Incidence and treatment of lymphedema in heart transplant patients treated with everolimus.

BACKGROUND: Proliferation signal inhibitors are increasingly used as immunosuppressive drugs in solid organ transplantation. Among their side effects peripheral lymphedema is rarely described in literature. METHODS: All heart transplant patients treated with everolimus (de novo or maintenance) at our center (135 patients: age 50.72±11.1 y, 115 male) were retrospectively analyzed. We considered the incidence of adverse events, particularly the appearance of peripheral edema (13 patients, 9.6%), and the correlation with preoperative characteristics, concomitant medications, other possible causes of edema, as well as all the measures developed for its therapeutic treatment. RESULTS AND CONCLUSIONS: Edema appearance, especially in lower limbs, was considered to be one of the most frequent side effects in heart transplant patients treated with everolimus. In some cases its regression was possible with an adjustment of drug dosages associated with diuretics and lymphatic drainage, but more often a suspension of the drug itself was required for complete regression of the symptoms.

Antioxidant activity of Punica granatum fruits.

Arils, juice and rinds of Punica granatum fruits and their aqueous and ethyl acetate extracts displayed good antioxidant activity.

Auditory attention at the onset of West syndrome: correlation with EEG patterns and visual function.

At the onset of West syndrome a specific impairment of visual function has been clearly demonstrated, while other aspects of sensorial development, and in particular of the auditory function, have been less studied. The aim of this study was to evaluate auditory function and orienting responses at the onset of West syndrome, and to relate the results with EEG patterns, visual function and neurodevelopmental competence. A prospective multicentric study was performed on 25 successively enrolled infants with West syndrome; all the patients underwent a full clinical assessment, including MRI and video-EEG, visual function and auditory orienting responses (AORs) as well as Griffiths' developmental scales. The whole assessment performed at the onset of spasms (T0) was repeated after two months (T1). AORs resulted significantly impaired both at T0 and T1. At the onset of spasms a highly significant relationship of auditory attention with visual function and neurodevelopmental competence was shown in both cryptogenic and symptomatic forms, but it was no longer present after two months. Our results may suggest a possible pervasive effect of the epileptic disorder on sensory processing, associated to a deficit of neurodevelopment. Although we failed to show a significant correlation between auditory orienting responses and EEG patterns, some evidence seems to support at least partially an influence of the epileptic disorder per se on the genesis of the sensorial impairment. A longer follow up and a larger cohort will be useful for a better clarification of these findings.

Evaluation of lactogenic immunity to canine parvovirus in pups.

Maternally-derived antibodies (MDA) transferred to pups through colostrum and milk are known as lactogenic immunity. In this report, we describe the kinetics of transfer of lactogenic immunity to canine parvovirus type 2 (CPV-2) from two bitches (A and B) to their offspring. At day 7 before parturition, bitches A and B had high serum antibody titers, which decreased rapidly within a few hours after parturition, in concomitance with the appearance of high HI titers in colostrum. Subsequently, the serum antibodies of the two dogs increased again, reaching approximately the initial titers. CPV-specific antibodies were observed in milk, with decreasing values, throughout the lactation period. The kinetics of MDA observed in the pups was consistent with the patterns of absorption and decline previously described.

Nonhypoxemic hazards of prolonged myoclonus.

Hyperkalemia, hyperthermia, and systemic hypotension developed in a patient with generalized myoclonus. These disorders reached life-threatening proportions but were rapidly and completely corrected after the patient was paralyzed with pharmacologic agents. Induced neuromuscular blockade may be indicated when the systemic effects of pathologically contracting muscle become life-threatening.