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Background: Consolidation radiotherapy for advanced Hodgkin lymphoma (AHL) is controversial. Precise knowledge of the most likely relapse location is crucial for radiotherapy planning. We performed detailed patterns of relapse analyses and evaluated if initial bulky disease, initial 18F-fluoro-deoxy-glucose (FDG)-avidity and/or a residual mass on computed tomography (CT)-scan after chemotherapy are sites with a high risk of relapse. This information could provide guidance for optimal use of radiotherapy in AHL. Material and methods: We included 133 patients treated with curatively intended chemotherapy for AHL. 23 patients received consolidation radiotherapy. For relapsed patients, imaging from diagnosis, response evaluation, relapse, and any radiotherapy planning, were retrieved and co-registered to determine the exact site(s) of relapse relative to initial site(s), residual mass(es) and to any irradiated volumes. Size and FDG-avidity of initial sites with later relapse, and residual CT-abnormalities after chemotherapy in these sites were registered. Survival analyses were done using the Kaplan–Meier method. Results: Nine (6.8%) patients relapsed, eight in initially involved sites. One relapse was in an initially irradiated site (as well as other sites). Initial bulky disease, high initial FDG-uptake, and/or residual masses on CT-scan after chemotherapy did not predict sites with a high risk of relapse. Overall survival was 79.6% (95% CI, 72.7–86.5%) and 70.6% (95% CI, 62.4–78.8%) at 5 and 10 years, respectively. Time to progression analysis showed 91.8% (95% CI, 86.9–96.7%) and 90.7% (95% CI, 85.4–96.0%) without progression at 5 and 10 years, respectively. Conclusion: Current treatment strategies for AHL provide excellent disease control. Neither initial bulk, high initial FDG-uptake, nor a residual CT-abnormality post-chemotherapy seem to indicate sites with a high risk of relapse.

Background [18F]FDG Positron Emission Tomography cannot differentiate between sterile inflammation and infection. Therefore, we, aimed to develop more specific radiotracers fitted for differentiation between sterile and septic infection to improve the diagnostic accuracy. Consequently, the clinicians can refine the treatment of, for example, prosthesis-related infection.METHODS: We examined different target points; Staphylococcus aureus biofilm (68Ga-labeled DOTA-K-A9 and DOTA-GSGK-A11), bone remodeling ([18F]NaF), bacterial cell membranes ([68Ga]Ga-Ubiquicidin), and leukocyte trafficking ([68Ga]Ga-DOTA-Siglec-9). We compared them to the well-known glucose metabolism marker [18F]FDG, in a well-established juvenile S. aureus induced osteomyelitis (OM) pig model.RESULTS: [18F]FDG accumulated in the OM lesions seven days after bacterial inoculation, but disappointingly we were not able to identify any tracer accumulation in OM with any of the supposedly more specific tracers.CONCLUSION: These negative results are, however, relevant to report as they may save other research groups from conducting the same animal experiments and provide a platform for developing and evaluating other new potential tracers or protocol instead.

Despite promising anti-cancer properties in vitro, all titanium-based pharmaceuticals have failed in vivo. Likewise, no target-specific positron emission tomography (PET) tracer based on the radionuclide 45Ti has been developed, notwithstanding its excellent PET imaging properties. In this contribution, we present liquid–liquid extraction (LLE) in flow-based recovery and the purification of 45Ti, computer-aided design, and the synthesis of a salan-natTi/45Ti-chelidamic acid (CA)-prostate-specific membrane antigen (PSMA) ligand containing the Glu-urea-Lys pharmacophore. The compound showed compromised serum stability, however, no visible PET signal from the PC3+ tumor was seen, while the ex vivo biodistribution measured the tumor accumulation at 1.1% ID/g. The in vivo instability was rationalized in terms of competitive citrate binding followed by Fe(III) transchelation. The strategy to improve the in vivo stability by implementing a unimolecular ligand design is presented.

A switch from batch to continuous manufacturing of gallium-68 (68Ga) and 68Ga-labeled pharmaceuticals can be advantageous, as it recycles isotopically-enriched zinc-68 (68Zn), removes pre- and post-irradiation target manipulations, and provides scalability via dose-on-demand production. Herein we report efficient extraction of radiogallium (66,67,68Ga = *Ga) from ZnCl2/HCl solutions in batch and in flow using a membrane-based liquid-liquid separator. From 5.6 M ZnCl2/3 M HCl, a 1/2 (v/v) diisopropyl ether (iPr2O)/trifluorotoluene (TFT) solvent extracts 76.3 ± 1.9% of *Ga and 1.9 ± 1.6% of Zn in flow using a single pass through. From 1 M ZnCl2/6 M HCl, a 1/2 (v/v) n-butyl methyl ether (n-BuOMe)/TFT solvent extracts 95.7 ± 2.0% of *Ga and 0.005 ± 0.003% of Zn in flow. TFT plays a key role in controlling the interfacial tension between the aqueous and the organic phases, ensuring clean membrane-based separation. The process did not extract Cu, Mn, and Co but did extract Fe. Using HGaCl4 and ZnCl2 as the extractable species, the COSMO-RS theory predicts the solvation-driven extraction of Ga and Zn with a mean unsigned error of prediction of 4.0% and 3.4% respectively.

Brännskador kan innebära ett trauma som kan leda till bestående ärrbildning och stor påverkan på den drabbade personens liv. Den fysiska läkningsprocessen pågår parallellt med bearbetning av traumat och anpassning till livet. För att påskynda läkningen behövs kunskap om hur personer med brännskador upplever sin brännskada och sina ärr. Sjuksköterskan har en viktig funktion både i den akuta och långsiktiga omvårdnaden av personer med brännskador. Det är av stor vikt att arbetet sker personcentrerat eftersom personer med brännskador upplever sitt trauma och sina ärr på olika sätt och eftersom bearbetningen är individuell. Syftet med litteraturstudien var att beskriva upplevelser av att leva med bestående ärrbildning efter en brännskada. Genom innehållsanalys bearbetades 11 vetenskapliga artiklar med kvalitativ ansats. Det framkom att livet påverkades i stor utsträckning både fysiskt och psykiskt efter en brännskada med bestående ärr. Kroppen upplevdes annorlunda, smärtsam och mer närvarande. Personer med brännskador upplevde psykisk ohälsa till följd av smärta, trauma och förändrat utseende. De upplevde hinder i det dagliga livet och det tog lång tid att acceptera att livet förändrats. Litteraturstudien bidrar till ökad förståelse kring personers upplevelser av en brännskada och kan ligga till grund för sjuksköterskors vidareutbildning inom smärtproblematik., Burns cause trauma that can lead to permanent scarring and can have a major impact on the affected person's life. The physical healing process is parallel to the processing of trauma and adaptation to life. To accelerate the healing it is essential to have knowledge about how people with burns experience their burn and scars. The nurse has an important function both in the acute and long-term care of people with burns. The aim of this literature study was to describe experiences of living with permanent scarring after a burn. Through content analysis, 11 qualitative articles were processed. It was found that life was influenced to a large extent both physically and psychological after a burn. The body felt different, painful, and more present. People with burns often experienced psychological difficulties as a result of pain, trauma, and an altered appearance. People who have suffered from a burn with permanent scarring felt that they were affected by the injury for an extensive period of time This literature study contributes to increased understanding of people's perceptions of a burn and can lay the foundation for nurse's further education in pain management.

The development of bacteria-specific infection radiotracers is of considerable interest to improve diagnostic accuracy and enabling therapy monitoring. The aim of this study was to determine if the previously reported radiolabelled 1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid (DOTA) conjugated peptide [68Ga]Ga-DOTA-K-A9 could detect a staphylococcal infection in vivo and distinguish it from aseptic inflammation. An optimized [68Ga]Ga-DOTA-K-A9 synthesis omitting the use of acetone was developed, yielding 93 ± 0.9% radiochemical purity. The in vivo infection binding specificity of [68Ga]Ga-DOTA-K-A9 was evaluated by micro positron emission tomography/magnetic resonance imaging of 15 mice with either subcutaneous Staphylococcus aureus infection or turpentine-induced inflammation and compared with 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG). The scans showed that [68Ga]Ga-DOTA-K-A9 accumulated in all the infected mice at injected doses ≥3.6 MBq. However, the tracer was not found to be selective towards infection, since the [68Ga]Ga-DOTA-K-A9 also accumulated in mice with inflammation. In a concurrent in vitro binding evaluation performed with a 5-carboxytetramethylrhodamine (TAMRA) fluorescence analogue of the peptide, TAMRA-K-A9, the microscopy results suggested that TAMRA-K-A9 bound to an intracellular epitope and therefore preferentially targeted dead bacteria. Thus, the [68Ga]Ga-DOTA-K-A9 uptake observed in vivo is presumably a combination of local hyperemia, vascular leakiness and/or binding to an epitope present in dead bacteria.

Combination of dopamine D3 antagonism, serotonin 5-HT1A partial agonism, and antagonism at 5-HT2A leads to a novel approach to potent atypical antipsychotics. Exploitation of the original structure-activity relationships resulted in the identification of safe and effective antipsychotics devoid of extrapyramidal symptoms liability, sedation, and catalepsy. The potential atypical antipsychotic 5bb was selected for further pharmacological investigation. The distribution of c-fos positive cells in the ventral striatum confirmed the atypical antipsychotic profile of 5bb in agreement with behavioral rodent studies. 5bb administered orally demonstrated a biphasic effect on the MK801-induced hyperactivity at dose levels not able to induce sedation, catalepsy, or learning impairment in passive avoidance. In microdialysis studies, 5bb increased the dopamine efflux in the medial prefrontal cortex. Thus, 5bb represents a valuable lead for the development of atypical antipsychotics endowed with a unique pharmacological profile for addressing negative symptoms and cognitive deficits in schizophrenia.

The imaging of infectious and inflammatory diseases using gallium-67 (Ga-67) citrate scintigraphy has been a well-established diagnostic tool for decades. In recent times, interest has focused on PET using the short-lived positron emitting radioisotope Ga-68. Ga-68 is not only more readily available, it also provides better quality images whose high resolution permits quantitative analyses, thus improving the management of patients suffering from infections or inflammation. The purpose of our study was to develop a fast and reliable synthesis protocol for the preparation of Ga-68 citrate under good manufacturing practice aspects without the use of organic solvents. A commercially available synthesis module was used to perform 10 syntheses with an average yield of 768 +/- 31 MBq (mean +/- SD) within 10 min; 92.04 +/- 1.23% of the radioactivity was located in the product vial, and the rest on the cation exchange cartridge (7.48 +/- 1.23 and in the waste vial (0.47 +/- 0.28. The radiochemical purity of the product determined by instant thin-layer chromatography was greater than 99 The products have been proven to be sterile and pyrogen-free. Variations were made in several critical synthesis parameters, and the results are presented herein. By eliminating the use of organic solvents, the previously required quality control testing of the final product by gas chromatography can be abandoned. This novel, high-yielding method allows for a more efficient synthesis of Ga-68 citrate with both shorter production time and high radiochemical purity.