Pre-Engraftment Syndrome After Myeloablative Umbilical Cord Blood Transplantation: Risk Factors and How To Stratify

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5482-5482
Author(s):  
Zimin Sun ◽  
Maojing Guan ◽  
Huilan Liu ◽  
Liangquan Geng ◽  
Xingbing Wang ◽  
...  

Abstract Introduction Pre-engraftment syndrome (PES) is a group of symptoms occurred after hematopoietic stem cell transplantation especially unrelated cord blood transplantation(UCBT) before the engraftment, including unexplained fever higher than 38.3°CAunexplained erythematous skin rashAdiarrheaAhepatic dysfunction Anon-cardiogenic edemaApulmonary infiltrates and weight gain. Severe PES can be fatal, however there’s no criteria to define it. We retrospectively analyzed the incidence, risk factors, manifestations and clinical outcomes of PES in CBT recipients, who had been treated for hematologic malignancies. All patients received TBI(12GY)/Ara-c(8g/ m2)/CY(120mg/kg) without ATG or Flu(120mg/ m2)/Ara-c(8g/ m2)+BU(12.8mg/kg)+CY (120mg/kg) myeloablative conditioning. Methods From April 2010 to July 2011, 61 patients underwent UCBT at our transplantation center and 40 patients(65.6%) developed PES at a median of 7 d (range 5–13) post-transplant. We analyze 8 factors related to treatment-related mortality (TRM) within 180 days : occurrence timeAthe maximum temperatureAclinical symptomsAconcentration of CyclosporinAthe initial dose of MPAmethylprednisolone (MP) effective daysAdays till MP reduced and reoccurrence after symptoms under control. Univariate analysis identified early occurrence time( day +5 or +6 ) AMP effective days and clinical symptoms as significant risk factors for higher TRM. In a multivariate analysis, we found these three factors are independent and have no interactions. We retrospectively analyze all the patients who developed PES from April 2010 to December 2012. Results There were 94 cases and we scored them based on these three factors. The patient got one score for each factor if he/she got a fever on day 5-6 after UCBT or had more than two clinical symptoms or not under control after 7 days of MP. We added the three scores together and divide the patients into four groups according to the total score(zero for Group 1Aone score for Group 2Atwo score for Group 3Athree for Group 4). The number of patients for Group 1-4 was 32A32A18 and 12. There is a significant difference for the TRM within 180 days between Group 4(58%) and Group 1(18.7%)AGroup 2(22.2%) (P<0.01). The TRM of Group 4 in one year is 66.7%, which is significantly higher than Group 1( 22.7%), Group 3(22.2%) (P<0.01), but shows less significant difference compared with TRM of group 2, which is 33%. The relapse rate of one year for each group from 1 to 4 was 9%A16.7%A5.5%A8.3%. The probability of one-year disease-free survival (DFS) was much higher in Group 1 (71.7%) and 3(72.2%) than Group 4(25%) (P<0.01). The difference was apparent as to the probability of one-year overall survival (OS) between Group 1 (74.8%) and 4(25%), the same is true whith Group 3 (71.3%) and 4(25%). The difference between Group 2(55.4%) and Group 4 was not clearly significant (P=0.06). Conclusions Recognizing and treating immediately severe PES will significantly reduce the TRM of UCBT. Our analyze confirmed that these three factors are crucial to define severe PES .We therefore put forward this ranking method to help to diagnosis and take effective treatment. Disclosures: No relevant conflicts of interest to declare.

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.


2020 ◽  
Vol 28 (3) ◽  
pp. 460-466
Author(s):  
Berkan Özpak

Background: In this study, we present one-year results of drug-eluting balloon treatment of femoropopliteal in-stent restenosis. Methods: A total of 62 patients (48 males, 14 females; mean age 64.2±9.1 years; range, 54 to 81 years) who underwent drug-eluting balloon stenting for femoropopliteal in-stent restenosis between August 2013 and October 2017 were included in the study. The patients were classified into three groups based on the narrowing length of stenosis in the stents. Group/Class 1 (n=17): narrowing <1/2 of the stent length; Group/Class 2 (n=22): narrowing >1/2 of the stent length, not totally occluded; and Group/Class 3 (n=23): totally occluded. In-stent restenosis was treated with drug-eluting balloon treatment. Results: There was a significant difference among all classes in terms of in-stent restenosis. The length of stenosis was a predictor for in-stent restenosis. The mean stent length was 107.7±24.6 mm in Group 1, 164.6±17.9 mm in Group 2, and 180±19.3 mm in Group 3. For non-occluded in-stent restenosis, restenosis rate at one year after balloon angioplasty was 47.1% in Group 1, 86.4% in Group 2, and 95.7% in Group 3. Femoropopliteal bypass was performed in five patients in whom treatment failed. None of the patients required amputation. Conclusion: The length of in-stent restenosis in the femoropopliteal arterial stents is an important predictor for recurrent stenosis, when re-flow is achieved with drug-eluting balloons.


Phlebologie ◽  
2015 ◽  
Vol 44 (01) ◽  
pp. 13-17
Author(s):  
J. Duben ◽  
J. Gatek ◽  
T. Saha ◽  
G. Hnatkova ◽  
L. Hnatek

SummaryIntroduction: During the last years, many endovascular techniques have been developed in order to eliminate not only the reflux in stem veins but in perforating veins and their tributaries, too.Aim: The aim of this study was to use endo -vascular RFITT and the foam sclerotherapy for the occlusion of perforating veins as the prime source of reflux and their tributaries.Material and Methods: The Celon method was used for the thermal treatment. Polydocalon with the concentration 1% and 2% with DSS technique was used for the foam sclerotherapy. The RFITT was accomplished in 127 perforating veins in total. This group was divided into three subgroups. The first one consists of patients where only RFITT was carried out (n= 41), in the second, there were patients with RFITT realized with sclerotherapy during one session (n= 48), in the third, RFITT was completed with sclerotherapy in one month after the RFITT intervention (n= 38). The control group included perforating veins treated only with sclerotherapy (n= 81). The power setting 6W was used on the generator during the RFITT with CelonProSurge micro and 18W for usage of Celon ProCurve probe.Results: The effectiveness of the procedure in the group 1 was 8.8%, in the group two 93.7%, in the group three 92.1% and in the control group 76.5% in one year follow up. There was no significant difference between the effectiveness in groups 1, 2 and 3. The marginal difference was among all three groups with RFITT and the control group. Significant differences were in the parameter of the extinction of visible varicose veins with the reflux from perforators. The extinction was faster in group 3 than in group 2 and in the control group and the slowest was in group 1. The significant difference was observed between groups 2 and 3 compared with group 1 and the margin difference was between groups 2 and 3 compared with the control group. No significant difference was observed between groups 1 and the control group.Conclusions: All procedures are effective. The most important is the combination of RFITT and the sclerotherapy one month after thermal intervention. This is associated with a low risk of recanalization and the fastest extinction of visible varicose veins.


2021 ◽  
Vol 14 (4) ◽  
pp. 1508-1513
Author(s):  
Ibraheem F Alshiddi

In order to assess the influence of finishing and polishing on the surface brightness and color stability of the ceramic veneer, fifty specimens were fabricated with 10 mm diameter and 2 mm thickness using IPS E-Max Ceramic. After glazing, 10 specimens were untouched as control group, and the other 40 specimens were abraded using 125µm diamond bur to create surface roughness. Forty specimens were divided into four groups (n=10), in group 1: specimens were finished using diamond point, in group 2 specimens’ surface was polished with a polishing kit, Group 3: Each specimen surface was polished with the polishing kit as in protocol 2 and was polished a polishing past and group 4 Each specimen was glazed by heating at 621℃ for 3 minutes followed by a temperature increase of 83℃/min up to 918℃ for 30 seconds. Color measurement was performed using spectrophotometer. Color stability data were analyzed using two-way ANOVA and Tukey’s HSD test (α=0.05). For Ra values, paired-samples t-tests were used to analyze the data and compare groups. The change in L and E showed a significant difference among the study groups; (group 1, group 2, group 3 and group 4) with respect to three variables L, a and b. A significant difference was noted when compared each group with the control; however, only group 2 showed a significant difference from group 4; the remaining groups demonstrated similar findings for all three variables. The study displayed a significant impact of the finishing and polishing technique on the surface brightness and color stability of ceramic restoration. However, it was evident that combination of two or three polishing techniques which includes polish kit and glaze enhances the surface finish and adds color stability by alternating the yellow – blue axis (increase in b) and red- green axis (decrease in a).


2019 ◽  
Vol 5 (2) ◽  
pp. 156-160
Author(s):  
Md Mahboob Morshed ◽  
Md Joynul Islam ◽  
ATM Ashadullah ◽  
Khondker Shaheed Hussain ◽  
Mohammad Ahtashamul Haque

Background: Different risk factors may be related with the haemoglobin and CRP level among the acute coronary syndrome patients. Objective: The purpose of the present study was to see the association of haemoglobin and CRP level with different type of risk factors among the acute coronary syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Age, cardiovascular risks factor, history, family history of cardiovascular disease, treatment history and ECG were taken during admission. Blood sample was collected for baseline laboratory investigations like Troponin-I, Random Blood Sugar (RBS), Blood urea, Serum creatinine, lipid profile, Hemoglobin & CRP level. Sample were then send to standard laboratory/Biochemistry department of MMCH. Result: The mean age of the population was 52.18±8.88 years. Smoking was the highest percentage in Group 1 which was 54(50.0%) cases (P=0.001). Hypertension was found most common in group 1 (47.6%), Group 2 (33.3%), Group 3 (10.7%) and Group 4 (8.3%). Smoking (p=0.001) and hypertension (p=0.016) was found statistically significant. Diabetes was found in Group 1 (37.7%), Group 2 (43.5%), Group 3 (11.6%) and Group 4 (7.2%). Group 1 (50%) and Group 2 (50%) patients were dyslipidaemic. Family history of IHD was present group-1 (36.8%), Group 2 (44.7%), Group 3 (73.2%) and Group 4 (53%). Among the smoker patient 65.6% cases had CRP level ˃12 mg/l; 39.8% cases had CRP level ˂12mg/L. Among the nonsmoker 34.4% cases had CRP level ˃12mg/l and 60.2% cases had CRP level ˂12mg/L. The finding was statistically significant. Conclusion: In conclusion haemoglobin and CRP level is associated with different type of risk factors among the acute coronary syndrome patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 156-160


Author(s):  
Abdurrahman Pirinç ◽  
Abdullah Özbilgin ◽  
Oğuzhan Kahraman ◽  
Esad Sami Polat

In this study, nutritional values of silages made from seed pumpkin residues were investigated. Pumpkin residues collected from Konya region were put into silo in vacuum sacks with various additives. As additives, straw, inoculant containing lactic acid bacteria or a mixture of both in certain proportions were used. After the silos were opened, their pH was determined and then samples were taken to determine the essential fatty acid compositions and nutrient analyses were done. Natural pumpkin (Group 1), natural pumpkin + inoculant (100ppm) (Group 2), withered pumpkin + 15% straw (Group 3), withered pumpkin + 15% straw + inoculant (100ppm) (Group 4) such that the fourth group is formed. Dry matter values of pumpkin groups are Group 1 7.89%, Group 2 6.62%, Group 3 12.22% and Group 4 12.25% respectively. Their pH is 3.78 in Group 1, 3.71 in Group 2, 3.86 in Group 3 and 3.82 in Group 4. The crude protein ratio in the experimental groups was determined in the highest Group 2 (14.97%) and the lowest in Group 3 (10.56%). NDF rate was determined in the highest group 4 (49.74%) and the lowest in Group 2 (28.51%). In addition, the highest ADF rate was determined in Group 4 (37.91%) and the lowest in Group 2 (24.90%). There was a statistically significant difference between the research groups in terms of ethanol content. Acetic acid and propionic acid content was found statistically significant between groups. As a result, when the pumpkin residues are silaged, it can be used as feed material in animal feeding. In addition, it can be said that pumpkin residues can be evaluated in different areas in the high amount of Ethanol content resulting from silage production.


2011 ◽  
Vol 69 (2b) ◽  
pp. 365-370 ◽  
Author(s):  
J Bustamante ◽  
M Socolovsky ◽  
R S Martins ◽  
J Emmerich ◽  
M G Pennini ◽  
...  

Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model. METHOD: Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test. RESULTS: The mean motor latency for the simple suture (2.27±0.77 ms) was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms). Similar values were founding in both group 1 (2.66±0.71 ms) and group 3 (2.64±0.6 ms). When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048). CONCLUSION: Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures.


Author(s):  
Mine ARGALI DENIZ ◽  
Hilal ER ULUBABA ◽  
M. Furkan ARPACI ◽  
Fatih CAVUS ◽  
Gokhan DEMIRTAS ◽  
...  

Objective: In this study, the effect of tracheal diverticula (TD) on chest anthropometry and its relation with chronic obstructive pulmonary disease (COPD) was evaluated. Method: Between January 2019 and March 2020, 995 patients who underwent chest CT were retrospectively analyzed and TD was detected in 31 cases. Group 1 is only TD, Group 2 is TD + COPD, Group 3 is only COPD, Group 4 is defined as control group. We measured the localization, size, the distance to carina and vocal cord of TDs. In all groups chest diameters at T4 and T9 levels were measured as transverse and vertical plans. Results: TDs detected mostly at the T2 and T3 levels. In Group 1 and Group 2, there was a statistically significant difference the distance to TD of vocal chords. A statistically significant difference was found between Group 1 and Group 3 only in the vertical diameter at the T4 and T9 levels. Conclusion: We observed that COPD effect TD location and also TD had opposite effect on anteroposteriorly increasing chest parameters in COPD. Precence of TD is essential on COPD patients about thorax anthropometry. Keywords: Tracheal diverticulum; antropometry; radiology; COPD; chest diameter


2012 ◽  
Vol 3 (2) ◽  
pp. 166-170
Author(s):  
Carla Zogheib ◽  
Etienne Medioni

ABSTRACT Forty-eight extracted maxillary anterior teeth instrumented with ProTaper system to apical preparations 0.25, 0.40 and 0.60 mm (n = 16 each) were divided into six groups for filling as following: Group 1: Apical preparation 25/100 + gutta-percha/AH Plus sealer, group 2: Apical preparation 25/100 + Resilon/Real Seal, group 3: Apical preparation 40/100 + gutta-percha/AH plus sealer, group 4: Apical preparation 40/100 + Resilon/Real Seal, group 5: Apical preparation 60/100 + gutta-percha/AH plus, group 6: Apical preparation 60/100 + Resilon/Real Seal. All teeth were filled using the warm vertical technique. Horizontal sections at 1, 2 and 3 mm from the apex were observed by SEM under 200 × magnification. Sections were digitally photographed under a stereomicroscope and the images were transferred to a compatible PC for image analysis. The surface area of voids were calculated and compared at all levels; using the Kruskal-Wallis test with Sidak correction and Mann-Whitney U test (p > 0.05). Comparisons within each group (gutta-percha/AH plus and Resilon/Real Seal) showed the presence of voids but there was no significant difference between any level of sectioning for apical preparations of 25 and 40 (p > 0.05). The only difference was in the groups prepared to size 60 and filled with Resilon/ Real Seal which showed significantly more voids than the group filled with gutta-percha/AH plus and especially at the 3 mm level. Conclusion The system Resilon/Real Seal did not achieve better results in terms of sealing ability in the apical third when compared to the conventional gutta-percha/AH plus sealing system. How to cite this article Zogheib C, Naaman A, Medioni E. Evaluation of Apical Filling after Warm Vertical Compaction using Two Different Endodontic Materials: Resilon® and Gutta-Percha. World J Dent 2012;3(2):166-170.


Stanovnistvo ◽  
2016 ◽  
Vol 54 (1) ◽  
pp. 1-14
Author(s):  
Zeljka Buturovic ◽  
Suzana Ignjatovic ◽  
Mirjana Rasevic

Many studies have looked at benefits of breastfeeding for the baby and, less frequently, the mother. Though many women find breastfeeding difficult, few studies have looked at the potential costs of breastfeeding for this group. From January 19th 2015 through April 18th 2015, the total of 1,980 Serbian mothers completed an on-line survey consisting of 74 questions which addressed their satisfaction with various areas of life. Mothers were divided into four groups depending on their breastfeeding experience: those who enjoy breastfeeding (Group 1), those who breastfeed despite finding it difficult (Group 2), those who do not breastfeed because they find it difficult, but otherwise would (Group 3) and those who do not breastfeed because ?it is their choice? (Group 4). There were 1,238 women (53.2%) in Group, 1, 546 (23.4%) in Group 2, 147 (6.3%) in Group 3 and 49 (2.1%) in Group 4. Group 2 scored lower than Group 1 on 25 out of 26 indicators of satisfaction. When these 26 indicators were averaged, there was a significant difference in the average scores between Group 1 (M = 6.87, SD = 1.10) and Group 2 (M = 6.33, SD = 1.20). Group 3 scored higher than Group 2 on 19 out of 26 indicators. There is a remarkably consistent difference in satisfaction across many areas of life between women who breastfeed joyfully and those who do it out of a sense of duty. As public pressure on women to breastfeed mounts, distinction between these two kinds of breastfeeding experiences should be kept in mind.


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