Secondary hemophagocytic syndrome after autologous hematopoietic cell transplant and immune therapy for neuroblastoma

Secondary hemophagocytic syndrome (HPS) has been described after autologous hematopoietic cell transplant (AutoHCT). We report two cases of secondary HPS after novel consolidation therapy for high‐risk neuroblastoma as part of an institutional phase 2 trial incorporating immunotherapy into a “standard” AutoHCT regimen. Both patients developed liver dysfunction beyond expected course of hepatic veno‐occlusive disease, coagulopathy, hyperferritinemia, and when evaluated, elevated soluble interleukin‐2 receptor and hemophagocytosis. These cases highlight the need for clinicians to have a high index of suspicion for immune‐related complications in patients receiving immune therapies.     

IgG autoantibodies against ACE2 in SARS-CoV-2 infected patients

How frequently autoantibodies against angiotensin-converting enzyme 2 (ACE2) occur in patients infected by SARS-CoV-2 is understudied and limited to investigations on a small sample size. The presence of these antibodies may contribute to the long-lasting effects of COVID-19 observed in some individuals, particularly if IgG-class antibodies would emerge in patients. This study assessed the prevalence of IgG autoantibodies against ACE2 in 1139 patients infected with SARS-CoV-2 and examined their relationship with severity, demographic characteristics, and status of vaccination against influenza. The overall prevalence of anti-ACE IgG antibodies in our cohort was 1.5%. Most of these individuals were men (76.5%) and underwent mild COVID-19, but some severe and asymptomatic cases were also observed. Patients with severe infection had twofold higher titers than mild and asymptomatic cases. Age, comorbidities, and influenza vaccination status were not related to antibody prevalence. The prevalence of IgG anti-SARS-CoV-2 antibodies (against nucleocapsid protein and S2 subunit, but not against receptor-binding domain) was higher in the subset with ACE2 autoantibodies. Further research is required to understand the potential spectrum and duration of effects of IgG autoantibodies against ACE2 in patients after SARS-CoV-2 infection, particularly concerning long COVID-19.     

Thirty years of evolution of oral health behaviors in the working-age Poles

Introduction

In an average Polish person aged 35–44, more than 16 teeth have or had been affected by dental caries. Of that number, almost half of the teeth have already been extracted. Oral health behaviours contribute to this civilization disease in 50%. Such poor oral health status limits the ability of the affected people to take many social and professional roles.

Objectives

To evaluate current oral health behaviours and their trends among 35–44 year old Polish people during the period of recent 30 years.

Material and Methods

The data were obtained from the International Collaborative Studies conducted in 1978 and 1988 at the Nofer Institute of Occupational Medicine, ?ód?, Poland, under the auspices of the World Health Organization (WHO) as well as from 3 stages of the study on Nationwide Monitoring of Oral Health Status and Its Conditioning performed in 1998, 2002 and 2010. The researchers evaluated oral health behaviours and oral health condition of 5425 subjects.

Results

Despite a noticeable improvement, poor oral health behaviours are observed in 30%–40% of the adults. In the analysed period, the number of people brushing their teeth at least twice a day increased by more than 10% and the number of people using dental floss increased by 38%. Only 60% of the adults visited a dentist at least once a year. Reduced accessibility of state-run, free-of-charge dental care has caused that over 58% of Poles paid for their dental services. Every 3rd person of working age has not visited a dentist for longer than 2.5 half years, primarily due to behavioural and financial reasons. Oral health behaviours of Polish people are among the poorest in Europe.

Conclusions

Despite a noticeable improvement of the behaviours, gap between the Poles and citizens of other highly developed countries is around 20 years. A health promotion programme including oral health issues, if implemented in workplaces, might considerably reduce this gap.     

Diatom indices in the biological assessment of the water quality based on the example of a small lowland river

The aim of the study was to compare the biological analyzes of the Linda River (Central Poland), which were based on three diatom indices: IO, GDI and IPS in order to select the best diatom index for the biological assessment of the lotic water quality. Additionally, the summary of the selected results of the biological and chemical analyzes was presented to show how precise the biological analyzes are as a basic tool in the assessment of the ecological status of the lotic waters. The results showed that each of the indices assessed the water in the Linda River to a specific but different quality class. The IO index showed class II of the water quality, while the IPS and GDI — class III. Statistical analysis conducted with the nonparametric Kruskal-Wallis test for independent samples (Kruskal, Wallis 1952) showed that differences in the values of individual indices at different sites were not statistically significant. It should be noticed that the IPS and GDI indices gave values that classify the water in the Linda River at least one class below. The obtained results confirmed that the biological methods are most reliable in the assessment of the water quality. These methods are less sensitive to a single impact of the environmental factors, therefore they permit accurate determination of the ecological status of the water ecosystems.     

Awake endotracheal intubation in patients with severely restricted mouth opening- alternative devices to fiberscope: series of cases and literature review

Awake Fiberoptic Intubation (AFI) is a standard method of airway management in the case of anticipated difficult intubation. It is usually performed with the use of flexible fiberscopes. In this report we have described two methods in which alternative devices to the fiberscope were utilized for awake intubation in patients with severely restricted mouth opening scheduled for craniomaxillofacial surgery: TruView PCD and Levitan FPS. Information about the use of these devices in such conditions has not been previously published in the literature. Some of the possible advantages of these alternative methods for AFI result from the fact that they are easy to use, especially for anesthesiologists who are relatively inexperienced with fiberscope intubation procedures. Additionally, these alternatives are cheaper than fiberscopes and can be used for many AFI procedures.     

Magnesium ions and opioid agonist activity in streptozotocin-induced hyperalgesia

Streptozotocin-induced hyperglycemia accompanied by a chronic decrease in the nociceptive threshold is considered a useful model of experimental hyperalgesia. We examined (1) the effect of the opioid receptor agonists and (2) the effect of the magnesium ions (Mg(2+)) on the antinociceptive action of opioid agonists in a diabetic neuropathic pain model. When administered alone, opioid agonists like morphine (5 mg/kg i.p.) and fentanyl (0.0625 mg/kg i.p.), as well as the partial agonist buprenorphine (0.075 mg/kg) had only little effect on streptozotocin-induced hyperalgesia. However, pretreatment with Mg(2+) at a dose of 40 mg magnesium sulfate/kg i.p. markedly enhanced the analgesic activity of all three investigated opioids. Practical aspects of co-administration of magnesium and opioids in diabetic neuropathy are discussed.     

Determination of phenolic compounds and their antioxidant activity in Erigeron acris L. extracts and pharmaceutical formulation by flow injection analysis with inhibited chemiluminescent detection

It was found that the chemiluminescence (CL) produced from the reaction of luminol with iodine in the alkaline medium was strongly inhibited by plant phenolic compounds. Based on this finding, a new flow injection CL method was developed for the determination of caffeic acid and 6'-caffeoylerigeroside. The latter compound was isolated for the first time from Erigeron acris L. herb. The method was simple, rapid and sensitive with a detection limit of 4 x 10(-3) ng mL(-1) (caffeic acid) and 0.18 ng mL(-1) (6'-caffeoylerigeroside), linear range of 0.1-1.5 ng mL(-1) (caffeic acid) and 1-200 ng mL(-1) (6'-caffeoylerigeroside), relative standard deviation of 3.3% for 10 measurements of 0.45 ng mL(-1) caffeic acid and 2.9% for 40 ng mL(-1) 6'-caffeoylerigeroside. This method was successfully applied to determine the content of phenolic compounds/antioxidant activity of E. acris L. extracts and phenolic acids content in pharmaceutical formulation. A possible mechanism of the inhibition of the proposed CL system was discussed.