Allogeneic stem cell transplant in adult patients with acute myelogenous leukemia: a systematic analysis of international guidelines and recommendations

In patients with acute myelogenous leukemia, published guidelines and treatment recommendations are usually the basis for starting the work-up process for allogeneic transplant. However, only consistent recommendations would allow a standardized clinical practice. We conducted a comprehensive systematic literature search to identify and evaluate the best available evidence from controlled clinical trials. In addition, recommendations given by leading organizations in the USA and Europe were analyzed. The following aspects were selected for systematic comparison: factors for risk assessment and categorization, role of type of donor, significance of allogeneic transplant in first or second complete remission and in relapse/progressive disease; and role of reduced intensity conditioning regimens. In conclusion, the recommendations for the use of allogeneic transplant given by the literature and by published guidelines are inconsistent and will need clarification.

Challenges for Participatory Conservation in Times of Global Change: Lessons from a Comparative Analysis and New Developments

Participatory approaches to conservation have been applied worldwide by governments and non-governmental organisations. However, results from a comparative analysis of the impacts of global change on management issues in 13 protected areas in Africa, Latin America, Asia, and Europe show that in many cases the involvement of local people has remained limited, and economic gains for local livelihoods have been limited or non-existent. Viewed from a ‘new institutionalist’ perspective and focusing on power relations and ideologies, the results of this study carried out within the framework of the Swiss National Centre of Competence in Research (NCCR) North-South show that in African cases local people do not feel part of the process and, therefore, become disengaged. In Asia, and even more so in Latin America, local indigenous peoples and their leaders support protected areas as a means to gain political rights over areas threatened by immigration. The European (Swiss) case is the only one where political rights and economic incentives present a context in which participation is of direct interest to local people. Meanwhile, recent debates on new global conservation developments in the context of climate change policy indicate a growing tendency to treat conservation as a commodity. We argue that this can have problematical effects on efforts to devolve power to the local level in the context of conservation.

Contrast enhanced ultrasound eases interpretation of an unclear renal tumor in addition to CT, MRI and histological findings--a case report in a young patient

Renal cancer represents accounts for approximately 3% of all adult malignancies with a rising incidence. Incidental diagnosis is mostly based upon ultrasound (US). US and Computed tomography (CT) are the standard imaging modalities for detecting renal cell cancer (RCC). Differentiation between malignant and benign renal tumors is of utmost importance. Contrast enhanced ultrasound (CUS) seems to be a promising new diagnostic option for diagnosis and preoperative treatment planning for patients with renal cancer. It is an additional examination to baseline ultrasound and CT. We report a case of a 37-year-old woman with a papillary renal cell cancer in which CUS helped to differentiate dignity of the tumor. CUS is an additional examination to baseline ultrasound and CT. It is a less invasive technique than contrast enhanced CT and shows even slight tumor blood flow. In addition it may allow a more rapid diagnosis, because of its bedside availability.

Clinical end points in coronary stent trials: a case for standardized definitions

BACKGROUND: Although most clinical trials of coronary stents have measured nominally identical safety and effectiveness end points, differences in definitions and timing of assessment have created confusion in interpretation. METHODS AND RESULTS: The Academic Research Consortium is an informal collaboration between academic research organizations in the United States and Europe. Two meetings, in Washington, DC, in January 2006 and in Dublin, Ireland, in June 2006, sponsored by the Academic Research Consortium and including representatives of the US Food and Drug Administration and all device manufacturers who were working with the Food and Drug Administration on drug-eluting stent clinical trial programs, were focused on consensus end point definitions for drug-eluting stent evaluations. The effort was pursued with the objective to establish consistency among end point definitions and provide consensus recommendations. On the basis of considerations from historical legacy to key pathophysiological mechanisms and relevance to clinical interpretability, criteria for assessment of death, myocardial infarction, repeat revascularization, and stent thrombosis were developed. The broadly based consensus end point definitions in this document may be usefully applied or recognized for regulatory and clinical trial purposes. CONCLUSION: Although consensus criteria will inevitably include certain arbitrary features, consensus criteria for clinical end points provide consistency across studies that can facilitate the evaluation of safety and effectiveness of these devices.

DESIGN AND SYNTHESIS OF NOVEL SYNTHETIC ANTIOXIDANTS FOR THE TREATMENT OF OXIDATIVE STRESS RELATED DISEASES

Free radicals play an important role in many physiological processes that occur in the human body such as cellular defense responses to infectious agents and a variety of cellular signaling pathways. While at low concentrations free radicals are involved in many significant metabolic reactions, high levels of free radicals can have deleterious effects on biomolecules like proteins, lipids, and DNA. Many physiological disorders such as diabetes, ageing, neurodegenerative diseases, and ischemia-reperfusion (I/R) injury are associated with oxidative stress.1 In particular, the deleterious effects caused by I/R injury developed during organ transplantation, cardiac infarct, and stroke have become the main cause of death in the United States and Europe.1,2 In this context, we synthesized and characterized a series of novel indole-amino acid conjugates as potential antioxidants for I/R injury. The synthesis of indole-phenol conjugate compounds is also discussed. Phenolic derivatives such as caffeic acid, butylated hydroxytoluene (BHT), butylated hydroxyanisole (BHA), resveratrol, and its analogues are known for their significant antioxidative properties. A series of resveratrol analogues have been designed and synthesized as potential antioxidants. The radical scavenging mechanisms for potential antioxidants and assays for the in vitro evaluation of antioxidant activities are also discussed.

Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy

BACKGROUND: Hypereosinophilic syndrome (HES) is a heterogeneous group of rare disorders defined by persistent blood eosinophilia > or =1.5 x 10(9)/L, absence of a secondary cause, and evidence of eosinophil-associated pathology. With the exception of a recent multicenter trial of mepolizumab (anti-IL-5 mAb), published therapeutic experience has been restricted to case reports and small case series. OBJECTIVE: The purpose of the study was to collect and summarize baseline demographic, clinical, and laboratory characteristics in a large, diverse cohort of patients with HES and to review responses to treatment with conventional and novel therapies. METHODS: Clinical and laboratory data from 188 patients with HES, seen between January 2001 and December 2006 at 11 institutions in the United States and Europe, were collected retrospectively by chart review. RESULTS: Eighteen of 161 patients (11%) tested were Fip1-like 1-platelet-derived growth factor receptor alpha (FIP1L1-PDGFRA) mutation-positive, and 29 of 168 patients tested (17%) had a demonstrable aberrant or clonal T-cell population. Corticosteroid monotherapy induced complete or partial responses at 1 month in 85% (120/141) of patients with most remaining on maintenance doses (median, 10 mg prednisone equivalent daily for 2 months to 20 years). Hydroxyurea and IFN-alpha (used in 64 and 46 patients, respectively) were also effective, but their use was limited by toxicity. Imatinib (used in 68 patients) was more effective in patients with the FIP1L1-PDGFRA mutation (88%) than in those without (23%; P < .001). CONCLUSION: This study, the largest clinical analysis of patients with HES to date, not only provides useful information for clinicians but also should stimulate prospective trials to optimize treatment of HES.

René Sand (1877-1953) and His Contribution to International Social Work, IASSW-President 1946 – 1953

The extraordinary significance of the life and work of René Sand lies in his central position as a mediator, promoter and coordinator of social work on an increasingly international level during the interwar-period and it can hardly be overestimated. To approach the achievements of Sand’s life and work you have to work archaeologically as he does not seem to have left any traces in the literature on social history. In Germany, even within the field of social work his name is hardly known. His biographical sketch and his importance for the development of the profession of social work have fallen into oblivion. The situation is a little different in the French-speaking countries where a biography has been published (compare Anciaux 1988a, b, c) which contains a detailed record of Sand’s writings. Altogether this lack of interest is regrettable because it doesn’t consider that René Sand is exemplary and in some parts fundamental to the emergence of professional social work in the 1920s in Belgium and Europe. Professional social work was established by a consequent international orientation and an emancipation from neighbouring fields such as social medicine and hygiene. Therefore it is a rewarding task to draw attention to this pioneer of social work and make the public appreciate his work. I want to emphasize explicitly that in this portrait Sand’s achievements concerning social work will be the main focus, even if this is an inevitable reduction of his accomplishments in the field of medicine and social medicine.

Educational and Anthropological Perspectives: An Italian View on Migration in Multi-cultural Urban Spaces

In contemporary societies there are different ways to perceive the relation between identity and alterity and to describe the difference between “us” and “them”, residents and foreigners. Anthropologist Sandra Wallman sustains that in multi-cultural urban spaces the frontiers of diversity are not only burdensome markers of identity, but rather they could also represent new chances to define “identity” and “alterity”. These frontiers, in fact, can work like interfaces through which to build time after time, in a creative way, a relationship with the other. From this point of view, the concept of boundary can offer many opportunities to creatively define the relation with the other and to sign new options for cognitive and physical movement. On the other side, in many cases we have a plenty of mechanisms of exclusion that transforms a purely empirical distinction between “us” and “them” in an ontological contrast, as in the case when the immigrant undergoes hostilities through discriminatory language. Even though these forms of racism are undoubtedly objectionable from a theoretical point of view, they are anyway socially “real”, in the sense that they are perpetually reaffirmed and strengthened in public opinion. They are in fact implicit “truths”, realities that are considered objective, common opinions that are part of day-to-day existence. That is the reason why an anthropological prospective including the study of “common sense” should be adopted in our present day studies on migration, as pointed out by American anthropologist Michael Herzfeld. My primary goal is to analyze with such a critical approach same pre-conditions of racism and exclusion in contemporary multi-cultural urban spaces. On the other hand, this essay would also investigate positive strategies of comparing, interchanging, and negotiating alterity in social work. I suggest that this approach can offer positive solutions in coping with “diversity” and in working out policies for recognizing a common identity which, at the same time, do not throw away the relevance of political and economic power.

Antigenic and genetic variations in European and North American equine influenza virus strains (H3N8) isolated from 2006 to 2007

Equine influenza virus (EIV) surveillance is important in the management of equine influenza. It provides data on circulating and newly emerging strains for vaccine strain selection. To this end, antigenic characterisation by haemaggluttination inhibition (HI) assay and phylogenetic analysis was carried out on 28 EIV strains isolated in North America and Europe during 2006 and 2007. In the UK, 20 viruses were isolated from 28 nasopharyngeal swabs that tested positive by enzyme-linked immunosorbent assay. All except two of the UK viruses were characterised as members of the Florida sublineage with similarity to A/eq/Newmarket/5/03 (clade 2). One isolate, A/eq/Cheshire/1/06, was characterised as an American lineage strain similar to viruses isolated up to 10 years earlier. A second isolate, A/eq/Lincolnshire/1/07 was characterised as a member of the Florida sublineage (clade 1) with similarity to A/eq/Wisconsin/03. Furthermore, A/eq/Lincolnshire/1/06 was a member of the Florida sublineage (clade 2) by haemagglutinin (HA) gene sequence, but appeared to be a member of the Eurasian lineage by the non-structural gene (NS) sequence suggesting that reassortment had occurred. A/eq/Switzerland/P112/07 was characterised as a member of the Eurasian lineage, the first time since 2005 that isolation of a virus from this lineage has been reported. Seven viruses from North America were classified as members of the Florida sublineage (clade 1), similar to A/eq/Wisconsin/03. In conclusion, a variety of antigenically distinct EIVs continue to circulate worldwide. Florida sublineage clade 1 viruses appear to predominate in North America, clade 2 viruses in Europe.

Impulses for an Effective and Modern Data Protection System

A substantial reform of data protection law is on the agenda of the European Commission as it is widely agreed that data protection law is faced by lots of challenges, due to fundamental technical and social changes or even revolutions. Therefore, the authors have issued draft new provisions on data protection law that would work in both Germany and Europe. The draft is intended to provide a new approach and deal with the consequences of such an approach. This article contains some key theses on the main legislatory changes that appear both necessary and adequate.

Palaeohydrology, fires and vegetation succession in the southern Baltic during the last 7500 years reconstructed from a raised bog based on multi-proxy data

We present the first 7500 yr long multi-proxy record from a raised bog located at the southern Baltic coast, Poland. Testate amoebae, plant macrofossils, pollen and microscopic charcoal were used to reconstruct environmental changes in Pomerania (northern Poland, Kaszuby Lakeland) from a 7-m thick peat archive of Stążki bog dated 5500 BC–AD 1250. We obtained a record of proxies representing different spatial scales: regional vegetation changed simultaneously with local vegetation, and testate amoebae showed a pattern of change similar to that of pollen and plant macrofossils. On the basis of the combined proxies, we distinguished three hydroclimatic stages: moist conditions 5500–3450 BC, drier conditions with regionally increased fires up to 600 BC, and again moist conditions from 600 BC onward. During the drier interval, a first climatic shift to wetter conditions at 1700 BC is indicated by regional pollen as the replacement of Corylus by Carpinus, and locally by, e.g., the increase of Hyalosphenia elegans and mire plants such as Sphagnum sec. Cuspidata. Furthermore, we observed a correlation since 600 BC among the re-expansion of Carpinus (after a sudden decline ca. 950 BC), increased peat accumulation, increase of Hyalosphenia species, and fewer fires, suggesting lower evapotranspiration and a stable high water table in the bog. Fagus started to expand after AD 810 gradually replacing Carpinus, which was possibly due to a gradually more oceanic climate, though we cannot exclude human impact on the forests. Peat accumulation, determined by radiocarbon dating, varied with bog surface wetness. The hydroclimatic phases found in Stążki peatland are similar to moisture changes recorded in other sites from Poland and Europe. This is the first detailed record of hydroclimatic change during the Holocene in the southern Baltic region, so it forms a reference site for further studies on other southern Baltic bogs that are in progress.