Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD

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Isolation and Cryopreservation of Animal Mesenchymal Stromal Cells

Scientific progress in cellular and molecular biotechnology has led to the development of advanced therapies, such as gene therapy, cell therapy, and tissue engineering. The application of stem cells as therapeutic agents has been investigated for several years in human medicine and, more recently, the same approach has been considered in the veterinary field as a novel opportunity for the treatment of animal diseases. Mesenchymal stem cell (MSC)-based therapies seem to contribute to the healing process by several mechanisms due to their peculiar biological features. It has been shown that MSCs could effectively differentiate into the required cell type to replace the damaged tissue. Furthermore, due to their autocrine and paracrine secretory activities, these cells are a powerful source of trophic mediators, growth factors, cytokines, and extracellular matrix components. The clinical application of MSCs needs great amounts of cells designed for in vivo implantation that can be obtained following their in vitro isolation, serial subcultivations, cryopreservation, and thawing. These procedures could determine their feature changes which could interfere with the therapeutic outcome. For these reasons, to preserve MSCs after in vitro manipulation for future applications, standardized quality controls and a reliable long-term cryopreservation method are required

Integrated forecasting models of pesticide concentrations and environmental monitoring campaigns

By integrating agri-environmental databases, mathematical models and geographic information systems, maps showing the potential vulnerability of soils to the leaching of plant protection products can be generated. However, these forecasts may not be subsequently corroborated by monitoring data. Here we present a case study based on glyphosate in Lombardy (Italy) and triazine herbicides in the Autonomous Community of Valencia (Spain). Glyphosate was found in the groundwater of Lombardy, despite modeling results clearly indicating the non-potential risk of groundwater contamination. Among the triazine herbicides in Valencia, simazine, although present in surface waters, was not found in groundwaters, contrary to its expected behavior as a potential leachate. The discrepancy in the behavior of glyphosate can be explained by infiltration and point contamination sources, and the absence of simazine by the facility of its degradation. Our study highlights the importance of integrating monitoring modeling and mapping approaches to improve knowledge and to obtain quality data. [Contrib Sci 10:151-160 (2014)

Fluorescent in-situ hybridization (FISH) for BCR/ABL in chronic myeloid leukemia after bone marrow transplantation

CONTEXT: Identification of Philadelphia chromosome or BCR/ABL gene rearrangement in chronic myeloid leukemia is important at diagnosis as well as after treatment. OBJECTIVE: To compare the results of karyotyping using fluorescent in-situ hybridization (FISH) upon diagnosis and 1 year after bone marrow transplantation in 12 patients. TYPE OF STUDY: Diagnostic test and residual disease detection. SETTING: Hematology and Hemotherapy Department, Federal University of São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. SAMPLE: 12 patients with chronic myeloid leukemia at diagnosis and 1 year after bone marrow transplantation. DIAGNOSTIC TEST: Karyotyping was done in the usual way and the BCR/ABL gene-specific probe was used for FISH. MAIN MEASUREMENTS: Disease at diagnosis and residual. RESULTS: At diagnosis, 10 patients presented t(9;22)(q34.1;q11) as well as positive FISH. Two cases did not have metaphases but FISH was positive. After bone marrow transplantation, 8 patients presented normal karyotype, 1 had persistence of identifiable Philadelphia chromosome and 3 had no metaphases. Two cases showed complete chimera and 2 had donor and host cells simultaneously. FISH was possible in all cases after bone marrow transplantation and confirmed the persistence of identifiable Philadelphia chromosome clone in one patient, and identified another that did not present metaphases for analysis. Cases that showed mixed chimera in karyotype were negative for BCR/ABL by FISH. CONCLUSION: The applicability of FISH is clear, particularly for residual disease detection. Classical and molecular cytogenetics are complementary methods.CONTEXTO: Na leucemia mielóide crônica, a detecção do cromossomo Philadelphia ou o rearranjo gênico BCR/ABL é importante tanto ao diagnóstico como após o tratamento. OBJETIVO: Comparar os resultados do cariótipo com a hibridação in situ por fluorescência ao diagnóstico e, após um ano de transplante de medula óssea, em 12 pacientes com leucemia mielóide crônica. TIPO DE ESTUDO: Teste diagnóstico e detecção de doença residual. LOCAL: Disciplina de Hematologia e Hemoterapia da Universidade de São Paulo/Escola Paulista de Medicina. AMOSTRA: 12 pacientes com leucemia mielóide crônica ao diagnóstico e um ano após transplante de medula óssea. TESTE DIAGNÓSTICO: A análise do cariótipo (forma clássica) e a hibridação in situ por fluorescência com a sonda específica para os genes BCR/ABL. VARIÁVEIS ESTUDADAS: Doença ao diagnóstico e residual. RESULTADOS: Ao diagnóstico, 10 pacientes apresentaram t(9;22)(q34.1;q11) no cariótipo assim como pela hibridação in situ por fluorescência. Dois casos em que na citogenética não havia mitoses, apresentaram rearranjo pela hibridação in situ por fluorescência. Após o transplante de medula óssea, o cariótipo mostrou ausência do cromossomo Philadelphia em 8 casos, persistência em um e ausência de metáfases em três. Em dois casos havia quimera completa e em outros dois havia concomitância de células do doador e do receptor. A hibridação in situ por fluorescência foi possível em todos os casos após o transplante de medula óssea, confirmando a persistência do clone cromossomo Philadelphia num paciente em que o cariótipo também havia mostrado e identificando noutro em que não havia metáfases. Os casos de quimera mista foram negativos para BCR/ABL pela hibridação in situ por fluorescência. CONCLUSÃO: Ficou evidente a aplicabilidade da hibridação in situ por fluorescência, particularmente na detecção de doença residual. A citogenética clássica e a molecular são métodos complementares.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Discipline of Hematology and HemotherapyUNIFESP, EPM, Discipline of Hematology and HemotherapySciEL

Mielodisplasia hiperfibrótica: relato de caso com resposta à terapia com corticosteróides

Context: Bone marrow fibrosis is observed in different clonal hematological disorders including myeloproliferative diseases, acute leukemias and myelodysplastic syndromes. In myelodysplastic syndrome a new clinical-pathological entity with significant increase in reticulin fibers has been suggested, and the term hyperfibrotic myelodysplasia was used to define it. Bone marrow biopsy shows increased reticulin fibers, megakaryocytic hyperplasia and dysplasia. Differential diagnosis with primary myelofibrosis may be difficult and hybrid cases may occur. Patients with hyperfibrotic myelodysplastic syndrome responding to treatment with steroids have been reported. In the majority of cases there was only hematological remission, although resolution of fibrosis occurred in one patient. Design: Case report. Case report: A 62-year old male presented in June 95 with a 6-month history of lethargy and dispnea. On examination he was pale without hepato-splenomegaly. Hemoglobin concentration was 3g/dL with marked anisocytosis without teardrop cells. Bone marrow aspirates resulted in dry tap. Bone marrow biopsy showed hypercellularity with increased fibrosis (grade IV) obliterating the normal marrow architecture. Megakaryocytes were increased in number, with abnormal morphology. Monoclonal antibodies against factor VIII and CD31 revealed that both were expressed in megakaryocytes. Prednisone (1mg/Kg) was introduced in June 1996, after what his symptoms lessened and hemoglobin increased. Bone marrow fibrosis decreased (grade IV to grade II). He has become transfusion independent till Jan/1999, when hemoglobin fell to 6g/dL and prednisone was reintroduced with a prompt rise in hemoglobin concentration.Contexto: A fibrose de medula óssea é encontrada em algumas doenças hematológicas clonais, incluindo síndromes mieloproliferativas, leucemias agudas e síndromes mielodisplásicas. Nas síndromes mielodisplásicas, uma nova entidade clinicopatológica com acentuado aumento das fibras de reticulina tem sido sugerida, e o termo síndrome mielodisplásica hiperfibrótica é usado para sua definição. A biópsia de medula óssea mostra aumento das fibras de reticulina e hiperplasia megacariocítica com displasia. O diagnóstico diferencial com mielofibrose primária é difícil, e casos híbridos podem ocorrer. Pacientes com síndromes mielodisplásicas hiperfibróticas que respondem à terapia com corticosteróide têm sido descritos. Na maioria dos casos a remissão é apenas hematológica, mas resolução da fibrose de medula óssea já ocorreu em um paciente. Planejamento: Relato de caso. Relato: Paciente do sexo masculino, 62 anos de idade, apresentou-se, em junho de 1995, com história de seis meses de letargia e dispnéia. Ao exame, mostrou-se pálido, sem hepatoesplenomegalia. A concentração de hemoglobina foi de 3g/dl, com acentuada anisocitose, mas sem células em lágrimas. Os aspirados de medula óssea mostraram-se secos, enquanto a biópsia revelou hipercelularidade e fibrose grau IV, obliterando a arquitetura habitual. Os megacariócitos estavam em número aumentado, com morfologia anômala, reagindo com anticorpos antifator VIII e CD31. Com a introdução de prednisona 1mg/kg em junho de 1996, os sintomas reduziram, a hemoglobina elevou-se e a fibrose cedeu para grau II, tornando-se independente de transfusões até janeiro de 1999. Então, a hemoglobina caiu para 6g/dl e, com a introdução de prednisona, houve pronta elevação da hemoglobina.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Curare e prendersi cura degli adolescenti ammalati di tumore: evoluzione di un modello di assistenza centrato sul paziente

Gli adolescenti ammalati di tumore costituiscono un gruppo peculiare di pazienti, con dei bisogni speciali. Questo articolo analizza l’impatto psicologico di una malattia grave, come il cancro, su questa delicata fascia d’età e descrive il Progetto Giovani della Pediatria dell’Istituto Nazionale dei Tumori di Milano, un progetto nato come un nuovo modello di assistenza per rispondere ai peculiari bisogni dei pazienti adolescenti e giovani adulti.Adolescents with cancer are a particular group of patients with special needs. The paper describes the psychological impact of cancer on adolescent patients and introduces the “Youth Project” of the Pediatric Oncology Unit IRCCS Fondazione Istituto Nazionale Tumori in Milan, dedicated to young patients with solid tumors. This project represents a possible new assistance model to address the unique needs of patients in this age group

Acute Myeloid Leukemia t(8;21) after treatment for hyperthyroidism using radioactive iodine: Secondary Leukemia?

Acute leukemia following treatment with Iodine131 is a rare event. The possible carcinogenic effect of Iodine131 is still not clear and a large series of cases did not show an increased incidence of cancer. A case of AML t(8;21), three years after Iodine131 treatment for hyperthyroidism, is reported. Secondary AML with t(8;21) is described following exposure to drugs that target topoisomerase II and radiotherapy. The controversial potential of Iodine131 as a leukemogenic agent and the fact that t(8;21) is also found in de-novo AML, emphasize the problem in establishing a relationship between these events although this potential can not be ruled out.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)UNIFESP, EPMSciEL

Analysis of Nucleotide Variations in Genes of Iron Management in Patients of Parkinson's Disease and Other Movement Disorders

The capacity to act as an electron donor and acceptor makes iron an essential cofactor of many vital processes. Its balance in the body has to be tightly regulated since its excess can be harmful by favouring oxidative damage, while its deficiency can impair fundamental activities like erythropoiesis. In the brain, an accumulation of iron or an increase in its availability has been associated with the development and/or progression of different degenerative processes, including Parkinson's disease, while iron paucity seems to be associated with cognitive deficits, motor dysfunction, and restless legs syndrome. In the search of DNA sequence variations affecting the individual predisposition to develop movement disorders, we scanned by DHPLC the exons and intronic boundary regions of ceruloplasmin, iron regulatory protein 2, hemopexin, hepcidin and hemojuvelin genes in cohorts of subjects affected by Parkinson's disease and idiopathic neurodegeneration with brain iron accumulation (NBIA). Both novel and known sequence variations were identified in most of the genes, but none of them seemed to be significantly associated to the movement diseases of interest