Cutaneous tissue shrinkage following excision is primarily because of intrinsic tissue contractility. Increasing patient age and solar elastosis correlate with less shrinkage. The clinicians and dermatopathologists must be cognizant of the expected shrinkage of submitted specimens for settling discrepancies within the medical record.

No abstract

Rasburicase is currently approved at a dosage of 0.15-0.2 mg/kg once/day for 5 days in pediatric patients with cancer to lower plasma uric acid concentrations and manage tumor lysis syndrome (TLS). Information on rasburicase dosing in adults is limited, with some data on using rasburicase as a single dose instead of multiple daily doses. Therefore, we evaluated the efficacy of a single dose of rasburicase for preventing or managing TLS in adults. We collected retrospective data for 11 adults with hematologic malignancies who received a single 6-mg dose of rasburicase. All patients received intravenous hydration with urinary alkalinization and allopurinol; however, due to adverse reactions, two patients received short courses of allopurinol. Only patients at high risk for TLS (e.g., large tumor burden, increasing uric acid concentration) or those with TLS received rasburicase. The single dose of rasburicase 6 mg resulted in a median 0.0773-mg/kg dose (range 0.0232-0.1361 mg/kg). The single 6-mg dose rapidly lowered uric acid concentrations in 10 of the 11 patients. The median uric acid concentration of 11.7 mg/dl (range 7.4-17.4 mg/dl) declined to 2.0 mg/dl (range 0.5-15.4 mg/dl) within a day after rasburicase administration (p=0.022). In these 10 patients, uric acid concentrations remained low despite subsequent chemotherapy, and none required additional rasburicase doses. The only patient who did not respond to the single 6-mg rasburicase dose was a morbidly obese man (259 kg, body mass index 87 kg/m2) who subsequently responded to an additional dose of rasburicase 12 mg. These results warrant further investigation of a single 6-mg dose of rasburicase in adults with TLS or at high-risk for developing TLS.

It is predicted that orbital decay by gravitational-wave radiation and tidal interaction will cause some close-binary stars to merge within a Hubble time. The merger of a helium-core white dwarf with a main-sequence star can produce a red giant branch star that has a low-mass hydrogen envelope when helium is ignited and thus become a hot subdwarf. Because detailed calculations have not been made, we compute post-merger models with a stellar evolution code. We find the evolutionary paths available to merger remnants and find the pre-merger conditions that lead to the formation of hot subdwarfs. We find that some such mergers result in the formation of stars with intermediate helium-rich surfaces. These stars later develop helium-poor surfaces owing to diffusion. Combining our results with a model population and comparing to observed stars, we find that some observed intermediate helium-rich hot subdwarfs can be explained as the remnants of the mergers of helium-core white dwarfs with low-mass main-sequence stars.

It is likely that at least some planetary nebulae are composed of matter which was ejected from a binary star system during common-envelope (CE) evolution. For these planetary nebulae the ionizing component is the hot and luminous remnant of a giant which had its envelope ejected by a companion in the process of spiralling-in to its current short-period orbit. A large fraction of CE phases which end with ejection of the envelope are thought to be initiated by low-mass red giants, giants with inert, degenerate helium cores. We discuss the possible end-of-CE structures of such stars and their subsequent evolution to investigate for which structures planetary nebulae are formed. We assume that a planetary nebula forms if the remnant reaches an effective temperature greater than 30 kK within 10 4 yr of ejecting its envelope. We assume that the composition profile is unchanged during the CE phase so that possible remnant structures are parametrized by the end-of-CE core mass, envelope mass and entropy profile. We find that planetary nebulae are expected in post-CE systems with core masses greater than about 0.3 M ⊙ if remnants end the CE phase in thermal equilibrium. We show that whether the remnant undergoes a pre-white dwarf plateau phase depends on the prescribed end-of-CE envelope mass. Thus, observing a young post-CE system would constrain the end-of-CE envelope mass and post-CE evolution.

For patients colonized with VRE, approximately 38% of high-risk neutropenic patients developed a VRE infection. This is the first study to specifically evaluate the incidence of VRE infections in febrile neutropenic patients colonized with VRE. Future research into the use and efficacy of empiric VRE coverage is needed.

No abstract

No abstract