Acute lymphoblastic leukemia in adults. Apropos of 42 cases

Between 1989 and 1995, 42 cases with acute lymphoblastic leukemia (18 males and 24 females) were diagnosed in our institution. Median age was 38.5 years (range, 16-88 years). Leukocyte count was more than 30.10(9)/l in 54% of cases. According to the French-American-British (FAB) criteria, 67% were classified L1 and 33% L2. Sixteen patients were treated with 12LA80 protocol, 14 patients with LALA 85 protocol, 6 patients with LALA 87 protocol and 6 patients with EORTC protocol. Complete remission was achieved in 22 cases (52%), 8 cases (20%) failed to respond and 12 (28%) died during induction. Relapse was observed in 10 cases. The 4-year survival rate was 28% confirming the worse prognosis of this leukemia when treated with standard chemotherapy.     

Intrachromosomal amplification of AML1 gene in childhood acute lymphoblastic leukemia

The introduction of routine molecular cytogenetic assays enabled us to reveal hitherto unknown genetic disorders of childhood acute leukemias. Of special interest is the recognition of those rare cytogenetic mutations of negative prognostic value, which are associated with well-known markers of good prognosis. In our present study we review a novel cytogenetic mutation typical for childhood B-cell ALL, the intrachromosomal amplification of chromosome 21, which requires high-risk therapy irrespective of other risk factors, and which is associated with a cryptic 12;21 translocation of good prognostic value.     

Acute hepatitis B infection in England and Wales: 1985-96

Confirmed acute hepatitis B infections are reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre by laboratories in England and Wales. These reports have been used to monitor trends in the incidence of hepatitis B virus (HBV) infection over time, and between exposure categories and age groups. Between 1985 and 1996 a total of 9252 cases of acute HBV infection were reported; the number of reports fell from 1761 in 1985 to 581 in 1996. Most infections were reported in adults aged 15-44 years [n = 7365 (80%)], and infections were more commonly reported in males [n = 6490 (70%)] than females [n = 2658 (29%)]. The probable means of acquisition was known for just over half of all adult cases [4827/8956 (54%)]. Injecting drug use was the most common exposure [n = 1901 (21%)], followed by sex between men and women [n = 1140 (13%)] and sex between men [n = 1025 (11%)]. The number of infections in injecting drug users fell in the late 1980s, but increased again from 1991 onwards. In children aged under 15 years, infections acquired by mother to baby transmission accounted for 35/170 (21%) of the total. Surveillance indicates that the incidence of acute hepatitis B infection fell in the late 1980s, probably reflecting changed behaviour in injecting drug users. An increase in the number of infections in injecting drug users since 1993 may indicate ongoing transmission that has not been contained by the introduction of needle exchange schemes or by selective vaccination.     

高频超声诊断急性阑尾炎96例体会

目的探讨高频超声在诊断急性阑尾炎中的检查方法及诊断价值。方法总结从2007年3月至2009年3月96例经手术、病理证实的急性阑尾炎患者的超声检查方法及声像图表现。结果本组96例术前超声检查中,92例能做出诊断,4例可见到继发征象,超声显示率95．8％;92例中有90例急性阑尾炎经术前超声明确诊断并手术病理证实,有2例分别出现误诊及漏诊,超声诊断符合率为97．8％。结论使用高频彩超,选择合适的检查方法,对急性阑尾炎诊断具有很高的价值,可以为临床提供明确、有效的依据,值得临床推广应用。     

Acute myocardial infarction in young adults: evaluation of the haemorheological pattern at the initial stage, after 3 and 12 months

Acute myocardial infarction (AMI) in young adults is considered by some authors as an autonomous disease, characterized by peculiar risk factor pattern, clinical course and prognosis. We studied, in a group of 96 patients aged < 46 years with recent AMI, the haemorheological parameters (whole-blood, plasma and serum viscosity, haematocrit, whole-blood filterability and erythrocyte deformability), and the influence of risk factors and coronary lesion extent on them. We re-examined 41 of the AMI patients after 3 and 12 months. At the initial stage, AMI subjects showed a hyperviscosity syndrome, not influenced by the number of risk factors and only slightly more evident in patients with more extensive coronary damage. In the AMI patients re-examined after 3 and 12 months, no significant variation in the haemorheological pattern emerged in comparison with basal values. The persisting alteration demonstrated that the hyperviscosity syndrome observed at the initial stage was not simply an acute reaction to AMI, and that it was not influenced by intervention on modifiable risk factors.     

Calculation of direct standard costs in the evaluation of new technologies: application to the treatment of acute myeloblastic leukemias

Financial incidence of new technology can be approached through the utilization of "direct standard cost". This method allows actualization of prices and permits the integration of new procedures. It is applied to acute non lymphoblastic leukemia.     

Selective feeding centres in refugee settings: evaluation framework protocol

Selective feeding programs are centres for the treatment of persons suffering from acute malnutrition. Unlike chronic malnutrition, acute malnutrition reflects recent problems. In a crisis situation, wasting is preferred above other indicators because it is sensitive to rapid change, indicates present change, can be used to monitor the impact of interventions and is a good predictor of immediate mortality risk. This paper reviews the current approach being used in the field to evaluate the effectiveness of feeding programs. There is no comprehensive evaluation framework in place to assess the impact of feeding programs on mortality due to malnutrition. Some loose outcome measures, such as the number of children enrolled in a feeding centre, are being used to determine if a feeding centre should continue. In addition, malnutrition prevalence and crude mortality rates determined through nutritional and mortality surveys are used to assess the impact of feeding programs. This procedure does not take into account potential confounding factors that impact on malnutrition prevalence, including access to non-relief foods and the general food ration. Therefore, one could not confidently say that the reduction of malnutrition prevalence is a result of feeding programs. This paper presents an alternative approach to evaluating feeding centres.     

Acute lymphocytic leukemia in the adolescent: diagnosis, treatment, and outcomes

Leukemia remains the most common cancer in childhood, and while great strides have been made in increasing event-free survival in the past 20 years, patients with high-risk features still pose a challenge for successful disease-free survival. Older children and adolescents are included in that high-risk group. Approximately 80-85% of cases of leukemia in the pediatric population are of the lymphocytic subtype. Overall disease-free survival rates for acute lymphocytic leukemia have increased to 80% for those with standard or low-risk disease and 65-70% for those with high-risk disease. This is a product of both a better understanding of the molecular pathophysiology of ALL and the development of better treatment strategies based on risk. In acute myelogenous leukemia, we have not achieved such success, and disease-free survival rates are in the 30-40% range. This article discusses the diagnosis of leukemia in the adolescent population with attention to pathogenesis, prognostic risk factors, therapy, outcome, and late effects of acute lymphocytic leukemia.     

Implementation of the EU Council Directive 96/29/EURATOM in industry

The 1996 EU Council Directive 96/29/EURATOM defines a series of specific requirements related to the safe use of radiation sources and to public and occupational exposure. The implementation of these requirements is seen in comprehensive radiation protection measures undertaken at user site and in regulatory practice. The implementation of the 96/29/EURATOM in the last years in Slovenia led to a comprehensive two-step process of authorisation of practices involving ionising radiation. The process is based on the assessment of risk associated with a practice involving radiation and a source. One of the steps includes either a registration or a permit issued by the regulatory authority to use a specific radiation source. The authorisation process has been described in detail in Slovene legislation. The 96/29/EURATOM also includes reporting intention to carry out a practice involving radiation, which is a new tool in Slovene legislation. The implementation of the 96/29/EURATOM has improved overall radiation protection in industry was improved thanks to well-defined requirements such as classification areas for control.