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91.
Sokal JE; Cox EB; Baccarani M; Tura S; Gomez GA; Robertson JE; Tso CY; Braun TJ; Clarkson BD; Cervantes F 《Blood》1984,63(4):789-799
The prognostic significance of disease features recorded at the time of diagnosis was examined among 813 patients with Philadelphia chromosome- positive, nonblastic chronic granulocytic leukemia (CGL) collected from six European and American series. The survival pattern for this population was typical of "good-risk" patients, and median survival was 47 mo. There were multiple interrelationships among different disease features, which led to highly significant correlations with survival for some that had no primary prognostic significance, such as hematocrit. Multivariable regression analysis indicated that spleen size and the percentage of circulating blasts were the most important prognostic indicators. These features, and age, behaved as continuous variables with progressively unfavorable import at higher values. The platelet count did not influence survival significantly at values below 700 X 10(9)/liter but was increasingly unfavorable above this level. Basophils plus eosinophils over 15%, more than 5% marrow blasts, and karyotypic abnormalities in addition to the Ph1 were also significant unfavorable signs. The Cox model, generated with four variables representing percent blasts, spleen size, platelet count, and age, provided a useful representation of risk status in this population, with good fit between predicted and observed survival over more than a twofold survival range. A hazard function derived from half of the patient population successfully segregated the remainder into three groups with significantly different survival patterns. We conclude that it should be possible to identify a lower risk group of patients with a 2-yr survival of 90%, subsequent risk averaging somewhat less than 20%/yr and median survival of 5 yr, an intermediate group, and a high- risk group with a 2-yr survival of 65%, followed by a death rate of about 35%/yr and median survival of 2.5 yr. 相似文献
92.
93.
Carmo GAL; Mandil A; Nascimento BR; Arantes BD; Bittencourt JC; Falqueto EB; Ribeiro AL 《Family practice》2009,26(1):22-26
Background. Ankle-brachial index (ABI) is an excellent methodfor the diagnosis of peripheral arterial disease (PAD) whenit is performed with Doppler. However, this device is not alwaysavailable for primary care physicians. The ABI measured withstethoscope is an easy alternative approach, but have not beenproved to be useful. Objective. To assess the accuracy of the ABI measured usinga stethoscope comparatively to that of the current eligiblemethod for the diagnosis of PAD, the Doppler ABI, and describethe characteristics of this new approach. Methods. We conducted a diagnostic study of ABI measured witha stethoscope and a Doppler probe and compared the results.Eighty-eight patients were accessed by both methods. Results. Mean stethoscope ABI, 1.01 ± 0.15, and meanDoppler ABI, 1.03 ± 0.20, (P = 0.047) displayed a goodcorrelation. Measurements of stethoscope ABI diagnostic accuracyin recognizing a Doppler ABI are described. The comparison ofthis data with the current gold standard method results gavea sensitivity of 71.4% [95% confidence interval (CI), 41.9–91.6]and specificity of 91.0% (95% CI, 81.5–96.6), with predictivepositive value of 62.5% (95% CI, 38.6–81.5) and negativepredictive value of 93.8% (95% CI, 85.2–97.6). The studyaccuracy was 87.7%. The area under the ROC curve was 0.895 (95%CI, 0.804–0.986, P < 0.0001). Conclusions. According to our study, the stethoscope ABI isa useful method to detect PAD and it may be suitable for itsscreening in the primary care setting. Keywords. Ankle-brachial index, peripheral arterial disease, stethoscope. 相似文献
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95.
Prétet Jean-Luc Dalstein Véronique Touzé Antoine Beby-Defaux Agnès Soussan Patrick Jacquin Élise Birembaut Philippe Clavel Christine Mougin Christiane Rousseau Alexandra Lacau Saint Guily Jean 《Clinical and experimental medicine》2023,23(1):87-96
Clinical and Experimental Medicine - The incidence of oropharyngeal cancers (OPC) is increasing in the world. Among OPC, those induced by human papillomaviruses have a better prognosis than... 相似文献
96.
Human parvo-virus B19 infection among children with sickle cell anaemia in Jos,North Central Nigeria
Girei AI Alao OO Joseph DE Damulak DO Banwat EB Nwadioha SI Jombo GTA 《海南医学院学报》2010,16(10):1263-1265,1268
Objective:Human Parvovirus B19 is known to cause significant morbidity and mortality and among diverse patient population groups.Among patients with sickle all disease,who have high red cell turn over due to chronic haemolysis,infection with parvovirus B19 can cause severe life threatening transient aplastic crisis.This study was conducted to determine the Seroprevalence of parvovirus B19 infection and to provide basic epidemiological data on parvovirus B19 infection among children with sickle cell anaemia in Jos,north central Nigeria.Methods: In a hospital based cross sectional survey,200 children aged 1-18 years confirmed to have sickle cell anaemia attending the paediatric sickle cell clinic of Jos university teaching hospital were studied.A questionnaire was designed to obtain basic socio-demographic information,& other relevant aspect of patients′ history.Blood samples were taken for anti parvo-virus B19 serology.Results: The over all prevalence rates of parvo-virus B19 immunoglobulin(IgG) and immunoglobulin(IgM) antibodies were 39.5% and 3.5% respectively,Conclusion: This study confirms that parvo-virus B19 infection is prevalent among children with sickle cell anaemia in Jos,North Central Nigeria.There is a need for further studies to fully evaluate the clinical impact of the infection on our sickle cell anaemia patients. 相似文献
97.
Aim: To test the validity and reliability of a Swedish version of the Non‐Communicating Children’s Pain Checklist – Postoperative Version (NCCPC‐PV). Methods: Thirty‐two consecutive children/adolescents (2–20 years of age) with cognitive impairment and no verbal communication from four habilitation centres were admitted to the study. Each child’s behaviour was observed by a parent or a caregiver and by a physiotherapist in two calm and two painful situations within the child’s everyday life. The raters independently assessed and graded the child’s behaviour during 5 min according to the translated Swedish version of the NCCPC‐PV. The intrarater and interrater reliability were determined, and the construct validity was examined. Results: The results from 202 assessments showed that the construct validity was good: children’s behavioural signs differed significantly between situations of pain and situations of calm (p < 0.001). Repeated assessments showed poor agreement both within and between raters [intraclass correlation coefficient (ICC) 0.51–0.65]. The agreement for pain was good (ICC 0.83). Conclusion: The Swedish version of the NCCPC‐PV can be used for pain assessment in children with cognitive impairments who lack verbal communication. Aspects of reliability need to be further analysed. 相似文献
98.
Mona Hommada Arsène Mekinian Pierre-Yves Brillet Sébastien Abad Claire Larroche Robin Dhôte Olivier Fain Michael Soussan 《Autoimmunity reviews》2017,16(11):1131-1137
Objectives
To assess the detection rate of aortitis in giant cell arteritis (GCA) with fluorodeoxyglucose positron emission tomography/computed tomography (PET) and to compare the findings with CT angiography (CTA).Methods
Fifty-two GCA patients and 27 controls were included. GCA patients had a PET scan at diagnosis (35/52) or during relapse (17/52). Concomitant CTA was performed in 35/52 patients. Aortitis was defined as FDG uptake higher than the liver for PET and wall thickness ≥ 3 mm for CTA. Agreement between PET and CTA was evaluated by the kappa coefficient and Spearman correlation coefficient.Results
Aortitis was diagnosed using PET in 40% (14/35) of patients at diagnosis and in 0% of controls (0/27). Agreement was perfect between PET and CT at a patient-based level, and very good at a vascular segment-based level (kappa: 0.72 to 1). PET was positive in 35% (6/17) of patients scanned during GCA relapse, showing aortitis (n = 4) and/or articular uptake (n = 4). Discrepancies between PET and CT were observed only in relapsing GCA (n = 3). Correlation between the maximum standardized uptake value and wall thickness was moderate at diagnosis (r: 0.57 to 0.7) and not statistically significant during relapse.Conclusions
The detection rate of aortitis in GCA patients using PET is 40%, approximately in the range of CTA rates, suggesting that the two techniques have similar sensitivity. PET seems valuable in relapsing GCA, allowing the detection of vascular and articular activities. 相似文献99.
Hepatitis B virus-related hepatocellular carcinoma: paradigms for viral-related human carcinogenesis 总被引:5,自引:0,他引:5
As discussed in detail in other chapters of this review, chronic hepatitis B (HBV) infection is a major risk factor for hepatocellular carcinoma (HCC). Most HCCs complicate the evolution of an active or inactive cirrhosis. However, some tumors occur on livers with minimal histological changes; the prevalence of such cases varies from one geographical region to the other, being much higher in the southern half of Africa (around 40% of HCCs) than in Asia, America and Europe, where at least 90% of HCCs are associated with the cirrhosis. This heterogeneity is probably a reflection of different environmental and genetic factors. This review will summarize the current knowledge on the mechanisms involved in HBV-related liver carcinogenesis. It will show in particular how viruses can be viewed as tools to discover and dissect new cellular pathways involved in cancer development and emphasize the potential synergistic effects between HBV and hepatitis C virus, as well as between viral infections and other environmental factors, such as alcohol. 相似文献
100.
H See G Aubertin F Angoulvant F Baculard V Soussan A Bourrillon A Faye 《Archives de pédiatrie》2006,13(9):1233-1235
Ear localization is sometimes the first symptom of tuberculosis. CASE REPORT: We report a case of a teen with a chronic otitis revealing a disseminated tuberculosis. The investigations showed ear, bones and pulmonary localisations. The outcome with treatment showed a persistent hearing loss. CONCLUSION: Middle ear tuberculosis should be suspected in patients with chronic otitis and risk factors of tuberculosis. A disseminated tuberculosis should be investigated and an early treatment is necessary to prevent hearing loss. 相似文献