Isolation of Aeromonas hydrophila in a case of wound infection in cattle in Nigeria

A three and a half year old N'dama cow weighing about 150kg was rescued from a steel jaw trap during grazing the previous day and presented at the Teaching and Research Farm Federal University of Agriculture, Abeokuta, Nigeria with a fresh, deep wound. The animal was treated but there were no satisfactory response to Penicillin/streptomycin intramuscular injection at 10,0001U/kg for seven days and also i/m 20% Oxytetracycline injection at 20mg/kg repeated after 48 hours. A loopful of pus samples aseptically taken from the wound were streaked on blood agar base enriched with 7% horse blood (Oxoid, UK) using the quadrant streaking method and incubated aerobically at 37°C for 24-48 hours. Aeromonas hydrophila was isolated which was resistant to the commonly used antibiotics on the farm. Following the results obtained from the sensitivity test, the animal was placed on Enrofloxacin for seven days, the swelling regressed, no pus was expressed from the wound site and no pain was elicited from the joint on application of pressure by the 8th day Aeromonas hydrophila is pathogenic to man; hence care should be taken in handling of animal traps.

A 3,5-dinitropyridin-2yl substituted naphthalimide-based fluorescent probe for the selective detection of biothiols and its application in cell-imaging

A highly selective OFF–ON fluorescent probe has been developed for the sensing of biothiols with a satisfactory response time and low detection limit. Also, the probe can be successfully applied for the sensing of biothiols in living cells.

Physiological Phimosis and The Use of Topical Steroid

Background: Aim of this study is to see the efficiency of topical 1% hydrocortisone in the treatment of physiological phimosis. Materials and Methods: Retrospective study was conducted in the Kaski Model Hospital, Pokhara, Gandaki, Nepal from January 2016 to June 2019. Forty-nine patients treated in outpatient basis have been selected for this study. Selection was made according to Kikiros and Woodward retractability grading. Results: Out of 49(100%) patients 40(81.63%) achieved complete response to steroid, which is Kikiros and Woodward retractability grade 0. 2(4.08%) patients showed satisfactory response (symptom free) which is Kikiros and Woodward retractability grade 1. And 7(14.28%) patients showed no response after six weeks course of treatment and underwent circumcision. Conclusion: This study demonstrates the use of 1% topical hydrocortisone is safe, simple and cost effective. And it could be the initial choice of treatment.

Must I Benefit Myself?

Morality seems to require us to attend to the good of others, but it does not require that we assign any importance to our own good. Standard forms of consequentialism thus appear vulnerable to the compulsory self-benefit objection: they require agents to benefit themselves when doing so is entailed by the requirement of maximizing overall impersonal good. Attempts to address this objection by appealing to ideally motivated consequentialist agents; by rejecting maximization; by leveraging consequentialist responses to the more familiar special relationships and demandingness objections; or by appealing to dual rankings of moral and all-things-considered reasons fall short of adequately answering this objection. A satisfactory response to the compulsory self-benefit objection is elusive because of consequentialism struggles to account for directed options (in this case, an option not to maximize one’s own good but not that of others) and for moral considerations that do not rest on the value of outcomes or states of affairs.

The Possibility of Vagueness

We previously stated an impossibility result and suggested that the standard approaches to vagueness were incapable of providing a satisfactory response to the result. This chapter considers how a more satisfactory response to the result might proceed. This will call for a radical revision in our general understanding of vagueness and in how its logic has usually been conceived. It will be argued that the indeterminacy characteristic of vagueness can be conceived in purely logical terms without the need for any specific vagueness-theoretic vocabulary. The resulting notion of indeterminacy is seen to be global in character in that it makes sense to say that there is indeterminacy over a range of cases but not that there is indeterminacy in a single case; and a semantics for the resulting theory, in terms of the compatibility of uses, is then developed.

Defining ‘Satisfactory Response’ to Therapy in Abdominal Tuberculosis: A Work in Progress

Abdominal tuberculosis is difficult to diagnose due to low sensitivity of microbiological tests and the low histological yield. Satisfactory response to therapy has long been used a criteria for the diagnosis of abdominal tuberculosis. However, the appropriate definitions of response to therapy in abdominal tuberculosis have remained unclear. Recent evidence suggests that mucosal healing of ulcers at the end of therapy or at two months (early mucosal response) is a helpful criteria of response to therapy. This also helps in exclusion of multidrug resistant tuberculosis and alternative diagnosis like Crohn’s disease. Further limited literature suggests the use of some biomarkers like C-reactive protein in the follow-up of patients with peritoneal or intestinal tuberculosis.

Preimplantation genome editing: CCR5 in China

Part of the criticism of the one reported case of human preimplantation genome editing (PGE) turned on the inadequacy of the purpose for which it was undertaken (inherent immunity to HIV) and its target (the CCR5 gene). The discussion of CCR5 in this context reveals the different values that inform the idea of acceptable uses of PGE and of the conditions of responsible biomedical innovation among the scientist responsible and his critics. While the use of PGE for any indication remains unacceptable (or, at the very least, premature), neither position offers a satisfactory response to this prospective biotechnology.

Sequential Therapy with Cyclophosphamide, Bortezomib and Dexamethasone Followed By Autologous Stem Cell Transplant Is Safe and Highly Effective in AL Amyloidosis

Introduction: Autologous stem cell transplant (ASCT) is a very effective treatment in AL amyloidosis. However, its role is challenged by novel, powerful, non-transplant therapy, also due to the potentially high treatment-related mortality (TRM) that requires an extremely careful patient selection. Bortezomib-based induction and consolidation preceding and following ASCT have been proposed to improve patient outcomes. Here we report the outcome of 139 patients treated with bortezomib-based induction followed by ASCT in case of unsatisfactory response. Methods: Starting in 2009 we offered upfront therapy with cyclophosphamide (300 mg/m2), bortezomib (1.3 mg/m2) and dexamethasone (40 mg) weekly (CyBorD) to all patients with AL amyloidosis who met the eligibility criteria for transplantation at our institution. Eligibility criteria for ASCT were: age < 65 years, NT-proBNP <5000 ng/L, eGFR >50 mL/min per 1.73 m2, NYHA class >3, PS-ECOG, ≤2, left ventricular EF >45%, DLCO >50% (Palladini and Merlini, Blood 2016). Patients who did not achieve a satisfactory response after CyBorD proceeded to ASCT (with melphalan 200 mg/m2), if still eligible. A satisfactory response was defined as complete response (CR), very good partial response (VGPR) with organ response (OR), or partial response (PR) with OR. Patients with overt multiple myeloma were excluded. We assessed response rates (by intent-to-treat), overall survival (OS) and time to next line of treatment or death (TNTD). Results: Between 2009 and 2018, 139 consecutive newly diagnosed patients were eligible for ASCT and received CyBorD as first line treatment. They represented 15% of all patients diagnosed at our center during the study period. Patients' characteristics are reported in Table 1. Treatment with CyBorD continued for 2 cycles in 44 patients (32%), 4 cycles in 64 (46%), 6 cycles in 20 (14%) and 8 cycles in 11 (8%) patients. Only one patient (stage IIIa) died within 100 days from CyBorD initiation due to sudden death. After CyBorD treatment, 26 (20%) patients achieved CR, 45 (32%) VGPR, and 24 (17%) PR (overall hematologic response rate 69%). Sixty-three patients (45%) achieved a satisfactory response after CyBorD and did not proceed to ASCT. Twenty-one patients (15%) who did not reach a satisfactory response after CyBorD did not proceed to ASCT because of organ progression that made them no longer eligible (16 subjects, 12%) or patient refusal (5 cases, 4%). The remaining 55 subjects (40%) received ASCT. No patients died within 100 days from ASCT. Hematologic response after ASCT was obtained in 80% of patients, with CR in 21 subjects (38%), VGPR in 15 (27%) and PR in 8 (15%). In the overall cohort, the hematologic response rate after CyBorD or CyBorD followed by ASCT was 77%, with 47 subjects (34%) attaining CR, 40 (29%) VGPR, and 19 (14%) PR. After a median follow-up of living patients of 48 months, 27 subjects died. In the whole study cohort, overall median survival (OS) was not reached and projected OS was 78% at 4 years and 69% at 10 years. In patients who proceeded to ASCT, median OS was not reached, and projected survival was 90% at 4 years and 77% at 10 years. In patients who achieved a satisfactory response after CyBorD and did not proceed to ASCT, median OS was not reached as well, and projected survival was 84% at 4 years and 72% at 10 years (P=0.438 compared to ASCT). In patients who did not proceed to ASCT despite having failed to achieve a satisfactory response after CyBorD, median survival was 47 months (P<0.001 compared to the 2 other groups). We then compared OS in patients who achieved VGPR or CR after CyBorD alone or after CyBorD followed by ASCT and found no significant difference (Figure 1). Finally, we evaluated TNTD in patients who attained CR and found no significant difference between subjects treated with CyBorD alone and those who received ASCT after CyBorD (relapsed or dead at 4 years 36% vs. 20%, P=0.737). This is in agreement with the median time to relapse from CR of 4.3 years reported by the Boston University group (Browning, et al. Blood 2017). Conclusion: This sequential treatment approach granted a high rate of profound hematologic responses and prolonged survival with minimal TRM (<1%) that occurred during the induction phase. In patients who attained profound hematologic response (CR or VGPR), OS and durability of response were similar in subjects who responded to initial CyBorD and in those who proceeded to ASCT. Figure 1 Disclosures Milani: Janssen: Honoraria; Pfizef: Honoraria. Palladini:Sebia: Honoraria; Celgene: Other: Travel grant; Janssen-Cilag: Other: Travel grant; Janssen-Cilag: Honoraria. OffLabel Disclosure: Bortezomib in AL amyloidosis