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The conjugation of doxorubicin (DOX) with nitric oxide (NO)-releasing groups gave rise to novel anthracyclines, such as nitrooxy-DOX (NitDOX), capable to overcome multidrug resistance. The widely described anthracycline cardiovascular toxicity, however, might limit their clinical use. This study aimed to investigate NitDOX-induced effects, as potential hazard, on vascular smooth muscle A7r5 and endothelial EA.hy926 cell viability, on the mechanical activity of freshly and cultured rat aorta rings, as well as on Cav1.2 channels of A7r5 cells. DOX was used as a reference compound. Although an increase in intracellular radicals and a reduction in mitochondrial potential occurred upon treatment with both drugs, A7r5 and EA.hy926 cells proved to be more sensitive to DOX than to NitDOX. Both compounds promoted comparable effects in A7r5 cells, whereas NitDOX was less active than DOX in inducing DNA damage and in eliciting apoptotic-mediated cell death revealed as an increase in sub-diploid-, DAPI- and annexin V-positive- EA.hy926 cell percentage. Moreover, in EA.hy926 cells, NitDOX doubled basal NO content, while preincubation with the NO-scavenger PTIO increased NitDOX-induced cytotoxicity. DOX exhibited a negligible contracturing effect in endothelium-intact rings, while NitDOX induced a significant ODQ-sensible, vasodilation in endothelium-denuded rings. In arteries cultured with both drugs for 7 days, NitDOX prevented either phenylephrine- or KCl-induced contraction at a concentration 10-fold higher than that of DOX. These results demonstrate that NitDOX displays a more favourable vascular toxicity profile than DOX. selleck Taking into account its greater efficacy against drug-resistant cells, NitDOX is worth of further investigations in preclinical and clinical settings.Background Teaching assistant (TA) cases are a training mainstay, due to increased resident autonomy. Since 2014, the American Board of Surgery (ABS) requires a 25 TA case minimum for graduating resident eligibility for board certification. Herein, we analyze our institution's experience compared with the national average, for any change effected by the requirement. Study design ACGME case log data were obtained for the July 2001 to June 2018 academic years. We compared average TA cases of our program against the national average and national 50th percentile 2001 to 2014, and 2014 to 2018 academic years. The program TA cases were also broken down by category, with a comparison before and after 2014. Values of p were calculated using a t-test and Mann-Whitney U test. Results From July 2001 to June 2018, our program averaged 30.1 TA cases/resident, and national 50th percentile average was 28.1. For July 2001 to June 2014 AY (aka pre-2014) and July 2014 to June 2018 AY (aka post-2014) cases per resident, our program averages were 24.9 and 46.1, respectively, and the national 50th percentile averages were 24.4 and 40.3, respectively-both statistically significant increases. Average program percentiles were 46.4 (pre-2014), and 61.5 (post-2014), and 59.6% of program cases logged were biliary, large intestine, and hernia (2001 to 2018 AY), with a statistically significant increase in several case subcategories post-2014. Conclusions Teaching assistant cases are an invaluable resource for residents, fostering increased autonomy. Since the 2014 minimum, a statistically significant increase in TA cases was noted in our program and nationally. The majority of sub-categories logged were core procedures. Unequivocally, the TA case minimum requirement has made a difference. This will hopefully lead to increased autonomy and therefore, more comfortable and capable general surgeons. Wide variability is noted in what counts as a TA case, with further clarification needed by the ACGME and ABS.Background Immunologic dysfunction due to coronavirus disease 2019 (COVID-19) is closely related to clinical prognosis, and the inflammatory response of pregnant women may affect the directional differentiation and function of fetal immune cells. Objective We sought to analyze the immune status of newborns from mothers with COVID-19 in the third trimester. Methods Along with collecting the clinical data from 51 newborns and their respective mothers, we recorded the immunophenotypes and cytokine and immunoglobulin levels of the newborns. Results None of the 51 newborns showed fever or respiratory distress during hospitalization. Detection of severe acute respiratory syndrome coronavirus 2 nucleic acid in pharyngeal swabs was negative. Except for the low level of CD16-CD56 cells, the count and proportion of lymphocytes, CD3, CD4, CD8, and CD19 were all in the normal range. Moreover, the serum IgG and IgM levels were within the normal range, whereas IL-6 showed increased levels. There was no correlation between maternal COVID-19 duration and the lymphocyte subsets or cytokine levels (IFN-γ, IL-2, IL-4, IL-6, IL-10, and TNF-α). There was a positive correlation between IL-6 and IL-10 levels and CD16-CD56 cells. One (1.96%) infant with an extremely elevated IL-6 concentration developed necrotizing enterocolitis in the third week after birth, and the remaining 50 infants did not show abnormal symptoms through the end of the follow-up period. Conclusions COVID-19 in the third trimester did not significantly affect the cellular and humoral immunity of the fetus, and there was no evidence that the differentiation of lymphocyte subsets was seriously unbalanced.Background Advanced systemic mastocytosis (advSM) is characterized by the presence of the KIT D816V mutation and pathologic accumulation of neoplastic mast cells (MCs) in various tissues, leading to severe symptoms and organ damage, eg, cytopenias, liver dysfunction, portal hypertension, malabsorption, and weight loss. Treatment with midostaurin, an orally active multikinase/KIT inhibitor now approved for advSM in the United States and the European Union, resulted in a high rate of response accompanied by reduced MC infiltration of the bone marrow and lowered serum tryptase level. Objective We aimed to determine whether midostaurin improves health-related quality of life (QOL) and MC mediator-related symptoms in patients with advSM. Methods In 116 patients with SM (89 patients with advSM fulfilling the strict inclusion criteria of the D2201 study, NCT00782067), QOL and symptom burden were assessed during treatment with midostaurin using the 12-Item Short-Form Health Survey (SF-12) and the Memorial Symptom Assessment Scale (MSAS) patient-reported questionnaires, respectively.
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