Hepatosplenic Gamma/Delta T-Cell Lymphoma Masquerading as Alcoholic Hepatitis and Methadone Withdrawal

Hepatosplenic gamma/delta T-cell lymphoma is a rare neoplasm of mature gamma/delta T-cells with sinusoidal infiltration of spleen, liver, and bone marrow. Patients are predominantly adolescent and young adult males and usually present with marked hepatosplenomegaly. Pancytopenia is another common finding. Despite an initial response to treatment, patients have a median survival of one to two years. In this report, we document a case of alcoholic hepatitis and methadone withdrawal masquerading unsuspected, hepatosplenic gamma/delta T-cell lymphoma with unusual CD20 positivity

Immune risk phenotype is associated with nosocomial lung infections in elderly in-patients

<p>Abstract</p> <p>Background</p> <p>Nosocomial infections are extremely common in the elderly and may be related to ageing of the immune system. The Immune Risk Phenotype (IRP), which predicts shorter survival in elderly patients, has not been evaluated as a possible risk factor for nosocomial infection. Our aim was to assess the prevalence of nosocomial infections in elderly in-patients and to investigate potential relationships between nosocomial infections and the immunophenotype, including IRP parameters.</p> <p>Results</p> <p>We included 252 consecutive in-patients aged 70 years or over (mean age, 85 ± 6.2 years), between 2006 and 2008. Among them, 97 experienced nosocomial infections, yielding a prevalence rate of 38.5% (95% confidence interval, 32.5-44.5). The main infection sites were the respiratory tract (21%) and urinary tract (17.1%) When we compared immunological parameters including cell counts determined by flow cytometry in the groups with and without nosocomial infections, we found that the group with nosocomial infections had significantly lower values for the CD4/CD8 ratio and naive CD8 and CD4 T-cell counts and higher counts of memory CD8 T-cells with a significant increase in CD28-negative CD8-T cells. Neither cytomegalovirus status (positive in 193/246 patients) nor presence of the IRP was associated with nosocomial infections. However, nosocomial pneumonia was significantly more common among IRP-positive patients than IRP-negative patients (17/60 versus 28/180; <it>p </it>= 0.036).</p> <p>Conclusion</p> <p>Immunological parameters that are easy to determine in everyday practice and known to be associated with immune system ageing and shorter survival in the elderly are also associated with an elevated risk of nosocomial pneumonia in the relatively short term.</p

Reflective Model Driven Engineering

In many large organizations, the model transformations allowing the engineers to more or less automatically go from platformindependent models (PIM) to platform-specific models (PSM) are increasingly seen as vital assets. As tools evolve, it is critical that these transformations are not prisoners of a given CASE tool. Considering in this paper that a CASE tool can be seen as a platform for processing a model transformation, we propose to reflectively apply the MDA to itself. We propos

Low hepatitis E virus RNA prevalence in a large-scale survey of United States source plasma donors

BACKGROUND: Hepatitis E virus (HEV) is a small, nonenveloped, single-stranded, RNA virus of emerging concern in industrialized countries. HEV transmission through transfusion of blood components has been reported, but not via plasma-derived medicinal products (PDMPs) manufactured with virus inactivation and/or removal steps. This study aimed to determine the prevalence of HEV among US source plasma donors. STUDY DESIGN AND METHODS: Samples were collected from US source plasma donors at centers across the United States and were initially screened for HEV RNA in 96-sample minipools using the Roche cobas HEV test on the cobas 8800 system. Assuming a sensitivity of 18.6 IU/mL, the minipool screening strategy allowed for reliable detection of individual donations with HEV RNA titers of more than 2 x 10(3) IU/mL. Reactive minipools were resolved to individual donations, which were further analyzed to quantify viral RNA concentration, determine HEV genotype, and immunoglobulin (Ig)G and IgM HEV antibody status. RESULTS: A total of 128,020 samples were collected from 96 CSL Plasma centers in the United States, representing 27 states. The prevalence of HEV RNA-positive samples was 0.002% with three unique HEV-positive donors identified, all HEV Subgenotype 3a. Virus titers of HEV-positive samples were relatively low (10(3)-10(4) IU HEV RNA/mL). One positive donation was HEV IgG seropositive. CONCLUSION: Routine screening of US source plasma donations for HEV would not substantially improve the safety of most PDMPs. The low prevalence and potential viral load of HEV, together with effective virus reduction steps in manufacturing processes, results in a low residual risk and acceptable safety margins for PDMPs derived from US plasma donors

RAFT dispersion polymerization : a method to tune the morphology of thymine-containing self-assemblies

YesThe synthesis and self-assembly of thymine-containing polymers were performed using RAFT dispersion polymerization. A combination of microscopy and scattering techniques was used to analyze the resultant complex morphologies. The primary observation from this study is that the obtained aggregates induced during the polymerization were well-defined despite the constituent copolymers possessing broad dispersities. Moreover, a variety of parameters, including the choice of polymerization solvent, the degree of polymerization of both blocks and the presence of an adenine-containing mediator, were observed to affect the resultant size and shape of the assembly.University of Warwick, National Science Foundation (U.S.) (NSF), Engineering and Physical Sciences Research Council (EPSRC

Transition metal catalyzed element–element′ additions to alkynes

The efficient and stereoselective synthesis of, or precursors to, multi-substituted alkenes has attracted substantial interest due to their existence in various industrially and biologically important compounds. One of the most atom economical routes to such alkenes is the transition metal catalyzed hetero element–element′ π-insertion into alkynes. This article provides a thorough up-to-date review on this area of chemistry, including discussions on the mechanism, range of Esingle bondE′ bonds accessible and the stoichiometric/catalytic transition metal mediators employed

Asymmetric copolymers: synthesis, properties, and applications of gradient and other partially segregated copolymers

This is an accepted manuscript of an article published by Wiley in Macromolecular Rapid Communications, available online: https://doi.org/10.1002/marc.201800357 The accepted version of the publication may differ from the final published version.Asymmetric copolymers are a class of materials with intriguing properties. They can be defined by a distribution of monomers within the polymer chain that is neither strictly segregated, as in the case of block copolymers, nor evenly distributed throughout each chain, as in the case of statistical copolymers. This definition includes gradient copolymers as well as block copolymers that contain segments of statistical copolymer. In this review, different methods to synthesize asymmetric copolymers are first discussed. The properties of asymmetric copolymers are investigated in comparison to those of block and random counterparts of similar composition. Finally, some examples of applications of asymmetric copolymers, both academic and industrial, are demonstrated. The aim of this review is to provide a perspective on the design and synthesis of asymmetric copolymers with useful applications.This research was financially supported by the ASYMCOPO Project, an international collaborative research project of the Deutsche Forschungsgemeinschaft (DFG, Germany) and the Agence Nationale de la Recherche (ANR, France); DFG project: GU 1685/1-1 (J. Z., C. G. S. and U. S. S.) and ANR project ANR-15-CE08-0039 (S. H.). C. G. S. and U. S. S. thank the Center for Excellence “PolyTarget” (SFB 1278, project Z01) of the Deutsche Forschungsgemeinschaft (DFG, Germany) for financial support. B. F. M. acknowledges the financial support from Consejo Nacional de Ciencia y Tecnologia (CONACyT, Mexico) to pursue her PhD.Published versio

Pathogen reduction/inactivation of products for the treatment of bleeding disorders:what are the processes and what should we say to patients?

Patients with blood disorders (including leukaemia, platelet function disorders and coagulation factor deficiencies) or acute bleeding receive blood-derived products, such as red blood cells, platelet concentrates and plasma-derived products. Although the risk of pathogen contamination of blood products has fallen considerably over the past three decades, contamination is still a topic of concern. In order to counsel patients and obtain informed consent before transfusion, physicians are required to keep up to date with current knowledge on residual risk of pathogen transmission and methods of pathogen removal/inactivation. Here, we describe pathogens relevant to transfusion of blood products and discuss contemporary pathogen removal/inactivation procedures, as well as the potential risks associated with these products: the risk of contamination by infectious agents varies according to blood product/region, and there is a fine line between adequate inactivation and functional impairment of the product. The cost implications of implementing pathogen inactivation technology are also considered