Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus.

BACKGROUND: The COVID-19 pandemic has created enormous challenges for the clinical management of patients with hematological malignancies (HMs), raising questions about the optimal care of this patient group. METHODS: This consensus manuscript aims at discussing clinical evidence and providing expert advice on statements related to the management of HMs in the COVID-19 pandemic. For this purpose, an international consortium was established including a steering committee, which prepared six working packages addressing significant clinical questions from the COVID-19 diagnosis, treatment, and mitigation strategies to specific HMs management in the pandemic. During a virtual consensus meeting, including global experts and lead by the European Society for Medical Oncology and the European Hematology Association, statements were discussed and voted upon. When a consensus could not be reached, the panel revised statements to develop consensual clinical guidance. RESULTS AND CONCLUSION: The expert panel agreed on 33 statements, reflecting a consensus, which will guide clinical decision making for patients with hematological neoplasms during the COVID-19 pandemic.

Phenomenological modeling of reactive dye adsorption onto fish scales surface in the presence of electrolyte and surfactant mixtures.

The aim of this work was an experimental and theoretical investigation of the influence of electrolyte (NaCl) and surfactant (SP), as textile auxiliary agents (TAAs), onto reactive blue 5G (RB5G) dye removal by applying untreated fish scales (FS) in batch system. Kinetic and equilibrium studies were performed, aiming at the comprehension of the mass transfer mechanisms through phenomenological modeling. The biosorbent was texturally characterized, to investigate the adsorbent's characteristics and to support the models' assumptions. Hence, a 'physically meaningful' modeling to assess different systems containing dye-TAA mixtures was employed. The experimental results indicated that despite the FS nonporous characteristics, it showed remarkable adsorption capacities (≈291 mg g-1), which may be ascribed to the adsorbent-adsorbate affinity and to dye-aggregates adsorption onto the FS surface. Those results evidence a potential use of FS as an alternative biosorbent material. The mathematical model was able to identify the rate-limiting step of the process; to predict the adsorption kinetics and equilibrium condition, comprising the description of aggregates formation; and to successfully predict kinetic behavior of independent data in simulated real effluent. Those results indicate that the model can be used to simulate operating conditions and, therefore, support the design, optimization, and scale-up of adsorption processes.

Temperature dependence of the nonlinear optical response of smectic liquid crystals containing gold nanorods.

The present study is devoted to the investigation of the nonlinear optical properties of a smectic liquid crystal doped with gold nanorods. Using the Z-scan technique, we investigate the changes in the optical birefringence of a homeotropic sample upon laser exposure, considering the configurations of normal and oblique incidence. Our results reveal that the birefringence variations may be governed by distinct physical mechanisms, depending on the relative angle between the far-field director and the wave vector of the excitation laser beam. In particular, we observe that the position dependence of the far-field transmittance exhibits different behaviors as the incidence angle is changed, indicating that distortions in the beam wavefront may be associated with the thermal lens phenomenon or an optically induced reorientation of the nematic director. The temperature dependence of the nonlinear refractive and absorptive coefficients is investigated close to the smectic-A-nematic phase transition. A detailed analysis of the interplay between smectic order and plasmon resonance is performed, thus unveiling the capability of plasmonic liquid crystal to be used in optical devices.

Apoptosis in follicles of individuals with female pattern hair loss is associated with perifollicular microinflammation.

OBJECTIVE: The objective of this study is to evaluate apoptosis in hair follicles of patients with female pattern hair loss (FPHL) and its association with follicular microinflammation. METHOD: Cross-sectional study involving 17 women with FPHL and five controls. Scalp skin samples were processed for HE and TUNEL assays. The variables were compared according to the categories of follicles (terminal versus miniaturized) and groups of patients (FPHL vs. controls). RESULTS: There was a higher apoptosis index among miniaturized follicles and among the test cases (P < 0.01). Microinflammation was prominent among miniaturized follicles, especially from FPHL (P = 0.02). In addition, a positive correlation between inflammatory infiltrate and apoptosis in miniaturized follicles (rS = 0.68; P < 0.01) was found. CONCLUSIONS: Apoptosis was prominent in hair follicles from the FPHL group, as well as in miniaturized ones. Moreover, it was also correlated with the inflammatory infiltrate, which suggests that inflammation can lead to apoptosis and play a role in the pathogenesis of follicle miniaturization.

Thermo-optical properties and nonlinear optical response of smectic liquid crystals containing gold nanoparticles.

The present work is devoted to the study of the thermo-optical and nonlinear optical properties of smectic samples containing gold nanoparticles with different shapes. By using the time-resolved Z-scan technique, we determine the effects of nanoparticle addition on the critical behavior of the thermal diffusivity and thermo-optical coefficient at the vicinity of the smectic-A-nematic phase transition. Our results reveal that introduction of gold nanoparticles affects the temperature dependence of thermo-optical parameters, due to the local distortions in the orientational order and heat generation provided by guest particles during the laser exposure. Further, we show that a nonlinear optical response may take place at temperatures where the smectic order is well established. We provide a detailed discussion of the effects associated with the introduction gold nanoparticles on the mechanisms behind the thermal transport and optical nonlinearity in liquid-crystal samples.

Tuberculosis caused by RDRio Mycobacterium tuberculosis is not associated with differential clinical features.

BACKGROUND: We recently described the Mycobacterium tuberculosis RD(Rio) genotype, a clonally derived sublineage within the Latin American-Mediterranean (LAM) family. Genetic diversity of M. tuberculosis likely affects the clinical aspects of tuberculosis (TB). Prospective studies that address this issue are scarce and remain controversial. OBJECTIVE: To determine the association of differential clinical features of pulmonary TB with the RD(Rio) M. tuberculosis etiology. METHODS: Culture-proven pulmonary TB patients (n = 272) were clinically evaluated, including history, physical examination, chest X-ray and anti-human immunodeficiency virus serology. Isolates were classified as RD(Rio) or non-RD(Rio) M. tuberculosis by multiplex polymerase chain reaction and further spoligotyped. Clinical and M. tuberculosis genotype data were analyzed. RESULTS: RD(Rio) M. tuberculosis caused disease in 26.5% (72/270) of all TB cases. The LAM genotype, of which RD(Rio) strains are members, was responsible for 46.0% of the TB cases. Demographic data, major signs and symptoms, radiographic presentation, microbiological features and clinical outcomes were not significantly different among patients with TB caused by RD(Rio) and non-RD(Rio) strains. CONCLUSIONS: Disease caused by M. tuberculosis RD(Rio) strains was not clinically distinctive or more severe than disease caused by non-RD(Rio) strains in this series of TB patients. Larger prospective studies specifically designed to disclose differential clinical characteristics of TB caused by specific M. tuberculosis lineages are needed.

Comparison of decontamination methods for primary isolation of Mycobacterium bovis in paucibacillary bovine tissues.

AIMS: To compare three decontamination methods applied to paucibacillary samples for primary isolation of Mycobacterium bovis from suspect lesions. Tuberculosis caused by Myco. bovis is an important infectious disease of cattle in Brazil and also has zoonotic potential. Although a national campaign based on testing and slaughtering cattle has achieved good results, there is a strong need to develop better diagnostic methods to identify cattle with recent infections harbouring few bacilli. METHODS AND RESULTS: A dairy herd (274 adult crossbred cows) located in the state of Rio de Janeiro was tested for tuberculosis with both single intradermal tuberculin test and comparative intradermal tuberculin test. Reactive cows (n=27, 9.8%) were slaughtered and suspect lesions were collected (one sample per cow). Samples considered paucibacillary (based on microscopy) were decontaminated with 0.75% hexadecylpyridinium chloride (HPC), 4% sodium hydroxide (Petroff) or 6% sulphuric acid. Using these methods, 10, five and six, respectively, of the 27 samples yielded positive cultures. Overall, Myco.bovis was isolated from 14 of 24 cows. Although the HPC method resulted in isolation of more Myco.bovis strains than either Petroff or sulphuric acid methods (P=0.015), it did not result in the recovery of Myco.bovis from all samples. However, using both HPC and 6% sulphuric acid methods for decontamination was possible to identify 13 of 14 (92·9%) of infected cows. CONCLUSIONS: At least two methods should be used concurrently for primary isolation of Myco. bovis from bovine tissues, particularly for paucibacillary samples. SIGNIFICANCE AND IMPACT OF THE STUDY: Detection of low numbers of Myco.bovis in tissue is an important goal in optimizing the detection of bovine tuberculosis and should assist in identification of infected cattle, in particular, those with few Myco.bovis bacilli. This was apparently the first study comparing three decontamination methods for the detection of Myco.bovis in paucibacillary samples from naturally infected cattle.

The rs5743836 polymorphism in TLR9 confers a population-based increased risk of non-Hodgkin lymphoma.

Non-Hodgkin lymphoma (NHL) has been associated with immunological defects, chronic inflammatory and autoimmune conditions. Given the link between immune dysfunction and NHL, genetic variants in toll-like receptors (TLRs) have been regarded as potential predictive factors of susceptibility to NHL. Adequate anti-tumoral responses are known to depend on TLR9 function, such that the use of its synthetic ligand is being targeted as a therapeutic strategy. We investigated the association between the functional rs5743836 polymorphism in the TLR9 promoter and risk for B-cell NHL and its major subtypes in three independent case-control association studies from Portugal (1160 controls, 797 patients), Italy (468 controls, 494 patients) and the US (972 controls, 868 patients). We found that the rs5743836 polymorphism was significantly overtransmitted in both Portuguese (odds ratio (OR), 1.85; P=7.3E-9) and Italian (OR, 1.84; P=6.0E-5) and not in the US cohort of NHL patients. Moreover, the increased transcriptional activity of TLR9 in mononuclear cells from patients harboring rs5743836 further supports a functional effect of this polymorphism on NHL susceptibility in a population-dependent manner.

Equilibrium of Cu(II) and Ni(II) biosorption by marine alga Sargassum filipendula in a dynamic system: competitiveness and selectivity.

The study focuses on the equilibrium of dynamic biosorption in single and binary systems containing Cu(II) and Ni(II) ions using Sargassum filipendula (a marine alga). The experiments were performed in fixed-bed columns with both single-component and bi-component metal solutions (using different molar concentrations). Experimental data were fitted with different equilibrium models such as Langmuir, Langmuir with inhibition, Jain and Snowyink and Langmuir-Freundlich equations. The biosorption of pure metal ions in solution presented adequate capacities both for Cu(II) and Ni(II). In binary solutions the preferential sorption of Cu(II) over Ni(II) was demonstrated by the displacement of Ni(II) (marked overshoot on the breakthrough curves).

Aedes aegypti egg counting system.

New monitoring methods of dengue vector and evaluation of public policies on dengue control are major concerns for several tropical countries. Drawback on monitoring methods base on oviposition surveys are the counting process of mosquito eggs, information store and analysis. Here we present a new automated egg counting system for remote Aedes aegypti population survey. The system is base on an optical scanning platform, a man-machine interface, and a software for mosquitoes eggs counting. Acquired information are sent over the internet and remotely analyzed. Prototypes of the device were installed and implement in two different cities.

Sorption kinetics and equilibrium for the removal of nickel ions from aqueous phase on calcined Bofe bentonite clay.

In this paper the kinetics and dynamics of nickel adsorption on calcined Bofe bentonite clay were studied. The clay was characterized through EDX, surface area (BET) and XRD analysis. The influence of parameters (pH, amount of adsorbent, adsorbate concentration and temperature) was investigated. Kinetic models were evaluated in order to identify potential adsorption process mechanisms. The Langmuir and Freundlich models were utilized for the analysis of adsorption equilibrium. Thermodynamic parameters were assessed as a function of the process temperature. The kinetics data were better represented by the second-order model. The process was found to be strongly influenced by the factors studied. The Bofe clay removed nickel with maximum adsorption capacity of 1.91 mg metal/g of clay (20 degrees C; pH 5.3) and that the thermodynamic data indicated that the adsorption reaction is spontaneous and of an exothermal nature. The Langmuir model provided the best fit for sorption isotherms.

Removal of nickel on Bofe bentonite calcined clay in porous bed.

Bentonite clays have been showing good adsorbing characteristics and are used as an alternative material in the removal of heavy metals. The purpose of this study is to evaluate the removal of nickel on Bofe bentonite calcined clay in porous bed. Firstly, a study was conducted to define the operation outflow, based on the minimum mass transfer zone (MTZ) obtained, useful (q(U)) and total adsorbed (q(T)) removal amounts and total nickel removal percentage (Rem (%)). Assays of nickel adsorption on clay were conducted according to a 2(2) factorial design with three central points to evaluate the effect of the particle diameter and initial adsorbate concentration on variables q(U), q(T) and Rem (%). Tests to obtain the adsorbent physical and chemical characteristics were performed on samples of Bofe clay in natura, calcined, and calcined submitted to nickel adsorption. This clay was characterized according to the following techniques: Energy Dispersive Spectroscopy (EDS), Thermogravimetry (TG), Differential Scanning Calorimetry (DSC), X-ray Diffraction (XRD), Fourier Transformed Infrared Spectroscopy (FTIR), Physisorption of N(2) (BET), Helium Picnometry and Scanning Electron Microscope (SEM) with metal mapping.

Evaluation of batch adsorption of chromium ions on natural and crosslinked chitosan membranes.

Removal of chromium ions from aqueous solutions by using natural and crosslinked chitosan membranes was achieved using batch adsorption experiments. The effect of pH (6.0 and 2.0), concentration of chromium ions and crosslinking agents (glutaraldehyde: GLA and epichlorohydrin: ECH) on the adsorption properties of chitosan membranes was analyzed. The experimental equilibrium data was fitted to Langmuir and Freundlich models. Through the model curves, it was possible to observe that the amount of chromium ions adsorbed was significantly higher for crosslinked membranes compared to non-crosslinked chitosan. The maximum adsorbed amount was about 1400 mg g(-1) for ECH-crosslinked chitosan at pH 6.0. The adsorption rates for crosslinked chitosan membranes with glutaraldehyde and epichlorohydrin were similar for natural chitosan. Desorption study using NaCl (1 mol L(-1)) solution was performed on chitosan membranes, in order to recover chromium ions and to determine the suitable number of cycles for repeated use of these membranes without considerable decrease in their adsorption capacity. The desorption results showed that chromium ions could be more effectively removed at pH 2.0 than pH 6.0, mainly for ECH-crosslinked chitosan.

Cytogenetic abnormalities in MALT lymphomas and their precursor lesions from different organs. A fluorescence in situ hybridization (FISH) study.

AIMS: To analyse the possible activation of distinct molecular pathways in mucosa-associated lymphoid tissue (MALT) lymphoma, we determined the prevalence of trisomies 3, 12, 18 in MALT lymphomas from different organs, as well as the prevalence of translocations of the MALT1 gene in a subset of primary breast MALT lymphomas. We compared the numerical cytogenetic alterations in lymphomas, precursor lesions and in normal non-haematolymphoid tissue from the same organs. METHODS AND RESULTS: Forty-two samples of paraffin-embedded tissue (29 MALT lymphomas from stomach, breast, parotid and thyroid; two Sjögren's syndrome; two Hashimoto's thyroiditis and nine reactive samples) were studied by fluorescence in situ hybridization (FISH). Analysed together, the cases of gastric, parotid and thyroid MALT lymphomas presented trisomy 3 in 46%, trisomy 12 in 28% and trisomy 18 in 21% of the cases. In contrast to other locations, trisomy 3 was not present in the majority of the cases of primary breast MALT lymphomas. None of the nine breast cases presented MALT1 gene rearrangements. Half of the cases of preneoplastic lesions exhibited trisomy 3 and trisomy 12; none exhibited trisomy 18. CONCLUSIONS: Trisomy 3 is the most frequent numerical abnormality in gastric, parotid and thyroid but not in primary breast MALT lymphomas. MALT1 gene rearrangements are also rare in this location, suggesting that distinct molecular pathways may be activated in breast cases.

Influence of the drying conditions of Sargassum sp. alga on the bioadsorption of hexavalent chromium.

Industrial wastes containing synthetic organic compounds and heavy metals are among the most dangerous residues, whose growth has followed the increase in industrial activity. Heavy metals are readily assimilated into the food chain and therefore easily accumulated in the ecosystem. To remove heavy metals from aqueous solutions, marine algae may be used as adsorbents either in their natural form or after treatments by a cross-linking process to improve their mechanical resistance. Drying of biosorbents, such as marine algae, is mentioned in many previous works as a step preceding the adsorption/dessorption cycle. Concerning algae, drying of its fresh biomass allows for proper storage and enhances performance in the sorption of heavy metals. In this work, physical and morphological analyses of fresh and dried Sargassum sp. marine algae, harvested offshore São Sebastião, São Paulo state, Brazil, were performed in order to assess the influence of drying conditions on the biosorption process. Chromium concentrations were also determined in different parts of the algal structure before and after the biosorption process. The drying promoted structural changes in the algae, like shrinkage and porosity reduction. It was also observed that the chromium retention was dependent on the structural arrangement of the alga parts, in which the leaf was the major biosorbent.

Ancestim (recombinant human stem cell factor, SCF) in association with filgrastim does not enhance chemotherapy and/or growth factor-induced peripheral blood progenitor cell (PBPC) mobilization in patients with a prior insufficient PBPC collection.

Up to a third of autologous transplantation candidates fail to mobilize hematopoietic progenitors into the peripheral blood with chemotherapy and/or growth factor treatment, thus requiring innovative mobilization strategies. In total, 20 cancer patients unable to provide adequate PBPC products after a previous mobilization attempt were treated with ancestim (20 microg/kg/day s.c.) and filgrastim (10 microg/kg/day s.c.). In 16 patients, the pre-study mobilization was with filgrastim alone. Eight patients underwent single large volume leukapheresis (LVL) and 12 multiple standard volume leukaphereses (SVL) in both mobilizations. Pairwise comparison of peripheral blood CD34(+) cell concentrations on the day of first leukapheresis failed to document synergism - median CD34(+)/microl of 3.2 (<0.1 to 15.4) and 4.5 (1-28.56) for the pre-study and on-study mobilizations (P = 0.79, sign test), and 4.2 (<0.1-15.4) and 5 (1-28.56), respectively, for the 16 patients previously mobilized with filgrastim alone (P = 1, sign test). The number of CD34(+) cells/kg collected per unit of blood volume (BV) processed was similar in both mobilizations - median 0.1 x 10(6)/kg/BV and 0.09 x 10(6)/kg/BV, respectively (P = 1, sign test). In this phase II study, the combination of ancestim and filgrastim did not allow adequate PBPC mobilization and collection in patients with a previous suboptimal PBPC collection.

Genotypic patterns of multiple isolates of M. tuberculosis from tuberculous HIV patients.

We investigated whether the recurrence of tuberculosis in HIV-infected patients is due to an exogenous reinfection or relapses after antituberculosis chemotherapy. We reviewed clinical information on 32 patients at a Rio de Janeiro hospital from whom multiple Mycobacterium tuberculosis isolates were taken. All isolates were analysed by DRE-PCR fingerprinting technique, and those with identical DRE-PCR patterns were analysed by the RFLP method. Twenty patients had M. tuberculosis simultaneously isolated from different organs. These patients and nine others with sequential positive cultures after 2 months of therapy showed stable DRE-PCR and RFLP patterns. One patient's isolate became resistant to isoniazid, but the molecular pattern remained unchanged despite the development of drug resistance. In three patients, the DRE-PCR patterns of the isolates changed dramatically. Clinical and microbiological evidence was consistent with active tuberculosis caused by a new strain of M. tuberculosis. The exogenous reinfection of the three patients was not due to an outbreak, but the isolates from each patient showed unique patterns.

Study of the evolution of the placenta and fetal pancreas in the pathophysiology of growth retardation intrauterine due to restricted maternal diet.

CONTEXT: Intrauterine growth retard (IUGR) continues to be a significant perinatology problem at the end of this century. The nature of the etiologic agent, the time when the attack occurred during pregnancy and its duration affect the type of IUGR. OBJECTIVE: To study the evolution of fetal pancreas and placenta between the 18th and 21st day of pregnancy in rats submitted to maternal protein-calorie restriction. DESIGN: Randomized controlled trial on laboratory animal. SAMPLE: Forty-one normoglycemic pregnant Wistar rats. INTERVENTION: Rats were divided into six experimental groups according to their access to food and date of cesarean section (18th or 21st day): control with free access to food; diet restricted to 25% introduced on 1st day of pregnancy; and diet restricted to 25% after the 3rd day of pregnancy. MAIN MEASUREMENTS: Newborn weight, placenta weight, histopathological study (morphological histochemistry). RESULTS: Maternal protein-calorie malnutrition caused intrauterine growth retard (IUGR) after the 18th day of pregnancy. Dietary restriction did not interfere with the morphology of the fetal pancreas and the immunohistochemical study of the placenta showed that glycogen stores were decreased between the 18th and 21st day in the control group and in a diet restricted to 25% from the first day of pregnancy. Dietary restriction after the 3rd day of pregnancy led to low placental glycogen concentrations on the 18th day and disappearance on the 21st day. CONCLUSION: The pathophysiology of IUGR due to maternal protein-calorie restriction in rats is related to lower placental weight and low placental glycogen stores.

The nuclear topography of ABL, BCR, PML, and RARalpha genes: evidence for gene proximity in specific phases of the cell cycle and stages of hematopoietic differentiation.

The mechanisms whereby chromosomal translocations are consistently associated with specific tumor types are largely unknown. A generally accepted hypothesis is that the physical proximity of the involved chromosomal regions may be one important factor in the genesis of these phenomena. Accordingly, a likely possibility is that such a proximity may occur in a cell-lineage and cell-differentiation stage-specific manner. In this work, we have addressed this issue using as models the ABL and BCR genes of t(9;22) and the PML and RARalpha genes of t(15;17). By using in situ hybridization and confocal microscopy, we have measured the distances between these two pairs of genes in three-dimensionally preserved hematopoietic cells belonging to different cell lineages, at various stages of differentiation, and at various stages of the cell cycle, with the following results. (1) Intergenic distances vary periodically during the cell cycle and a significant association of ABL with BCR and of PML with RARalpha is seen at the transition between S and G2, which persists during G2 and prophase (such a behavior is not observed for distances between ABL or PML and the beta-globin genes, used as a control). (2) The proportion of cells in which PML and RARalpha or ABL and BCR are closely associated is higher in hematopoietic precursors than in B-lymphoid cells (whereas the distances between ABL or PML and the beta-globin genes are not affected by cell type). (3) When intergenic distances in unstimulated bone marrow CD34(+) cells were compared with those in CD34(+) cells treated with interleukin-3 (IL-3), a trend towards a higher proximity of the ABL and BCR genes in the former and of the PML and RARalpha genes in the latter is observed. (4) Analysis of B-lymphoid cells during mitosis shows that intergenic distances at metaphase are strongly influenced by physical constraints imposed by the chromosomal location of the gene, by the size of the respective chromosome, and by the geometry of the metaphase plate. These findings suggest that intrinsic spatial dynamics, established early in hematopoiesis and perpetuated differentially in distinct cell lineages, may facilitate the collision of individual genes and thus reciprocal recombination between them at subsequent stages of hematopoietic differentiation.

[Faculty's behavior in undergraduate nursing teaching: the students' perception]. / Comportamento docente no ensino de graduação em Enfermagem: a percepção dos alunos.

The purposes of the present study are: to identify faculty's predominant behaviors in undergraduate nursing teaching, according to the students' perception and to classify them in different groups of faculty, relating them to the teaching framework. Data were obtained through questionnaires, applied to fifty-two students from the Federal University of Mato Grosso do Sul. Considering the results obtained from both periods, we can conclude that there is a certain plurality in the faculty behaviors, with a predominance of teachers concerned about contents, methods and techniques, with characteristics of the traditional, behaviorist and cognitive frameworks.