An Overview of Sex Bias in C. neoformans Infections.

Cryptococcosis, a fungal disease arising from the etiologic agent Cryptococcus neoformans, sickens a quarter of a million people annually, resulting in over 180,000 deaths. Interestingly, males are affected by cryptococcosis more frequently than females, a phenomenon observed for more than a half century. This disparity is seen in both HIV− (~3M:1F) and HIV⁺ (~8M:2F) populations of cryptococcal patients. In humans, male sex is considered a pre-disposing risk factor for cryptococcosis and males suffering from the disease have more severe symptoms and poorer outcomes. There are numerous observational, clinical and epidemiological studies documenting the male disadvantage in C. neoformans but with no further explanation of cause or mechanism. Despite being commonly acknowledged, little primary research has been conducted elucidating the reasons for these differences. The research that has been conducted, however, suggests sex hormones are a likely cause. Given that the sex difference is both prevalent and accepted by many researchers in the field, it is surprising that more is not known. This review highlights the data regarding differences in sexual dimorphism in C. neoformans infections and suggests future directions to close the research gap in this area.

Chemical stability of hydromorphone hydrochloride in patient-controlled analgesia injector.

The chemical stability of hydromorphone hydrochloride in patient-controlled analgesia injectors was studied for 34 weeks at different temperatures. The sterility of the solution was also monitored at the end of 16-week storage. For the determination of stability of hydromorphone, five groups of six patient-controlled analgesia injectors containing hydromorphone solutions of 0.2 mg/mL (6 mg of drug solution in 30 mL 0.9% normal saline) sealed with plastic tip caps were stored at 5 degrees Celsius in refrigerator, 20 degrees Celsius on bench top, 20 degrees Celsius in dark, 35 degrees Celsius in dark, and 50 degrees Celsius in dark. Chemical stability was determined throughout a storage period of 34 weeks using high performance liquid chromatography. Sterility test was also performed at 16 weeks. Hydromorphone solutions stored in different conditions up to 34 weeks remained clear and free of visible precipitation throughout the study. After 8 weeks of storage in the patient-controlled analgesia injectors in different temperature conditions, the concentrations of hydromorphone in all the samples remained over 95% of their original value. At 16 and 34 weeks, the concentration of hydromorphone in the injectors decreased to 92% to 96% and 86% to 88% of their original value, respectively. In the sterility test of bacterial contamination of the hydromorphone solutions in the patient-controlled analgesia injectors at 16 weeks, none of the injector solutions showed evidence of microbial growth after 14 days of incubation in fluid thioglycolate medium. This study demonstrates the stability and sterility of hydromorphone hydrochloride solution.