Performance evaluation of Alfred60AST rapid susceptibility testing directly from positive blood cultures in the routine laboratory workflow

European Journal of Clinical Microbiology & Infectious Diseases - The aim of this study was to evaluate the performance of the new automated system Alfred60AST which is based on light...     

Successful Outcome of Hyperhemolysis in Sickle Cell Disease following Multiple Lines of Treatment: The Role of Complement Inhibition

Abstract

Delayed hemolytic transfusion reaction (DHTR) is a life-threatening complication in patients with sickle cell disease, characterized by difficulties in diagnosis and management. Certain reports have suggested successful salvage treatment with the terminal complement inhibitor, eculizumab. We here report evidence of complement activation and successful complement inhibition with one dose of eculizumab in an adult sickle cell disease patient presenting DHTR with hyperhemolysis. A 21-year old female sickle cell disease patient [Hb S (HBB: c.20A>T)/β-thalassemia (β-thal)] presented at our Adult Thalassaemia Unit, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece, with headaches, perioral numbness and pain in both antibrachia. The patient was admitted with the diagnosis of vaso-occlussive crisis (VOC) and treated symptomatically. On her third day of admission, due to hemoglobin (Hb) value of 6.9?g/dL with increase in reticulocytes, the patient was transfused with one unit of compatible leukodepleted red blood cells (RBC). The following day, hemolytic parameters increased, although Coombs, panel antibodies and screening tests were negative. Five days later, she again received a unit of RBCs, resulting in another increase of hemolytic parameters. During the following 2 days, there was a dramatic decrease of Hb levels to 5.4?g/dL with reticulocytes at 6.0%, negative Coombs testing and negative alloantibodies. Based on these findings, we recognized the syndrome of DHTR with hyperhemolysis. Given the lack of immediate access to other treatment, we administered intravenous rituximab, immunoglobulins and corticosteroids. As there was no response, one dose of eculizumab (900?mg) was then administered with ciprofloxacin as prophylaxis. The patient remains well 6 months post treatment.     

Endoscopically drained abdominal abscess compressing the sigmoid

Intra-abdominal abscesses (IAA) complicate numerous medical and surgical pathologic conditions. Accurate radiological diagnosis combined with percutaneous or surgical drainage and antibiotics is the current standard of care for IAA. We herein report a case of a 52-year-old woman with a 10-day history of fever and abdominal pain. An intra-abdominal abscess externally compressing the sigmoid was revealed and successfully drained during colonoscopy.     

MR imaging findings of an atypical pulmonary hamartoma in a 12-year-old child

We present the MR imaging findings in an atypical pulmonary hamartoma in a 12-year-old boy. CT showed no evidence of fat or calcifications in the tumour. It demonstrated peripheral rim enhancement on arterial-phase MR images due to a compressed respiratory epithelium, and progression to nearly homogeneous contrast enhancement on delayed-phase images. Small cystic spaces were identified on MR hydrographic and contrast-enhanced images formed by invaginating respiratory epithelium, a unique imaging finding in this condition.     

Low-birth-weight,but not catch-up growth,correlates with insulin resistance and resistin level in SGA infants at 12 months

Objective: To investigate the insulin resistance status in SGA infants at 12 months and its relationship with auxological and metabolic parameters.

Methods: One group of 45 SGA and one of 50 appropriate for gestational age infants were followed from birth to the end of the first year of life. At 12 months, skinfold thickness, waist circumference, and blood levels of glucose, insulin, adiponectin, leptin, resistin, visfatin, retinol-binding protein 4, IGFs, lipids profile were determined, and the HOMA-IR index was calculated.

Results: The SGAs had increased insulin (5.2?±?2.7 versus 2.9?±?2.4 μIU/ml, p?=?0.012) and HOMA-IR (1.09?±?0.9 versus 0.59?±?0.55, p?=?0.016). In multiple regression, insulin resistance indices were independently correlated with low-birth-weight (β?=??2.92, p?=?0.015 for insulin, β?=??2.98, p?=?0.011 for HOMA-IR) but not with catch-up growth in either height or weight or any other metabolic parameter. Resistin was higher in the SGAs (5.1?±?2.1 versus 3.9?±?2.1?ng/ml, p?=?0.03) and independently correlated with low-birth-weight but not insulin resistance. Resistin was negatively correlated with total cholesterol (R?=??0.33, p?=?0.007) and positively with lipoprotein(a) (R?=?0.49, p?=?0.001).

Conclusion: Low-birth-weight, but not catch-up growth or adiposity tissue hormones, was correlated with insulin resistance at 12 months in non-obese SGA infants. The higher resistin in SGA infants and its correlation with total cholesterol and lipoprotein(a) need further clarification.