Invasive aspergillosis in pediatric oncology patients: a rare event with poor prognosis--case analysis to plan better targeted prophylactic or therapeutic measurement.

Despite the implementation of new antifungal drugs, invasive aspergillosis (IA) still remains a considerable challenge in pediatric oncology with a severe mortality. Prophylactic and therapeutic measurement have to be evaluated in these rare but poor prognostic patients. Therefore the entire group of patients at risk of developing IA has to be defined before cooperative prospective trials. In a retrospective analysis including all our patients with malignancies we looked for patients with proven/probable IA. Cases of the period from 2003 to 2008 were analyzed in detail.In the period between 2003 to 2008 24 of 755 patients were affected by proven/ probable IA. Compared to former studies incidence increased from 1.3%in 1980 to 3.4% in 2008. AML patients with or without allogeneic/haploidentical stem cell transplantation were at highest risk (24% and 25% respectively, in comparison to 1% in ALL-patients). Survival after 2 years was 50% for patients with AML and IA. In patients with high risk to develop IA the effect of intensified, intravenous antimycotic prophylaxis has to be proven prospectively in a cooperative and randomized setting.

A simple and efficient dual optical signaling chemodosimeter for toxic Hg(II).

10-Methylthioacridone, designated as acrithion, has been employed as an easily accessible chemodosimeter for the optical targeting of toxic Hg(2+) in buffered aqueous DMSO. The Hg(2+)-mediated desulfurization of the probe is translated into selective dual signaling of Hg(2+) by means of color bleaching and fluorescence amplification while several other metal ions, including potentially competing Ag(+), Cu(2+) and Pb(2+), afford no significant interferences even in excess concentrations.

Effects of altered photoperiod due to COVID-19 lockdown on pregnant women and their fetuses.

Maternal circadian rhythms provide highly important input into the entrainment and programming of fetal and newborn circadian rhythms. The light-dark cycle is an important regulator of the internal biological clock. Even though pregnant women spend a greater part of the day at home during the latter stages of pregnancy, natural light exposure is crucial for the fetus. The current recommended COVID-19 lockdown might dramatically alter normal environmental lighting conditions of pregnant women, resulting in exposure to extremely low levels of natural daylight and high-intensity artificial light sources during both day and night. This article summarizes the potential effects on pregnant woman and their fetuses due to prolonged exposure to altered photoperiod and as consequence altered circadian system, known as chronodisruption, that may result from the COVID-19 lockdown.

[3.3]Dithia-bridged cyclophanes featuring a thienothiophene ring: synthesis, structures and conformational analysis.

The synthesis of [3.3]dithia-bridged cyclophanes 7, 9 and 11 incorporating a fused heterocycle, thieno[2,3-b]thiophene is described. The structures are established by ¹H NMR analysis and, in the case of 11, also by single crystal X-ray crystallography. Conformational analysis by variable temperature NMR suggests that cyclophanes 7, 9 and 11 exhibit conformationally rigid bridges and rings at least up to 130° C. Energy minimization of 11 revealed anti-11 to be the most stable conformation. Although, the computed energy difference between the most stable conformation anti-11 and the next higher energy conformation syn-anti-11 is only 2.98 kJ/mol, it is intriguing that 11 does not exhibit thia-bridge inversion even at elevated temperatures.

Outcome of primary bone fragment replacement in compound depressed skull fractures.

OBJECTIVE: To assess the outcome in terms of infectious complications after primary bone fragment replacement in compound depressed skull fractures, regardless of the degree of wound contamination. DESIGN: Case series. PLACE AND DURATION OF STUDY: Combined Military Hospital, Rawalpindi, from August 2005 to October 2006. PATIENTS AND METHODS: Patients of all ages and both genders with compound depressed skull fractures irrespective of the degree of wound contamination were selected. Patients with already infected skull wounds were excluded. Bone fragments were replaced in all cases. Main outcome variables were age, associated CT scan findings, type of fracture, location of fracture, wound type, admission to operation time, interval and infectious complications after surgery. RESULTS: Of the 51 cases, the wounds were classified as clean in only 9 patients and the rest had variable degrees of contamination. Thirty five patients were operated within 24 hours, 13 were debrided and bone fragments replaced within 24-72 hours and 3 patients were treated after 72 hours. Thirty five patients were earthquake victims. The average age of the patients was 28.6 years. Three patients developed wound infection and osteomyelitis. One patient had free-floating bone fragments due to the development of hydrocephalus with no evidence of infection. CONCLUSION: Bone fragment removal in compound depressed skull fractures, regardless of the degree of wound contamination, is not obligatory and primary bone fragment replacement is a suitable alternative, which also avoids a second cranioplasty.

A 65-year old female with synchronous HIV and Extramedullary Plasmacytoma of Maxillary sinus.

Extramedullary plasmacytoma in the head and neck region is a rare malignant neoplasm comprising approximately 3% of all the plasma cell neoplasms and less than 1% of head and neck tumors. This extraskeletal lesion is a unifocal, monoclonal, neoplastic proliferation of plasma cells. Some investigators believe that this lesion represents the least aggressive part of the spectrum of plasma cell neoplasms which extends to multiple myeloma. Therefore, plasmacytoma is believed to have clinical importance. We report a case of extramedullary plasmacytoma in the right maxillary sinus of a 65-year-old HIV positive female as a clinical rarity with review of the relevant literature.

Some immunological parameters in workers occupationally exposed to n-hexane.

1. To estimate the quantitative relation between exposure to airborne n-hexane and various markers of immune function, 35 male workers were examined and compared with unexposed controls. 2. Urinary 2,5-hexanedione concentrations were significantly higher in the exposed group than in the unexposed. 3. A significant suppression was observed in the serum immunoglobulin (IgG, IgM and IgA) levels between two populations. Also, a significant correlation was found between urinary 2,5-hexanedione concentrations and serum Ig level of the exposed group. 4. No significant difference between white blood cell counts was found in the two groups.

Proliferative response of peripheral blood lymphocytes and lymphocyte subpopulations in n-Hexane, toluen, and methyl ethyl ketone co-exposed workers.

To estimate the quantitative relation between chronic co-exposure to airborne n-hexane, toluen, methyl ethyl ketone (MEK) and various markers of immune function such as proliferative response of peripheral blood lymphocytes and lymphocyte subpopulations, a group of workers employed in a shoe factory were examined and compared with the unexposed controls. A significant increase was observed in the proliferative response of the peripheral lymphocytes to 2.5 and 5 µg PHA in the exposed group compared with that of the control group. There was no significant change in the percentage of circulating CD3(+), CD4(+), CD8(+), CD19(+), CD16(+) lymphocytes even in those workers with 3.3-fold higher mean levels of urine 2,5-hexanedione (2,5-Hxdn) and approximately twofold higher mean levels of urine hippuric acid (HA) as compared to controls. No difference was also observed between the mean granulocyte, monocyte, lymphocyte percentages of the groups, but a significant increase was observed in mean serum C3 level of the workers. Our results suggest that while lymphocyte subpopulations and leucocyte percentages are not affected, the proliferative response of the peripheral lymphocytes is stimulated after chronic co-exposure to n-hexane, toluen and MEK at the defined levels.

The different faces of facial nerve schwannomas.

Facial nerve schwannomas are rare benign tumors. The tumor can arise anywhere along the course of the facial nerve. The most common presentation for this tumor is a slowly progressive facial nerve paralysis. Sensorineural hearing loss (SNHL) and tinnitus are later symptoms. The symptoms and signs depend on the site of tumor along the nerve. We report three cases of facial nerve schwannomas with different clinical presentations. Appropriate management of a facial nerve schwannoma should be based on the site and extent of the tumor and status of the nerve function.