Radiomics in colorectal cancer patients

The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease. However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging. Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files: This image numerical analysis...     

Thrombosis prophylaxis in hospitalised medical patients: does prophylaxis in all patients make sense?

BACKGROUND: Most studies on thrombosis prophylaxis focus on postoperative venous thrombosis. In medical wards thrombosis prophylaxis is generally restricted to patients who are immobilised. Our primary aim was to investigate the incidence of venous thrombosis in a general internal ward, to assess whether more rigorous prophylaxis would be feasible. METHODS: We investigated the incidence of venous thrombosis in patients hospitalised from 1992 to 1996 and related our findings to literature reports. RESULTS: The incidence of symptomatic venous thrombosis in internal patients during hospitalisation was 39/6332 (0.6%). Among these 39 patients, 24 had a malignancy, whereas 876 out of all 6332 patients had a known malignancy. So, the incidence in this group with cancer was 2.7% compared with 0.3% (15/5456) in the non-cancer group (relative risk for venous thrombosis due to malignancy was 10.0 (95%C.I. 5.3-18.9). CONCLUSION: The incidence of venous thrombosis during hospitalisation in a department of general internal medicine is low and does not justify prophylaxis in all internal patients. Cancer is a strong risk factor for hospital-acquired thrombosis in the medical ward. Further studies may answer the question as to whether thrombosis prophylaxis in this subgroup is feasible.     

Catheter-related infection in gastrointestinal fistula patients

AIM:To study the incidence,bacterial spectrum and drugsensitivity of catheter-related infection (CRI) in gastrointestinalfistula patients.METHODS:A total of 216 patients with gastrointestinalfistulae during January 1998 to April 2001 were studiedretrospectively.Two hundred and sixteen catheters of the358 central venous catheters used in 216 gastrointestinalfistula patients were sent for microbiology analysis.RESULTS:Ninety-five bacteria were cultivated in 88catheters (24.6%).There were 54 Gram-negative bacteria(56.8%),35 Gram-positive bacteria (36.8%),and 6 fungi(6.4%).During the treatment of CRI,20 patients changedto use antibiotics or antifungal,and all patients were cured.The mean time of catheters used was 16.9±13.0 d.CONCLUSION:CRI is still the common complication duringtotal parenteral nutrition (TPN) treatment in patients withgastrointestinal fistulae,and Gram-negative bacteria arethe main pathogens,and bacterial translocation is consideredthe common reason for CRI.     

Pseudo-Pelger-Huët in kidney-transplanted patients

Pelger-Hu?t anomaly is an inherited condition characterized by hyposegmentation of the neutrophil nucleus and excessive chromatin clumping. Acquired Pelger-Hu?t, also known as pseudo-Pelger-Hu?t, has been described in several clinical conditions including transplant recipients who received immunosuppressive drugs. The incidence of pseudo-Pelger-Hu?t in kidney transplant patients, characterized as neutrophil dysplasia, was observed in 9 of 170 patients (5.3%) at the S?o Francisco Hospital de Assis, Belo Horizonte, Brazil. Awareness of possible circulating neutrophil alterations in transplant patients is important for laboratory professionals who should report these findings of cell changes. It should be highlighted that the poor segmentation and the chromatin hypercondensation observed initially in pseudo-Pelger-Hu?t patients can be suggestive of early-stage neutrophils. Only a combination of laboratory and clinical data will facilitate a better understanding of this anomaly and its correct follow-up and management.     

Thromboprophylaxis with dalteparin in medical patients: which patients benefit?

It is unclear whether thromboprophylaxis produces a consistent risk reduction in different subgroups of medical patients at risk from venous thromboembolism. We performed a retrospective, post hoc analysis of 3706 patients enrolled in the PREVENT study. Patients were at least 40 years old with an acute medical condition requiring hospitalization for at least 4 days and had no more than 3 days of immobilization prior to enrolment. Patients received either subcutaneous dalteparin (5000 IU) or placebo once daily. The primary end point was the composite of symptomatic deep vein thrombosis (DVT), pulmonary embolism, asymptomatic proximal DVT, or sudden death. Primary diagnosis subgroups were acute congestive heart failure, acute respiratory failure, infectious disease, rheumatological disorders, or inflammatory bowel disease. All patients, except those with congestive heart or respiratory failure, had at least one additional risk factor for venous thromboembolism. A risk reduction was shown in patients receiving dalteparin versus placebo. The relative risk (RR) was 0.73 in patients with congestive heart failure, 0.72 for respiratory failure, 0.46 for infectious disease, and 0.97 for rheumatological disorders. The RR was 0.52 in patients aged > or = 75 years, 0.64 in obese patients, 0.34 for patients with varicose veins, and 0.71 in patients with chronic heart failure. No subgroup had a significantly different response from any other. Importantly, multivariate analysis showed that all patient groups benefited from thromboprophylaxis with dalteparin. Our findings, therefore, support the broad application of thromboprophylaxis in acutely ill hospitalized medical patients.     

Alcohol septal ablation in elderly patients: Is it as effective as in young patients?

Hypertrophic cardiomyopathy (HCM) is a common genetic abnormality that can occur in as many as 1 in 500persons. 1 Researchers have found multiple mutations in 10different sarcomeric proteins such as myosin heavy chain and tropomyosin can cause this disease. ……     

Alcohol septal ablation in elderly patients:Is it as effective as in young patients?

Hypertrophic cardiomyopathy (HCM) is a common genetic abnormality that can occur in as many as 1 in 500 persons. Researchers have found multiple mutations in 10 different sarcomeric proteins such as myosin heavy chain and tropomyosin can cause this disease. HCM is the most common monogenic cardiac disorder and the most common     

Prevalence of subclinical hepatic encephalopathy in cirrhotic patients in China

AIM:Subclinical hepatic encephalopathy (SHE) is a commoncomplication of liver diseases.The aim of this study wasto find out the normal value of psychometric test and toinvestigate the prevalence of SHE in Chinese patients withstabilized hepatic cirrhosis.METHODS:Four hundred and nine consecutive cirrhoticpatients without overt clinical encephalopathy werescreened for SHE by using number connection test part A(NCT-A) and symbol digit test (SDT).SHE was defined aspresence of at least one abnormal psychometric test.Theage-corrected normal values were defined as the mean±2times standard deviation (2SD),and developed in 356 healthypersons as normal controls.Four hundred and sixteenpatients with chronic viral hepatitis were tested as negativecontrols to assess the diagnostic validity of this test battery.RESULTS:There was no significant difference in NCTscores and SDT quotients between healthy controls andchronic hepatitis group (P>0.05).In all age subgroups,the NCT and SDT measurements of cirrhotic patientsdiffered significantly from those of the controls (P<0.05).When mean±2SD of SDT and NCT measurements fromhealthy control group was set as the normal range,229cirrhotic patients (29.1%) were found to have abnormalNCT-A and SDT tests,53 (13.0%) were abnormal only inSDT and 36 (8.8%) only in NCT-A.Taken together,SHEwas diagnosed in 208 (50.9%) cirrhotic patients by thistest battery.The prevalence of SHE increased from 39.9%and 55.2% in Child-Pugh's grade A and B groups to 71.8%in Child-Pugh's grade C group (P<0.05).After theadjustment of age and residential areas required from thetests,no correlation was found in the rate of SHE andcauses of cirrhosis,education level and smoking habit.CONCLUSION:Psychometric tests are simple and reliableindicators for screening SHE among Chinese cirrhoticpatients.By using a NCT and SDT battery,SHE could befound in 50.9% of cirrhotic patients without overt clinicalencephalopathy.The prevalence of SHE is significantlycorrelated with the severity of liver functions.     

Incidence of toxoplasmosis in patients with cirrhosis

AIM:It is known that toxoplasmosis rarely leads to variousliver pathologies,most common of which is granulomatosehepatitis in patients having normal immune systems.Patientswho have cirrhosis of the liver are subject to a variety ofcellular as well as humoral immunity disorders.Therefore,itmay be considered that toxoplasmosis can cause morefrequent and more severe diseases in patients with cirrhosisand is capable of changing the course of the disease.Theaim of this study was to investigate the frequency oftoxoplasmosis in patients with cirrhosis.METHODS:Serum samples were taken from 108 patientswith cirrhosis under observation in the Hepatology Polyclinicof the Gastroenterology Clinic,and a control group madeup of 50 healthy blood donors.IFAT and ELISA methodswere used to investigate the IgG and IgM antibodies,whichhad developed from these sera.RESULTS:Toxoplasma IgG and IgN antibody positivity wasfound in 74 (68.5%) of the 108 cirrhotic patients and 24(48%) of the 50 people in the control group.The differencebetween them was significant (P<0.05).CONCLUSION:In conclusion,it was found that thetoxopiasma sero-prevalence in the cirrhotic patients in thisstudy was higher.Cirrhotic patients are likely to form atoxoplasma risk group.More detailed studies are neededon this subject.     

Helicobacter pyloriseroprevalence in patients with lung cancer

AIM:To assess Helicobacter pylori(Hpylon)seroprevalence in a cohort of Greek patients with lung cancer. METHODS:Seventy-two lung cancer patients(55 males and 17 females,aged 58.2±11.7 years)and 68,age and gender-matched,control subjects were enrolled.All subjects underwent an enzyme-linked immunosorbent assay IgG serologic test for Hpylori diagnosis. RESULTS:A correlation between age and HpyloriIgG level was detected for both lung cancer patients(r=0.42, P=0.004)and controls(r=0.44,P=0.004).Seropositivity for Hpyloridid not differ significantly between patients with lung cancer and controls(61.1% vs 55.9%,P>0.05). Concerning the mean serum concentration of IgG antibodies against Hpylori,no significant difference between the two groups was detected(32.6±19.1 vs 27.4±18.3 U/mL, P>0.05). CONCLUSION:No significant association between Hpylori infection and lung cancer was found.     

Saliva secreting functions in patients with TCM-Piyinxu

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Is hepatitis C more aggressive in renal transplant patients than in patients with end-stage renal disease?

BACKGROUND: The eventual impact of immunosuppression on the natural history of hepatitis C virus (HCV) infection in patients with end-stage renal disease (ESRD) is still unknown because of the lack of comparative data for HCV-infected patients with ESRD and renal transplant patients. The aim of this study was to compare the biochemical and histological characteristics of chronic HCV infection in renal transplants patients and ESRD patients undergoing hemodialysis. METHODS: Thirty-eight renal transplant patients and 38 ESRD patients undergoing hemodialysis who were chronically infected with HCV and were matched for gender, age at infection, and estimated time of infection were included in the study. The groups were compared regarding laboratory and histological variables. RESULTS: Renal transplant patients showed similar alanine aminotransferase and higher gamma-glutamyltransferase levels (P = 0.05) when compared with ESRD patients. Comparative analysis of histological variables revealed a higher proportion of cases with septal fibrosis (P = 0.04) and confluent necrosis (P = 0.01) among transplant-recipient patients. No difference between groups was observed regarding the intensity of portal and periportal inflammatory infiltrates. Steatosis was more prevalent among transplant-recipient patients (P < 0.001). There was no difference between groups regarding the prevalence of lymphoid aggregates or bile duct injury. CONCLUSION: Renal transplant patients had a larger proportion of cases with septal fibrosis and confluent necrosis than did ESRD patients, suggesting that renal transplantation might modify the natural history of hepatitis C in ESRD patients, leading to a more aggressive liver disease.     

Atherosclerosis in elderly patients with renal insufficiency

Introduction As people age, cardiovascular structure and function change and this is superimposed on by specific pathophysiologic disease mechanism. In addition to lipid levels, diabetes, sedentary lifestyle, and genetic factors that are known risks for coronary disease, hypertension, and stroke - the quintessential cardiovascular (CV) diseases related to atherosclerosis within our society - advancing age unequivocally confers the major risk. (Fig. 1) Mortality due to cardiovascular disease is more than any other disease and creates enormous costs for the health care system. The main underlying problem in cardiovascular disease is atherosclerosis, a process that obstructs major arteries with lipid deposits and cell accumulation.Decreased kidney function (estimated GFR < 70 mL/min/1.73 m2) is an independent risk factor for cardiovascular disease and all-cause mortality in the general population.     

Does ischemic preconditioning occur in patients?

Ischemic preconditioning offers powerful protection from ischemie necrosis in a wide range of animal species, but does it occur in humans? Support for preconditioning in humans comes from several sources: studies showing increased tolerance to repetitive balloon inflations during angioplasty, some (but not all) studies suggesting that preinfarction angina confers an early beneficial effect, studies showing that patients can develop sudden tolerance to repetitive exercise- or pacing-induced ischemia, cardiothoracic studies of intermittent aortic cross-clamping showing better preservation of myocardial adenosine triphosphate and in vitro studies of isolated human trabecular muscle and isolated human ventricular myocytes that demonstrate a biology consistent with preconditioning. In the future, preconditioning or “preconditioning mimetic” agents have the potential to be applied to a wide array of cardiovascular disorders and might result in better preservation of the heart in instances of cardiopulmonary bypass, heart transplantation, angina and myocardial infarction.