Sixty-eight previously untreated patients with primary gastric non-Hodgkin's lymphoma (NHL) available for analysis, were entered in a study in which the prognostic significance of serum beta 2 microglobulin levels were evaluated. The serum beta 2 microglobulin was the most significant prognostic factor. Patients with high levels (greater than 3.5 micrograms/mL) had a relapse-free survival (RFS) of 36 months, while the median RFS has not been reached in patients with normal levels (p less than 0.001). The 5-year survival was 80 per cent for patients with normal levels, statistically significant when compared to patients with high levels: 38 per cent (p less than 0.001). Serum beta 2 microglobulin should be included in the initial staging of patients with primary extranodal NHL and patients with high levels should be treated more aggressively.

Age Factors↗

PubMedDate not supplied

Angiocentric T-cell lymphoma of the nose, paranasal sinuses and hard palate.

Sixty-five cases of malignant lymphoma of the nose, paranasal sinuses and hard palate were retrospectively analysed to identify the presence or absence of angiocentric lesions. We observed that the 23 patients with angiocentric lesions had a worse prognosis with a shorter duration of response and also a shorter duration of survival, compared with 42 cases of malignant lymphoma of the same anatomical region but without angiocentric lesions. Patients with angiocentric lymphoma were associated with other bad prognostic factors such as elevated levels of lactic dehydrogenase and beta 2 microglobulin, local bone destruction and lymphopenia. Immunophenotyping studies showed that most patients with angiocentric lesions had T cell lymphomas (18 of 23, 78 per cent). We believe that patients with angiocentric T cell lymphomas of the nose, paranasal sinuses and hard palate represent a distinctive clinico-pathological entity with different clinical presentation and outcome. Patients with angiocentric T cell lymphomas had frequent relapse at extranodal sites and combined therapy should be considered as the initial therapeutic approach.

Adult↗

PubMedDate not supplied

Diagnosis of typhoid fever by two serologic methods. Enzyme-linked immunosorbent assay of antilipopolysaccharide of Salmonella typhi antibodies and Widal test.

Serum samples from 85 patients with proven typhoid fever, 11 patients with p-typhoidal fever, 101 patients with febrile non-typhoidal, and 130 healthy subjects were tested for immunoglobulin G (IgG), IgA, and IgM antilipopolysaccharide (LPS) of Salmonella typhi antibodies by enzyme-linked immunosorbent assay (ELISA) and Widal test. The levels of all three classes of immunoglobulin anti-LPS of S. typhi were higher in typhoid patients than in healthy or febrile nontyphoidal groups; we selected various combinations between the three classes of immunoglobulin to obtain the best combination of sensitivity and specificity. The sum of the absorbance values obtained from the ELISA assay for IgG+IgA+IgM (sigma lgs) was the best choice for diagnostic utility for typhoid fever. We selected a positive test at a decision level of sigma lgs > or = 1.2 with a sensitivity of 94% and a specificity of 92% with a frequency of false negative of 5.9%. The frequency of false positives for healthy controls was 7.7% and, for the febrile nontyphoidal group, it was 7.9%. We also compared receiver (or relative) operating characteristic (ROC) curves for the diagnostic usefulness of the ELISA with that of the Widal test, whose merits and limitations, especially in endemic regions, are discussed. The ELISA assay was much more sensitive and specific than any combination of the Widal test, and hence it could be a useful tool for the serologic diagnosis of typhoidal fever with a single blood sample.

Agglutination Tests↗

PubMedDate not supplied

Analysis of mitral inertance: a factor critical for early transmitral filling.

The upslope of the transmitral E wave depends on the combined influence of the rate of change of the atrioventricular gradient and the inertial mass of blood within the mitral apparatus (inertance). To use observed transmitral velocity to predict the atrioventricular pressure (delta p) difference requires knowledge of the magnitude of mitral inertance (M, inertial mass divided by effective orifice area), closely related to the length over which blood accelerates and decelerates on passing through the valve. To define the magnitude and determining factors for mitral inertance in typical valvular geometries, we used an in vitro model in which a known atrioventricular gradient (delta p, range 3.8 to 39 mm Hg) was applied instantaneously to orifices (areas of 0.5, 1, 1.5, 2, and 2.5 cm2) and conduits (volume 2.5 to 24 ml). Continuous wave Doppler spectra were recorded and the slope (dv/dt) of the tangent to the upslope was measured manually. From slope and pressure difference, inertance was calculated as delta p/(dv/dt). In 103 combinations of pressure gradients and orifices or conduits, inertance ranged between 1.9 and 12.7 gm/cm2. Linear regression showed that inertance M was highly correlated with orifice diameter D (M = 3.17 D; r = 0.84; p < 0.0001) and, in the conduits, with diameter and length L (M = 4.1 D + 0.7 L-1.8; r = 0.87; p < 0.0001). Inertance was not significantly related to the pressure gradient. In conclusion, inertance depends mainly on the mitral apparatus geometry and most strongly on orifice diameter. Knowledge of mitral inertance should help to extract quantitative data on atrioventricular pressure difference from the upslope of the transmitral E wave.

Binomial Distribution↗

PubMedDate not supplied

Sexually transmitted diseases and related genital pathologies in oligozoospermia.

Sexually transmitted pathogens are associated with a wide range of anomalies and diseases, including recurrent genital herpes, urethritis, syphilis, prostitis, genital ulcers, perihepatitis, unexplained infertility, infant prematurity, low birth weight, and neonatal death or malformations. Prompt diagnosis of sexually transmitted diseases (STDs) is essential to ensure appropriate specific treatment and to reduce complications. Extensive studies on the etiology of male infertility include poorly treated infections such as STDs, epididymitis, complications associated with mumps, delayed treatment of undescended testes, repair of inguinal hernia, varicocele, endocrine disorders, anomalies of the reproductive tract and male accessory organs, trauma, surgery, heat-cold injury, and active-passive immunization.

Adult↗

PubMedDate not supplied

Bacterial infection and semen characteristics in infertile men.

Semen samples of 190 men attending an andrology clinic were evaluated with bacteriological culture and categorized as negative (group I) and positive (group II); the effect of bacteriospemia on semen characteristics was also analyzed. Semen samples from both groups were simultaneously analyzed for routine parameters such as volume, sperm count, motility, viability and morphology. The semen culture was negative in 34% and positive in 66% of the samples. From 123 samples, 157 aerobes and 8 anaerobes were recovered. The most commonly isolated organism was Staphylococchs epidermidis (in 63% of the samples), followed by Streptococchs viridans (28%), Escherichia coli (9%), Staphylococcus aureus (5%), Streptococcus faecalis (5%), beta-hemolytic Streptococcus (4%), and Enterobacter agglomerans (4%). Other microorganisms, including Klebsiella sp, Candida sp., and Proteus mirabilis, were recovered in fewer than 4% of the specimens. The comparison of semen characteristics between infected and noninfected men showed that motile spermatozoa and viability were lower when the microorganisms were present in the semen. It would appear that the bacteria can have a direct effect on semen quality with negative consequences in fertility.

Adult↗

PubMedDate not supplied

Packaging yourself for success as a CNE presenter.

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Clinical Competence↗