Medical and Adjunctive Treatment of Mucormycosis in Children: Scientific Rationale and Analysis of Cases Reported in the Literature

Mucormycosis is associated with significant morbidity and mortality in both children and adults. Studies have shown an increase in the incidence of mucormycosis, particularly among hematopoietic stem cell transplant (HSCT) recipients, patients with hematologic malignancies, and those with diabetic ketoacidosis. The infection typically presents as soft tissue, rhinoorbitocerebral, pulmonary, or disseminated disease and is characterized by rapid clinical progression and high mortality rates. Treatment with amphotericin B lipid formulations in combination with surgery offers the best option for treatment and survival; posaconazole, a relatively new antifungal triazole, is increasingly used for consolidation or salvage therapy. Because of the poor prognosis of zygomycosis, particularly in immunocompromised cancer patients, adjunctive treatments such as hyperbaric oxygen therapy, use of immunomodulatory cytokines, and in vivo iron chelation continue to be explored. Thus far, it is unclear how these adjunctive treatments can be harnessed to impact outcomes and which patients may benefit from them.     

Promotion of petunia (Petunia hybrida L.) regeneration in vitro by ethylene

The influence of ethylene on shoot and root formation from petunia leaf explants was studied in cultures in test tubes placed in 51 glass jars. Reduction of the endogenously produced ethylene by inclusion of ethysorb (KMnO₄), an ethylene absorbent, caused a decrease of the number of shoots. On the other hand, supplementing the cultures with ethylene (0.01–10 ppm) caused a marked increase of the number of shoots without, however, any effect on the length and fresh weight. Ethylene treatments (1 ppm) were found to be most effective when they were applied in the second week of culturing of petunia explants. Addition of Co⁺⁺ to the medium resulted in a reduction of the endogenously produced ethylene and concomitantly reduced shoot formation. Similarly, inclusion of Ag⁺, an inhibitor of ethylene action, resulted in poor shoot formation. Ethylene also appeared to play a role on rooting of petunia microshoots in vitro in an auxin-free medium. Ethylene at a concentration of 10 ppm induced adventitious root formation considerably, whereas at low levels (0.01–1 ppm) it had no influence on rooting.     

Host cystathionine-γ lyase derived hydrogen sulfide protects against Pseudomonas aeruginosa sepsis

Hydrogen sulfide (H₂S) has recently been recognized as a novel gaseous transmitter with several anti-inflammatory properties. The role of host- derived H₂S in infections by Pseudomonas aeruginosa was investigated in clinical and mouse models. H₂S concentrations and survival was assessed in septic patients with lung infection. Animal experiments using a model of severe systemic multidrug-resistant P. aeruginosa infection were performed using mice with a constitutive knock-out of cystathionine-γ lyase (Cse) gene (Cse^-/-) and wild-type mice with a physiological expression (Cse^+/+). Experiments were repeated in mice after a) treatment with cyclophosphamide; b) bone marrow transplantation (BMT) from a Cse^+/+ donor; c) treatment with H₂S synthesis inhibitor aminooxyacetic acid (ΑΟΑΑ) or propargylglycine (PAG) and d) H₂S donor sodium thiosulfate (STS) or GYY3147. Bacterial loads and myeloperoxidase activity were measured in tissue samples. The expression of quorum sensing genes (QS) was determined in vivo and in vitro. Cytokine concentration was measured in serum and incubated splenocytes. Patients survivors at day 28 had significantly higher serum H₂S compared to non-survivors. A cut- off point of 5.3 μΜ discriminated survivors with sensitivity 92.3%. Mortality after 28 days was 30.9% and 93.7% in patients with H₂S higher and less than 5.3 μΜ (p = 7 x 10⁻⁶). In mice expression of Cse and application of STS afforded protection against infection with multidrug-resistant P. aeruginosa. Cyclophosphamide pretreatment eliminated the survival benefit of Cse^+/+ mice, whereas BMT increased the survival of Cse^-/- mice. Cse^-/- mice had increased pathogen loads compared to Cse^+/+ mice. Phagocytic activity of leukocytes from Cse^-/- mice was reduced but was restored after H₂S supplementation. An H₂S dependent down- regulation of quorum sensing genes of P.aeruginosa could be demonstrated in vivo and in vitro. Endogenous H₂S is a potential independent parameter correlating with the outcome of P. aeruginosa. H₂S provides resistance to infection by MDR bacterial pathogens.     

Pseudo-polymorphic Ventricular Tachycardia in a 12-lead Holter Recording

We present an image of pseudo-polymorphic ventricular tachycardia recording on a 12-lead surface ECG Holter. Although at first glance the appearance of the recording resembled polymorphic ventricular tachycardia, careful investigation revealed normal electrocardiographic findings.     

The Role οf Ion Channels in the Development and Progression of Prostate Cancer

Molecular Diagnosis & Therapy - Ion channels have major regulatory functions in living cells. Apart from their role in ion transport, they are responsible for cellular electrogenesis and...