Biomedical subjects

Haq Nawaz

Publications and source records attributed to Haq Nawaz.

At least 19 recordsLinked to original sources

PubMed2006

Studies on sildenafil citrate (Viagra) interaction with DNA using electrochemical DNA biosensor.

The interaction of sildenafil citrate (Viagra) with DNA was studied by using an electrochemical DNA biosensor. The binding mechanism of sildenafil citrate was elucidated by using constant current potentiometry and differential pulse voltammetry at DNA-modified glassy carbon electrode. The decrease in the guanine oxidation peak area or peak current was used as an indicator for the interaction in 0.2M acetate buffer (pH 5). The binding constant (K) values obtained were 2.01+/-0.05 x 10(5) and 1.97+/-0.01 x 10(5)M(-1) with constant current potentiometry and differential pulse voltammetry, respectively. A linear dependence of the guanine peak area or peak current was observed within the range of 1-40 microM sildenafil citrate with slope=-2.74 x 10(-4)s/microM, r=0.989 and slope=-2.78 x 10(-3)microA/microM, r=0.995 by using constant current potentiometry and differential pulse voltammetry, respectively. Additionally, binding constant values for sildenafil citrate-DNA interaction were determined for the pH range of 4-8 and in biological fluids (serum and urine) at pH 5. The influence of sodium and calcium ions was also studied to elucidate the mechanism of sildenafil citrate-DNA interaction under different solution conditions. The present study may prove to be helpful in extending our understanding of the anticancer activity of sildenafil citrate from cellular to DNA level.

Biosensing Techniques↗

PubMed2006

Repeated serum lipid measurements during the peri-hospitalization period.

The early treatment of hyperlipidemia in hospitalized patients confers potential benefit, yet total cholesterol is known to vary with acute illness, often delaying treatment decisions. A prospective study was conducted of 61 patients (mean age 57 years; 49% women) admitted to an acute care community hospital with various diagnoses with random nonfasting lipid profile measurements at admission, followed by second fasting lipid profile measurements on day 3 of hospitalization or upon discharge (whichever occurred first), and final fasting lipid profile measurements 4 weeks after discharge. All individual values of the lipid profile decreases at discharge, whereas the ratios of total cholesterol to high-density lipoprotein (HDL) and of low-density lipoprotein (LDL) to HDL did not change significantly. The 95% confidence interval around the total cholesterol/HDL ratio for each patient was within the same National Cholesterol Education Program Adult Treatment Panel III treatment recommendation category 42.6% of the time, whereas corresponding intervals for total cholesterol and LDL were within a single treatment category only 6.6% of the time. The total cholesterol/HDL ratio was significantly more consistent with regard to treatment implications than LDL or total cholesterol (p <0.0001). In conclusion, serum lipid values vary significantly during and after a hospital stay, whereas the ratio of total cholesterol to HDL remains relatively stable. This ratio may therefore serve as a more reliable basis for early treatment decisions in dyslipidemia.

Adult↗

PubMed2006

Electrochemical DNA biosensor for the study of ciprofloxacin-DNA interaction.

The interaction of ciprofloxacin with DNA was studied by using an electrochemical DNA biosensor. The binding mechanism of ciprofloxacin was elucidated by using constant current potentiometry and differential pulse voltammetry at DNA-modified glassy carbon electrode. The decrease in the guanine oxidation peak area or peak current at +0.9 V was used as an indicator for the interaction mechanism in 0.2M acetate buffer (pH 5). The binding constant (K) values obtained were 1.33+/-0.02 x 10(4) and 1.32+/-0.08 x 10(4) M(-1) with constant current potentiometry and differential pulse voltammetry, respectively. A linear dependence of the guanine peak area or peak currents was observed in the range of 40-80 microM ciprofloxacin, with a detection limit of 24 microM with r=0.995 and 9 microM with r=0.999 by using constant current potentiometry and differential pulse voltammetry, respectively. Moreover, the influence of sodium and calcium ions was also studied to elucidate the mechanism of ciprofloxacin-DNA interaction at different solution conditions, and this proved to be helpful in understanding the ciprofloxacin-DNA interaction.

Anti-Bacterial Agents↗

PubMed2006

Acute health effects of the Tasman Spirit oil spill on residents of Karachi, Pakistan.

BACKGROUND: On July 27 2003, a ship carrying crude oil ran aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasman Spirit on residents of the affected coastline in Karachi, Pakistan. METHODS: We conducted a study consisting of an exposed group including adults living in houses on the affected shoreline and two control groups (A and B) who lived at the distance of 2 km and 20 km away from the sea, respectively. We selected households through systematic sampling and interviewed an adult male and female in each household about symptoms relating to eyes, respiratory tract, skin and nervous system, smoking, allergies, beliefs about the effect on their health and anxiety about the health effects. We used logistic regression procedures to model each symptom as an outcome and the exposure status as an independent variable while adjusting for confounders. We also used linear regression procedure to assess the relationship exposure status with symptoms score; calculated by summation of all symptoms. RESULTS: Overall 400 subjects were interviewed (exposed, n = 216; group A, n = 83; and group B, n = 101). The exposed group reported a higher occurrence of one or more symptoms compared to either of the control groups (exposed, 96% vs. group A, 70%, group B 85%; P < 0.001). Mean summary symptom scores were higher among the exposed group (14.5) than control group A (4.5) and control group B (3.8, P < 0.001). Logistic regression models indicated that there were statistically significant, moderate-to-strong associations (Prevalence ORs (POR) ranging from 2.3 to 37.0) between the exposed group and the symptoms. There was a trend of decreasing symptom-specific PORs with increase in distance from the spill site. Multiple linear regression model revealed strong relationship of exposure status with the symptoms score (beta = 8.24, 95% CI: 6.37-10.12). CONCLUSION: Results suggest that the occurrence of increased symptoms among the exposed group is more likely to be due to exposure to the crude oil spill.

Adolescent↗

PubMed2006

Immunohistochemical localization of G protein betagamma subunits in the lateral wall of the rat cochlea.

The role of G protein-mediated signal transduction in the production of endolymph, an extracellular fluid of unusual ionic composition, is beginning to be understood. The identity of Galpha subunits in the stria vascularis and the spiral ligament of the lateral wall of the cochlear duct is well established. However, little is known about the presence of betagamma subunits. This study used immunohistochemistry to investigate the distribution of G protein betagamma subunits in the lateral wall of the cochlea. Temporal bones of 6- to 8-week-old rats were fixed in 4% paraformaldehyde and 0.1% glutaraldehyde and processed for embedding in paraffin wax. The dewaxed, midmodiolar sections of the cochlea were incubated with subunit-specific polyclonal antibodies. The results show that the pattern of immunoreactivity varies for the G protein beta1-4 and gamma1-3, 5 and 7 subunits in the stria vascularis and spiral ligament. In the stria vascularis, immunoreactivity was detected for beta2, beta3, beta4, gamma1, gamma2 and gamma7 subunits. All five types of fibrocytes in the spiral ligament exhibited positive staining for gamma2 and gamma7. However, immunoreactivity for beta1-4 subunits was variable. Immunoreactivity for gamma3 and gamma5 subunits was not detected in the lateral cochlear wall. The expression pattern of G protein betagamma subunits in lateral wall provides a basis for interpreting the functions of G protein-coupled receptors in cochlear fluid homeostasis.

Animals↗

PubMed2005

Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: a report on recommendations of the Task Force on Community Preventive Services.

Reducing morbidity and mortality related to overweight and obesity is a public health priority. Various interventions in school and worksite settings aim to maintain or achieve healthy weight. To identify effective strategies for weight control that can be implemented in these settings, the Task Force on Community Preventive Services (Task Force) has conducted systematic reviews of the evidence on nutrition, physical activity, combinations of these interventions, and other behavioral interventions (e.g., cognitive techniques such as self-awareness and cue recognition). Task Force recommendations are based on evidence of effectiveness, which is defined in this report as achieving a mean weight loss of > or =4 pounds, measured > or =6 months after initiation of the intervention program. The Task Force recommends multicomponent interventions that include nutrition and physical activity (including strategies such as providing nutrition education or dietary prescription, physical activity prescription or group activity, and behavioral skills development and training) to control overweight and obesity among adults in worksite settings. The Task Force determined that insufficient evidence existed to determine the effectiveness of combination nutrition and physical activity interventions to prevent or reduce overweight and obesity in school settings because of the limited number of qualifying studies reporting noncomparable outcomes. This report describes the methods used in these systematic reviews; provides additional information regarding these recommendations; and cites sources for full reviews containing details regarding applicability, other benefits and harms, barriers to implementation, research gaps, and economic data (when available) regarding interventions.

Health Behavior↗

PubMed2005

Egg consumption and endothelial function: a randomized controlled crossover trial.

BACKGROUND: Because of egg cholesterol content, reduction in egg consumption is generally recommended to reduce risk of cardiovascular disease. Recently, however, evidence has been accumulating to suggest that dietary cholesterol is less relevant to cardiovascular risk than dietary saturated fat. This randomized controlled crossover trial was conducted to determine the effects of egg ingestion on endothelial function, a reliable index of cardiovascular risk. METHODS: Forty-nine healthy adults (mean age 56 years, 40% females) underwent a baseline brachial artery reactivity study (BARS), and were assigned to two eggs or oats daily for 6 weeks in random sequence with a 4-week washout. A BARS was done at the end of each treatment phase, measuring flow-mediated vasodilation (FMD) in the brachial artery using a high-frequency ultrasound. RESULTS: FMD was stable in both egg and oat groups, and between-treatment differences were not significant (egg -0.96%, oatmeal -0.79%; p value >0.05). Six weeks of egg ingestion had no effect on total cholesterol (baseline: 203.8 mg/dl; post-treatment: 205.3) or LDL (baseline: 124.8 mg/dl; post-treatment: 129.1). In contrast, 6 weeks of oats lowered total cholesterol (to 194 mg/dl; p = 0.0017) and LDL (to 116.6 mg/dl; p = 0.012). There were no differences in body mass index (BMI), triglyceride, HDL or SBP levels between egg and oat treatment assignments. CONCLUSION: Short-term egg consumption does not adversely affect endothelial function in healthy adults, supporting the view that dietary cholesterol may be less detrimental to cardiovascular health than previously thought.

Cross-Over Studies↗

PubMed2005

Benign prostatic hyperplasia: mode of presentation and postoperative outcome.

OBJECTIVE: To find out various modes of benign prostate hyperplasia (BPH) presentation in our region and their relation to postoperative failure to void after transurethral resection of prostate (TURP). METHODS: A study was conducted at Urology Department, Sandeman Teaching Hospital Quetta and Akram Hospital (Private) Quetta from January 2000 to December 2003. All BPH patients in whom the primary mode of presentation was accurately determined and later on underwent TURP were included in the study. Four modes of presentation were defined: (1) lower urinary tract symptoms (LUTS), (2) acute retention, (3) chronic retention and (4) and acute on chronic retention. After relevant investigations all these patients underwent TURP. Postoperatively catheter was removed when the urine was clear, usually within 48 hours of operation. Patients failing to void were recatheterized and given a second trial without catheter (TWOC) at third day of recatheterization. Resumption of spontaneous voiding on either the first or second TWOC was defined as "successful TWOC". Failure to void on second TWOC was defined as "failure to void" and was managed by a six week period of catheterization, followed by an additional TWOC. Statistical analysis was used to see any significant relation of failure to void postoperatively to mode of presentation of BPH, age of the patients and weight of the resected prostatic tissues. RESULTS: A total of 345 BPH patients were included in the study. Of these 270 (78.3%) patients presented with urinary retention and 75 (21.7%) with lower urinary tract symptoms (LUTS). Patients who presented with retention were acute retention 129 (37.4%), chronic retention 81(23.5%) and acute on chronic retention 60 (17.4%). The proportion of men failing to void after TURP was significantly higher (P < 0.05) in those with (i) acute retention as compared to LUTS (ii) chronic retention compared to acute retention and (iii) acute on chronic retention as compared to acute retention. The proportion of men failing to void postoperatively was highly significant (P < 0.005) in those with retention of any type as compared to LUTS. Age of the patients and weight of the resected prostatic tissues were found not significant factors in relation to failure to void postoperatively. CONCLUSION: BPH patients in our region present very late, most of them (> 78%) with complication of urinary retention. Mode of presentation of BPH greatly influences the postoperative outcome of this disease. Patients presenting with complications of chronic and acute on chronic retention have less favourable results regarding pOstoperative voiding after TURP. Moreover age of the patient and weight of the prostate are not significant factors in relation to failure to void postoperatively.

Aged↗

PubMed2005

Xanthogranulomatous pyelonephritis due to calculi: report of 63 cases and review of literature.

OBJECTIVE: To examine the relationship between clinical history and results of renal investigations in patients with xanthogranulomatous pyelonephritis. METHODS: A retrospective review was conducted on 63 cases presenting with histopathological diagnosis of xanthogranulomatous pyelonephritis between 1995 to 2002, at the department of Urology, Bolan Medical College and Sandeman Provincial Teaching Hospital Quetta. RESULTS: There were 26 males and 37 females having an average follow up of two years. Positive findings on examination and investigations at presentation were fever and flank pain in 59 (93.6%) patients and pyuria in 34 (53.9%) patients. All the patients had renal and ureteric calculi with no or severe reduction in the function of the affected kidney on DTPA scan. Hypertrophy of the contra lateral kidney was seen in 56 (88.8%) patients. CONCLUSION: Xanthogranulomatous pyelonephritis is a common entity in this part of the world. Late referral leads to loss of the kidney. Pre-operative diagnosis of the condition is desirable and if surgery is mandatory then all infected tissues have to be removed.

Adolescent↗

PubMed2004

Oats, antioxidants and endothelial function in overweight, dyslipidemic adults.

OBJECTIVE: To determine effects of oat and antioxidant vitamin (C 500 mg, E 400 IU) ingestion on endothelial function in overweight, dyslipidemic adults. DESIGN: Randomized, blinded, placebo-controlled, crossover trial Intervention(s): Subjects (16 males > or = age 35; 14 postmenopausal females) were assigned, in random order, to oats (60 g oatmeal), vitamin E (400 IU) plus vitamin C (500 mg), the combination of oats and vitamins, or placebo, and underwent brachial artery reactivity scans (BARS) following a single dose of each treatment, and again following 6 weeks of daily ingestion, with 2-week washout periods. At each test, a provocation high-fat meal (50 g, predominantly saturated) was administered and subjects were scanned pre, and 3 hours post-ingestion. RESULTS: Mean flow-mediated vasodilation (FMD; measured as percent diameter change before and after treatments) at baseline was 6.35 +/- 3.37. Oats increased FMD non-significantly (p > 0.05) with both single acute dose (from 6.07 +/- 6.25 to 9.22 +/- 8.82) and six weeks of sustained treatment (from 6.01 +/- 10.07 to 8.69 +/- 8.42). The direction of effect was negative for vitamins and the oat/vitamin combination with both acute and sustained treatment. There were no significant differences in FMD change among the treatments in either phase of the study, however when acute and sustained effects were pooled, oat treatment significantly augmented FMD (p < 0.05). CONCLUSIONS: This trial suggests but does not confirm a beneficial influence of oat ingestion on endothelial function in overweight, dyslipidemic adults. Further study of this potential association is warranted.

Adult↗

PubMed2003

Long-term patency of the right internal mammary artery used as a coronary bypass conduit and the effect of the recipient vessel.

This study reviewed our experience with the long-term patency of the right internal mammary coronary artery (RIMA) bypass graft in 58 patients over 1 year. Thirty-one percent (n = 18) of patients had obstructive lesions in the RIMA. In vessels with any lesion, the percent stenosis was 85.5% (range 30% to 100%). Eleven of 38 patients (28%) with right-sided recipient vessels had significant stenosis, whereas 21% of left-sided recipient vessels had significant stenosis of the RIMA. When compared with left internal mammary artery grafting, the long-term patency of the RIMA was lower than expected and warrants larger prospective studies.

Adult↗

PubMed2003

Evaluation of low ligation and high ligation procedures of varicocele.

OBJECTIVE: To describe the mode of presentation of varicocele and to compare the low ligation (Inguinal approach/Ivanissevich's procedure) and high ligation (Retroperitoneal approach/modified Palomo's procedure) of varicocele repair regarding efficacy and postoperative complications. DESIGN: Institutional-based randomized comparative clinical trial. PLACE AND DURATION OF STUDY: This study was conducted at the Urology Department, Bolan Medical College and Sandeman Provincial Teaching Hospital, Quetta from December 1996 to November 2001 (5 years). SUBJECTS AND METHODS: A total of 213 patients of varicocele who underwent treatment in the department and completed 6 months follow-up were included in the study. The mode of presentation of varicocele was recorded for all patients. For treatment purpose patients were randomly divided into two groups: in group I (n: 115) varicocele was ligated by inguinal approach (Ivanissevich's procedure) while in group II (n: 98) by retroperitoneal approach (modified Palomo's procedure). The efficacy and postoperative complications of the two procedures were carefully recorded and compared between the two groups. RESULTS: The mean age of the patients of group-I and group-II was 27.2 and 27.5 years respectively. More than 50% patients of both groups presented with feeling of heaviness/dragging sensation on ipsilateral side. Presentation with infertility/sub fertility in group-I and group-II was 16.5% and 15.3% respectively. Majority of patients of both groups had grade III varicocele with visible deformity. The rate of postoperative complications was very low in both groups of patients. Recurrence of varicocele and postoperative hydrocele formation were slightly more common in group-II as compared to group-I but the difference was statistically not significant (p>0.05). An extremely significant improvement occurred postoperatively in both sperms density and motility in infertile/sub fertile patients of both groups. CONCLUSION: Both procedures of varicocele repair are equally effective and have a low rate of complications. There is no significant difference in postoperative complications. An extremely significant improvement occurs in semen parameters of infertile/sub fertile patients postoperatively, irrespective of method/technique of varicocelectomy

Adolescent↗

PubMed2003

Retrocaval ureter.

Two cases of retrocaval ureter are reported. A 22 years old male patient presented to us with the complaints of right flank pain and hematuria and a child of 2 years referred to us for evaluation of right side moderate hydronephrosis detected on ultrasound. The diagnosis was confirmed on intravenous urography and retrograde pyelography. Both the ends were transected and anastomosed above a JJ stent in front of the inferior vena cava. Postoperatively the patients remained asymptomatic and the hydronephrosis improved.

Adult↗

PubMed2003

Raloxifene and endothelial function in healthy postmenopausal women.

OBJECTIVE: The purpose of this study was to determine the effects of raloxifene on endothelial function in healthy, postmenopausal women. STUDY DESIGN: This was a randomized, double-blind, placebo-controlled crossover trial. Subjects (n = 19; mean age, 61 years) underwent endothelial function testing at baseline and after treatment with placebo or raloxifene (60 mg per day for 6 weeks). RESULTS: Brachial artery diameter change (flow-mediated dilation) increased 5.0% with placebo and 8.56% with raloxifene (SE = 1.83, P =.03) in response to a hyperemic stimulus; an adjustment of this response for a variation in stimulus intensity resulted in greater discrimination (P =.009). The ratio of area under the curve response to area under the curve reference with the use of laser Doppler measures was 1.18 for placebo and 1.28 for raloxifene (P =.05). Flow-mediated dilation and area under the curve ratio correlated significantly (r = 0.33, P =.04). CONCLUSION: Treatment with raloxifene enhanced endothelial-mediated dilation in brachial arteries and digital vessels in healthy, postmenopausal women. A potential mechanism for a cardioprotective effect of raloxifene is suggested and warrants further study.

Brachial Artery↗

PubMed2003

Utility of HbA(1c) levels for diabetes case finding in hospitalized patients with hyperglycemia.

OBJECTIVE: We evaluated the role of a single measurement of HbA(1c) in a diabetes case finding in hospitalized patients with random hyperglycemia at admission. RESEARCH DESIGN AND METHODS: From 20 March to 31 July 2000, 508 patients admitted through the emergency department of one hospital were tested for random hyperglycemia (plasma glucose [PG] >125 mg/dl). Consenting patients with hyperglycemia (without preexisting diabetes or on corticosteroids) underwent testing for HbA(1c) levels, two fasting PG levels, and an outpatient oral glucose tolerance test (OGTT) if necessary. RESULTS: Of the patients, 50 (9.8%) met the inclusion criteria. Of these, 70% (n = 35) completed the study, and 60% (n = 21) were diagnosed with diabetes. Patients with diabetes had higher HbA(1c) levels than subjects without diabetes (6.8 +/- 0.4 vs. 5.3 +/- 0.1%, P = 0.002). An HbA(1c) level >6.0% was 100% specific (14/14) and 57% sensitive (12/21) for the diagnosis of diabetes. When a lower cutoff value of HbA(1c) at 5.2% was used, specificity was 50% (10/21) and sensitivity was 100% (7/14). CONCLUSIONS: In acutely ill patients with random hyperglycemia at hospital admission, an HbA(1c) >6.0% reliably diagnoses diabetes, and an HbA(1c) level <5.2% reliably excludes it (paralleling the operating characteristics of the standard fasting glucose measurements); however, the rapidity of the HbA(1c) level can be useful for diabetes case finding and treatment initiation early in the hospital course.

Biomarkers↗

PubMed2003

Longitudinal change in left ventricular hypertrophy in the elderly on antihypertensive therapy.

Left ventricular hypertrophy is an independent risk factor for adverse cardiovascular events. Factors related to left ventricular hypertrophy progression or regression in the extremely elderly population including role of antihypertensive therapy, are not well recognized. We conducted a structured retrospective chart review analysis of a cohort of 100 homebound elderly, predominately female African American subjects. All persons had at least two 2-D echocardiograms interpreted by the same cardiologist prior to the initiation of this study. Information was collected on demographics, functional status, comorbid conditions, use of medication, and progression or regression of left ventricle hypertrophy between baseline and follow-up echocardiogram. At baseline and follow-up echocardiogram, 47% (n = 47) and 56% had evidence of hypertrophy, respectively. There was no association between treatment with beta-blocker, calcium channel-blocker, or diuretic therapy, and left ventricular hypertrophy at follow-up echocardiogram. Only angiotensin converting enzyme inhibitor therapy was associated with the progression of left ventricular hypertrophy in all subjects. Logistic regression analysis based on all subjects revealed that risk of left ventricular hypertrophy on follow-up echocardiogram was lower with increasing age (OR 0.95, CI 0.904-0.997) and higher with angiotensin converting enzyme inhibitor therapy (OR 3.27, CI 1.41-7.63). Among subjects with no evidence of left ventricular hypertrophy at baseline, only the presence of hypertension was associated with left ventricular hypertrophy (OR 4.4, CI 1.19-16.3). Treatment of hypertension in the elderly with angiotensin converting enzyme inhibitor seemed to worsen left ventricle hypertrophy in this patient population.

Adrenergic beta-Antagonists↗

PubMed2002

Technical skills for weight loss: preliminary data from a randomized trial.

BACKGROUND: Optimal behavioral interventions for sustainable weight loss are uncertain. We therefore conducted a study among overweight/obese women comparing conventional dietary counseling of individuals (counseling-based intervention) to a novel, group-based skill-building intervention. METHODS: Eighty subjects were randomly assigned to either the counseling-based or to the skill-building intervention. Outcomes included weight loss, dietitian hours per group and per unit weight loss, and dollars spent per group and per unit weight lost. RESULTS: Weight loss at 6 months (follow-up rate 61.3%) in the counseling-based group was 8.8 lb (P = 0.0001), and in the skill-building group was 3.8 lb (P = 0.01). A total of 160 dietitian hours were required for the counseling-based group, and 131 for the skilled-building group. The counseling-based group cost an average of $21 per pound lost, while the skill-building cost an average of $48 per pound lost (P = 0.16). CONCLUSIONS: At 6 months, individualized office-based counseling produced more weight loss than a skill-building approach and cost less than half as much per pound of weight loss. Longer-term follow-up is required to determine if, as hypothesized, the skill-building intervention produces more sustainable weight loss.

Adult↗

PubMed2002

T-cell rich B-cell lymphoma: clinical distinctiveness and response to treatment in 45 patients.

T-cell rich B-cell lymphoma (TCR-BCL) is a recently described pathologic diagnosis without a place among traditional lymphoma classification systems. In the past, TCR-BCL has been included among other diagnoses, in particular lymphocyte predominant Hodgkin's disease (LPHD). The study of TCR-BCL cohorts may elucidate clinical distinctiveness, response to therapy, and the effect of treatment regimen on outcome. Between 1992 and 1997, a hematopathologist at Memorial Sloan-Kettering Cancer Center (MSKCC) diagnosed 45 patients with TCR-BCL according to published criteria. Clinical data was collected through retrospective chart review and communication with other patient providers. Our patients presented most commonly as males in their fourth decade with advanced stage disease. Three-year overall survival (OS) and failure-free survival (FFS) were 73 and 37%, respectively. Conventional combination chemotherapy regimens were utilized for an aggressive non-Hodgkin's lymphoma (NHL) diagnosis in 26 and for a Hodgkin's disease (HD) diagnosis in 10. Disease-free survival (DFS) was significantly better for NHL (36%) vs. HD (10%) directed chemotherapy at 3 years (p = 0.003). Overall survival at 3 years was not statistically different (62 vs. 79%) due to successful salvage therapy in both groups. It is important to distinguish TCR-BCL from LPHD and classical HD. Advanced stage, extranodal disease, involvement of the mediastinum, mesentery and/or spleen are clinical clues to a TCR-BCL diagnosis. Chemotherapy directed to a NHL diagnosis rather than HD results in a significant improvement in disease-free survival. Initial Hodgkin's disease-directed (HD-directed) chemotherapy should be avoided, although salvage transplantation may result in prolonged survival.

Adolescent↗