BACKGROUND: High-dose treatment with autologous stem cell transplantation (ASCT) has become the standard of care for patients with myeloma below the age of 65 years. AIMS: We report an audit of 60 patients (median age: 52.5 years) who underwent ASCT in the National Bone Marrow Transplant centre in St James's Hospital in Dublin between 1997 and 2003 inclusive. METHODS: Clinical and laboratory data were retrieved from patient medical records and hospital information management systems. RESULTS: Thirty-six patients had IgG, 11 IgA, 1 IgD, 9 light chain and 3 non-secretory MM. Fifty-seven (95%) patients received anthracycline-corticosteroid combination chemotherapy prior to autografting. There was no transplant-related mortality (TRM). Complete (CR) and Partial Responses (PR) were seen in 16 (29.6%) and 29 (53.7%) of those evaluable (n = 54 (90%)). The actuarial Progression-Free (PFS) and Overall Survival (OS) rates at five years are 13% and 55% respectively. CONCLUSION: Centre outcome is comparable to published international series and supports the use of ASCT in the treatment of this malignancy.

Aged↗

PubMedDate not supplied

Anthelmintic resistance--the state of play.

There is evidence that the incidence of anthelmintic resistance is increasing in livestock in countries throughout the world including the United Kingdom. Early detection of emerging drug resistance is important since reversion to susceptibility appears not to occur in highly selected homozygous strains. Because the current in vivo and in vitro assays, which generally determine the degree of disruption of normal physiological function of different parasite stages, are relatively insensitive, effort is being made to develop more direct genetic and biochemical diagnostic assays. Studies on the selection and genetics of resistance suggest that resistance is normally polygenic and arises from within the normal phenotypic range and that there are three phases in the selection process. An initial susceptible phase is followed by an intermediate one in which heterozygous resistant individuals are common within the population and finally homozygous resistant individuals predominate within the population. For these reasons low efficacy treatments, which enable the survival of heterozygous resistant individuals, and suppressive regimes, which only allow homozygous resistant individuals to survive, increase the rate of development of drug resistance. Strategies to delay the onset of resistance and control resistant strains usually incorporate minimal chemoprophylaxis, seek to maximize drug efficacy, and if possible include a 'slow' drug rotation and seek to limit host parasite contact by manipulation of the grazing environment. Although multi-species mathematical models of anthelmintic resistance appear to offer a means of assessing the long term impact of these and other control strategies, current models are limited by a lack of detailed biological knowledge. In particular, more information on the status and numbers of alleles associated with resistance to specific drugs, their frequencies within populations of different species and the fitness of resistant and susceptible populations is required. Anthelmintic resistance provides an example of the adaptability of metazoan parasites under intensive selection and suggests that sustainable control strategies will require an integrated approach in which both chemotherapy and immunotherapy, together with environmental management are used to control nematodoses.

Animal Diseases↗

PubMedDate not supplied

Plasma profiles of albendazole metabolites after administration of netobimin and albendazole in sheep: effects of parasitism and age.

Netobimin and albendazole were administered to 3-month-old lambs with moderate infections of Nematodirus battus and to comparable parasite-naive lambs. Albendazole sulphoxide and albendazole sulphone concentrations were determined in the plasma of all lambs at frequent intervals after treatment. Both anthelmintic preparations were 100% effective in reducing nematode faecal egg output in the lambs. There were no significant differences in the concentrations of the sulphoxide or sulphone metabolites in parasitized compared with non-parasitized lambs given the same parent anthelmintic. The parasite-naive lambs were subsequently weaned and maintained indoors in conditions designed to preclude nematode parasite infection until they were 9 months old. Netobimin and albendazole were administered again and the plasma profiles of the albendazole sulphoxide and albendazole sulphone metabolites determined. There were no significant differences in the plasma distribution of these metabolites with age of the lambs. The area under the plasma concentration time curve, mean resident time and apparent half-life of the albendazole sulphoxide metabolite was determined following administration of each parent drug and the clearance of the metabolite/systemic availability of parent drug was determined as a marker of the amount of drug available for metabolism. There were no significant differences in pharmacokinetic variables between parasitized and non-parasitized animals nor with the age of the animals.

Aging↗

PubMedDate not supplied

Comparative field evaluation of divided-dosing and reduced feed intake upon treatment efficacy against resistant isolates of Teladorsagia circumcincta in sheep and goats.

The effects of modifying drug administration and food intake upon the efficacy of fenbendazole against resistant isolates of Teladorsagia (Ostertagia) circumcincta were investigated using naturally infected sheep and goats. Administration of the manufacturer's recommended dose (MRD) as two 2.5 mg kg(-1) bodyweight doses divided by a 12-hour interval resulted in an apparent increase in efficacy of over 28 per cent compared with conventionally treated sheep. Withholding feed for 24 hours before treatment at the MRD resulted in respective increases of 39.7 per cent (P<0.05) and 25.2 per cent compared with conventionally treated sheep and goats. A combination of food withdrawal and divided dosing did not further increase treatment efficacy in goats. It is suggested that withholding feed, divided-dosing or combining these methods may extend the useful life of the broad spectrum class of anthelmintics.

Animals↗

PubMedDate not supplied

Schistosomiasis prophylaxis in vivo using N,N-diethyl-m-toluamide (DEET).

Topical N,N-Diethyl-m-toluamide (DEET) was studied as a schistosomiasis prophylactic in vivo for the use of individuals with limited exposure. Fifteen subjects, on a 3-week expedition to Lake Malawi in September 2001, applied 50% DEET to their skin after exposure to lake water. No subjects developed evidence of a new infection at 3-month follow-up.

Administration, Cutaneous↗

PubMedDate not supplied

Patient rights: when a patient's "no" had to be the nurse's "yes".

Explore the source record for details and available documents.

Humans↗

PubMedDate not supplied

Comparative aspects of plasma antioxidant status in sheep and goats, and the influence of experimental abomasal nematode infection.

This paper provides, for the first time, comparative data on the plasma antioxidant status of two ruminant species, namely sheep and goats. In addition, the influence of experimental infection with Teladorsagia circumcincta on antioxidant status in the same two species is compared and contrasted. In general terms, antioxidant status was significantly higher in uninfected kids than in lambs. Differences in protein sulphydryl groups and vitamin E concentrations were particularly noteworthy; trends were similar, however, for albumin, vitamin A and total antioxidant capacity (TAC). Parasitological results, based on worm burden, faecal egg counts and peripheral blood eosinophil numbers, confirmed that goat kids were more susceptible than lambs to experimental T. circumcincta infection. "Trickle infection" had a variable impact on both total and individual antioxidant status; particularly during the early weeks, the trend was for reduced values in lambs and increased values in kids, as compared with uninfected controls. Subsequent challenge infection was associated with a transient decrease in TAC and albumin in trickle-infected animals of both species, and in appropriate control animals. The observed differences in plasma antioxidant capacity between sheep and goats may have important implications in terms of the comparative resilience of sheep and goats to parasite infection.

Abomasum↗