The Incidence of Corrected Hypercalcemia and Its Relationship with Prognosis for Chinese Multiply Myeloma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4903-4903
Author(s):  
Xi Zhang ◽  
Chunkang Chang ◽  
Xiao Li ◽  
Jiying Su ◽  
Lingyun Wu ◽  
...  

Abstract Abstract 4903 Purpose This paper is to study and analze the serum calcium level after corrected for serum albumin and its effect on prognosis in Chinese multiple myeloma (MM). Methods Serum calcium levels before and after corrected by serum albumin were retrospectively analyzed in 165 Chinese multiple myeloma patients. Corrected serum calcium (mmol/L)=serum calcium (mmol/L) – 0.025 x serum albumin (g/L)+1.0 (mmol/L). We also analyzed the relationship of serum calcium, serum creatinine and disease categories in Durie-Salmon (DS) staging system with patients' long-term overall survival rate. Results In 165 patients, the incidences of before and after corrected hypercalcemia were 8.7% and 40.6%, which were statistically significantly different (p=0.0245). Based on DS staging, the before and after corrected serum calcium levels of sixteen MM patients in I stage were 2.316±0.082 mmol/L and 2.344±0.073 mmol/L with a p value equal to 0.3236; the before and after correccted serum calcium levels of fifty MM patients in II stage were 2.314±0.17 and 2.407±0.235 mmol/L with a p value equal to 0.0251; the before and after corrected serum calcium levels of ninety-nine MM patients in II stage were 2.428±0.32 and 2.671±0.309 mmol/L with a p value equal to 0.0000. There is no significant difference in overall survival time between normal serum calcium group and elevated serum calcium group, p=0.8929. There is significant difference in overall survival time between normal serum creatinine patients and raised serum calcium patients with a p value equal to 0.0170. Patients in I stage in DS staging system have statistically significant longer overall survival time than those patients in II/III stage in DS staging system, p=0.0382. Conclusion The incidence of corrected hypercalcemia in Chinese MM is similar to foreign reports. Hypercalcemia has smaller or limit impact on patients' long-term overall survival compared to serum creatinine and DS staging. Disclosures No relevant conflicts of interest to declare.

2020 ◽  
Vol 48 ◽  
Author(s):  
Lucas Cavalli Kluthcovsky ◽  
Bruna Fernanda Firmo ◽  
Pedro Carvalho Cassino ◽  
Andrigo Barboza De Nardi ◽  
Jorge Luiz Costa Castro ◽  
...  

Background: Mast cell tumors (MCT) are among the most common malignant cutaneous neoplasm in dogs with variable biologic behavior and remain a therapeutic challenge in high-grade cases. Surgery remains the primary treatment for canine MCT; however, chemotherapy and radiation therapy are commonly used to treat aggressive cases. The combination of vinblastine (VBL) at a dose of 2 mg/m² and prednisone is the classically described protocol for MCT treatment. Studies have shown the safety of higher VBL doses for dogs with MCT, but there is a lack of information regarding dose intensity and outcome as a goal after chemotherapy.   This study aimed to evaluate the impact of a higher dose of VBL on MCT treatment outcome.Materials, Methods & Results: This was an observational and comparative study conducted in two different Veterinary Teaching Hospitals. Client-owned dogs with histopathological diagnosis of grade II or III MCT were selected and underwent at least four chemotherapy sessions with VBL and prednisone. The experimental group (EG) consisted of 18 dogs that received a dose of 3 mg/m² VBL treated in one institution. The control group (CG) included 31 dogs that received a dose of 2 mg/m² VBL treated at the other institution. All dogs treated in both groups had a clinical and complete blood count (CBC) evaluation performed previous the start of chemotherapy (T0) and before each weekly treatment (T1, T2, T3, and T4). After treatment, dogs in both groups were followed-up for the recurrence rate and overall survival time after diagnosis. There was no significant difference in clinical variables between EG and CG. During treatment, dogs of EG showed a significant reduction in erythrocyte, hemoglobin, and hematocrit values between T0 and T1, T2, T3, and T4 (P < 0.001). Comparatively, the CG showed significant reduction in hemoglobin (P = 0.02) and total leucocytes (P = 0.001) values in the same period. Despite these findings, these hematological parameters did not exceed the lower limit for the species in both groups. There was a higher-grade neutropenia one week after the first VBL application (T2) in both groups, with no statistical difference in neutrophil counts at T2 or during the whole treatment. There were discrete and self-limited episodes of anorexia, vomiting, and diarrhea in both groups. After chemotherapy, dogs in EG showed a significantly lower rate of recurrence than dogs in CG (P = 0.02). There was no significant difference in the overall survival time between groups.Discussion: The absence of significant differences in clinical variables (e.g. sex, age, histological grading, and tumor location) between EG and CG suggests that the groups may be similar regarding these parameters. All dogs included in this study had a recommendation for MCT post-operative chemotherapy treatment. VBL action is non-selective and anemia is not a commonly described adverse effect associated with its administration. Despite that, EG dogs exhibited a reduction in erythrocytes, hematocrit, and hemoglobin, and CG dogs in hemoglobin throughout T0 to T4. The highest number of neutropenia episodes occurred during T2, after the first VBL application in both groups with a trend of stabilization after T2, which is compatible with findings described in the literature. Any dog of EG or CG had to interrupt the treatment due to hematological or gastrointestinal toxicity or died during treatment. The role of VBL dose intensity in outcome is still debatable for dogs with MCT, once it is a multifactorial disease with variable presentation. In this study, there was no difference in overall survival time after diagnosis between groups, and EG dogs treated with a higher VBL dose showed significantly less tumor recurrence than CG.


2021 ◽  
Author(s):  
Jimmy Ming-Jung Chuang ◽  
Li-Han Lin ◽  
Meng-Hsiang Chen ◽  
Wei-Che Lin ◽  
Cheng-Hsien Lu ◽  
...  

Abstract Purpose Extensive resection probably confers a modest survival advantage in patients with glioblastoma. Studies have revealed the positive effects of intraoperative stimulation mapping (ISM) on the extent of resection, but no consensus for contribution of intraoperative stimulation mapping is reached. Methods This retrospective study enrolled two groups of patients who underwent surgery for motor-eloquent glioblastoma: the non-ISM group of 57 patients (surgery in 2008–2013) and ISM group of 13 patients (surgery in 2014–2015). The two groups and subgroups based on resection extent and postoperative additional neurological deficit were compared using Kaplan–Meier analysis and the log-rank test. Results Gross or near total resection (≥ 90% resection quality) was significantly more common in the ISM group than the non-ISM group (76.9% versus 24.6%; p = 0.001). The extent of resection was also significantly greater (90.5% ± 15.6% versus 64.6% ± 29.2%; p = 0.002). The neurological outcome in the ISM group was thus superior, but the two differences were not significant. The median progression-free survival time was significantly longer in the ISM group (22.0 ± 5.1 months vs 8.0 ± 1.0 months; p = 0.037) but a significant difference was not indicated in median overall survival time (22.0 ± 8.4 months vs 16.0 ± 2.2 months; p = 0.167). Conclusion ISM was discovered to lead to higher quality of resection and delayed recurrence. The neurological outcome and median overall survival time in the ISM group was thus superior, but the two differences were not significant. Trial registration number (for clinical trials) Nil


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4712-4712
Author(s):  
Carsten Schrader ◽  
Wolfram Klapper ◽  
Dirk Janssen ◽  
Paul Riis ◽  
Peter Meusers ◽  
...  

Abstract Gene expression profiles revealed that proliferation associated genes are important prognostic factors in the clinical outcome in mantle cell lymphoma (MCL). Beside this well accepted markers also analysis of apoptotic proteins are now under investigation. We investigated immunohistochemically the expression of the apoptotic marker NF-kB in relation to the clinical course in 89 patients enrolled in two multicenter prospective trials. Biopsies were recut and stained with mandatory antibodies (CD20, CD5, CD3, CD23, cyclin D1) and NF-kB. The NF-kB expression was analyzed in three groups: negative, cytoplasmatic positive and nuclear positive (more than 1/HPF). The expression was compared with the overall survival data analyzed according to Kaplan and Meier. In 13 cases a negative NF-kB staining was detected. Fifty-seven cases were positive only in the cytoplasma and in 17 cases more than 1 cell per high power field showed nuclear activity. Patients with mantle cell lymphoma that had negative and cytoplasmatic positive expression had a median overall survival time of 35.7 months compared to 22.4 months for patients with a nuclear NF-kB expression. The Kaplan-Meier analysis showed a significant difference in the overall survival time (p=0.0121). The immunohistochemical detection of NF-kB in mantle cell lymphoma is possible and a tool to identify patients with a poor prognosis.


Author(s):  
Halah Tarek Mohammed Mansour ◽  
Hamed Mohamed Mohamed Elsharkawy ◽  
Sahar Mohey Eldin Hazzaa ◽  
Mohammed Abd-Ellatif Nassar

Background: As a result of prematurity, Acute kidney injury (AKI) occurs commonly in preterm neonates and is associated with increased morbidity and mortality. (AKI) is defined as a rapid, potentially reversible deterioration in renal functions sufficient to result in accumulation of nitrogenous wastes in the body. Aim of the Study: the aim of this study was to determine whether preterm neonates who took caffeine citrate from the first day after birth were less likely to AKI within the first 7 days. Patients and Methods: This case control study was conducted on 100 preterm neonates at Neonatal Intensive Care Units (NICUS), Pediatric Department, Tanta University with gestational age less than (30 weeks) were grouped into group A and B. Group A 50 preterm neonates who received caffeine citrate from the first day after birth with dose (20 mg/kg) loading dose, and (5 mg/kg/dose) every 24hrs of maintenance dose, given as slow intravenous infusion over twenty to thirty minutes for a week. Group B 50 preterm neonates who did not receive caffeine citrate. Inclusion Criteria: all preterms <30 weeks admitted within first 24 hours after birth presented by respiratory distress according to Downes score. Exclusion Criteria: newborns with congenital heart disease except non-significant PDA, neonatal mortality < 48 h of life, clinical signs suggest chromosomal anomalies, newborns with congenital renal anomalies. Hematological Investigations: serum albumin, serum creatinine, blood urea. Urinary Investigations: measuring urine output. Results: There was a statistically significant difference between the two studied groups as regard serum creatinine in day (5,7) (p<0.001), urea in day 7 (p value <0.001), serum albumin in day (5,7) (p value ≤ 0.05), urine output in day (4,5,6,7) (p value ≤0.05), AKI incidence (p value <0.001). Conclusion: Caffeine Citrate administration in preterm neonates from the first day of life for one week was associated with reduced occurrence and severity of AKI.


2021 ◽  
Vol 11 (1) ◽  
pp. 4-8
Author(s):  
Amna Khan ◽  
Anila Farhat ◽  
Hamayun Anwar ◽  
Sajid Shamim ◽  
Mujeeb Ur Rehman ◽  
...  

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.


2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Ge Zhang ◽  
Wan-Li Liu ◽  
Lin Zhang ◽  
Jun-Ye Wang ◽  
Miao-Huan Kuang ◽  
...  

The indoleamine 2,3-dioxygenase-(IDO-) mediated microenvironment plays an important role in tumor immune escape. However, the inhibitory effects of IDO on the CD8+tumour-infiltrating lymphocytes (CD8+TILs) in esophageal squamous cell carcinoma (ESCC) have not been clarified yet. Here, we found that the level of IDO expression in ESCC tumor specimens correlated with a reduction in the number of CD8+TILs. Patients with high IDO expression and a low number of CD8+TILs had significantly impaired overall survival time. IDO expression and functional enzyme activity in ESCC cell lines could be induced by IFNγ. When exposed to the milieu generated by IDO-expressing Eca109 cells, the CD8+TILs were suppressed in proliferation, and their cytolytic functions against target tumor cells were lost. These results suggested that impairing CD8+TIL functions by IDO expressed in ESCC possibly contributed to the finding that patients with higher IDO expression have more aggressive disease progression and shorter overall survival time.


2020 ◽  
Vol 8 (4) ◽  
pp. 416
Author(s):  
Anita Liliana ◽  
Melania Wahyuningsih

Abstract Adequacy of milk production in the newborns will affect the success of exclusive breastfeeding. Not all postpartum mothers are able to increase milk production in the postpartum period. Acupressure at the meridian points is one way to increase milk production in postpartum mothers. This study aims to determine the effect of acupressure therapy on increasing breast milk production in postpartum mothers at PKU Muhamadiyah Bantul. This study was a quantitative study  a quasi-experimental research design with pre-test and post-test nonequivalent control group. The number of respondents in each group was 17 people. The treatment given was acupressure at the meridian points for 5 minutes on days 2 and 3of poatpartum. Breastfeeding adequacy was assessed before treatment and on day 4 postpartum. Data were analyzed by Mc Nemar analysis. The results showed that there was a significant difference in breast milk production before and after acupressure with p value of 0.000 (p value <0.05). There was a significant difference in breast milk production in the control group before and after being given the breastfeeding technique leaflet p value 0.001 (p value <0.05). Conclusion: There is no significant difference in breast milk production after being given acupressure and after being given leaflets about breastfeeding techniques at PKU Muhamadiyah Bantul p value 0.100 (p value> 0.05).  Keywords: acupressure, breast milk production, postpartum


2020 ◽  
Vol 1 (2) ◽  
pp. 22-29
Author(s):  
Yulni Yulni ◽  
Veni Hadju ◽  
Burhanuddin Bahar ◽  
Citrakesumasari Citrakesumasari ◽  
Rahayu Indriasari ◽  
...  

The aim of this study was to determine the effect of Moringa oleifera leaf extract supplements, Moringa oleifera leaf extract plus royal jelly and placebo on hemoglobin levels in anemic pregnant women. This research is a randomized controlled double blind design study which was conducted in Polombangkeng Utara District, Takalar Regency for 2 months. The subjects of this study were pregnant women with anemia, the majority of which were 20-35 years old, primigravida parity, income less than UMR, unemployment, higher education, pregnancy distance of more than 2 years with p value> 0.05. Then divided into three groups, namely Moringa capsules plus royal jelly (KRJ) (n = 24), Moringa capsules (KTR) (n = 24) and placeco (PLC) (n = 21). Before and after the intervention, measurements of hemoglobin levels were carried out using the Hemocue tool and interviewing the characteristics of the respondents. The results showed that the average Hb level increased from each group (mean SD): KRJ 10.06 ± 0.75 to 11.42 ± 1.23, P = 0.001, KTR 10.40 ± 0.46 to 11.15 ± 0 , 90 P = 0.001 and PLC 10.43 ± 0.42 becomes 11.14 ± 0.88 P = 0.002. but there was no significant difference from the difference in the average increase in Hb levels in the three groups, but there was a tendency that KRJ was superior to the KTR and PLC groups with an increase of 1.36 gr / dl, KTR 0.75 gr / dl and PLC 0.71 gr / dl. So it can be concluded that KRJ is better than KTR and PLC in increasing Hb levels in anemic pregnant women in Takalar Regency.


2017 ◽  
Vol 8 (2) ◽  
pp. 134-145
Author(s):  
Wiena Arynda ◽  
Rosmida M Marbun

In Indonesia, 93.5% of the population aged ≥10 years still consume less fruits and vegetables 5 servings per day for 7 days a week (RISKESDAS, 2013).  The preliminary study conducted at SDN Mekarjaya I shows that the level of knowledge of school children about vegetables and fruits by 60% is still low and 93.3% of vegetable and fruit consumption is still lacking. In addition, SDN Mekarjaya I has never been used as a place of prior research. Therefore, it is necessary to conduct research on the knowledge of fruit vegetables in the fourth grade students of SDN Mekarjaya I. One of them is by doing counseling with the media of puzzle game. This research was conducted to know the increase of knowledge about vegetables and fruits before and after given counseling with puzzle game media in fourth grade students of SDN Mekarjaya I. This research was conducted by Pre-exsperiment method using "One group pretest and posttest" research design. Sampling by purposive sampling is 66 people. The statistical test used is paired sample t-test. Based on the results of the analysis shows that there is a significant difference of knowledge where p-value 0.000 or p <0,05 means there is a meaningful difference between before and after given counseling with puzzle game media.This puzzle game media can be developed by the teachers as a medium of learning in the classroom so that students are more motivated in following the learning process and make students do not feel bored


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