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Disease Features (disease + feature)
Selected AbstractsAssessment of peripheral blood lymphocyte subsets in idiopathic myelofibrosisEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2000Francisco Cervantes Abstract: The objective of this study was to contribute to a better characterization of the immunological profile of idiopathic myelofibrosis (IM) at presentation by analysing the blood lymphocyte subsets and their possible correlations with other disease features. Absolute blood lymphocytes and lymphocyte subsets were assessed in 31 IM patients, compared with those from 34 healthy individuals, and correlated with the patients' main clinical, hematological and bone marrow histologic features. The mean lymphocyte count of the IM patients was 1.1 (SD 0.6)×109/L, versus 1.6 (SD 0.49)×109/L in controls (p=0.0006), with 24 of the 31 patients (77.4%) showing lymphocytopenia (<1.5×109/L). IM patients had significantly lower counts of CD3, CD4, CD8, and CD3,/CD56+ cells, and significantly higher CD3+/CD56+ lymphocyte counts. Although no significant differences were found between patients and controls with regard to CD19+/CD5+ cell counts, increased CD5+ B-cell lymphocytes were observed in three IM patients. In one of the latter patients, Ig gene rearrangement analysis of the heavy chain gene demonstrated such a subpopulation to be clonal, but the patient did not develop features of chronic lymphoid leukemia during a 5-yr follow-up. No correlation was found between the patients' blood lymphocyte counts and other disease features. We conclude that most IM patients have absolute lymphopenia, decreased T cells and increased cytotoxic T cells at diagnosis, and 10% of them show an increased CD5+ B-cell subpopulation. [source] Neurogenesis and cell cycle-reactivated neuronal death during pathogenic tau aggregationGENES, BRAIN AND BEHAVIOR, Issue 2008K. Schindowski The aim of the present study was to investigate the relation between neurogenesis, cell cycle reactivation and neuronal death during tau pathology in a novel tau transgenic mouse line THY-Tau22 with two frontotemporal dementia with parkinsonism linked to chromosome-17 mutations in a human tau isoform. This mouse displays all Alzheimer disease features of neurodegeneration and a broad timely resolution of tau pathology with hyperphosphorylation of tau at younger age (up to 6 months) and abnormal tau phosphorylation and tau aggregation in aged mice (by 10 months). Here, we present a follow-up of cell cycle markers with aging in control and transgenic mice from different ages. We show that there is an increased neurogenesis during tau hyperphosphorylation and cell cycle events during abnormal tau phosphorylation and tau aggregation preceding neuronal death and neurodegeneration. However, besides phosphorylation, other mechanisms including tau mutations and changes in tau expression and/or splicing may be also involved in these mechanisms of cell cycle reactivation. Altogether, these data suggest that cell cycle events in THY-Tau22 are resulting from neurogenesis in young animals and cell death in older ones. It suggests that neuronal cell death in such models is much more complex than believed. [source] Present status and perspectives regarding the therapeutic strategy for acute myeloid leukemia, non-Hodgkin's lymphoma and multiple myeloma in the elderlyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2009Masatsugu Ohta The incidence of cancers increases with advancing age. To improve the quality of life of elderly patients with hematological malignancies, appropriate therapeutic approaches have to be provided under adequate informed consent and with evaluation of the prognostic factors that predict the therapeutic outcome of each disease. Even in elderly patients, combination chemotherapies are effective for obtaining a good outcome for selected populations judged by factors such as performance status, pre-existing comorbid conditions or disease features; however, non-intensive treatment or supportive care might also be considered for patient groups with a poor prognosis. Therefore, the clinical parameters of the relevance for treatment decisions in the elderly are herein addressed. During cancer treatment, attention must be paid to the presence of age-related organ dysfunction, drug resistance, drug-induced side-effects such as end organ-targeted toxicity, or neutropenia due to myelosuppression by cytotoxic drugs. Current therapeutic approaches are therefore expected to have good compliance and better outcome in elderly patients by the introduction of several molecularly targeted therapies, novel nucleoside analogs or non-myeloablative stem cell transplantation. [source] Postradiotherapy surveillance practice for head and neck squamous cell carcinoma,too much for too little?,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 12 2003David L. Schwartz MD Abstract Introduction. Limited information is available regarding surveillance patterns after head and neck cancer radiotherapy. We cataloged follow-up for a specified patient cohort treated at three neighboring university, community, and Veterans Administration institutions. Methods. One hundred fifteen patients were treated with curative intent between 1994,1998 with definitive or postoperative radiotherapy for newly diagnosed squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx. One hundred patients had continuous follow-up at their treating institution and were included for analysis. Median follow-up until disease recurrence or censorship was 28.5 months. Results. Median follow-up frequency was 5.7 visits/year and was highly variable. Although visit frequency correlated with disease stage and the presence of high-risk disease features, this association was lost when patients with early recurrences were removed from analysis. Procedure and test utilization closely mirrored visit frequency, resulting in a wide range of estimated yearly charges ($0,15,668/year; median, $1,772/year). Actuarial 3-year overall survival for the study group was 71%. Eighty-six percent (19 of 22) of potentially salvageable locoregional failures were discovered secondary to symptomatic complaint rather than by test results. Disease failure, whether detected by symptom or testing, predicted for poor survival (22% at 24 months after recurrence). Conclusions. Postradiotherapy surveillance for head and neck cancer is inconsistently pursued. A proven correlation between intensive follow-up and improved patient survival is lacking. Surveillance directed by patient symptoms should be investigated as an alternative approach. © 2003 Wiley Periodicals, Inc. Head Neck 25: 000,000, 2003 [source] Unusual presentation of large B cell lymphoma: a case report and review of literatureINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 5 2006L. AIRAGHI Summary Diffuse large B cell lymphoma (DLBCL) is the largest subtype of non-Hodgkin's lymphomas (NHLs) and is characterized by relatively frequent extranodal presentation. In these cases, the most common extranodal localizations are stomach, CNS, bone, testis and liver. Simultaneous detection of multiple extranodal involvement at presentation is quite uncommon, with the majority of these cases characterized by gastric or intestinal disease localization. Retrospective analysis concerning multifocal extranodal NHLs never pointed out disease features such as those described here. We report a patient with an unusual presentation of DLBCL, characterized by adrenal and renal involvement, associated with symptoms and signs of the cold agglutinin disease and a hypercoagulable state. Subsequently, computed tomography (CT) and fluorodeoxyglucose-positron emission tomography (FDG-PET) scanning disclosed a rapidly extensive spread to nodes and bones. Cytofluorimetric analysis of a renal specimen showed medium-to-large lympho-monocytoid elements positive for CD20 with monoclonal expression of immunoglobulin kappa light chain. Histopathological examination confirmed a renal CD20 positive DLBCL localization. [source] Myelodysplastic syndromes associated with interstitial deletion of chromosome 5q: Clinicopathologic correlations and new insights from the prelenalidomide era,,AMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2008Shernan G. Holtan To better estimate prognosis for patients with myelodysplastic syndromes (MDS) associated with clonal interstitial deletions of the long arm of chromosome 5 (del(5q)), we reviewed the medical records of 130 adults with del(5q) MDS seen at our institution over a 15-year period. Overall median survival of this cohort was 9.5 months, shorter than reported in earlier series. The least favorable outcomes are associated with complex cytogenetics, lack of any normal metaphases, normocytic rather than macrocytic erythrocyte indices, and low baseline lymphocyte counts. Lymphopenia but not neutropenia at the time of diagnosis appears to be a new adverse prognostic indicator. Cytogenetic breakpoints defined by G-banded karyotyping correlate poorly with particular disease features. Surprisingly, survival of patients with treatment-related MDS was equivalent to that of de novo MDS with del(5q) in this series. Morphologic features associated with del(5q) are diverse. Most patients with del(5q) MDS do not meet criteria for WHO-defined 5q-syndrome, and the presence of del(5q) does not appear to modify the clinical phenotype otherwise risk-stratified by the International Prognostic Scoring System (IPSS). Additional important prognostic factors not taken into account by the IPSS include the baseline erythrocyte indices, lymphocyte count, and clonal burden. Am. J. Hematol., 2008. © 2008 Wiley-Liss, Inc. [source] Encouraging preliminary results in 12 patients with high-risk haematological malignancies by omitting graft-versus-host disease prophylaxis after allogeneic transplantationBRITISH JOURNAL OF HAEMATOLOGY, Issue 2 2000Athanasios B.-T. Immunosuppressive therapy, routinely given after allogeneic transplantation to modulate graft-versus-host disease (GVHD) may have an adverse effect on the graft-versus-tumour (GVT) effect. Twelve patients with high-risk haematological malignancies were given cyclophosphamide, total body irradiation and antithymocyte globulin followed by peripheral blood stem cell grafts from HLA-identical siblings without prophylactic immunosuppression. At the earliest clinical evidence of GVHD, patients were treated with high-dose solumedrol and tacrolimus. Prompt haematological recovery [absolute neutrophil count (ANC) >,1·0 × 109/l] was observed (median time 9 d). All patients developed grade III,IV GVHD (median onset 9 d), involving the skin (11), intestine (five) and liver (three). Of nine evaluable patients, seven developed chronic GVHD [extensive (six), limited (one)]. Six patients died 1,6·5 months after transplantation. Three patients died from treatment-related complications, two from acute GVHD and one from relapsing disease. The remaining six patients are alive 5,26 months after transplantation, five in complete remission and one myeloma patient in very good partial remission. In conclusion, omission of post-transplantation GVHD prophylaxis is feasible, does not lead to graft failure or a high incidence of uncontrollable GVHD and appears to be associated with encouraging clinical responses in a group of patients with high-risk disease features. [source] Influence of disease features on adherence to prophylactic migraine medicationACTA NEUROLOGICA SCANDINAVICA, Issue 6 2008M. Linde Objectives,,, Randomized controlled trials of prophylactic treatments for migraine focus on the effects in an ideal situation and underestimate the impact of non-adherence, which in this study was examined in a natural setting. Materials and methods,,, A sample of 174 adult migraineurs with a current prescription of pharmacological prophylaxis were consecutively recruited at a specialist clinic. Logistic regression analysis was performed to analyse the association between adherence (self-reported with the Medication Adherence Report Scale) and number of years with migraine, frequency of attacks, number of days with migraine per month, attack duration, presence of cardinal features, mean intensity of pain, and recovery between attacks. Results,,, One third (35%) were non-adherent. Neither demographic characteristics nor any of the disease specific variables were significantly associated with adherence. Conclusion,,, Characteristics of the disease per se did not predict non-adherence which was also observed among patients with severe migraine. The full benefit of drugs cannot be realized at currently achieved levels of adherence. [source] Primary tumour diameter as a risk factor for advanced disease features of differentiated thyroid carcinomaCLINICAL ENDOCRINOLOGY, Issue 2 2009Frederik A. Verburg Summary Objective, To study the relationship between primary tumour size and the risk of advanced disease features (multifocal or locally invasive disease, lymph-node or distant metastases) in differentiated thyroid carcinoma (DTC). Design, A retrospective chart review study. Patients, The study sample comprised 935 papillary (PTC) and 291 follicular thyroid carcinoma (FTC) patients treated in our hospital from 1978 to 2007. Measurements, Kaplan,Meier analyses and log-rank tests were performed to calculate tumour size-adjusted cumulative risk of advanced disease features. Results, Accounting for primary tumour diameter, there were no significant differences in cumulative risks of multifocal carcinoma (P = 0·12) or distant metastases (P = 0·49) between PTC and FTC. PTC showed higher cumulative risks of local invasion (P < 0·0001) or lymph-node metastases (P < 0·0001). The cumulative risk of tumour multifocality increased 5%/cm of primary tumour diameter. The cumulative risk of local invasion or lymph-node metastases in PTC and of distant metastases in DTC increased exponentially at a threshold tumour diameter of 10 mm. In FTC, lymph-node metastases are associated almost exclusively with primary tumours showing extrathyroidal growth. Conclusions, Starting with a 1 cm primary tumour diameter, increasing tumour size is associated with an exponentially increasing risk of local invasion or lymph-node or distant metastases of DTC. The current classification of carcinomas < 2 cm as T1 is therefore questionable. [source] Explanatory models in the interpretations of clinical features of dental patients within a university dental education settingEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 1 2002Gerardo Maupome Clinicians may acquire biased perceptions during their dental education that can affect decisions about treatment/management of dental decay. This study established explanatory models used by students to interpret clinical features of patients. It employed a stereotypical dental patient under standardised consultation conditions to identify the interpretation of oral health/disease features in the eyes of student clinicians. The study aimed to establish the perceptions of the patient as a client of the university dental clinic, as seen through the ideological lens of a formal Dental Education system. The discourse during simulated clinical consultations was qualitatively analysed to interpret values and concepts relevant to the assessment of restorative treatment needs and oral health status. Three constructs during the consultation were identified: the Dual Therapeutic Realms, the Choices Underlying Treatment Options, and the High-Risk Triad. Comparing these discourse components, the Patient Factors of the Bader and Shugars model for treatment decisions supported the existence of a core set of themes. It was concluded that certain consultation circumstances influenced the adequacy of diagnostic strategies, mainly by introducing loosely defined but highly specific socio-cultural biases ingrained in the Dental Education concepts and diagnostic/treatment needs systems. [source] | ||||||||||