RESUMEN
An increased incidence of acute myeloid leukemia (AML) has recently been documented in patients post-solid organ transplantation but the incidence and types of myelodysplastic syndromes (MDS) occurring in this patient population are not known. We identified 5 patients (3M, 2F, age 48-64 years) who developed MDS ranging from 1.8 to 25 years (median 4.2 years) post-solid organ transplantation, only 2 patients had received azathioprine. The cumulative incidence of MDS in heart and lung transplant recipients at 15 years was 0.5% and 1.8%, respectively, which is markedly higher compared to the general population. Low-risk types of MDS predominated, 3 of 5 patients are alive (median 3.9 years) since diagnosis. Deletions of chromosome 20q, which have not been previously reported in post-transplant MDS/AML, were identified in 3 cases. Our findings expand the morphologic and cytogenetic spectrum of MDS occurring post-solid organ transplantation and suggest that mechanisms beside azathioprine toxicity might be important in disease pathogenesis.
Asunto(s)
Síndromes Mielodisplásicos/clasificación , Síndromes Mielodisplásicos/epidemiología , Trasplante de Órganos/efectos adversos , Biopsia , Médula Ósea/patología , Femenino , Humanos , Incidencia , Leucemia Mieloide/epidemiología , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/patología , Trasplante de Órganos/clasificación , Complicaciones Posoperatorias/clasificación , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/patología , Estudios RetrospectivosRESUMEN
The intraspecific variability of Triatoma dimidiata Latreille, a major vector of Chagas disease, was studied in four departments of Guatemala. Insects were collected from either domestic and sylvatic habitats, and their cuticular hydrocarbon pattern and head morphology were analyzed using ordination and classification techniques. A significant discrimination was obtained both with morphometric and hydrocarbon analyses. Insects from northern departments were easily differentiated from southern conspecifics. Distinctive hydrocarbon pattern and head shape were detected for insects collected from caves in the north central region of the country, posing concern about their taxonomic status.
Asunto(s)
Reduviidae/anatomía & histología , Reduviidae/química , Animales , Enfermedad de Chagas/transmisión , Cromatografía de Gases , Femenino , Guatemala , Hidrocarburos/análisis , Insectos Vectores , Masculino , Especificidad de la EspecieRESUMEN
Acceptance of digital radiography is increasing but has not yet progressed to the mainstream. A key factor in widespread use of this advancement is acceptance--both theoretical and technological--by dental health plans for claim submissions. This article details a survey of California third parties to examine their practices, concerns, and plans regarding digital dental radiography.
