Safety of outpatient autologous hematopoietic cell transplantation for multiple myeloma and lymphoma.

Autologous hematopoietic cell transplantation (Auto-HCT) is commonly an in-patient procedure. However, Auto-HCT is increasingly being offered on an outpatient basis. To better characterize the safety of outpatient Auto-HCT, we compared the outcome of 230 patients who underwent Auto-HCT on an in-patient vs outpatient basis for myeloma or lymphoma within a single transplant program. All outpatient transplants occurred in a cancer center day hospital. Hematopoietic recovery occurred earlier in the outpatient cohort, with median time to neutrophil recovery of 10 vs 11 days (P<0.001) and median time to platelet recovery of 19 vs 20 days (P=0.053). Fifty-one percent of the outpatient cohort never required admission, with this percentage increasing in later years. Grade 3-4 non-hematologic toxicities occurred in 29% of both cohorts. Non-relapse mortality at 1 year was 0% in the outpatient cohort and 1.5% in the in-patient cohort (P=0.327). Two-year PFS was 62% for outpatient vs 54% for in-patient (P=0.155). One- and two-year OS was 97% and 83% for outpatient vs 91% and 80% for in-patient, respectively (P=0.271). We conclude that, with daily outpatient evaluation and aggressive supportive care, outpatient Auto-HCT can result in excellent outcomes for myeloma and lymphoma patients.

Mineralogy at Meridiani Planum from the Mini-TES Experiment on the Opportunity Rover.

The Miniature Thermal Emission Spectrometer (Mini-TES) on Opportunity investigated the mineral abundances and compositions of outcrops, rocks, and soils at Meridiani Planum. Coarse crystalline hematite and olivine-rich basaltic sands were observed as predicted from orbital TES spectroscopy. Outcrops of aqueous origin are composed of 15 to 35% by volume magnesium and calcium sulfates [a high-silica component modeled as a combination of glass, feldspar, and sheet silicates (approximately 20 to 30%)], and hematite; only minor jarosite is identified in Mini-TES spectra. Mini-TES spectra show only a hematite signature in the millimeter-sized spherules. Basaltic materials have more plagioclase than pyroxene, contain olivine, and are similar in inferred mineral composition to basalt mapped from orbit. Bounce rock is dominated by clinopyroxene and is close in inferred mineral composition to the basaltic martian meteorites. Bright wind streak material matches global dust. Waterlain rocks covered by unaltered basaltic sands suggest a change from an aqueous environment to one dominated by physical weathering.

Initial results from the Mini-TES experiment in Gusev Crater from the Spirit Rover.

The Miniature Thermal Emission Spectrometer (Mini-TES) on Spirit has studied the mineralogy and thermophysical properties at Gusev crater. Undisturbed soil spectra show evidence for minor carbonates and bound water. Rocks are olivinerich basalts with varying degrees of dust and other coatings. Dark-toned soils observed on disturbed surfaces may be derived from rocks and have derived mineralogy (+/-5 to 10%) of 45% pyroxene (20% Ca-rich pyroxene and 25% pigeonite), 40% sodic to intermediate plagioclase, and 15% olivine (forsterite 45% +/-5 to 10). Two spectrally distinct coatings are observed on rocks, a possible indicator of the interaction of water, rock, and airfall dust. Diurnal temperature data indicate particle sizes from 40 to 80 microm in hollows to approximately 0.5 to 3 mm in soils.

Basaltic rocks analyzed by the Spirit Rover in Gusev Crater.

The Spirit landing site in Gusev Crater on Mars contains dark, fine-grained, vesicular rocks interpreted as lavas. Pancam and Mini-Thermal Emission Spectrometer (Mini-TES) spectra suggest that all of these rocks are similar but have variable coatings and dust mantles. Magnified images of brushed and abraded rock surfaces show alteration rinds and veins. Rock interiors contain

Isoprinosine in the early pre-erosive stage of rheumatoid arthritis: a pilot study.

The etiology of rheumatoid arthritis is unknown. Virus infection is one of alleged factors initiating the disease process. In view of this, the authors undertook a trial of administration of an antiviral and immunostimulating preparation - isoprinosine, given in the early phase of the disease prior to the development of erosions. Isoprinosine was given to ten seropositive cases of rheumatoid arthritis (two males, eight females) aged 34-61 years, with disease duration from 6 months to 5 years treated previously only with non-steroidal anti-inflammatory drugs. Isoprinosine was administered for 4 weeks (2 weeks of 3.0 g daily and 2 weeks of 1.5 g daily). After the treatment, a statistically significant reduction was observed in the number of joints painful on pressure, the number of swollen joints, and the duration of morning stiffness. The grip strength of the left hand was increased. The ESR and serum uric acid level were not changed significantly. The titre of Waaler-Rose reaction in four patients was decreased, in two it was increased, and in four it remained unchanged. No side effects were observed during the treatment. In the light of these observations it seems worthwhile to continue further studies on the action of isoprinosine in early rheumatoid arthritis.

Observations on the symptoms and signs of "early" rheumatoid arthritis in a prospective study.

The authors have made a detailed study of 202 cases recognized as early RA. All of them were referred to the Institute for thorough examination and were afterwards followed up for two to six years. The observation of the course of the disease revealed four groups: 1. Cases where development of bone erosions proved the diagnosis of RA, 2. Cases in whom all previous symptoms and signs disappeared, 3. Cases in whom diagnosis could not be established after follow-up, 4. Cases in whom other diseases were manifest. The first two groups were analysed retrospectively to find the characteristic features in the early stages of RA.

Free-radical mediated aggregation of human gamma-globulin.

Ultra-violet irradiation of human gamma-globulin results in aggregation and the formation of fluorescent products. The fluorescence was inhibited by ascorbate and propyl gallate indicating the release of oxygen-free radicals.

Venous air embolism: comparative merits of external cardiac massage, intracardiac aspiration, and left lateral decubitus position.

The treatment of venous air embolism was compared in adult mongrel dogs utilizing left lateral decubitus position, external cardiac massage, and intracardiac aspiration of air. Following the rapid injection of a lethal dose (15 ml/kg) of air, it was found that the left lateral decubitus position and external cardiac massage each produced 57.1 percent survival, both being as effective as intracardiac aspiration of air (61.9 percent survival). Resuscitation time was shortest in dogs treated with intracardiac aspiration, 2.7 +/- 0.28 minutes, whereas with external cardiac massage and left lateral decubitus position, resuscitation times were 18.3 +/- 2.1 minutes and 19.50 +/- 3.0 minutes, respectively. Our study shows external cardiac massage, left lateral decubitus position, and intracardiac aspiration to be equally effective in the treatment of venous air embolism. Our data did not show intracardiac aspiration to be superior to either external cardiac massage of left lateral decubitus position despite the shorter resuscitation time. External cardiac massage has the advantage of simplicity and speed of initiation.

Humidification: Indications and hazards in respiratory therapy.

Scientific data fail to support the widespread use of humidity and mist in respiratory therapy. A clear indication exists to provide humidification of inspired air in patients in whom the proximal airway is bypassed by endotracheal cannulation. Indications for the use of concentrated mist atmospheres in therapy of lung disease is less well documented, and too often the importance of adequate systemic hydration is overlooked. Theory supports the use of a highly humid or mist atmosphere in therapy of upper airway disease, but little benefit is derived from such therapy in diseases of the smaller airways and lung parenchyma. Danger of bacterial contamination and infection and an increase in airway resistance are significant hazards to the patient exposed to highly humid atmospheres.