Pediatric Nasopharyngeal Cancer: Case Report and Review of the Literature.

Pediatric nasopharyngeal carcinoma, also referred to as cavum carcinoma, is a rare pediatric disease with an infrequent incidence rate. We present the case of a pediatric patient with nasopharyngeal cancer who received an adult schedule of concomitant chemotherapy and conformal radiotherapy with a brachytherapy boost. Adult protocols with high radiotherapy doses are not commonly used in pediatric patients due to the high comorbidity associated with this practice. In this case, the patient displayed excellent overall survival, a longer disease-free period, and fewer side effects and comorbidities, even in the absence of interferon therapy, which is not easily available in low-income countries. In addition, this case shows that conformal radiotherapy and brachytherapy are options that can be used to escalate the radiotherapy dose and decrease side effects. A 12-year-old female pediatric patient presented to our outpatient clinic with an eight-month history of moderate-to-severe otalgia, intermittent hyaline rhinorrhea, asthenia, adynamia, nasal congestion, epistaxis in the previous months, and local pruritus. Upon physical examination, a 60x60 mm mass was detected at level II of the neck, and a biopsy of the lesion confirmed a histopathological diagnosis of undifferentiated carcinoma compatible with nasopharyngeal carcinoma. The patient was considered to have clinical Stage III cancer, and she received an adult Al-Sarraf protocol with chemoradiotherapy and an intracavitary brachytherapy boost. The patient had a complete response, and she remains without local or distance relapse. Treating pediatric nasopharyngeal carcinoma patients with the Al-Sarraf protocol could be a feasible modality, as observed in this clinical case, despite the elevated cost of using interferon-beta in low-income countries when using more advanced radiotherapy techniques such as conformal radiotherapy and now, modulated intensity radiotherapy. It should be noted that brachytherapy boosts should be used with caution in pediatric patients; the potential side effects should be weighed against improved local control.

Risk of neonatal mortality according to gestational age after elective repeat cesarean delivery.

PURPOSE: Despite the well-known neonatal morbidity risks after elective cesarean deliveries performed before 39 weeks, there are scarce data regarding mortality risks. The objective of this study was to calculate the risk of neonatal mortality after elective repeat cesarean delivery (ERCD) by gestational age. METHODS: The Linked Birth-Infant Death Data Files from the Vital Statistics Data of the Center for Disease Control and Prevention of the U.S. from 2004 to 2008 were analyzed. Only ERCD cases were included. Early death (<7 days), neonatal death (<28 days), and infant death (<1 year) were evaluated. A logistic regression model was used to calculate odds ratios. Cases delivered at 37-41 weeks were studied with 40 weeks as reference. RESULTS: A total of 483,052 cases were included for analysis. The distribution of rates and odds ratios for infant, neonatal and early death was U-shaped with the nadir at 39 weeks. There was a statistically significant increase in early death at 37 compared to 40 weeks' gestation [OR (95 %) CI = 1.929(1.172-3.176)]. No statistical increase was found in any of the other mortality risks. CONCLUSION: There is an increased risk in early death with ERCD performed at 37 weeks. Our study provides evidence of neonatal harm beyond the reported morbidity risks.

Isolation and partial characterization of antifungal metabolites produced by Bacillus sp. IBA 33.

Antifungal proteins produced by Bacillus sp. IBA 33 were purified by ammonium sulfate precipitation and DEAE-Sephacel column chromatography. The two purified proteins inhibited the growth of Geotrichum candidum, the sour rot disease agent in lemon. The proteins were stable at 20 (3 months), 40, 60 and 100 degrees C (30 min) and remained active after sterilization at 121 degrees C for 15 min. Their hydrophobic nature was proved and when were developed with ninhydrin they did not show any free amino groups. The infrared spectrum showed vibrational modes corresponding to peptide, ester or ketone links and saturated CH links corresponding to long chain fatty acids. UV scan spectroscopy showed tyrosine and or tryptophan amino acids in their composition. The remarkable thermo-resistance of proteins may be a good feature to be used in the development of a new biocontrol method of Geotrichum candidum.

Temperature, soluble solids and pH effect on Alicyclobacillus acidoterrestris viability in lemon juice concentrate.

Alicyclobacillus acidoterrestris is a thermoacidophilic, non-pathogenic, spore-forming bacterium detected in spoiled commercial pasteurized fruit juice. Apple, white grape and tomato are particularly susceptible. A. acidoterrestris spores are resistant to lemon juice pasteurization (2 min at 82 degrees C), and they can germinate and grow causing spoilage. This contamination is characterized by a medicinal or disinfectant smell attributed to guaiacol (o-dihydroxybenzene) production and other taint chemicals. The aim of this work was to study the influence of temperature (82, 86, 92 and 95 degrees C), total soluble solids (SS) (6.20, 9.8, 50 and 68 degrees Brix) and pH (2.28, 2.45, 2.80, 3.25, 3.5) on decimal reduction time (D) of the A. acidoterrestris in clarified and non-clarified concentrated lemon juice. Once D-value was determined, the resistance of A. acidoterrestris at the assayed temperatures was confirmed. SS and pH influence spore viability, because spore resistance increases with higher SS (50 degrees Brix 22 min 82 degrees C-68 degrees Brix 28 min 82 degrees C) and pH values (pH 2.28, 17 min-pH 4.00, 22 min). Bacterial growth was lower in clarified lemon juice, 26 min at 82 degrees C, than in non-clarified lemon juice, 51 min at 82 degrees C. Temperature was the parameter that had the greatest influence on the D value.