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Introduction

Induction chemotherapy with cytarabine and an anthracycline (7+3) remains the standard of care for acute myeloid leukemia (AML).

Patients and Methods

We retrospectively analyzed 183 newly diagnosed AML patients to compare the utility of rapid peripheral blast clearance (PBC), day of peripheral blast disappearance, residual blasts, and cellularity at day 14 bone marrow biopsy (D14BM) in predicting clinical response to 7+3 induction, overall survival (OS), and relapse-free survival (RFS).

Results

In multivariable logistic regression analysis, day 2 PBC > 85% [P = .0016] was the only predictor of remission status, with sensitivity and specificity of 75%. Peripheral blast disappearance within 5 days after induction and < 10% cellularity in D14BM predicted superior OS and RFS in multivariate analysis. Median follow-up of patients was 28 months since diagnosis. Two-year OS and RFS for patients with ≤ 10% versus > 10% cellularity at D14BM was 60.6% [95% confidence interval (CI), 50.8%-72.2%] versus 32.5% [95% CI, 23.0%-45.8%], and 51.9% [95% CI, 41.9%-64.3%] versus 28.8% [95% CI, 19.1%-43.4%], respectively [P = .0003 for OS and .002 for RFS].

Conclusion

Rapid PBC after 7+3 induction showed a significant improvement in specificity compared with D14BM, with similar sensitivity. Neither of these methods were reliably specific tools for the decision of early reinduction, despite their prognostic value. Our findings indicate that morphological cellularity in D14BM is an independent prognostic factor for OS and RFS, regardless of blast percentage, and that ≤ 10% cellularity defines D14BM hypoplasia.  相似文献   
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Prevalence of osteoporosis is more than 50% in older adults, yet current clinical methods for diagnosis that rely on areal bone mineral density (aBMD) fail to detect most individuals who have a fragility fracture. Bone fragility can manifest in different forms, and a “one-size-fits-all” approach to diagnosis and management of osteoporosis may not be suitable. High-resolution peripheral quantitative computed tomography (HR-pQCT) provides additive information by capturing information about volumetric density and microarchitecture, but interpretation is challenging because of the complex interactions between the numerous properties measured. In this study, we propose that there are common combinations of bone properties, referred to as phenotypes, that are predisposed to different levels of fracture risk. Using HR-pQCT data from a multinational cohort (n = 5873, 71% female) between 40 and 96 years of age, we employed fuzzy c-means clustering, an unsupervised machine-learning method, to identify phenotypes of bone microarchitecture. Three clusters were identified, and using partial correlation analysis of HR-pQCT parameters, we characterized the clusters as low density, low volume, and healthy bone phenotypes. Most males were associated with the healthy bone phenotype, whereas females were more often associated with the low volume or low density bone phenotypes. Each phenotype had a significantly different cumulative hazard of major osteoporotic fracture (MOF) and of any incident osteoporotic fracture (p < 0.05). After adjustment for covariates (cohort, sex, and age), the low density followed by the low volume phenotype had the highest association with MOF (hazard ratio = 2.96 and 2.35, respectively), and significant associations were maintained when additionally adjusted for femoral neck aBMD (hazard ratio = 1.69 and 1.90, respectively). Further, within each phenotype, different imaging biomarkers of fracture were identified. These findings suggest that osteoporotic fracture risk is associated with bone phenotypes that capture key features of bone deterioration that are not distinguishable by aBMD. © 2021 American Society for Bone and Mineral Research (ASBMR).  相似文献   
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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Mit Beginn der Impfkampagne hat eine neue Phase der Bewältigung der Coronapandemie begonnen. Zulassung und Empfehlung...  相似文献   
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PURPOSE: The aim of this in vitro study of titanium abutments was to investigate the extent of treatment traces, the roughness depth, and the quantity of titanium or, in the case of coated abutments, titanium nitride (TiN) removed from the surface after treatment with various instruments. MATERIALS AND METHODS: Eleven uncoated, mechanically smoothed abutments and 11 TiN-coated abutments were used. The abutments were treated with titanium, steel, and plastic curettes; a rubber cup; an ultrasonic scaler with a steel tip; and an air scaler and cleaning powder. There were two 2 x 2-mm test fields on each abutment; each was subjected to standardized treatment with an instrument. The untreated surfaces of each abutment served as controls. The roughness depth (Rz) and profile height of treated and untreated surfaces were measured with a profilometer; profile height served as a basis for determining the amount of substance removed by treatment. The treatment traces were analyzed by scanning electron microscopy and light microscopy. RESULTS: Both the ultrasonic scaler and the steel and titanium curettes left pronounced traces on the uncoated abutments and increased Rz. Substantial substance removal was recorded following the use of the ultrasonic scaler (17.57 +/- 2.87 microm) and the steel curettes (8.48 +/- 2.81 microm) on the uncoated abutments. In tests of the coated abutments, measurable substance removal (4.80 +/- 0.99 microm) and increased roughness depth were noted only with use of the steel curettes. The treatment traces left by the other instruments were distinctly less pronounced than on the uncoated abutments. Light microscopy revealed detachment of the TiN coating after use of the ultrasonic scaler, titanium curettes, and steel curettes. Slight to moderate treatment traces were recorded after use of the rubber cup; no substance removal was observed. On the TiN-coated abutments, only slight treatment traces, if any, were recorded, and there was no substance removal. A planing effect (ie, an Rz decrease of 66.4%) was observed. The plastic curette and the air scaler caused no damage to the titanium or TiN surfaces. DISCUSSION AND CONCLUSION: The TiN-coated abutments displayed fewer treatment traces, less roughness depth, and less substance removal after being treated with various instruments. Two concerns, however, are the detachment of the coating after only few actions with steel and titanium curettes or with an ultrasonic scaler with steel tip, and the greater initial roughness depth of coated implants.  相似文献   
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Akbil  Bengisu  Meyer  Tim  Stubbemann  Paula  Thibeault  Charlotte  Staudacher  Olga  Niemeyer  Daniela  Jansen  Jenny  Mühlemann  Barbara  Doehn  Jan  Tabeling  Christoph  Nusshag  Christian  Hirzel  Cédric  Sanchez  David Sökler  Nieters  Alexandra  Lother  Achim  Duerschmied  Daniel  Schallner  Nils  Lieberum  Jan Nikolaus  August  Dietrich  Rieg  Siegbert  Falcone  Valeria  Hengel  Hartmut  Kölsch  Uwe  Unterwalder  Nadine  Hübner  Ralf-Harto  Jones  Terry C.  Suttorp  Norbert  Drosten  Christian  Warnatz  Klaus  Spinetti  Thibaud  Schefold  Joerg C.  Dörner  Thomas  Sander  Leif Erik  Corman  Victor M.  Merle  Uta  Kurth  Florian  von Bernuth  Horst  Meisel  Christian  Goffinet  Christine 《Journal of clinical immunology》2022,42(6):1111-1129
Journal of Clinical Immunology - Six to 19% of critically ill COVID-19 patients display circulating auto-antibodies against type I interferons (IFN-AABs). Here, we establish a clinically applicable...  相似文献   
8.
OBJECTIVE: To describe the pain relief, satisfaction, and health-related quality of life results of moderate or severe migraines treated with a sumatriptan/naproxen sodium combination tablet. METHODS: Sumatriptan and naproxen sodium as a single-dose formulation tablet was used to treat moderate to severe migraines over a 12-month period in a phase 3, open-label, multicenter study (n = 565) in patients with at least 6 months' history of migraine headaches. RESULTS: Seventy percent of all attacks were treated with 1 dose of sumatriptan/naproxen sodium. Overall subjects treated 24,485 attacks; of these, 81% attacks achieved pain relief and 60% pain-free by 2 hours. At 3 months, the percentage of patients satisfied or very satisfied increased from baseline on all 8 Patient Perception of Migraine Questionnaire (PPMQ) items and remained high throughout the study. Mean Migraine-Specific Quality of Life Questionnaire (MSQ) domain scores also increased by 13-15 points from baseline during this time and remained high. CONCLUSIONS: Sumatriptan/naproxen sodium provides consistent relief of migraine attacks over 12 months, resulting in improved patient satisfaction and migraine specific quality of life.  相似文献   
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