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Transfusion-related acute lung injury (TRALI) is a leading cause of transfusion related morbidity and mortality. Current concepts regarding the pathogenesis of this disorder imply a "two-hit" model in which neutrophils are sequestered in the pulmonary capillary bed, and subsequently activated by substances in the transfused blood product. We report a case of TRALI in a patient with neutropenia and discuss the possible factors contributing to the respiratory symptoms in this patient. We also emphasise the importance of recognising mild cases of TRALI in order to investigate the implicated donor/s appropriately, and to minimise the risk for more severe episodes in other patients.

SUMMARY1. Miosis was observed after enucleation in unopened eyes from normal or atropinized, atropinesterase-free rabbits. Such a phenomenon was not seen in enucleated cat eyes, in which the pupils remained widely dilated, whether atropine had been administered or not.2. Pre-treatment of the animals with reserpine did not alter this difference between the species.3. The difference does not appear to be due to absence of irins from the cat iris, since aqueous extracts of cat irides contained a smooth-musclecontracting activity (cat irin) extractable into ether at pH 3 and therefore consisting of lipid acid(s).4. The difference is not due to insensitivity of the cat sphincter pupillae muscle to irins, since injections of ether-purified cat or rabbit irins into the anterior chamber of enucleated cat eyes kept at room temperature constricted the pupil; injections of histamine were ineffective.5. In experiments on animals treated with atropine + mepyramine i.v., photographic measurements revealed a further difference, namely in the speed of miosis after stroking the iris in vivo. The response started later in the cat, and developed more slowly, but often to a fuller extent than in the rabbit.6. In a proportion of cat eyes there was little or no change in intraocular pressure after irritation of the iris adequate to induce maximum pupillary constriction; this was so whether mepyramine had been administered or not.7. Possible reasons for the above species differences are discussed.

e24151 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common intractable side effect of oxaliplatin treatment that presents with numbness, tingling, and nerve pain in both hands and feet; and sometimes, weakness and impaired balance and quality of life. Moderate-vigorous (MV) physical activity (PA) may reduce CIPN by improving blood circulation, chemotherapy distribution, inflammation, oxidative stress, and neuroplasticity. This dose-response analysis aimed to explore the effect of different MVPA and total PA doses on CIPN severity among oxaliplatin-receiving gastrointestinal cancer survivors. Methods: The original pilot RCT tested an 8-week home-based brisk walking intervention versus PA education alone to reduce CIPN. This analysis focuses on the intervention group ( n = 29), which received MVPA motivational supports (e.g., a Fitbit Charge 2, walking plan, motivational interviewing). Participants completed self-report CIPN severity surveys at baseline (2nd oxaliplatin infusion) and 8 weeks. Fitbit-classified minutes of weekly MV and daily total (light-vigorous) PA were averaged over the 8 weeks. MVPA was dichotomized: met 225 weekly MVPA minutes ( n = 17) or not ( n = 19). Linear regression was used to analyze the effect of MVPA/total PA changes and effects on 8-week CIPN severity, controlling for oxaliplatin dose received and baseline CIPN levels. Results: Increases over the 8 weeks were observed in patients’ MVPA (mean difference [ MD] = 17.39 min/week; 95% CI 1.38, 33.40; p = .03) and total PA ( MD = 7.80 min/week; 95% CI 2.31, 13.29; p = .01). Total PA had no effect on the outcomes. However, averaging at least 225 MVPA minutes per week led to less severe sensory CIPN ( MD = -7.28; 95% CI -13.53, -1.03; p = .03), particularly tingling in the hands ( MD = -26.35; 95% CI -44.03, -8.68; p = .01). The models accounted for 37% and 44% of the variance in sensory CIPN ( p = .02) and tingling at 8 weeks ( p = .01), respectively. Conclusions: This pilot study provides preliminary evidence that increasing weekly MVPA, specifically, may lead to reduced CIPN severity among gastrointestinal cancer survivors receiving oxaliplatin. A larger study that utilizes stronger MVPA measurement and biomarker evaluation is needed. Clinical trial information: NCT03515356 .