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B Conclusions: b LNM and MTV, both assessed in baseline PET/CT, turned out as the most frequently used tools to guide treatment in RAFTING trial, superseding PET-2 and possibly paving the way to future eHL Tx options based on new metrics in baseline PET/CT. B Introduction: b The efficacy of combined-modality treatment (Tx) with chemotherapy (CT) and radiotherapy (RT) in early-stage Hodgkin Lymphoma (eHL) is offset by long-term morbidity, with a cumulative incidence of 2nd primary malignancy at 40 years of 48.5% (Schaapveld 2015). Baseline-PET derived metrics are the most relevant factors for risk stratification in early-stage nonbulky HL: preliminary results of the RAFTING trial. [Extracted from the article]

Background and purpose: Rituximab, a chimeric anti‐CD20 monoclonal antibody, has been used in polyneuropathy associated with anti‐myelin‐associated glycoprotein (anti‐MAG) antibody polyneuropathy with controversial results. Herein, two patients with anti‐MAG antibody neuropathy and concurrent chronic lymphocytic leukemia (CLL) are reported, who dramatically responded to obinutuzumab, a novel glycoengineered humanized anti‐CD20 monoclonal antibody. Methods: Patient 1 was an 82‐year‐old man with severe demyelinating sensory‐motor neuropathy. He was wheelchair‐bound, with loss of sensation up to the knees. He had a CLL, immunoglobulin M (IgM) lambda monoclonal gammopathy, with anti‐MAG antibodies >70 000 Bühlmann titer units (BTU). Patient 2 was an 84‐year‐old woman with demyelinating neuropathy, paresthesias and gait instability. She had CLL and IgM kappa paraprotein with anti‐MAG antibodies >70 000 BTU. Both patients were treated with obinutuzumab intravenously at 100 mg on day +1, 900 mg +2, then at 1000 mg on days 8 and 15 of cycle 1 and day 1 of cycles 2–6; chlorambucil was given orally at 0.5 mg/kg on days 1 and 15 of cycles 1–6. Results: Patient 1 at cycle 6 was able to stand, gait was possible with monolateral support, hypoesthesia and strength improved. M‐protein and IgM level decreased. In patient 2, already after three cycles, the monoclonal component disappeared and there was dramatic improvement of symptoms and gait normalization. At the end of therapy anti‐MAG antibody titer decreased to 5462 BTU. Neurophysiology also improved. Conclusions: In our patients, obinutuzumab was effective as a first‐line treatment of anti‐MAG antibody polyneuropathy. CLL might have had a role in the response to therapy, but the associations might be considered in future trials. [ABSTRACT FROM AUTHOR]

O presente artigo tem como objetivo identificar como ocorre o desenvolvimento das competências docentes no ensino superior. A coleta de dados foi realizada por meio de uma pesquisa descritiva, aplicada por intermédio da plataforma virtual do “Google Forms”. A amostra foi composta por 199 docentes que atuam em universidades públicas e privadas no estado Santa Catarina, sendo coletada por acessibilidade e conveniência. Por meio da técnica estatística de regressão múltipla, evidenciou-se que o suporte institucional se apresentou como preditor exclusivamente para o desenvolvimento de competências gerais e a autoaprendizagem demonstrou-se como preditora apenas para o desenvolvimento de competências de ensino, pesquisa e competências gerais. Constatou-se ainda a necessidade de ampliar o desenvolvimento das competências de extensão e de gestão nas instituições de ensino, por meio do suporte institucional ou da autoaprendizagem

The prevalence of patients suffering pain in hospital is high. This situation is censured during congresses on the study and treatment of pain, which highlight how little consideration the problem is given. Our study, which measured exactly how far pain is underestimated and inappropriately treated, took place as part of the project 'Towards a Pain-Free Hospital' in San Bortolo Hospital, Vicenza. Data were collected by means of a questionnaire consisting of 5 questions and 2 numeric scales concerning the presence of pain, its intensity and its causes, and on the type of treatment received. Data were collected for each patient regarding their sex, the ward they were in, the type of analgesics used and how they were taken. Prevalence of pain in this study was 44% (95% CI, 41%-48%). It was higher among women than men (47% vs. 41%), as it was in the 62-72 years age group (49.7%) compared to other age groups and in the surgical wards as opposed to general medicine wards, without there being, however, a significant difference between groups. There was little agreement between patients' perceived pain and nurses' interpretation of their pain (Cohen's k =0.17, 95% CI, 0.09-0.25); these findings show a tendency for caregivers to underestimate the patient's pain. Among those patients in pain, 59% were taking analgesics. Of these, 67% were taking them only on a prn basis, 20% at fixed times and 12% both at fixed times and on a prn basis; 82% were being treated only with non-steroidal anti-inflammatory drugs (NSAIDs), 8% only with opioids, and 3.7% with both. Of the patients using NSAIDs, 72% were taking them on a prn basis, while 86% of those using opioids were taking them according to a fixed schedule. These data are rather disappointing as they indicate a certain negligence towards patients (40% of patient with pain were not treated) and an inappropriate use of analgesics. [ABSTRACT FROM AUTHOR]

In this study we investigated whether IL-2-aclivated killer cells may bind and exert lytic activity against non-transformed lung fibroblasts. We demonstrated that human lymphokine-activated killer (LAK) cells generated in vitro following incubation with recombinant IL-2 of either peripheral blood mononuclear cells (PB-LAK) or lymphocytes obtained from bronchoalveolar lavage (BAL-LAK). but not resting cells, can lyse normal lung fibroblasts obtained from transbronchial lung biopsies in a 4-h51 Cr release assay. Both autologous and allogeneic fibroblasts were consistently lysed by LAK cells, thus suggesting that the phenomenon we observed is not MHC-restricted. Since fibroblasts can bind IL-2 through specific receptors, we evaluated whether long-term culture with rlL-2 could modulate the susceptibility to lysis of target cells. Our data showed that autologous fibroblasts were more resistant to lysis than allogeneie fibroblasts when they were cultured with rlL-2. Since LAK cells have been demonstrated to release a series of different immunomodulatory cytokines, we evaluated the ellect of short-term incubation of fibrobiasts with different factors, including IL-1. lL-2, lL-3. lL-4, lL-6. tumour necrosis ftictor-alpha (TNF-d), and interferon-gamma (IFN-7), on the binding and the lysis mediated by LAK cells. These cytokines were not directly cytotoxic on fibroblasts. Only IFN-γ was found to have a significant protective effect against the lysis. Our data support the concept that a self-directed cytotoxicity against pulmonary fibroblasls is generated during lymphocyte activation with rlL-2. [ABSTRACT FROM AUTHOR]

We studied superoxide anion (O2-) generation by alveolar macrophages (AM) isolated from bronchoalveolar lavages (BAL) of patients with sarcoidosis, and assayed immediately after the isolation or after maintenance in culture for 2 days. In assays of cells freshly isolated from BAL, AM of patients with active sarcoidosis with a high-intensity lymphocytic alveolitis produced more O2- in response to phorbol myristate actetate than AM of patients with inactive sarcoidosis. Also, after 2 days of cultivation sarcoid AM were heterogeneous in their capability to metabolize oxygen, although both AM of active and inactive sarcoid patients produced higher amounts of O2- than AM of healthy subjects. In vitro treatment with recombinant interferon-gamma (rIFN-γ) caused an enhancement of the capability of AM of inactive sarcoid patients to produce O2- in response to PMA. AM of patients with active sarcoidosis did not respond to rIFN-γ when they already produced O2- vigorously. However, they became sensitive to the activating effect of rIFN-γ after the down-modulation of their capability to produce O2-, that occurred upon prolonged cultivation. Monocytes isolated from blood of sarcoid patients and assayed immediately or after different times of cultivation did not produce more O2- than control monocytes and monocyte-derived macrophages, thus indicating that the activation of AM in sarcoidosis is likely a local phenomenon. These studies strengthen the notion that T lymphocyte-macrophage interaction is a critical event in the pathogenesis of sarcoidosis and establish that the enhanced capability to metabolize oxygen to highly reactive intermediates by AM is one of the consequence of this interaction. [ABSTRACT FROM AUTHOR]

T lymphocyte regulation of immunoglobulin production may be abnormal in some patients with common variable immunodeficiency (CVI). Phenotypic analysis of peripheral blood T lymphocytes from nine patients with CVI was conducted to examine whether an abnormal distribution could be detected in a functionally distinct T lymphocyte subpopulation. The percentage of CD8+ lymphocytes proved to be increased in some patients and decreased in others. In comparison with normal controls, many patients with CVI had reduced percentages of lymphocytes expressing both CD4 and CD45RA, a phenotype associate with naive CD4+ cells. There was no significant difference in CD4+ populations bearing CD29 or leucocyte adhesion molecule-1 (LAM-1) antigens. The pattern of gene rearrangement of the T cell antigen receptor (TCR) was studied using peripheral blood lymphocytes from these patients with CVI. Genomic DNA from freshly isolated lymphocytes as well as from selectively propagated CD4+ or CD8+ populations were examined using Southern blot analysis and a probe for the β chain of the TCR. A polyclonal pattern of TCR gene rearrangement, without the appearance of dominant non-germline bands, was demonstrated in all patient samples. These data suggest that the T lymphocytes in patients with CVI have a polyclonal pattern of TCR rearrangement despite an abnormal distribution of T cell subpopulations in some patients. [ABSTRACT FROM AUTHOR]

In 20 patients with lymphoproliferative disease of granular lymphocytes (LDGL) the cytotoxic in vitro function of peripheral blood mononuclear cells was studied against both NK sensitive (K-562) and NK resistant target cells (Daudi). Cytotoxicity was analysed at resting conditions and after in vitro pre-incubation with recombinant α2-interferon, γ-interferon and interleukin 2. At resting conditions, a heterogeneous cytotoxic picture was observed against the K-562 targets, with 11 of the 20 patients showing a normal or increased NK activity, and nine an impaired function. Against the Daudi targets, unstimulated cells from all patients displayed a normal cytotoxic activity. Following in vitro stimulation, an increased lytic function against K-562 cells was demonstrated in six of the nine patients with low basal values, in three after boosting with all lymphokines tested and in three with interleukin 2. In three of these six patients incubation with interleukin 2 also produced an increased cytotoxic function against Daudi target cells; this phenomenon may be associated to the lymphokine-activated killer (LAK) system. The importance of investigating the cytotoxic in vitro function in LDGL patients to further characterize the biological features of GL and its relevance to better define the nature of this disease are discussed. [ABSTRACT FROM AUTHOR]