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101.
Bone marrow transplantation in patients aged 45 years and older 总被引:5,自引:8,他引:5
Klingemann HG; Storb R; Fefer A; Deeg HJ; Appelbaum FR; Buckner CD; Cheever MA; Greenberg PD; Stewart PS; Sullivan KM 《Blood》1986,67(3):770-776
Increasing age has been reported to be a poor prognostic factor for survival after bone marrow transplantation. We evaluated causes of death and frequency and type of complications after marrow grafting in 24 syngeneic and 39 allogeneic recipients who were 45 to 68 years old at the time of transplant. Most patients were in an advanced stage of hematologic malignancy. Among patients given syngeneic transplants, actuarial disease-free survival at 7 years is 20%. The major causes of death were relapse of leukemia and idiopathic interstitial pneumonia. Among allogeneic recipients, 9 (23%) are currently alive, and actuarial disease-free survival at 7 years is 11%. Cytomegalovirus pneumonia and septicemia were the most frequent causes of death. Patients over 50 years of age had the poorest survival rate (1/13), but many of these were transplanted in an advanced stage of their disease. However, among 12 patients transplanted while in remission or at an early stage of their disease, 5 are surviving 65 to 1,160 days after transplantation, with an actuarial survival rate of 22% at 3 years. This is in contrast to those who received their transplant in relapse: 2 out of 20 patients (10%) became long-term survivors, with a probability of survival of 15% at 3 years. The actuarial incidence of grade II through IV acute graft- v-host disease (GVHD) was 30% for allogeneic recipients 45 to 50 years of age. This was not significantly different from the incidence in younger patients. In patients 51 to 62 years of age, the actuarial incidence of acute GVHD was 79%; however, this group included three partially HLA-mismatched transplants. Ten of 15 patients surviving at least 3 months developed chronic GVHD. These results suggest that marrow transplantation is feasible and should be considered in patients over 45 years, especially if recipients are in good clinical condition and are at an early stage of their disease, such as the chronic phase of chronic myelogenous leukemia and preleukemia. For patients more than 50 years of age, allogeneic marrow grafting cannot presently be considered first-line therapy. 相似文献
102.
Amitabh Monga Ravinder PS Makkar Anju Arora Surabhi Mukhopadhyay Ajay K Gupta 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2003,14(4):230-231
Hepatitis E virus is one of the leading causes of acute viral hepatitis in India but usually manifests as a mild self-limiting illness. Viral hepatitis in the presence of glucose-6-phosphate dehydrogenase (G6PD) deficiency may be associated with complications such as severe anemia, hemolysis, renal failure, hepatic encephalopathy and even death. The incidence of G6PD deficiency in the general population of northern India is reported to be between 2.2% and 14%. Despite both hepatitis E infection and G6PD deficiency being common, their impact on patient illness has only recently been reported. The present study reports a case of severe hemolysis in a patient with G6PD deficiency and hepatitis E infection.
Key Words: Glucose-6-phosphate dehydrogenase, G6PD, Hemolysis, Hepatitis EHepatitis E is an enterically transmitted virus and is one of the most common causes of acute viral hepatitis in India (1). Glucose-6-phosphate dehydrogenase (G6PD) deficiency is found in 2.2% to 14% of the general population in North India (2). The coexistence of viral hepatitis and G6PD deficiency has been reported to be associated with severe jaundice and other complications (3,4). Hepatitis E infection with G6PD deficiency has been associated with more severe illness in only one previous report (5). We report an additional case. 相似文献
103.
Immunolocalization of inducible nitric oxide synthase in synovium and cartilage in rheumatoid arthritis and osteoarthritis 总被引:8,自引:1,他引:8
Grabowski PS; Wright PK; Van 't Hof RJ; Helfrich MH; Ohshima H; Ralston SH 《Rheumatology (Oxford, England)》1997,36(6):651-655
Nitric oxide has been implicated as a mediator of inflammatory arthritis,
and recent work has shown that pro-inflammatory cytokines stimulate NO
production in vitro by activation of the inducible nitric oxide synthase
(iNOS) pathway. In order to identify the cellular sources of NO production
within the joint, we have used immunohistochemical techniques to study the
distribution of iNOS in synovium and cartilage from normal and diseased
joints. iNOS was most strongly expressed in the synovial lining layer,
subsynovium, vascular smooth muscle and chondrocytes from patients with
rheumatoid arthritis (RA). Analysis of serial sections, coupled with double
immunofluorescent staining, showed that the CD68+ macrophages in the
synovial lining layer and, to a lesser extent, fibroblasts were the
predominant source of iNOS within synovium, whereas T cells, B cells and
neutrophils were negative. A similar pattern of iNOS staining was seen in
osteoarthritis, but fewer cells were iNOS positive and the intensity of
staining, particularly in cartilage, was much weaker than in RA. In
contrast, no evidence of iNOS was detected in non- inflammatory synovium or
in cartilage derived from normal joints (fractured neck of femur). In
conclusion, these data support the hypothesis that synovium and cartilage
are important sources of increased NO production in patients with
inflammatory arthritis. Localization of iNOS at these sites within the
inflamed joint raises the possibility that increased local production of NO
may contribute to the pathogenesis of inflammatory arthritis by increasing
synovial blood flow and by modulating cellular function within synovium and
articular cartilage.
相似文献
104.
Illness Perceptions Explain the Variance in Functional Disability,but Not Habitual Physical Activity,in Patients With Chronic Low Back Pain: A Cross‐Sectional Study 下载免费PDF全文
105.
106.
107.
Johanna M Monk Kevin G Rowley Ian PS Anderson 《Health research policy and systems / BioMed Central》2009,7(1):25
Priority setting is about making decisions. Key issues faced during priority setting processes include identifying who makes these decisions, who sets the criteria, and who benefits. The paper reviews the literature and history around priority setting in research, particularly in Aboriginal health
research. We explore these issues through a case study of the Cooperative Research Centre for Aboriginal Health (CRCAH)'s
experience in setting and meeting priorities. 相似文献
108.
Background
Posterior capsular opacification is the most common complication of modern cataract surgery.Methods
A prospective study was conducted on 150 patients (150 eyes) out of which 50 eyes each underwent cataract surgery by extracapsular cataract extraction, small incision cataract surgery and phacoemulsification technique. On postoperative follow up posterior capsular opacification and Neodymium: Yttrium Aluminium Garnet laser capsulotomy rate was evaluated.Result
Posterior capsular opacification rate was significantly less (p=0.03) in eyes which had undergone phacoemulsification as compared to extracapsular cataract extraction. However capsulotomy rate was not statistically significant after comparison of the three surgical techniques of cataract surgery.Conclusion
Posterior capsular opacification following cataract surgery can be minimized by the use of small incision cataract surgery and phacoemulsification.Key Words: Posterior capsular opacification, Capsulorrhexis, Hydrodissection 相似文献109.
Background : In plateletpheresis blood is withdrawn from a donor in anticoagulant solution and separated into components. Platelets are retained and the remaining components are returned to the individual. 相似文献
110.