A blockage monoclonal antibody protocol as an alternative strategy to avoid anti-CD38 interference in immunohematological testing.

BACKGROUND: As CD38 is expressed on red blood cells (RBCs), the plasma of patients on daratumumab (DARA) reacts with the panel cells of pretransfusion tests, masking underlying alloantibodies. The treatment of RBCs with dithiothreitol (DTT) is the most disseminated method to overcome DARA effect on immunohematological tests, but it hampers the identification of potentially harmful antibodies. Our goal was to validate a new strategy, the blockage monoclonal antibody protocol (BMAP), to mitigate the DARA interference on RBCs using anti-CD38 and antihuman globulin. METHODS: Samples of patients receiving DARA were included in the study. Sera were tested using both DTT- and BMAP-treated RBCs, which comprised three steps: 1) titration of monoclonal anti-CD38, 2) treatment of RBCs obtained from donors with anti-CD38, and 3) blockage of anti-CD38-adsorbed RBCs with antihuman globulin. RESULTS: Twenty patients were included in the study. Donor RBCs were treated with anti-CD38 and successfully blocked with antihuman globulin. In 19 patients, DARA-mediated agglutination was eliminated using both DTT- and BMAP-treated RBCs. In one patient, agglutination persisted when tested against the BMAP-treated RBCs, and alloantibodies were identified. Patient samples were mixed with commercial anti-D, -C, -e, -K, -Jka, -Kpb and tested against antigen-positive BMAP-treated RBCs, resulting in detection of these antibodies. CONCLUSION: This study validated a new strategy to minimize the interference of DARA on immunohematological tests. The protocol preserves the integrity of RBC antigens, permitting the detection of antibodies from all blood group systems. The BMAP has potential use in other situations where specific antibodies may interfere with pretransfusion screening.

Aneurisma toracoabdominal / Thoracoabdominal aneurysm

Los aneurismas toracoabdominales son poco frecuentes; según la literatura su incidencia es de 1 por cada 100.000 personas siendo esto estimado en la incidencia de los aneurismas abdominales 1-3%. La edad media de aparición es de 65 años y en su mayoría la principal causa es de enfermedad aterosclerótica. La clasificación de los aneurismas toracoabdominales es en base a la que describió Crawford: Tipo I- Tipo IV. En la Unidad de Cirugía Cardiovascular de Guatemala se trató un caso de un paciente joven con un aneurisma toracoabdominal según la clasificación de Crawford Tipo III.

Thoracoabdominal aneurysms are a rare disease; according to the literature the incidence is 1 per 100,000people this being estimated incidence of abdominal aneurysms 1-3%. The average age of onset is 65 yearsold and mostly the main cause is atherosclerotic disease. The classification of thoracoabdominal aneurysms isbased on that described Crawford: Type I-Type IV. In the Unidad de Cirugía Cardiovascular de Guatemala acase of a young patient with thoracoabdominal aneurysm was treated as classified by Crawford type III.

Porphyrin-kaolinite as efficient catalyst for oxidation reactions.

The preparation, characterization, and application in oxidation reactions of new biomimetic catalysts are reported. Brazilian Sao Simao kaolinite clay has been functionalized with [meso-tetrakis(pentafluorophenyl)porphinato]iron(III), Fe(TPFPP). To obtain the functionalized clay, the natural clay was purified by dispersion-sedimentation, expanded by insertion of dimethyl sulfoxide (DMSO), and functionalized with amino groups by substitution of DMSO with ethanolamine. These previous steps allowed clay functionalization with Fe(TPFPP), leading to a layered material with a basal spacing of 10.73 A. Clay functionalization with the porphyrin was confirmed by formation of the secondary amine, as demonstrated by FTIR bands at 3500-3700 cm(-1). UV-vis spectroscopy revealed a red shift in the Soret band of the iron porphyrin in the functionalized material as compared to the parent iron porphyrin catalyst in solution, indicating Fe(III)P --> Fe(II)P reduction. The catalytic performance of the functionalized clay was evaluated in the epoxidation of cyclooctene, with complete selectivity for the epoxide (100% epoxide yield), and ketonization of cyclohexane, cyclohexanone being the major product. The novel catalyst was also evaluated in the Baeyer-Villiger (BV) oxidation of cyclohexanone, with 85% conversion of cyclohexanone in epsilon-caprolactone, with total selectivity to epsilon-caprolactone.

Fibrilación auricular de diagnóstico reciente en pacientes adultos del Hospital Roosevelt: identificación de patología asociada más frecuente / Atrial fibrilation of recent onset in adult patients at Roosevelt Hospital: Identification of the most frequent predisposing factors

La fibrilación auricular es la arritmia cardiaca más frecuente que el médico enfrenta diariamente. La mayoría de las personas que sufren de este padecimiento tienen una cardiopatía de base, siendo hipertensión arterial crónica y la cardiopatía isquémica, las patologías más frecuentes. Se realizó un estudio cuyo objetivo era identificar las causas más frecuentes que predisponen a padecer de este problema. Durante enero 2002 a junio 2003 ingresaron al hospital Roosevelt 80 pacientes con diagnóstico reciente de fibrilación auricular los resultados obtenidos fueron los siguientes...