Search

Objectives: We report a case of an 83 year old man who developed oxaliplatin immuneinduced syndrome (OIIS) after his 19th cycle of FOLFOX (5FU, leucovorin, oxaliplatin). When oxaliplatin was omitted from his next cycle of chemotherapy he continues to show signs of drug-induced immune thrombocytopenia (DITP) and was found to have drug-dependent, platelet-reactive antibodies (DDPA) to leucovorin and palonosetron as well as oxaliplatin. Methods: The patient was admitted for monitoring but required no transfusions and thrombocytopenia resolved without treatment during his first admission. Drug-dependent antibody testing was performed on his blood by the Blood Center of Wisconsin (Diagnostic Laboratories; Milwaukee, WI). Results: No RBC or platelet IgG or IgM antibodies were detected in the absence of any drugs, but upon addition of palonosetron, leucovorin, or oxaliplatin, the tests became strongly positive for anti-RBC IgG and anti-platelet IgG antibodies. Discussion: Repeated administration of oxaliplatin can result in drug-induced immune thrombocytopenia (DITP) or autoimmune hemolytic anemia (AIHA). This phenomenon has recently been termed OIIS and may additionally include Evan's syndrome or thrombotic microangiopathy (TMA). Here we describe a patient who developed OIIS with drugdependent, platelet-reactive antibodies (DDPA) to leucovorin and palonosetron. To our knowledge, these two drugs have never been described in the literature as a cause of DDPA. We suggest that OIIS in addition to oxaliplatin-induced thrombocytopenia may be associated with the development of DDPAs to other drugs causing clinically significant thrombocytopenia which is important to recognize and manage with discontinuation of provoking agents. [ABSTRACT FROM AUTHOR]

Agricultural production responds to social, political, economic, environmental, and technological drivers that influence producers' decisions and shape the individual systems through modification of management practices, crop and livestock mix, and marketing strategy. We use an interview and discussion approach with producer panels to examine production systems in the eastern United States and explore key drivers impacting their unique characteristics and development. The internal social driver that values the farming lifestyle is a principle factor that leads people to choose farming. Irrespective of location, farming is first and foremost a lifestyle choice. The choice of type of production system is partly a lifestyle preference and partly influenced by other external factors, including economic and environmental elements. A second principle driver is economic, arising from a need to make a living, and tempers the internal social driver. Economic return is partially a function of the marketability of products. Marketing channels are dependent on social drivers, including education of producers and consumers, community support and community values. Farmers in the Northeast are able to take a more active role in determining contract terms than those in the Southeast, and are also more aggressive in developing new markets. Development of local markets and community support strengthens the link between farmers and consumers, and reinforces the economic sustainability of Northeastern production systems. With decreased reliance on external risk reduction approaches, Northeastern producers bear greater risk, but also have greater flexibility in altering the crop and livestock mix and are better able to respond to consumer demand. [ABSTRACT FROM AUTHOR]

Decomposition is a critical process that links the above- and below-ground portions of the nutrient cycle. A study was initiated in North Dakota, USA, to evaluate the decomposition rate between three genetically improved grass species monocultures, Agropyron desertorum, Bromus inermis, and Pascopyrum smithii, and two native perennial grass species occurring in area rangelands, Nassella viridula and Bouteloua gracilis. Standing litter of all five species was harvested in October 1996 and placed into litterbags. Litterbags were placed along transects in early November 1996 and randomly selected bags were sampled in June, July, August, September, and October, 1997. Carbon (C), nitrogen (N) and lignin were determined on all samples including the initial litter samples. The percent of dry matter decomposed across time ranged from 18.4% for B. gracilis to 26.8% for A. desertorum. The two native species, occurring in undisturbed rangeland, had significantly lower rates of decomposition than did the monocultures of the improved cultivars, including the monoculture of the improved native, P. smithii. Most decomposition occurred prior to the June 1997 sampling date, and from June to October 1997 decomposition was approximately the same for all species (7 to 8% ). The N concentration of the initial samples had the strongest correlation (r = 0.78 P < 0.01) with decomposition rates. Lignin had a significant positive correlation (r = 0.49, P = 0.03) and the C:N ratio had a significant negative correlation (r = -0.67 P < 0.01) with decomposition. Traits, such as decomposition, that can affect ecosystem functioning need to be given greater emphasis in genetic selection of native and improved grass species. [ABSTRACT FROM AUTHOR]