Marrow transplantation with or without donor buffy coat cells for 65 transfused aplastic anemia patients

Sixty-five multiply transfused patients with severe aplastic anemia were given cyclophosphamide followed by grafts anemia were given cyclophosphamide followed by grafts from HLA-identical siblings. The effect of the administration of viable donor buffy coat cells following the marrow inoculum was evaluated with regard to graft rejection and survival. Results in 43 patients so treated are presented along with those in 22 concurrent patients given marrow alone. Most patients given buffy coat had positive in vitro tests of sensitization indicating a high risk for graft rejection, while all but one of the patients given marrow alone had negative tests. Thirty of the 43 (70%) patients given marrow and buffy coat are alive between 10 and 61 mo (median 36) after grafting; 4 died after graft rejection and 6 with acute or chronic graft-versus-host disease (GVHD). Eleven of the 22 (50%) patients given marrow alone are alive between 29 and 65 mo (median 52); 7 died after graft rejection and 3 with GVHD. The addition of buffy coat cell infusions to the marrow inoculum reduced the risk of rejection and increased survival in the currently reported transfused patients when compared to patients grafted before 1976. However, there was an increased risk of chronic GVHD. Recipients of marrow from female donors survived slightly better (73%) than recipients of male marrow (58%).     

Multivariate analysis of risk factors for development of duodenal ulcer in Helicobacter pylori-infected patients

BACKGROUND: Although Helicobacter pylori is a significant etiologic factor of peptic ulcer disease, it remains unknown why ulcers develop only in the minority of infected individuals. AIM: The aim of this cross-sectional study was to evaluate the association between the presence of duodenal ulcer in H. pylori-infected patients and different risk factors. METHODS: A total of 122 H. pylori-infected patients were enrolled; 79 had duodenal ulcer and 43 gastritis. Univariate analysis was conducted using either Fisher's exact test or exact Cochrane-Armitage trend test. In multivariate analysis the logistic model was used. RESULTS: Univariate analysis indicated six factors (male sex, smoking, antral H. pylori density, CAGA presence in antrum, and VACA s1a presence in antrum and corpus). Four factors (sex, smoking-alcohol index, H. pylori density index, and CAGA index) were found to be significant in multivariate analysis. The best model predicting duodenal ulcer included male sex, smoking, presence of H. PYLORI on histopathology in antrum and CAGA presence in corpus. CONCLUSION: Although several risk factors were significantly associated with duodenal ulcer, we failed in the identification of either a single risk factor or a set of factors that can unequivocally differentiate patients with ulcer from those with gastritis.     

Monocausal Attributions Along Cross-Sections of Psychosis Development and Links with Psychopathology and Data Gathering Style

Several attributional biases have been discussed as putative causal factors in psychosis formation and maintenance. The monocausality bias in particular describes the excessive tendency to disregard multifactorial explanations and to instead attribute events to a single cause. To elucidate the role of monocausality in psychosis development, this study compared patients with an at-risk mental state of psychosis (ARMS, n?=?49), first-episode patients (FEP, n?=?35), chronic schizophrenia patients (SZ, n?=?32) and healthy controls (HC, n?=?39) on the Internal Personal and Situational Attributions Questionnaire—Revised. FEP patients made significantly more monocausal attributions than HC to the external-personal locus for positive events. Moreover, monocausality was linked with psychotic as well as depressive symptoms and tentatively also with a hasty data gathering style. Future studies should explore associations with other metacognitive deficits and the potential to prevent or correct the monocausality bias through psychological interventions.     

A patient-reported outcome measure for patients with pituitary adenoma undergoing transsphenoidal surgery

Pituitary - Pituitary adenomas affect patients’ quality-of-life (QoL) across several domains, with long-term implications even following gross-total resection or disease remission. While...     

Effects of L-thyroxine suppressive therapy on cardiac mass in patients with differentiated thyroid cancer

Patients with differentiated thyroid carcinoma (DTC) receive a life time l-thyroxine therapy in suppressive doses and may exhibit signs of cardiac hypertrophy. The aim of the study was to analyze the left ventricle mass parameters by echocardiography in patients treated with suppressive doses of thyroxine and to relate them to the possible occurrence of cardiac arrhythmias. Ninety four patients aged 19-70 years treated chronically with l-thyroxine were randomly chosen from the population of patients with DTC without concomitant diseases of circulatory system. They were divided into two subgroups according to the length of thyroxine therapy (< 60 months and > or = 60 months). Control group consisted of 41 healthy volunteers, aged 22-73 years. Heart muscle dimensions were measured by echocardiography. Left ventricle mass (LVM) and mass index (LVMI) was calculated. Electrocardiography according to Holter was carried out in 57 patients. The results of echocardiography in the whole group of patients did not differ significantly from the control group, although a tendency towards higher dimensions of the left ventricle was observed. No correlation of hormonal parameters, or thyroxine dose, with LVM or results of Holters ecg was noted. When patients were subdivided into two groups, according to the duration of therapy, significantly higher values of LVM (215 +/- 64 g versus 186 +/- 55; p < 0.05) and LVMI (114 +/- 31 g/m versus 102 +/- 23 g/m; p < 0.05) were observed in patients treated > or = 60 months in comparison to the control group. When results of Holter's ecg in patients with increased LVMI were analyzed, cardiac rhythm disturbances were stated in 50% of them, but most were of minor clinical relevance. Suppressive l-thyroxine therapy does not induce significant left heart hypertrophy during the first 5 years of treatment. Patients treated through a longer period of time should be controlled by echocardiography because of the increasing risk of the left ventricle hypertrophy and arrhythmia.