Diffuse Large B-Cell Lymphoma Presenting Primarily as a Cutaneous Leg Lesion: A Case Report and Literature Review.

Primary cutaneous B-cell lymphoma (PCBCL) has three subtypes, among those, the leg type variant is the rarest with the highest rates of relapse and recurrence making it an intriguing focus for researchers. Nevertheless, prior to framing a diagnosis solely based on the lesion's location, it is prudent to reconsider whether it is genuinely a primary cutaneous B-cell lymphoma (PCBCL) or if it aligns more closely with the more prevalent lymphoma variants such as diffuse large B-cell lymphoma (DLBCL) with cutaneous involvement. We are reporting a case of an 85-year-old African American lady, who presented with unilateral left leg DLBCL with cutaneous involvement.

Characterization of PFAS residuals: A case study on PFAS content in a firefighting foam delivery system of an aircraft rescue and firefighting vehicle.

When fire suppression systems that held aqueous film forming foams (AFFF) are transitioned to per- and polyfluoroalkyl substance (PFAS)-free firefighting formulations, PFAS can dissolve from the wetted surfaces of the systems and release into the new firefighting formulations. The overall objective of this work was to characterize PFAS residual mass on the wetted surfaces of aircraft rescue and firefighting (ARFF) vehicle on-board fire suppression system components from the water, mixed fire water, and foam concentrate systems with various geometries, materials of construction, and locations within the fire suppression system. The ARFF vehicle components were dismantled from the system after a triple water rinse procedure which removed 19,600 mg total measured PFAS post-TOP assay from the foam concentrate system and 23 mg total measured PFAS post-TOP assay from the water system.

Pharmacokinetics, pharmacodynamics, safety, and efficacy of crizanlizumab in patients with sickle cell disease: final results from the phase II SOLACE-adults study.

Background: Crizanlizumab is a novel inhibitor of P-selectin, a key player in multicellular adhesion and inflammatory signaling, that leads to vaso-occlusion in sickle cell disease (SCD).

Objectives: The SOLACE-adults study evaluated the pharmacokinetics, pharmacodynamics (P-selectin inhibition), safety, and efficacy of crizanlizumab, with or without hydroxyurea/hydroxycarbamide, in patients with SCD.

Design: Phase II, single-arm, multicenter study.

The use of abstract animations and a graphical body image for assessing pain outcomes among adults with sickle cell disease.

Painimation, a novel digital pain assessment tool, allows patients to communicate their pain quality, intensity, and location using abstract animations (painimations) and a paintable body image. This study determined the construct validity of painimations and body image measures by testing correlations with validated pain outcomes in adults with sickle cell disease (SCD). Analyses used baseline data from a multisite randomized trial of 359 adults with SCD and chronic pain.

Comprehensive molecular profiling of multiple myeloma identifies refined copy number and expression subtypes.

Multiple myeloma is a treatable, but currently incurable, hematological malignancy of plasma cells characterized by diverse and complex tumor genetics for which precision medicine approaches to treatment are lacking. The Multiple Myeloma Research Foundation's Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile study ( NCT01454297 ) is a longitudinal, observational clinical study of newly diagnosed patients with multiple myeloma (n = 1,143) where tumor samples are characterized using whole-genome sequencing, whole-exome sequencing and RNA sequencing at diagnosis and progression, and clinical data are collected every 3 months. Analyses of the baseline cohort identified genes that are the target of recurrent gain-of-function and loss-of-function events.

Acute myeloid leukemia mitochondria hydrolyze ATP to resist chemotherapy.

Despite early optimism, therapeutics targeting oxidative phosphorylation (OxPhos) have faced clinical setbacks, stemming from their inability to distinguish healthy from cancerous mitochondria. Herein, we describe an actionable bioenergetic mechanism unique to cancerous mitochondria inside acute myeloid leukemia (AML) cells. Unlike healthy cells which couple respiration to the synthesis of ATP, AML mitochondria were discovered to support inner membrane polarization by consuming ATP.

A machine learning approach to predict mortality due to immune-mediated thrombotic thrombocytopenic purpura.

Background: Mortality due to immune-mediated thrombotic thrombocytopenic purpura (iTTP) remains significant. Predicting mortality risk may potentially help individualize treatment. The French Thrombotic Microangiopathy (TMA) Reference Score has not been externally validated in the United States.

Riociguat in patients with sickle cell disease and hypertension or proteinuria (STERIO-SCD): a randomised, double-blind, placebo controlled, phase 1-2 trial.

Background: Although nitric oxide based therapeutics have been shown in preclinical models to reduce vaso-occlusive events and improve cardiovascular function, a clinical trial of a phosphodiesterase 5 inhibitor increased rates of admission to hospital for pain. We aimed to examine if riociguat, a direct stimulator of the nitric oxide receptor soluble guanylate cyclase, causes similar increases in vaso-occlusive events.

Methods: This was a phase 1-2, randomised, double blind, placebo-controlled trial.

Acute pulmonary injury in hematology patients supported with pathogen-reduced and conventional platelet components.

Patients treated with antineoplastic therapy often develop thrombocytopenia requiring platelet transfusion, which has potential to exacerbate pulmonary injury. This study tested the hypothesis that amotosalen-UVA pathogen-reduced platelet components (PRPCs) do not potentiate pulmonary dysfunction compared with conventional platelet components (CPCs). A prospective, multicenter, open-label, sequential cohort study evaluated the incidence of treatment-emergent assisted mechanical ventilation initiated for pulmonary dysfunction (TEAMV-PD).

Mental health, pain and likelihood of opioid misuse among adults with sickle cell disease.

Depressive symptoms are prevalent in individuals living with sickle cell disease (SCD) and may exacerbate pain. This study examines whether higher depressive symptoms are associated with pain outcomes, pain catastrophizing, interference and potential opioid misuse in a large cohort of adults with SCD. The study utilized baseline data from the 'CaRISMA' trial, which involved 357 SCD adults with chronic pain.

PFA-100 System: A New Method for Assessment of Platelet Dysfunction.

This is a celebratory reprint of a historical paper published in STH in 1998. The original Abstract follows.The PFA-100 system is a platelet function analyzer designed to measure platelet-related primary hemostasis.

Operating room efficiency of orthopedic surgery during the COVID-19 era.

Objective: The COVID-19 pandemic forced operating rooms (ORs) to adopt new safety protocols. Although these measures protected the health of patients and providers, their impact on OR efficiency remains unclear. Our objective was to further elucidate the effects of COVID-19 on orthopedic surgery OR efficiency.

Crizanlizumab in sickle cell disease.

Vaso-occlusion in sickle cell disease (SCD) leads to a myriad of manifestations driving morbidity and mortality in patients with SCD. Increased leucocyte adhesion and P-selectin expression on platelets and endothelial cells is an inciting event that leads to obstruction of microcirculation by adhesion with rigid sickled red blood cells. Crizanlizumab is a first-in-class monoclonal antibody that inhibits P-selectin and has been shown to decrease the frequency of vaso-occlusive pain crises in patients with SCD in clinical trials.

Revisiting Cancer Care in Eastern North Carolina: 2023 Update.

Since 2002, when Dr. William Bobzien first provided insight into the challenges of providing oncology care in Eastern North Carolina, we have made significant improvements. But we still face challenges, many of which are related to the ongoing socioeconomic issues of the citizens of our region.

Fasciotomy on a female patient with acquired factor VIII: A case report and literature review of management.

Key Clinical Message: Acquired factor VIII inhibitors can be a rare cause of extensive intramuscular bleeding requiring fasciotomy. The subsequent postoperative period requires close monitoring due to high risk of fatal blood loss.

Abstract: Acquired factor VIII inhibitors are a rare cause of often extensive bleeding and subsequently large hematomas.

The cost of a plastic surgery team assisting with cranioplasty.

Objectives: Cranioplasty is a commonly performed neurosurgical procedure that restores cranial anatomy. While plastic surgeons are commonly involved with cranioplasties, the cost of performing a cranioplasty with neurosurgery alone (N) vs. neurosurgery and plastic surgery (N + P) is unknown.

Pharmacokinetics, pharmacodynamics, safety, and efficacy of crizanlizumab in patients with sickle cell disease.

Crizanlizumab is an anti-P-selectin monoclonal antibody indicated to reduce the frequency/prevent recurrence of vaso-occlusive crises (VOCs) in patients with sickle cell disease (SCD) aged ≥16 years. This analysis of an ongoing phase 2, nonrandomized, open-label study reports the pharmacokinetics (PK), pharmacodynamics (PD), safety, and efficacy of crizanlizumab 5.0 mg/kg (N = 45) and 7.

Characterization of per- and polyfluoroalkyl substances on fire suppression system piping and optimization of removal methods.

Fire suppression systems are known to be impacted with residual, entrained per- and polyfluoroalkyl substances (PFASs) because of historical use of aqueous film forming foam (AFFF) and fluoroprotein foam. Amphiphilic PFASs aggregate at liquid:solid interfaces creating a hydrophobic layer which reduces the effectiveness of water to remove PFAS from layered surfaces. When fire suppression systems are transitioned to fluorine free foam (F3) without appropriate cleaning, residual PFASs associated with the surfaces of the fire suppression system can contaminate the replacement F3.

Perfluorobutanoic Acid (PFBA) Induces a Non-Enzymatic Oxidative Stress Response in Soybean ( L. Merr.).

Short-chain perfluoroalkyl substances (PFAS) are generally considered to be of less environmental concern than long-chain analogues due to their comparatively shorter half-lives in biological systems. Perfluorobutanoic acid (PFBA) is a short-chain PFAS with the most root-shoot transfer factor of all PFAS. We investigated the impact of extended exposure of soybean plants to irrigation water containing environmentally relevant (100 pg-100 ng/L) to high (100 µg-1 mg/L) concentrations of PFBA using phenotypical observation, biochemical characterization, and transcriptomic analysis.

Race, rituximab, and relapse in TTP.

Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is characterized by recurring episodes of thrombotic microangiopathy, causing ischemic organ impairment. Black patients are overrepresented in iTTP cohorts in the United States, but racial disparities in iTTP outcome and response to therapy have not been studied. Using the United States Thrombotic Microangiopathies Consortium iTTP Registry, we evaluated the impact of race on mortality and relapse-free survival (RFS) in confirmed iTTP in the United States from 1995 to 2020.

Comparative risk of pulmonary adverse events with transfusion of pathogen reduced and conventional platelet components.

Background: Platelet transfusion carries risk of transfusion-transmitted infection (TTI). Pathogen reduction of platelet components (PRPC) is designed to reduce TTI. Pulmonary adverse events (AEs), including transfusion-related acute lung injury and acute respiratory distress syndrome (ARDS) occur with platelet transfusion.

Field-Scale Demonstration of PFAS Leachability Following In Situ Soil Stabilization.

A field-scale validation is summarized comparing the efficacy of commercially available stabilization amendments with the objective of mitigating per- and polyfluoroalkyl substance (PFAS) leaching from aqueous film-forming foam (AFFF)-impacted source zones. The scope of this work included bench-scale testing to evaluate multiple amendments and application concentrations to mitigate PFAS leachability and the execution of field-scale soil mixing in an AFFF-impacted fire-training area with nearly 2.5 years of post-soil mixing monitoring to validate reductions in PFAS leachability.