RESUMO
Key Clinical Message: Complete molecular remission in a "variant APL" patient with short isoform of PML-RARα and FLT3-ITD mutation was achieved in response to ATRA and ATO plus IDA instead of standard treatment protocol. The use of FLT3 inhibitor in APL induction management is implicated to prevent differentiation syndrome and coagulopathy experienced in in patients with FLT3-ITD. Abstract: FLT3-ITD mutations are the most common activating mutations in FLT3 gene, occurring in about 12 to 38% of acute promyelocytic leukemia cases, and are mainly associated with high white blood cell counts and poor clinical outcomes. Here, we present a case of APL variant with adverse prognostic features who showed short isoform [bcr3] of PML-RARα and FLT3-ITD mutation at diagnosis. The patient received all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) plus idarubicin (IDA) instead of standard treatment protocol, and achieved a complete morphological, cytogenetic and molecular response. However, the patient experienced differentiation syndrome, and coagulopathy that was subsequently resolved by continuous oxygen therapy, dexamethasone, and enoxaparin. The use of FLT3 inhibitor in APL induction management is implicated to prevent differentiation syndrome and coagulopathy in patients with FLT3-ITD mutation.
RESUMO
The precise association of serum leptin (Lep) with the body mass index (BMI) and blood pressure (BP) is not well known for understanding their involvement in health and disease. Hence, the present study was conducted to investigate the association of BP, BMI and serum Lep levels in young normal-weight (NW) and overweight (OW) male Saudi students. The NW (n: 198) and OW (n: 192) male subjects in the age range of 18-20 years were consulted. The BP was measured with a mercury sphygmomanometer. Leptin Human ELISA Kits were employed for the determination of the serum Lep levels. The mean ± SD values of BMI (kg/m2), Lep (ng/mL), systolic BP (SBP; mmHg), and diastolic BP (DBP; mmHg) all showed significant differences for young OW vs. NW subjects as: 27.52 ± 1.42 vs. 21.49 ± 2.03; 10.70 ± 4.67 vs. 4.68 ± 1.91; 121.37 ± 2.59 vs. 118.51 ± 1.54 and 81.44 ± 1.97 vs. 78.79 ± 1.44, respectively. All associations (among BMI, Lep, SBP and DBP) showed a positive linear and significant correlation, except the nonsignificant correlation of BMI and SBP for the NW group. Other variables showing significant variation for NW vs. OW subjects were: interleukin-6, high sensitivity C-reactive protein, apelin (APLN) and resistin. Serum APLN correlated significantly with Lep, BMI, SBP and DBP in lower and higher levels of BMI, with considerable progressive patterns in both the NW and OW groups and subgroups. The present study in young Saudi male students presents significant variations for BP and serum leptin levels, and a significant positive linear association among serum leptin, BMI and BP.
RESUMO
OBJECTIVES: This study aimed to forecast the morbidity and mortality of dengue fever using a time series analysis from 2006 to 2016. METHODS: Data were compiled from the Jeddah Dengue Fever Operations Room (RFOR) in a primary health care centre. A time series analysis was conducted for all confirmed cases of dengue fever between 2006 and 2016. RESULTS: The results showed a significant seasonal association, particularly from May to September, and a time-varying behaviour. Air temperature was significantly associated with the incidence of dengue fever (p < 0.001) but was not correlated with its mortality. Similarly, relative humidity was not significantly associated with the incidence of dengue fever (p = 0.237). CONCLUSION: The strong seasonal association of dengue fever during May to September and its relation to air temperature should be communicated to all stakeholders. This will help improve the control interventions of dengue fever during periods of anticipated high incidence.
RESUMO
Dengue fever is a major public health problem in Saudi Arabia. Unfortunately, preventive strategies are still deficient. It can progress to severe and lethal forms, and available knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF). The aim of this study was to evaluate the host and viral factors that could play a role in the progression of severe dengue cases in the frame of the revised 2009 WHO classification. Data were compiled from the Jeddah Dengue Fever Operation Room (DFOR) in the Maden Al-Fahd primary healthcare center in Jeddah. An unmatched case-control study was conducted on 123 severe cases, and 245 controls (non-severe cases) diagnosed during 2014-2016. Risk factors for severe dengue fever were secondary infection (p = 0.02), and co-morbidities, particularly diabetes and hypertension (p < 0.001). Age, gender, nationality, socioeconomic status, viral serotype, and access to health care were not significantly associated with severe disease. The main risk factors for severe dengue fever were secondary infection, and co-morbidities (hypertension and diabetes). We recommend disseminating these data to stakeholders to improve dengue control interventions in periods with anticipated high incidence.