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Prevalence,severity and correlates of fatigue in newly diagnosed patients with myelodysplastic syndromes 下载免费PDF全文
Fabio Efficace Gianluca Gaidano Massimo Breccia Marianna Criscuolo Francesco Cottone Giovanni Caocci David Bowen Michael Lübbert Emanuele Angelucci Reinhard Stauder Dominik Selleslag Uwe Platzbecker Grazia Sanpaolo Anna Jonasova Francesco Buccisano Giorgina Specchia Giuseppe A. Palumbo Pasquale Niscola Chonghua Wan Huiyong Zhang Susanna Fenu Virginia Klimek Odile Beyne‐Rauzy Khanh Nguyen Franco Mandelli 《British journal of haematology》2015,168(3):361-370
The primary objective of this study was to investigate factors associated with fatigue severity in newly diagnosed patients with higher‐risk myelodysplastic syndromes (MDS). The secondary objectives were to assess symptom prevalence and to examine the relationships between fatigue, quality of life (QoL) and overall symptom burden in these patients. The analyses were conducted in 280 higher‐risk MDS patients. Pre‐treatment patient‐reported fatigue was evaluated with the Functional Assessment of Chronic Illness Therapy (FACIT)‐Fatigue scale and QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 (EORTC QLQ‐C30). Female gender (P = 0·018), poor performance status (i.e., ECOG of 2–4) (P < 0·001) and lower levels of haemoglobin (Hb) (P = 0·026) were independently associated with higher fatigue severity. The three most prevalent symptoms were as follows: fatigue (92%), dyspnoea (63%) and pain (55%). Patients with higher levels of fatigue also had greater overall symptom burdens. The mean global QoL scores of patients with the highest versus those with the lowest levels of fatigue were 29·2 [standard deviation (SD), 18·3] and 69·0 (SD, 18·8), respectively and this difference was four times the magnitude of a clinically meaningful difference. Patient‐reported fatigue severity revealed the effects of disease burden on overall QoL more accurately than did degree of anaemia. Special attention should be given to the female patients in the management of fatigue. 相似文献
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艾滋病合并隐球菌脑膜炎18例临床分析 总被引:6,自引:1,他引:6
目的 提高对艾滋病 (AIDS)合并隐球菌脑膜炎的认识。方法 对赤道几内亚巴塔地区医院 18例AIDS合并隐球菌脑膜炎患者进行临床综合分析。结果 18例AIDS合并隐球菌脑膜炎患者的临床主要表现为 :发热、剧烈头痛、极度乏力、肢体痛、脑膜刺激征及消瘦与脱水等。脑脊液 (CSF)培养均为新型隐球菌生长 ;涂片及隐球菌多糖荚膜抗原 (ELISA法 )检测的阳性率分别为 77 8% (14/ 18) ,94 4% (17/ 18)。结论 隐球菌脑膜炎为AIDS常见机会性感染及主要致死病因之一。 相似文献
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SP Attard-Montalto C Camacho-Hübner AM Cotterill L D'Souza-Li S Daley K Bartlett D Halliday OB Eden 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(1):54-60
Changes in insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding proteins (IGFBPs) were correlated with protein synthesis and breakdown using [1- 13C]leucine before chemotherapy and during subsequent febrile neutropenia (FN) in eight children with cancer, aged 6.3–17.5 y. IGF-I levels were similar to age-matched controls before chemotherapy (mean ±SEM: 250 ±28 and 228 ±22 μg l-1, respectively). During FN, IGF-I fell to 156 ±22 /ng l -1(p= 0:02), and rose to 276 ±27 μ g l -1 with recovery at 6 months (p = 0:004). Similarly, IGFBP-3 decreased from 4.0 ±0.2mgl-1 before chemotherapy to 3.0 ±0.3 mgl-1 during FN (p= 0:01), and returned to 4.1 ±0.2mgl -1 at 6 months (p= 0:01). IGF-I correlated with IGFBP-3 (r=+0:7, p <0:001). Scanning densitometry showed a decrease in IGFBP-3 from 94 to 54% during FN, when the presence of IGFBP-3 protease activity was observed. Compared with normal human serum, IGFBP-2 was elevated throughout the study. IGFBP-1 increased from 14.6 ±3.5 to 30.6 ±2.8/ngl-1 (p = 0:004), whereas serum insulin decreased from 26.5 ±6.8 to 7.8 ±0.8 mUl-1 (p= 0:03) before and during FN, respectively. Whilst IGF-I and IGFBP-3 fell, daytime growth hormone increased from 3.3 ±0.6 to 6.7±0.8mUl -1 (p= 0:01), and cortisol from 197 ±48 to 594±98nmoll -1 (p = 0:005). Albumin decreased from 47 ±2 to 38 ±2gl-1 (p= 0:004) and improved to 47 ±2gl-1 with recovery (p= 0:003). Protein synthesis increased from 4.5 ±0.4 to 5.0 ±0.6gkg-1 d-1 before chemotherapy and during FN, while protein breakdown rose from 5.4 ±0.4 to 6.3 ±0.4kg-1d-1. Increasing protein breakdown was related to falling IGF-I and IGFBP-3 levels. Modification of IGFBP-3 by circulating proteolytic activity may alter IGF bioavailability, allowing protein synthesis to increase during periods of severe catabolic stress. 相似文献
7.
E Hesketh OB Eden HR Gattamaneni RHA Campbell MEM Jenney L Lashford 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(4):452-454
Four children with spinal cord compression due to malignant tumours are presented. The severity of the condition was not initially recognized by parents, or the nature of the likely cause by the initial physicians. Lower limb asymmetrical weakness, clear-cut sensory levels, and marked pain indicate need for urgent imaging and exclusion of a space occupying lesion. In 1997 diagnosis of Guillain-Barré syndrome should not be made without careful prior spinal imaging. 相似文献
8.
The release of certain cytokines, e.g. tumour necrosis factor (TNF)- alpha,
in the amniotic fluid has been suggested to be a cause of preterm birth.
The predisposition to excessive liberation of cytokines from peripheral
leukocytes has been shown to depend partly on the individual's HLA-DR
genotype. The HLA-DR1 and -DR3 alleles have previously been reported as
being associated with a TNF-alpha high responder status and have also been
associated with unexplained recurrent spontaneous abortions. In the present
study, HLA-DR typing was performed in 10 women who had experienced
recurrent very early preterm births resulting in perinatal death, or late
spontaneous abortions under a clinical picture resembling that
traditionally attributed to cervical incompetence. All patients had had at
least one mid-trimester miscarriage in spite of the insertion of a cervical
cerclage. Nine out of 10 (90%) patients had the HLA-DR phenotypes DR1
and/or DR3 compared with 37% in the background population (P < 0.005).
The results suggest that HLA-DR-associated immunological factors might play
a part in recurrent late spontaneous abortions and extremely preterm births
under a cervical incompetence-like picture, at least in the subset of cases
not treatable by cervical cerclage.
相似文献
9.
This study investigated the dental health of children (aged 1-14 years) diagnosed with cancer 4-36 months earlier. Sixty patients were examined and interviewed; 43% had untreated decay and only 35% had seen a dentist since their malignancy had been diagnosed. A significant source of bacterial infection is not being treated in this at risk population. The level of dental disease and lack of dental prevention indicates a need to integrate medical and dental care. 相似文献
10.
O Kambur R Talka OB Ansah VK Kontinen A Pertovaara E Kalso PT M?nnist? 《British journal of pharmacology》2010,161(7):1553-1565