Primary cutaneous anaplastic large-cell lymphoma: a review of the SEER database from 2005 to 2016.

INTRODUCTION: Primary cutaneous anaplastic large-cell lymphoma (PC-ALCL) is a rare T-cell lymphoma. A prior analysis of the Surveillance, Epidemiology, and End Results (SEER) database reported only 157 cases of localized primary cutaneous CD30+ T-cell lymphoproliferative disorders (PC-ALCL and lymphomatoid papulosis) from 1973 to 2004. Our analysis of the SEER database since 2004 is the largest to date and our results improve our understanding of this disease and their potential prognostic factors. METHODS: We used the SEER database to retrospectively identify patients. Survival was analysed using the Kaplan-Meier method, and log-rank tests were used to compare survival distributions. RESULTS: There were 501 cases of PC-ALCL recorded from 2005 to 2016. Overall survival rates at 5 and 10 years were found to be 80.6% (95% CI 76.3%-84.3%) and 61.5% (95% CI 54.1%-68.1%) respectively. Age ≥ 60 years [hazard ratio (HR) = 1.09, P = 0.001 and use of chemotherapy (HR = 1.86, P = 0.01)] were associated with lower overall survival. In contrast to the 1973-2004 cohort, the head and neck site was not significantly associated with prognosis on multivariate analysis. CONCLUSION: PC-ALCL has been increasingly recognized over the past decade. Age > 60 years and use of chemotherapy are associated with a worse outcome. Contrary to prior studies, location was not associated with poor survival.

VOC elimination in a compost biofilter using a previously acclimated bacterial inoculum.

A comparison of biodegradation efficiencies was done for volatile benzene, toluene, ethylbenzene, m-xylene, p-xylene, and o-xylene elimination in a compost biofilter. The column was first exposed to a synthetic mixture and then a free phase product mixture containing these compounds at increasing pollutant loads. The optimal moisture content of the system was determined, and this was used in the biodegradation experiments. An acclimated culture was used as an inoculum for the biofilter, the matrix of which consisted of composted forestry products, composted sewage sludge, lime, and perlite. Inlet and outlet concentrations were measured, and pollutant loads, elimination capacities, and removal efficiencies were determined for each of the compounds. Optimal moisture content for this system was found to be 40%, and the short lag times (one to five days) in acclimating to the compounds was ascribed to the presence of the well-acclimated inoculum. The compounds in the synthetic mixture had higher removal efficiencies (80-99%) even at the higher pollutant loads experienced, with the exception of o-xylene. Dynamic removal efficiencies and acclimation periods were seen in the free phase product mixture, with a removal efficiency range from 70 to 95%. This was attributed to the presence of chlorinated aliphatics in the free phase product.

Safe withdrawal from acute alcohol abuse in the aged.

It is imperative to consider chronic and acute alcoholism as possibly underlying problems that aged persons may exhibit. The potential exacerbation of organ dysfunctions, the complexity of medication regimens, and negative interactions of these are all more likely to create problems in the treatment of the elderly alcoholic patient. The nurse, the social worker, the nutritionist, the physician, and the pharmacologist must work as a team to treat these patients properly. The nurse focuses on maintaining patient safety and function, continually assessing, observing, and reassessing. On the basis of these data the pharmacologist collaborates with the physician to manage medications and titrate dosages properly. Malnutrition is a prevalent problem among the aged, particularly older alcoholic men who live alone. The nutritionist must assess dietary deficiencies and recommend therapeutic vitamins, minerals, and foods as needed. It is imperative to evaluate serum levels of folic acid, cyanocobalamin, thiamine, magnesium, and to monitor periodically potassium. Before discharge the social worker assists the patient in beginning an appropriate alcoholic treatment plan. The situation of the acutely ill alcoholic patient requires ongoing and precise collaboration of the team to achieve acceptable outcomes.

Clinical pharmacology of a novel diarylsulfonylurea anticancer agent.

LY186641 (diarylsulfonylurea, [DSU]) is a novel anticancer agent because of its unique diarylsulfonylurea chemical structure, broad-spectrum antisolid-tumor activity in preclinical models, presumed novel mechanism of action and preclinical toxicities of methemoglobinemia (Met Hgb) and decreased red blood cell (RBC) survival. In this study, the in vitro drug sensitivity of human tumors as well as clinical pharmacology and toxicology of DSU in patients with cancer were examined. DSU was administered orally, daily for 7 days with a 3-week treatment cycle. Dose-limiting toxicities were Met Hgb and RBC hemolysis. The maximum-tolerated dose was found to be 1,200 mg/m2/d for 7 days. In pharmacokinetic studies, DSU was found to have a prolonged serum half-life (approximately 30 hours) and a large area under the plasma disappearance curve (8,883.3 micrograms.hr/mL at 1,200 mg/m2/d). A partial remission was observed in one patient with refractory ovarian cancer. In conclusion, DSU can be safely administered to cancer patients and does display antitumor activity. Potential means of obviating the toxicities of this compound are discussed.