians of whom 90 responded (65%). Most physicians were trained in MSK medicine after a career in other medical specialities. They reported to combine their SMT treatment with a variety of diagnostic and treatment options part of which were only permissible for physicians, such as prescription medication and injections. The majority of patients presented with complaints of long duration (62.1% > 1 year), most frequently low back pain (48.1%) or neck pain (16.9%), with mean scores of 6.0 and 6.2, respectively, on a 0 to10 numerical rating scale (NRS) for pain intensity. Mean scores on all PROMs showed moderate impairment. Patients most frequently reported previous treatment by physical therapists (68.1%), manual therapists (37.7%) or chiropractors (17.0%). Conclusion: Our study showed that MSK physicians in The Netherlands used an array of SMT techniques. They embedded their SMT techniques in a broad array of other diagnostic and treatment options, part of which were limited to medical doctors. Most patients consulted MSK physicians with spinal pain of long duration with moderate functional impairment

Transport of Particles in Intestinal Mucus under Simulated Infant and Adult Physiological Conditions: Impact of Mucus Structure and Extracellular DNA

The final boundary between digested food and the cells that take up nutrients in the small intestine is a protective layer of mucus. In this work, the microstructural organization and permeability of the intestinal mucus have been determined under conditions simulating those of infant and adult human small intestines. As a model, we used the mucus from the proximal (jejunal) small intestines of piglets and adult pigs. Confocal microscopy of both unfixed and fixed mucosal tissue showed mucus lining the entire jejunal epithelium. The mucus contained DNA from shed epithelial cells at different stages of degradation, with higher amounts of DNA found in the adult pig. The pig mucus comprised a coherent network of mucin and DNA with higher viscosity than the more heterogeneous piglet mucus, which resulted in increased permeability of the latter to 500-nm and 1-µm latex beads. Multiple-particle tracking experiments revealed that diffusion of the probe particles was considerably enhanced after treating mucus with DNase. The fraction of diffusive 500-nm probe particles increased in the pig mucus from 0.6% to 64% and in the piglet mucus from ca. 30% to 77% after the treatment. This suggests that extracellular DNA can significantly contribute to the microrheology and barrier properties of the intestinal mucus layer. To our knowledge, this is the first time that the structure and permeability of the small intestinal mucus have been compared between different age groups and the contribution of extracellular DNA highlighted. The results help to define rules governing colloidal transport in the developing small intestine. These are required for engineering orally administered pharmaceutical preparations with improved delivery, as well as for fabricating novel foods with enhanced nutritional quality or for controlled calorie uptake

Phosphorus and nitrogen fertiliser use efficiency of wheat seedlings grown in soils from contrasting tillage systems

Aims: This paper assessed the effect that the vertical stratification of nutrients in conservation cropping systems of Australia has on phosphorus (P) and nitrogen (N) fertiliser use efficiency. Methods: Intact soil cores from two long-term tillage experiments, located on a Vertosol and on a Calcarosol were used to assess if tillage system (zero tillage - ZT vs conventional tillage - CT) and soil water influence fertiliser use efficiency (using 33P and 15N) of wheat under controlled growth conditions. Results: Adding P increased shoot growth and P uptake on the Calcarosol, provided the surface remained moist and N was applied. The percentage of plant P derived from fertiliser (Pdff) was greater on the Calcarosol regardless of tillage practice. Pdff increased when the soil remained wet or when N was added. The percentage of N derived from fertiliser (%Ndff) was not affected by tillage practice on the Vertosol but when the soil surface was allowed to dry, it was significantly greater under ZT than CT on the Calcarosol. Adding P increased N fertiliser recovery but tillage practice had no effect. Conclusion: The effect of tillage practice on P and N fertiliser use efficiency depends on soil and topsoil water status.R.D. Armstrong, K. Dunsford, M.J. McLaughlin, T. McBeath, S. Mason, V.M. Dunbabi

A monoclonal antibody which blocks infection with feline immunodeficiency virus identifies a possible non-CD4 receptor.

Monoclonal antibody vpg15 detects a 24-kDa cell surface protein on feline cells permissive for infection with feline immunodeficiency virus (FIV). The antibody blocks infection of FIV-susceptible cells, and expression of the vpg15 marker is decreased in FIV-infected cells in vitro. These results suggest that the antibody may recognize an FIV receptor distinct from CD4

Factors influencing cellular immune responses to feline immunodeficiency virus induced by DNA vaccination

Virus-specific effector cytotoxic T lymphocytes (CTL) were elicited in the peripheral blood of domestic cats following a single intramuscular inoculation of replication defective feline immunodeficiency virus proviral DNA (FIVΔRT). Higher levels of virus-specific cytolysis were observed in the blood when cats were co-inoculated with feline γ-interferon (IFN) DNA. The responses declined by 12 weeks following the first DNA inoculation and were, with the exception of FIV Gag-specific responses in some cats, refractory to repeated DNA inoculations. Nevertheless, a significant proportion of the cats were protected from challenge with homologous virus. The effects of interval between inoculations, route of DNA delivery, and promoter used to regulate viral gene expression on the induction of virus-specific CTLs were evaluated. The highest levels of virus-specific lysis were recorded following intramuscular co-inoculation of FIVΔRT and γ-IFN DNA, where FIV gene expression was under the control of a cytomegalovirus (CMV) promoter. However, the highest levels of protection were observed using the viral 5′LTR as the promoter. These results suggest that a single intramuscular inoculation of FIVΔRT DNA together with γ-IFN DNA may be sufficient to induce virus-specific CTLs and protection