Stability of carboplatin infusion solutions used in desensitization protocol.

Carboplatin hypersensitivity reactions are one of the major clinical challenges in treating patients with relapse/recurrent ovarian malignancies. Desensitization protocols allow the continuation of treatment in patients who have presented hypersensitivity reactions by gradually re-introducing small amounts of the drug up to full therapeutic doses. Carboplatin desensitization protocol is based on three solutions that are usually prepared in the chemotherapy centralized units of hospital pharmacies. First and second solutions are diluted under the established concentration limit to guarantee the stability of the preparation. We developed a specific high-performance liquid chromatography assay to determine the stability of carboplatin infusion solutions that have been diluted to 0.2 mg/mL and 0.02 mg/mL in 250 mL of 5% dextrose in polypropylene infusion bags which were stored 24 h protected from light at room temperature. Samples were withdrawn at t = 0 h, 3 h, 6 h, and 24 h. The analytical column was a Zorbax eclipse XDB-C18 (150 mm × 4.6 mm; 5 µm particle size). The mobile phase had a flow rate of 1 mL/min under isocratic conditions of water-methanol (98:2, v/v). For 0.2 mg/mL solution, the high-performance liquid chromatography assay revealed no significant losses in carboplatin concentration. However, in 0.02 mg/mL solution remaining carboplatin was > 105% the initial dose after 3 h of storage at room temperature. The ultraviolet-visible spectra analysis showed that carboplatin remained intact during the study in 0.2 mg/mL solution, but some changes were detected in 0.02 mg/mL solution. Thus, 0.2 mg/mL carboplatin solution is stable for 24 h at room temperature in 5% dextrose polypropylene infusion bags but stability could not be proved for 0.02 mg/mL solution.

Análisis comparativo de los métodos de bioimpedancia en la evaluación nutricional de pacientes con enfermedades respiratorias / Comparative analysis of bioimpedance methods in the nutritional evaluation of patients with respiratory disease

ANTECEDENTES: las guías clínicas actuales consideran la monitorización nutricional una parte importante en la evaluación de pacientes respiratorios. Gracias a la bioimpedancia, es posible obtener una medida de la composición corporal. OBJETIVO: comparar los dos métodos más comunes de análisis de la composición corporal mediante bioimpedancia sobre una población de pacientes respiratorios: una única frecuencia (SFBIA) y espectroscopía de bioimpedancia (BIS). MÉTODO: grupo I (pacientes en Rehabilitación Respiratoria, 6 personas); Grupo II (pacientes hospitalizados, 10 personas); Grupo III (sujetos sanos, 5 personas). Medidas: dispositivo SFBIA y dispositivo BIS. Análisis comparativo con índices normalizados: porcentaje de grasa e índice de masa libre de grasa (FFMI). RESULTADOS: análisis Bland-Altman del porcentaje de grasa: valor medio de -3,5%, límites de concordancia del 95% desde -18,8% a 11,7%. Análisis Bland-Altman de FFMI: valor medio de 0,8 kg/m2, límites de concordancia del 95% desde -3,5 kg/m2 a 5,1 kg/m2. Correlación en el porcentaje de grasa: r = 0,73 (p = 0,0009). Correlación en FFMI: r = 0,86 (p = 0,00001). CONCLUSIONES: en la muestra analizada, los métodos SFBIA y BIS han mostrado una buena correlación y una concordancia moderada a la hora de estimar la composición corporal. En la mayoría de los casos, el método SFBIA subestimó el porcentaje de grasa y sobreestimó la masa magra comparado con el método BIS. Las mayores discrepancias entre ambos métodos fueron observadas en los casos extremos de composición corporal

BACKGROUND: Current clinical guides consider nutritional monitoring to be an important part of the evaluation of respiratory patients. Thanks to bioimpedance, it is possible to obtain a body composition measurement. OBJECTIVE: to compare the two most common methods for analyzing body composition using bioimpedance in a population of respiratory patients: single frequency (SFBIA) and bioimpedance spectroscopy (BIS). METHODS: group I (respiratory rehabilitation patients: 6 people); group II (hospitalized patients: 10 people); group III (healthy subjects: 5 people). Measurements: SFBIA device and BIS device. Analysis: comparison with normal indexes: percent fat and fat free mass index (FFMI). RESULTS: Bland-Altman analysis of percent fat: mean value of -3.5%, 95% limits of agreement from -18.8% to 11.7%. Bland-Altman FFMI analysis: mean value of 0.8 kg/m2, 95% limits of agreement from -3.5 kg/m2 to 5.1 kg/m2. Correlation in percent fat: r = 0.73 (p = 0.0009). Correlation in FFMI: r = 0.86 (p = 0.00001). CONCLUSIONS: in the sample analyzed, the SFBIA and BIS methods have shown good correlation and moderate agreement when estimating body composition. In most cases, SFBIA underestimated the percent fat and overestimated the lean mass compared to the BIS method. The largest discrepancies between the two methods were seen in the cases of extreme body composition

Severe malaria in immigrant haematological patient.

Severe malaria is a life-threatening condition caused by Plasmodium falciparum. Rupture of red blood cells when merozoites release to the bloodstream is responsible for the clinical manifestations, febrile fever reaching 39 °C, and other unspecific symptoms. P. falciparum is considered as the worst form of malaria. Moreover, this species has cytoadherence to red blood cells. This can lead to an organic dysfunction. People coming from hyper endemic areas have developed a partial immunity, but immunodepressed people are a group with a greater risk. Due to the high mortality rate associated to this disease, early diagnosis and a prompt treatment implementation are essential. However, the missed or delayed diagnosis is one of the major reasons of reaching a severe malaria disease. This case reflects the complexity of the diagnosis in an immigrant and immunodepressed patient with a haematological neoplasm with a severe infection by P. falciparum due to the unspecified symptoms and the overlapping of the same.

Prolyl oligopeptidase induces angiogenesis both in vitro and in vivo in a novel regulatory manner.

BACKGROUND AND PURPOSE A serine protease, prolyl oligopeptidase (POP) has been reported to be involved in the release of the pro-angiogenic tetrapeptide acetyl-N-Ser-Asp-Lys-Pro (Ac-SDKP) from its precursor, 43-mer thymosin ß4 (Tß4). Recently, it was shown that both POP activity and the levels of Ac-SDKP are increased in malignant tumours. The aim of this study was to clarify the release of Ac-SDKP, and test if POP and a POP inhibitor, 4-phenyl-butanoyl-L-prolyl-2(S)-cyanopyrrolidine (KYP-2047), can affect angiogenesis. EXPERIMENTAL APPROACH We used HPLC for bioanalytical and an enzyme immunoassay for pharmacological analysis. Angiogenesis of human umbilical vein endothelial cells was assessed in vitro using a 'tube formation' assay and in vivo using a Matrigel plug assay (BD Biosciences, San Jose, CA, USA) in adult male rats. Moreover, co-localization of POP and blood vessels was studied. KEY RESULTS We showed the sequential hydrolysis of Tß4: the first-step hydrolysis by proteases to <30-mer peptides is followed by an action of POP. Unexpectedly, POP inhibited the first hydrolysis step, revealing a novel regulation system. POP with Tß4 significantly induced, while KYP-2047 effectively prevented, angiogenesis in both models compared with Tß4 addition itself. POP and endothelial cells were abundantly co-localized in vivo. CONCLUSIONS AND IMPLICATIONS We have now revealed that POP is a second-step enzyme in the release of Ac-SDKP from Tß4, and it has novel autoregulatory effect in the first step. Our results also advocate a role for Ac-SDKP in angiogenesis, and suggest that POP has a pro-angiogenic role via the release of Ac-SDKP from its precursor Tß4 and POP inhibitors can block this action.

Estimation of survival and gonotrophic cycle length of Simulium metallicum sensu lato (Diptera: Simuliidae) in southern Mexico.

This study compares the use of a mark-recapture analysis and a time-series analysis to estimate the gonotrophic cycle length and survivorship of Simulium metallicum s.l. in southern Mexico. Daily collections were performed with human- and horse-baited traps at 3 sites in a coffee plantation. The mark-recapture and time series experiments on these collections conclusively yielded a gonotrophic cycle length estimate of 3 days. Horizontal estimates of daily survivorship ranged from 0.75 to 0.69 and these values were similar to that estimated vertically of 0.77. The survival to infective stage (9 days) ranged from 0.012 to 0.043, taking into account at least 12 days for development of 3rd-stage larvae of Onchocerca volvulus. Mark-recapture and time-series methods were found to be suitable for estimating the gonotrophic cycle length and daily survivorship of S. metallicum s.l. under field conditions in southern Mexico.