ABSTRACT
Non-myeloablative (MA) and reduced intensity allo-SCT regimens are offered to older patients and/or those with comorbidities because the morbidity and mortality attributable to fully MA conditioning is thought to be unacceptably high. A total of 207 patients aged 50-66 years were treated between 1999 and 2008 with SCT after MA conditioning with fludarabine 50 mg/m(2) daily × 5 and i.v. BU 3.2 mg/kg daily × 4.90 (43%) had additional TBI 200 cGy × 2. GVHD prophylaxis was CsA, MTX and thymoglobulin (4.5 mg/kg total dose). As defined by the hematopoietic cell transplantation co-morbidity index (HCT-CI) scoring system 117 (57%) pts scored 0 and 90 (43%) 1. At 5 years OS was 39 vs 54% (P=0.008), disease-free survival 38 vs 49% (P=0.03), TRM 39 vs 19% (P=0.003) and relapse 36 vs 39% (P=ns) in those with scores of 0 and 1, respectively. Multivariate analysis confirmed the influence of HCT-CI scores on TRM (subhazard ratios=2.29; 95% confidence interval=1.29-4.08; P=0.005). We conclude that comorbidities as assessed by the HCT-CI do influence TRM with this regimen but that age alone should not be an indication to prefer a less intense protocol.
Subject(s)
Antilymphocyte Serum/therapeutic use , Busulfan/therapeutic use , Hematologic Neoplasms/therapy , Hematopoietic Stem Cell Transplantation/methods , Transplantation Conditioning/methods , Vidarabine/analogs & derivatives , Age Factors , Aged , Comorbidity , Disease-Free Survival , Female , Graft vs Host Disease/etiology , Hematologic Neoplasms/drug therapy , Hematologic Neoplasms/surgery , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Male , Middle Aged , Retrospective Studies , Survival Rate , Transplantation Conditioning/adverse effects , Transplantation, Homologous , Vidarabine/therapeutic useABSTRACT
Pelvic limb length discrepancies > 4 cm are a challenge that some orthopedists face and multiple methods and procedures have been proposed; among them, callotasis facilitates the management of these discrepancies. This paper reports the experience obtained with 133 femoral lengthenings divided into "and" 14 years of age with acquired or congenital conditions. Lengthening variables and complications were analyzed (with Velásquez' criteria). This study has favorable factors for case analysis, such as the use of a single type of fixator and the use of the same treatment method in pediatric patients. Our results are no different from the world literature concerning the incidence rate of complications by age and diagnosis as well as the healing rate.
Subject(s)
Bone Lengthening/methods , External Fixators , Femur/abnormalities , Femur/surgery , Leg Length Inequality/surgery , Adolescent , Child , Female , Humans , MaleABSTRACT
To obtain accurate, timely data on the health status of persons in evacuation camps after the eruption of the Mt. Pinatubo volcano, the Philippine Department of Health (DOH) conducted a survey of the health needs of the evacuees and established disease surveillance in each camp. Surveys of the camps revealed that sources of potable water, sanitary means of waste disposal, and shelters were inadequate. Disease surveillance showed that measles, acute respiratory infections, and diarrhea were the most important problems. Surveillance detected outbreaks of measles and an outbreak of vomiting and diarrhea in the camps. Deaths, primarily caused by measles (31%), diarrhea (29%), and respiratory infections (22%), totaled 349 in the first 12 weeks. Death rates peaked in the seventh week, when a death rate of 26/10,000 occurred among the Aetas, a tribe evacuated from the slopes of the volcano. The surveys guided the DOH in allocating supplies and medicine, while disease surveillance enabled disaster managers to monitor the effectiveness of health programs, identify high-risk groups, and respond appropriately to the situation.