Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.
Patients and Methods
In this retrospective study, 415 consecutive patients with MM managed at a tertiary care center in North India during a study period of January 1, 2010 to December 31, 2015 were evaluated for MPE. The patients with MPE were analyzed for their clinical profile, diagnosis, treatment, and outcomes.
Results
Of these 415 patients, 11 (2.65%) patients had MPE. The median age of the study population was 50 years with male preponderance. The majority of these patients had immunoglobin (Ig)G Kappa disease. All patients had higher than International Staging System stage I disease. MPE was a presenting feature at MM diagnosis in 45.45% (n = 5) of the patients, whereas the rest developed MPE during follow-up. MPE presented predominantly (81.8%) as a unilateral effusion. Concurrent extramedullary involvement at other site was seen in 45.45% (n = 5), with 3 (27%) patients having concurrent myelomatous ascites. Six of these were managed aggressively, whereas 5 patients opted for palliation. The outcomes were dismal (90.9% mortality), with a median survival of 2.47 months.
Conclusion
MPE is a rare entity, and positive outcomes of therapy remain low with dismal prognosis. 相似文献
1. The present study is designed to investigate the brain distribution and plasma pharmacokinetics profiles of chlorogenic acid (CGA) after intranasal administration in Charles–Foster rats to evaluate whether the CGA molecules are transported directly via the nose-to-brain path.
2. The CGA is administered intravenously (IV) and intranasally (IN) at the dose of 10?mg/kg. Further, its concentration in the plasma, cerebrospinal fluid (CSF) and the whole brain is analyzed by HPLC-UV method.
3. The study observes that CGA is rapidly absorbed in plasma with tmax of 1?min similar to IV route after IN administration. The peak plasma concentration and AUC0–24 are higher by 3.5 and 4.0 times respectively in IV administration, compared to IN delivery that represents the significant less systemic exposure of CGA in IN route.
4. However, the concentration of CGA in the brain is 4, 6.5, 5.3, 5.2 and 4.5 times higher at 30, 60, 120, 240 and 360?min, respectively in IN administration compared to IV administration. The exposure of CGA in the brain after IN administration (AUCbrain, IN) was significantly greater (4 times) as compared to the exposure of CGA in the brain (AUCbrain, IV) after IV administration reflecting significant brain uptake of CGA through nasal route. Therefore, IN delivery of CGA can be a promising approach for the treatment of stroke and neurodegenerative disorders. 相似文献
Introduction Fine needle aspiration cytology is not a commonly employed diagnostic modality in the diagnosis of parathyroid tumors.Case report A 28 year old lady being followed-up for 5 years after en bloc resection of a parathyroid carcinoma presented with a nodule in the lower neck, away from the parathyroidectomy scar. The 1 cm isolated nodule was located in the muscular and subcutaneous plane and corresponded to the needle track of FNA performed on a neck nodule before the parathyroidectomy. On evaluation, she had mild hypercalcemia and high normal serum parathyroid hormone levels. FNAC and histology including immunohistochemistry for Chromogranin A after local excision of the nodule confirmed the nodule to be a recurrent parathyroid carcinoma along the needle track.Discussion To the best of the authors’ knowledge, this is only the second case of needle track implantation after FNA in parathyroid carcinoma reported to date. This case highlights the risk of engraftment of parathyroid tissue after FNA and cautions against the use of FNA as a preoperative diagnostic modality for the evaluation of parathyroid lesions.Drs. Agarwal and Dhingra have contributed equally, as joint first authors. 相似文献
SETTING: A private infertility care and in vitro fertilisation (IVF) centre in Northern India. OBJECTIVES: To describe the prevalence, clinical spectrum, management strategy and outcome of infertility due to female genital tuberculosis (GTB) diagnosed with the help of a simplified tuberculosis (TB) algorithm. DESIGN: Data from 150 women with infertility (Group I) and 47 women with general gynaecological problems (Group II) were analysed. RESULTS: GTB was diagnosed in 7.2% of Group I and 2.8% of Group II women. Anti-tuberculosis treatment resulted in resolution of symptoms other than infertility in over 90% of cases. Of the total 20 pregnancies in the group, 10 were obtained in 32 IVF treatment patients. CONCLUSIONS: A definitive bacteriological diagnosis was generally difficult to achieve in GTB before administration of anti-tuberculosis treatment. A high index of suspicion and several other morphological and/or laboratory criteria were employed. It is suggested that a step-wise algorithm can help in the management of these cases. 相似文献
A patient of chronic obstructive pulmonary disease (COPD) with cor-pulmonale and chronic respiratory failure, who was given intermittent positive pressure ventilation at home, is reported. The patient did remarkably well on home mechanical ventilatory support. We believe this to be the first case report of domiciliary mechanical ventilation in a patient of COPD from India. 相似文献
The complex electrical impedance of a goat eye lens is studied in the frequency range 10mHz−10Hz at room temperature, using
a computer-controlled AC impedance system. AC impedance software (model 368, version 2.2) is employed to determine the total
impedance and capacitance of the eye lens at various frequencies. A Cole-Cole plot of the eye lens material is drawn between
the real component of impedance Z′ and the imaginary component Z″ for each excitation frequency that shows a perfect arc of
a semicircle, with its centre lying below the abscissa at an angle of 35°. The half-angle ϕ between R0 and R∞ is found to be 55°, which mathematically demonstrates the selective permeability of the eye lens. Using graphical analysis
of the Cole-Cole plot, characteristic frequency fc and distribution factor α are observed to be 1Hz and 0.77, respectively. At characteristic frequency, capacitance and total
impedance are found to be 1.14μF and 9.08kΩ. The effect of electrode polarisation on capacitance is corrected, based on Fricke's
power function. The observed electrical parameters are then used to explain the multiple current path through various tissue
compartments. Further, an attempt is made to explain the results on the basis of a possible dipolar model. 相似文献
Pancreatoblastoma or infantile pancreatic carcinoma is a rare pancreatic tumor with distinct acinar and squamoid cell differentiation that generally affects infants and young children. Ultrasound and CT scan may be useful but preoperative diagnosis is often quite difficult. The outcome is generally favourable. A such case of 10 years old boy with an abdominal mass is being presented. 相似文献
A computer assisted AC impedance system is used to measure the DC voltage—current (V-I) characteristics and AC impedance of
a goat eye lens using a two-probe Ag−AgCl electrode system. The measurement of the V-I characteristics shows that when a DC
voltage from 0mV to 30mV is applied, the resultant current decreases from an initial value of 0.58μA to 0.006μA. However,
when the voltage is increases beyond 30mV, the current increases and reaches a value of 0.9μA at 100mV. The data on the frequency
response (0.01–10 Hz) of the impedance of lens tissue show an inverse relationship with frequency. The effect of various DC
voltages, namely 0, 30, 50, 100 and 200 mV, on the impedance of the eye lens is also investigated over a frequency range of
0.01–10 Hz. The measurement results for both V-I characteristics and AC impedance further suggest the presence of a 30 mV
voltage compartment in the goat eye lens. 相似文献