Mitoxantrone pleurodesis to palliate malignant pleural effusion secondary to ovarian cancer

BACKGROUND: Advanced ovarian cancer is the leading non-breast gynaecologic cause of malignant pleural effusion. Aim of this study was to assess the efficacy of mitoxantrone sclerotherapy as a palliative treatment of malignant pleural effusions due to ovarian cancer. METHODS: Sixty women with known ovarian cancer and malignant recurrent symptomatic pleural effusion were treated with chest tube drainage followed by intrapleural mitoxantrone sclerotherapy. Survival, complications and response to pleurodesis were recorded. The data are expressed as the mean ± SEM and the median. RESULTS: The mean age of the entire group was 64 ± 11,24 years. The mean interval between diagnosis of ovarian cancer and presentation of the effusion was 10 ± 2,1 months. Eighteen patients (30%) had pleural effusion as the first evidence of recurrence. The mean volume of effusion drained was 1050 ± 105 ml and chest tube was removed within 4 days in 75% of patients. There were no deaths related to the procedure. Side effects of chemical pleurodesis included fever (37–38,5°C) chest pain, nausea and vomiting. At 30 days among 60 treated effusions, there was an 88% overall response rate, including 41 complete responses and 12 partial responses. At 60 days the overall response was 80% (38 complete responses and 10 partial responses). The mean survival of the entire population was 7,5 ± 1,2 months. CONCLUSIONS: Mitoxantrone is effective in the treatment of malignant pleural effusion secondary to ovarian cancer without causing significant local or systemic toxicity

Enigmatic Fossils from the Lower Carboniferous Shrimp Bed, Granton, Scotland

The Lower Carboniferous (Visean) Granton Lagerstätte (Edinburgh, Scotland) is principally known for the discovery of the conodont animal, but has also yielded numerous crustaceans and other faunas. Here we report on small branching colonies, reaching 10 mm in length. They are small, erect, arborescent, and irregularly branched with predominant monopodial and dichotomous growth. They bud in a single plane. In one specimen the wall microstructure is well preserved and it is composed of evenly spaced, linear fibers, running parallel to the axis of the stems, and connected by transverse bars. We discuss possible biological affinities of these organisms; we consider algal, poriferan, hydrozoan and bryozoan affinities. The general pattern of branching, presence of fan-like structures (interpreted here as possible gonophores) and microstructure suggests affinity to Hydrozoa, affinity to non-calcifying algae is less likely. Assuming hydrozoan nature; the microstructure might suggest affinities with the extant family Solanderiidae Marshall, 1892 that possess an internal chitinous skeleton. The EDS analysis shows that fossils discussed here are preserved as phosphates. The skeletons were probably not mineralized, the presence of phosphorus suggests that the colonies were originally composed of chitin. We describe these organisms as Caledonicratis caridum gen. et sp. nov. (Solanderiidae?, Capitata?). Colonies of C. caridum gen et. sp. nov. sometimes encrust the exuviae of crustaceans, which very probably lived in fresh to brackish water thus indicating a likely habitat of Caledonicratis