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Non-Covalent BTK Inhibitors-The Fresh BTKids in the street for B-Cell Malignancies.
BACKGROUND Implementation of the Haemophilus influenzae type b (Hib) conjugate vaccine brought about a reduction in the number of cases and morbidity from type B but increase in nontypeable strain infections. CASE REPORT We had 3 cases of invasive non type Hemophilus influenzae (NTBHI) in immunocompromised children. The first was a fully vaccinated 2-year-old male with a history of pseudomonas sepsis who presented with 1 day of lethargy, fever, vomiting, and diarrhea. Blood culture was positive for Haemophilus influenzae e and cerebrospinal fluid (CSF) confirmed meningitis. Immune deficiency and genetic testing revealed X-linked agammaglobulinemia. The second case was a 4-year-old male, status post liver transplantation, who presented with pneumonia, with positive blood culture for H. influenzae. The last case was of a 2-year-old male with H. influenzae biotype VI in both blood and CSF cultures, who on follow-up was confirmed to have hypogammaglobulinemia. CONCLUSIONS For children diagnosed with an invasive disease caused by NTBHI, a workup for immunodeficiency could be warranted. With the appearance of nontype b serotypes, more studies are needed to determine epidemiology and virulence of these types, and their clinical relevance - perhaps developing a new vaccine to cover nontype b stereotypes, especially for immunodeficient patients.The authors informed the journal that an error occurred in their manuscript. The authors selected the wrong figure when uploading it due to the similarity of figures. They found this error when they were periodically sorting the experimental data and contacted the journal. This change does not affect the final results and conclusion. Reference 1. Dalong Xie, Chao Shang, Hui Zhang, Yan Guo, Xiaojie Tong Upregulation of miR-9 Target CBX7 Regulates Invasion Ability of Bladder Transitional Cell Carcinoma. Med Sci Monit 2015; 21 225-230. DOI 10.12659/MSM.893232.in English, Italian SCOPO Le infezioni del sito chirurgico (SSIs) e le complicanze infettive sistemiche dopo chirurgia tiroidea sono di non comune riscontro. La profilassi antibiotica nei pazienti a basso rischio infettivo (ASA ≤3) sembra priva di significativi vantaggi sull’incidenza delle SSIs e delle complicanze settiche sistemiche. Scopo dello studio è stato quello di valutare l’incidenza delle SSI e delle complicanze infettive sistemiche in una serie consecutiva di pazienti sottoposti a chirurgia della tiroide in assenza di profilassi antibiotica (NO-AP). PAZIENTI E METODI Lo studio di tipo osservazionale prospettico includeva 77 pazienti (57 F; età media 57.1 anni; 20 M; età media 56.8) sottoposti a chirurgia tiroidea nel periodo Gennaio 2018-Dicembre 2019 presso l’ospedale universitario “ A. Fiorini” di Terracina. Nessun paziente veniva sottoposto a profilassi antibiotica. L’intervento chirurgico era eseguito da chirurghi esperti della procedura e prevedeva l‘utilizzo del Ligasure Harmonic Ethicon®, di causa di prolungamento della durata della degenza clinica. Pertanto la febbre, la leucocitosi neutrofila e l’aumento della PCR non possono essere valutati come fattori predittivi di complicanza infettiva. CONCLUSIONI Non sono stati identificati fattori di aumentato rischio infettivo. L’antisepsi del campo operatorio con Clorexidina gluconato, il miglioramento della tecnica chirurgica, la protezione dei margini cutanei di incisione, l’utilizzo dei nuovi devices, l’emostasi accurata e la riduzione dei tempi operatori si sono associati al mancato riscontro di SSIs e di complicanze infettive sistemiche in tutti i pz sottoposti a chirurgia tiroidea in assenza di profilassi antibiotica.The nucleotide analogue remdesivir is an investigational drug for the treatment of human coronavirus infection. Remdesivir is a phosphoramidate prodrug and is known to target viral RNA-dependent RNA polymerases. In this issue, Gordon et al. identify that remdesivir acts as a delayed RNA chain terminator for MERS-CoV polymerase complexes. © 2020 Kirchdoerfer.Positron emission tomography (PET) imaging is commonly used in adult patients. Its use in pediatric patients is limited but indicated in certain cancers such as lymphoma, sarcoma, neuroblastoma and central nervous system tumors (1). The main limitation of PET imaging is its relatively limited spatial resolution in detecting small lesions which is mainly due to non-collinearity of the 511 keV annihilation photons, positron range, detector scatter, and parallax error (2-5). However, small-animal PET scanners have higher spatial resolution than standard human PET scanners (approximately 1 mm versus 4-6 mm) (2, 5, 6). Images taken in small-animal PET scanners are less effected by the non-collinearity of the 511 keV annihilation photons as compared to images taken at the standard human PET scanners due to their smaller ring diameter (2). Depending on the manufacturer, diameter of the ring is around 10-20 cm in small-animal PET scanners and around 70-90 cm in adult PET scanners. Eflornithine ic50 Building small-bore pediatric PET scanners may be beneficial for the pediatric patients as they may detect smaller lesions as compared to large-bore standard PET scanners. Alternative may be to build a dual-head PET (open PET) with a large field of view in axial direction (total body or half body) and moveable heads to adjust the distance to the patient (as in dual head gamma cameras) which can be used both in pediatric and adult patients, and in brain studies and also be more suitable for claustrophobic and pediatric patients (7). Copyright © 2020 by the Society of Nuclear Medicine and Molecular Imaging, Inc.When performing myocardial perfusion imaging (MPI) (1-8), the best test to evaluate hemodynamic changes during stress is an exercise treadmill test. It provides independent prognostic value including evaluation of total exercise time, performance and capacity, heart rate response during exercise, with ischemia, and in recovery, blood pressure response, myocardial oxygen demand and assessment of symptoms. Combining these exercise data with perfusion imaging provides the best prognostic value and risk stratification for patients. While exercise stress testing accompanied with MPI is preferential, it is not always possible since an increasing number of patients are unable to exercise to a maximal (symptom limited) level. Further, there is much evidence in the literature demonstrating a sub-optimal, non-symptom limited (not achieving at least 4-6 minutes or less then 85% of MPHR) exercise test performed as part of a MPI study may result in a false negative outcome. Therefore, pharmacologic stress agents provide an excellent alternative for those patients who are unable to achieve adequate heart rate response or adequately perform physical exercise.
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