Despite usual iron chelating therapy based on desferrioxamine, patients affected by beta-thalassemia major (beta-TM) often develop progressive heart failure caused by myocardial iron overload, which is the leading cause of mortality within the third decade of life. Heart transplantation is a limited therapeutic option, as very often these patients have multi-organ iron deposits and infective complications (particularly hepatitis C), secondary to frequent blood transfusions. We report the case of a 26-year-old male affected by beta-TM with end-stage heart failure, who showed a dramatic improvement in symptoms and myocardial function when a new oral iron chelating agent, deferiprone, was added to standard therapy with desferrioxamine. 相似文献
During the first decade after the discovery of primary effusion lymphoma (PEL), sporadic and serial reports suggested that Kaposi-sarcoma-associated-herpesvirus/human-herpesvirus-8 (KSHV/HHV-8)-associated lymphomas in their liquid and solid presentation are clinically distinct, representing part of the spectrum of PEL. In HIV-seropositive patients with serous effusions, these solid lymphomas were reported before the development of an effusion lymphoma and following resolution of PEL. More recently, solid lymphomas not associated with lymphomatous effusion have been found in HIV-seropositive and HIV-seronegative patients. Despite the diversification in the clinical presentation of KSHV/HHV-8-associated lymphomas, most cases demonstrated a similar morphology, immunophenotype and KSHV/HHV-8 viral status. 相似文献
Androgen deprivation therapy still remains the gold standard in the treatment of advanced prostate cancer. Unfortunately, patients with metastatic prostate cancer treated with androgen deprivation therapy frequently develop androgen-independent prostate cancer. Cytotoxic chemotherapy has not been used routinely and the current standard regimens have not demonstrated any significant alteration in the development of hormone-refractory disease. Recent phase III randomized clinical trials have suggested that docetaxel-based therapy, demonstrating a real increase of survival in treated patients, could represent the new standard treatment for metastatic patients. There is also promising activity of new drug combinations, such as taxanes plus vinca alkaloids, and of classic chemotherapeutic agents plus biological drugs. This review focuses on the current therapies for the treatment of HRPC. 相似文献
AIM: To examine the effectiveness of reflexology foot massage in hospitalized cancer patients undergoing second or third chemotherapy cycles. BACKGROUND: Since the late-1970s, studies have been conducted to assess the efficacy of behavioural and relaxation approaches in controlling nausea/vomiting, anxiety and other side-effects associated with chemotherapy. METHODS: The study consisted of 30 patients being admitted to the oncology unit at a Scientific Research Hospital in Italy. Only 15 of the 30 participants received therapeutic massage. The subjects' self-reports of anxiety (measured by the Spielberger State-Trait Anxiety Inventory) were recorded before, after and 24 hours after the intervention. RESULTS: There was an average decrease of 7.9 points on the state-anxiety scale in the treatment group and of 0.8 points in the control group (P < 0.0001). CONCLUSIONS: Reflexology foot massage can be considered a support treatment used in combination with traditional medical treatments and executed by an expert, qualified person to help cancer patients receiving chemotherapy feel better and also cope better with their disease. 相似文献
Edge-to-edge tricuspid transcatheter repair requires extensive echocardiographic planning before the procedure. Sometimes, anatomic features may anticipate a suboptimal result. For this reason, a tailored strategy is the key to the procedural success. We report a case of massive tricuspid regurgitation due to multiple complex mechanisms that was successfully treated by clipping the antero-septal commissure to restore functional coaptation of the valve leaflets at multiple sites. 相似文献
Immunocompromised patients with acute diverticulitis are at increased risk of morbidity and mortality. The aim of this study was to compare clinical presentations, types of treatment, and outcomes between immunocompromised and immunocompetent patients with acute diverticulitis.
Methods
We compared the data of patients with acute diverticulitis extracted from the Web-based International Registry of Emergency Surgery and Trauma (WIRES-T) from January 2018 to December 2021. First, two groups were identified: medical therapy (A) and surgical therapy (B). Each group was divided into three subgroups: nonimmunocompromised (grade 0), mildly to moderately (grade 1), and severely immunocompromised (grade 2).
Results
Data from 482 patients were analyzed—229 patients (47.5%) [M:F = 1:1; median age: 60 (24–95) years] in group A and 253 patients (52.5%) [M:F = 1:1; median age: 71 (26–94) years] in group B. There was a significant difference between the two groups in grade distribution: 69.9% versus 38.3% for grade 0, 26.6% versus 51% for grade 1, and 3.5% versus 10.7% for grade 2 (p < 0.00001). In group A, severe sepsis (p = 0.027) was more common in higher grades of immunodeficiency. Patients with grade 2 needed longer hospitalization (p = 0.005). In group B, a similar condition was found in terms of severe sepsis (p = 0.002), quick Sequential Organ Failure Assessment score > 2 (p = 0.0002), and Mannheim Peritonitis Index (p = 0.010). A Hartmann’s procedure is mainly performed in grades 1–2 (p < 0.0001). Major complications increased significantly after a Hartmann’s procedure (p = 0.047). Mortality was higher in the immunocompromised patients (p = 0.002).
Conclusions
Immunocompromised patients with acute diverticulitis present with a more severe clinical picture. When surgery is required, immunocompromised patients mainly undergo a Hartmann’s procedure. Postoperative morbidity and mortality are, however, higher in immunocompromised patients, who also require a longer hospital stay.
