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Complete Work-up (complete + work-up)
Selected AbstractsUrinary tract cancer screening through analysis of urinary red blood cell volume distributionINTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2000Mamoru Wakui Abstract Background: Hematuria is differentiated between glomerular and urinary tract origins on the basis of urinary red cell morphology. We used this distinction in a program of mass screening for urinary tract cancer to achieve cost-effective and safe hematuria screening. Methods: Of a total of 21 372 adults (mean age 52.3 years; range 20,79 years) participating in a health screening, 912 (4.3%) had a positive dipstick for hematuria and were enrolled in the present study. Urinary red cell volume distribution curves (RDC), the simplest method of assessing urinary red cell morphology, were calculated and subjects were divided into two groups based on their RDC patterns. Group I subjects had a normocytic or mixed pattern and they were immediately investigated for urinary tract malignancy because of the associated risk for urological disease. Group II subjects had a microcytic pattern and, therefore, were judged to be at a low risk of urologic malignancy and were followed up 3 years later without urologic investigations. Results: Among the 38 subjects in group I (4% of all dipstick-positive subjects), one case of bladder cancer was detected. In the remaining 37 patients, 15 cases of benign diseases were discovered. Group II was composed of 869 subjects (96%). The inquiry into their health status conducted 3 years later revealed that 831 (95.6%) were healthy and, of these, 13 had experienced gross hematuria during the period but urological malignancies were ruled out by their urologists, two (0.2%) had died of diseases other than urological cancer and 36 (4.1%) were lost to follow-up. With our method, total costs have been reduced by 93.8% against a conventional setting of a full evaluation for all cases of hematuria. Conclusions: Microcytic hematuria, accounting for 96% of asymptomatic microhematuria cases in the present study, was not associated with a risk for urinary tract malignancy. Compared with conventional hematuria screening with a complete work-up of all cases of hematuria, investigating only subjects with mixed or normocytic RDC patterns was safe and cost effective. [source] Pediatric venous thromboembolic disease in one single center: congenital prothrombotic disorders and the clinical outcomeJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 12 2003C. H. Van Ommen Summary., To learn more about the frequencies of congenital prothrombotic disorders in pediatric venous thromboembolism (VTE) and the outcome of this disease, we evaluated consecutive patients from 0 to 18 years with objectively diagnosed VTE at a single tertiary center over a 12-year period. We included 100 patients, with a median age at diagnosis of 1.0 year (range 2 days to 17 years). At least one underlying clinical condition was present in 96% of the patients. Factor (F)V G1691A mutation was present in 13%, FII G20210A mutation in 3%, antithrombin deficiency in 1%, protein C deficiency in 1% and protein S deficiency in 1% of the tested patients. Combined defects were present in 2.6% of the 77 patients with a complete work-up. Positive family history appeared to be the only predictor for positive testing for congenital disorders (OR 14.9, 95% CI 1.9,113). The overall mortality rate was 20%. The cumulative recurrence-free survival was 92% after 1 year of follow-up, and 82% after 7 years. The incidence and severity of the post-thrombotic syndrome was analyzed in a subgroup of 33 patients with VTE of the lower extremities. Twenty-three (70%) patients developed PTS: moderate in three and mild in 20 patients. In conclusion, congenital prothrombotic disorders seem to play a role in the development of pediatric VTE, and the risk of complications of this disease is high. [source] Laparoscopic resection of extra-gastrointestinal stromal tumor of the transverse mesocolonASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 2 2010N Asakage Abstract The patient was a 58-year-old man. A recent complete work-up was done to find the cause of epigastric pain and revealed a nodule about 4 cm in diameter in the upper right abdomen on CT scans. Laparoscopic resection was performed to allow for a definitive diagnosis to be made and to treat the lesion. The tumor was located in the transverse mesocolon, and there was no communication between the lesion and the ascending or transverse colon. Spindle-shaped tumor cells were arranged in palisades. The number of mitotic figures was only 1/50 HPF. The tumor was weakly positive for KIT and negative for CD34. From these findings, a diagnosis of extra-gastrointestinal stromal tumor originating in the transverse mesocolon was made. [source] Principles of immunosuppression in uveitisACTA OPHTHALMOLOGICA, Issue 2009F WILLERMAIN Non infectious uveitis is a heterogeneous group of diseases mediated through autoimmune and autoinflammatory mechanisms. It is thus crucial to perform a complete work-up to characterise the disease and eventually find a precise aetiology or a systemic associated condition. When the inflammation is bilateral and the vision threatened, systemic drugs are usually proposed. Despite tremendous progress in the understanding of the disease, treatments are generally based on the administration of non specific immunosuppressive molecules. Currently, high doses oral corticosteroids are first given, followed by a slow tapering of the dosage. If this strategy does not lead to disease control, a steroid-sparing agent should be considered. Antimetabolites, T-cell inhibitor and alkylating agents will be chosen (alone or in combination), depending on the severity of the disease and patients general status. Recently the development of biologic agents offers the possibility to target various specific molecules important in non infectious uveitis development. Nowadays, anti-TNF, have been mostly tested with encouraging results. However, it is likely that different uveitis subtypes would require different biologic agents. In the future, the growing production of specific inhibitors might lead to a more tailored approach of uveitis treatment. [source] | ||||||||||