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101.
R Kneen MD Nguyen T Solomon NG Pham CM Parry TT Nguyen TL Ha A Taylor TT Vo TT Nguyen NP Day NJ White 《Clinical infectious diseases》2004,39(11):1591-1598
BACKGROUND: Despite the availability of antitoxin and antibiotics, the mortality rate for diphtheria remains high, mostly because of cardiac complications. METHODS: During 1 year, 154 Vietnamese children with diphtheria admitted to a referral hospital were studied prospectively with clinical examination, including a simple pseudomembrane score, 12-lead and 24-hour electrocardiography, measurement of serum cardiac enzyme levels, and estimation of troponin T levels. RESULTS: Thirteen children had diphtheritic cardiomyopathy on admission, and 19 developed it subsequently. Twelve children (8%) died. The combination of pseudomembrane score of >2 and bull neck predicted the development of diphtheritic cardiomyopathy, with a positive predictive value of 83% and a negative predictive value of 93%. Administration of 24-hour electrocardiography on admission improved the ability to predict diphtheritic cardiomyopathy by 57%. Fatal outcome was best predicted by the combination of myocarditis on admission and a pseudomembrane score of >2. Of the cardiac enzyme levels measured, an elevated aspartate aminotransferase level was the best predictor. The presence of troponin T identified additional children with subclinical cardiac damage. CONCLUSIONS: The development of diphtheritic cardiomyopathy can be predicted by means of simple measures. 相似文献
103.
Second malignancies after treatment for laparotomy staged IA-IIIB Hodgkin's disease: long-term analysis of risk factors and outcome 总被引:2,自引:1,他引:2
Mauch PM; Kalish LA; Marcus KC; Coleman CN; Shulman LN; Krill E; Come S; Silver B; Canellos GP; Tarbell NJ 《Blood》1996,87(9):3625-3632
The survival of patients with Hodgkin's disease has dramatically improved over the past 30 years because of advances in treatment. However, concern for the risk of long-term complications has resulted in a number of trials to evaluate reduction of therapy. The consequences of these trials on recurrence, development of long-term complications, and survival remain unknown. One major consequence of successful treatment of Hodgkin's disease is the development of second malignant neoplasms. We sought to determine the factors most important for development of second tumors in pathologically staged and treated Hodgkin's disease patients followed for long intervals to provide background information for future clinical trials and guidelines for routine patient follow-up. Between April 1969 and December 1988, 794 patients with laparotomy staged (PS) IA-IIIB Hodgkin's disease were treated with radiation therapy (RT) alone or combined radiation therapy and chemotherapy (CT). There were 8,500 person-years of follow-up (average of 10.7 person-years per patient). Age and gender-specific incidence rates were multiplied by corresponding person-years of observation to obtain expected numbers of events. Observed to expected results were calculated by type of treatment, age at treatment, sex, and time after Hodgkin's disease. Absolute (excess) risk was expressed as number of excess cases per 10,000 person-years. Seventy-two patients have developed a second malignant neoplasm. Eight patients developed acute leukemia, 10 had non-Hodgkin's lymphoma (NHL), and 53 patients developed solid tumors at a median time of 5 years, 7.25 years, and 12.2 years, respectively, after Hodgkin's disease. One patient developed multiple myeloma 16.5 years after Hodgkin's disease. The relative risk (RR) of developing a second malignancy was 5.6. The absolute excess risk per 10,000 person-years (AR) of developing a second malignancy was 69.6 (7.0% excess risk per person per decade of follow-up). The highest RR occurred for the development of leukemia (RR = 66.2), however because of the low expected risk, the AR was only 9.3. The RR of solid tumors after Hodgkin's disease was lower (4.7); however, the AR was greater (49) than for acute leukemia. Among the solid tumors, breast, gastrointestinal, lung, and soft tissue cancers had the highest absolute excess risks. The risk for developing breast cancer after Hodgkin's disease was greatest in women who were under the age of 25 at treatment. The most significant risk factor for the development of both leukemia and solid tumors was the combined use of radiation therapy and chemotherapy. The RR following RT alone was 4.1 (AR = 51.1); for RT + CT (initially or at relapse) the RR was 9.75 (P < 0.05, nonoverlapping confidence limits, AR = 123.9). Survival following development of a second malignancy was poor in patients with leukemia, gastrointestinal tumors, lung cancer, and sarcoma. Survival from other malignancies including NHL and breast cancer was more encouraging. Second malignant neoplasms are a major cause of late morbidity and mortality following treatment for Hodgkin's disease. The most significant risk factor for the development of second tumors is the extent of treatment for Hodgkin's disease. Recommendations are presented for both prevention and early detection of these tumors. 相似文献
104.
Ruiz-Arguelles GJ; Katzmann JA; Greipp PR; Gonchoroff NJ; Garton JP; Kyle RA 《Blood》1984,64(2):352-356
The bone marrow and peripheral blood of 14 patients with multiple myeloma were studied with murine monoclonal antibodies that identify antigens on plasma cells (R1-3 and OKT10). Peripheral blood lymphocytes expressing plasma cell antigens were found in six cases. Five of these cases expressed the same antigens that were present on the plasma cells in the bone marrow. Patients that showed such peripheral blood involvement were found to have a larger tumor burden and higher bone marrow plasma cell proliferative activity. In some patients, antigens normally found at earlier stages of B cell differentiation (B1, B2, and J5) were expressed by peripheral blood lymphocytes and/or bone marrow plasma cells. 相似文献
105.
106.
NJ Gogtay KD Kamtekar SS Dalvi SS Mehta AR Chogle U Aigal NA Kshirsagar 《BMC infectious diseases》2006,6(1):16-4
Background
The WHO recommends that adults with uncomplicated P. falciparum successfully treated with a blood schizonticide receive a single dose of primaquine (PQ) 45 mg as a gametocytocidal agent. An earlier pilot study suggested that 75 mg of bulaquine (BQ), of which PQ is a major metabolite, may be a useful alternate to PQ. 相似文献107.
Abdelrazeq AS Rahman M Botterill ID Alexander DJ 《Diseases of the colon and rectum》2008,51(7):1100-1106
Purpose We report the results of the cleft lift procedure in the management of nonacute pilonidal sinus disorders.
Methods Seventy consecutive patients who underwent a cleft lift for nonacute pilonidal sinus were evaluated prospectively. Responses
to a postal questionnaire were analyzed for long-term outcome.
Results All patients who fulfilled the criteria for day-case were operated on as such. Sixty-six patients achieved complete wound
healing within six weeks. Delayed wound healing occurred in three patients and nonhealing occurred in one. Fourteen patients
had one or more complications: wound breakdown, superficial (n = 7) and deep (n = 1); wound infection (n = 5); wound seroma
(n = 4); and early recurrence (n = 1). The median time off work and to return to normal activities was two and four weeks,
respectively (range, 0.5–12). Forty-seven patients completed the questionnaire at a median follow-up of 24 months: five patients
reported minimal tenderness in the sacral region; none reported recurrence of pilonidal symptoms; and all were satisfied.
Conclusions The cleft lift procedure is easy to perform as a day-case procedure. It is associated with high rates of primary healing,
durable low recurrence rates, and early functional recovery. This technique may be the procedure of choice in the surgical
management of nonacute pilonidal disorders.
Presented in part at the meeting of the Association of Coloproctolgy of Great Britain and Ireland, Glasgow, United Kingdom,
July 2 to 5, 2007. 相似文献
108.
埃索美拉唑能有效控制内镜阴性胃食管反流症状——6个月"按需治疗"对照试验 总被引:3,自引:0,他引:3
对于大多数胃食管反流病 (GERD)病人而言 ,治疗的主要目的在于控制症状和防止复发。而伴有糜烂性食管炎者 ,其主要目标则为愈合糜烂和 /或防止并发症。目前发现 ,大多数GERD病人 ,不论其内镜表现如何 ,短时间内使用抑酸药后 ,症状在 6个月内复发。要维持原来的疗效 ,确保糜烂愈合 ,用最小剂量质子泵抑制剂 (PPI)作维持治疗已是公认的较理想方法。当然长期维持治疗的选择也应顾及病人意愿。如果症状发作不频繁 ,那么按需治疗是一个合理的处理方案。事实上 ,病人也仅在症状复发时才会正规、持续地服药。对这类病人 ,以PPI作为按… 相似文献
109.
Alessio M; Greco NJ; Primo L; Ghigo D; Bosia A; Tandon NN; Ockenhouse CF; Jamieson GA; Malavasi F 《Blood》1993,82(12):3637-3647
The surface glycoprotein CD36 (GPIV) is known to mediate the adhesion of Plasmodium falciparum malaria-infected red blood cells and to be a receptor for extracellular matrix proteins such as collagen and thrombospondin. The murine monoclonal IgM antibody NL07, which is specific for CD36, has now been shown to also be a potent inhibitor of the adhesion of P falciparum malaria-infected red blood cells to C32 melanoma cells. Treatment of platelets with NL07 monoclonal antibody resulted in rapid degranulation, release of ATP and serotonin, increase in [Ca2+]i, and tyrosine phosphorylation of a substrate protein of 130 kD. In about one-half of the experiments, activation with NL07 resulted in the formation of small aggregates of 10 to 30 platelets, whereas in the other half of the experiments, large aggregates were seen similar to those induced by adenosine diphosphate (ADP) and these large aggregates could be converted to the small aggregates by ATP alpha S or by AP-2 or other antibodies against GPIIb and/or IIIa. Microaggregates of 2 to 5 platelets were seen with Glanzmann's platelets that constitutively lack GPIIb/IIIa. Aggregate formation was not seen with heat-treated serum, in the presence of anti C1q antibodies, or when using C5-, C8-, or C9-deficient human sera. Although activation of platelets with purified complement components results in a slow morphologic change without aggregation, involvement of CD36 results in rapid complement-mediated activation leading to formation of small aggregates that is largely independent of GPIIb/IIIa and that, under certain circumstances, proceeds to the formation of large ADP-dependent aggregates. 相似文献
110.