Bacillus Calmette-Guerin infection following intravesical instillation: Does the strain matter?

PURPOSE: Intravesical BCG is the standard treatment of non-muscle invasive bladder cancer. No difference has yet been reported in the safety profiles of the various BCG strains. METHODS: A nationwide multidisciplinary retrospective survey was conducted between January 2013 and December 2016 to identify cases of BCG infection and differentiate them based on the type of BCG strain used. RESULTS: Forty patients were identified (BCG RIVM 28; other strains 8; unknown 4). Patients treated with BCG RIVM were less severely ill, with fewer occurrences of septic shock (3.6% vs. 50%, P=0.003) and ICU admission (7.1% vs. 62.5%, P=0.003). A higher frequency of pulmonary miliaries (71.4% vs. 12.5%, P=0.005) but lower transaminase levels (mean AST 65 vs. 264 U/L, P=0.001) were observed in these patients. No difference in terms of recovery was reported. CONCLUSION: The type of BCG strain could correlate with the frequency and severity of subsequent BCG infections.

[Best practice guide for radiation therapy of non-small cell bronchial cancers]. / Guide de bonne pratique pour la radiothérapie thoracique exclusive ou postopératoire des carcinomes non à petites cellules.

The objective was the drafting of a practical document intended for radiotherapists and radiophysicists, describing the technique of irradiation of a non small cell bronchial cancer. The good practices concern the care of patients affected by bronchial cancer localized in the thorax and inoperable or patients who must undergo postoperative irradiation. The document has been developed according to a methodology aiming to join the current scientific data from an analysis of the literature on the subject and the assessment of radiotherapists, radiophysicists, lung specialists and methodologists from Rhône-Alpes area. From the stages necessary for the good progress of a radiotherapy, the writers of this document proposed common definitions concerning the centering and the location of the zone to be treated, the calculation of the dose distribution, the preparation of the patient for the treatment, the treatment and the surveillance during the treatment. The recommendations of this guide took into account the peculiarities bound to the nature of the treated region and more particularly the lung heterogeneity, respiratory movements and the radiosensibility of healthy lung tissue. Even if the technical aspect of the radiotherapy was particularly developed, the interest accorded to patient information takes on all its importance for a therapeutic coverage of quality. The authors of the document wished that this Guide of Good Practices, which will be regularly updated, helps the radiotherapists and allows them to harmonize their practices.

Phenology of flowering and starch accumulation in grape (Vitis vinifera L.) cuttings and vines.

BACKGROUND AND AIMS: A reliable protocol for flowering and fruiting in cuttings was developed with the aim of (a) studying inflorescence and flower development in grapevine cuttings and field plants, and (b) assisting haploid plant production. METHODS: Inflorescence and flower development was studied in 'Gewurztraminer' (GW) and 'Pinot Noir' (PN) grape vines and cuttings grown in a glasshouse, along with variations in starch in the flowers. As there is a strong relationship between flower development and starch, the starch content of reproductive structures was estimated. KEY RESULTS: Inflorescence and flower development were similar in the vines and cuttings with consistent differences between the two cultivars. Indeed, the ontogenesis of male and female organs is not synchronous in GW and PN, with both female and male meiosis occurring earlier in PN than in GW. Moreover, changes of starch reserves were similar in the two plant types. CONCLUSIONS: Cuttings have a similar reproductive physiology to vines, and can be used to study grape physiology and to develop haploid plants.

Non-dopaminergic catecholaminergic neurons of mesencephalic and medullary nuclei contain different levels of dopamine.

The present study addresses the question whether metabolic dopamine can be immunocytochemically detected within non-dopaminergic catecholaminergic axonal fibers. For this purpose, confocal microscopy was used to analyze sections treated for the double fluorescence immunostaining of dopamine and either noradrenaline or phenylethanolamine-N- methyltransferase (the enzyme in adrenergic neurons that converts noradrenaline into adrenaline). Our data demonstrate that throughout the brain and spinal cord, the majority of the axonal fibers that reacted with the anti-phenylethanolamine-N-methyltransferase antibodies also exhibited faint to intense dopamine immunoreactivity. Similarly noradrenaline and dopamine immunoreactivities were frequently colocalized within axonal fibers innervating brain and spinal cord regions that receive a dense innervation from medullary noradrenergic neurons. On the contrary, dopamine was rarely detected within noradrenaline-immunoreactive fibers in those regions where the noradrenergic innervation essentially arises from noradrenergic neurons of the locus coeruleus. A similar differential dopamine immunostaining was observed in the corresponding neuronal perikarya of the medulla oblongata and the locus coeruleus. These data indicate that two types of non-dopaminergic catecholaminergic neurons can be distinguished according to their content in dopamine: (i) the noradrenergic and adrenergic neurons located in the medulla oblongata, whose cell bodies and axons contain high concentrations of metabolic dopamine and (ii) the noradrenergic neurons located in the mesencephalon, which contain low levels of metabolic dopamine.

[Intraoperative radiotherapy. Preliminary results]. / La radiothérapie per-opératoire. Résultats préliminaires.

We report a series of 40 patients treated by intraoperative radiotherapy between 1988 and 1992 (18 primary tumors, 13 local recurrences and 9 nodal extensions). The doses delivered were 15 Gy to 25 Gy, completed by external radiotherapy (15 to 45 Gy) in 13 cases. The local tumor control rate was 61% for initial therapy in primary tumors (70% for adenocarcinoma of the stomach) and 80.9% after complete en bloc surgery. The local control rate after palliative surgery for local recurrences is 38% and 33% for nodal extension. Two patients died (5%) during the postoperative period. We observed 2 hemorrhages and 3 cases of stone-free cholecystitis. The value of this approach must be confirmed in rigorous indications in comparison with surgery alone in controlled and randomised clinical trials.

Clinical background of patients treated with clean intermittent catheterization in Norway.

This study reports on the use of clean intermittent catheterization (CIC) in Norway in 1988/89. A total of 407 adult out-patients was studied. CIC was used in all age-groups and equally in both sex. The patients were divided into five diagnostic groups. There were twice as many patients suffering from neurogenic diseases as non-neurogenic ones. A neurourological index was constructed based on neurological examination and urodynamic data giving a good differentiation and expression of the bladder affection. It appeared that CIC could be performed even by highly disabled persons. A statistically significant correlation was found between the neuro-urological results in patients with decompensated bladder and their over all disability.

Computation of fertility rates following a defined reproductive risk event, by the life table method, with ectopic pregnancy used as an example.

We have adapted the life table for use in the observation study of subjects desirous of pregnancy following a well-defined risk event in their reproductive lives. The construction of the table is described and illustrated, with the fertility after ectopic pregnancy given as the example.

PIP: The life table method has been underutilized in clinical reproduction research, despite its advantages of recording every pertinent event on the time scale and having no observational time limit. This article constructs a life table for the purpose of computing fertility after ectopic pregnancy in IUD users. The study population was comprised of women who underwent surgery for an ectopic pregnancy at a Bergen hospital in 1979-83 and made subsequent attempts to conceive. These women were classified as current IUD users, and never users. Cumulative fertility rates were computed through use of 100% minus the cumulative proportion not achieving pregnancy. Columns in the life table included: postoperative observation time (in 6 month intervals), number of study subjects at the start of the interval, the total number of intrauterine pregnancies (including spontaneous abortion and legal abortion) during each interval, the number of women experiencing an ectopic pregnancy, the total number of women who conceived (intrauterine and ectopic) during each interval, the number of study subjects who withdrew or were lost to follow-up, the effective number exposed to the possibility of pregnancy during the interval, the proportion of subjects with intrauterine pregnancies, the proportion of subjects who did not experience conceptions resulting in an intrauterine pregnancy, the cumulative proportion of women experiencing conception resulting in intrauterine pregnancy during successive intervals, and the standard deviation of these cumulative proportions. Any research worker with access to a computer can easily produce a life table-based graphic display of time sequences of events in a population.