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1.
J Eur Acad Dermatol Venereol ; 33(4): 661-666, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30633376

ABSTRACT

BACKGROUND: The efficacy and safety of methyl aminolevulinate daylight photodynamic therapy (MAL DL-PDT) for actinic keratosis (AK) treatment has previously been demonstrated in several studies. OBJECTIVE: To evaluate patient-reported outcomes, effectiveness and tolerability of patient self-applied MAL DL-PDT. PATIENTS AND METHODS: An open study was conducted in Germany in patients with thin or non-hyperkeratotic and non-pigmented AK. At baseline, the investigator delimited the target anatomical area and skin preparation was discretionary. On day 1, the patient performed MAL DL-PDT at home, in accordance with instructions (after applying sunscreen and skin preparation by abrasive pad). Patient questionnaires were completed on day 1 and 3 months post-treatment. Effectiveness was assessed by investigator at 3 months. Pain and adverse events (AE) were recorded. RESULTS: Patients (n = 50) were mostly elderly (mean age: 73.4 years) men (86%). After treatment on day 1, 94% of patients were overall satisfied or very satisfied with the treatment and 98% found the instructions convenient. At 3 months, most patients were satisfied or very satisfied with treatment effectiveness (88%) and aspect of their skin (80%). At 3 months, 62% of overall lesions were completely clear. The main related AEs were mild and expected (erythema, procedural pain and skin burning sensation). CONCLUSIONS: Patient self-application of MAL DL-PDT resulted in high levels of patient satisfaction, effectiveness and tolerability.


Subject(s)
Aminolevulinic Acid/analogs & derivatives , Keratosis, Actinic/drug therapy , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Self Care , Aged , Aged, 80 and over , Aminolevulinic Acid/adverse effects , Aminolevulinic Acid/therapeutic use , Facial Dermatoses/drug therapy , Female , Germany , Humans , Male , Patient Reported Outcome Measures , Patient Satisfaction , Photochemotherapy/adverse effects , Photosensitizing Agents/adverse effects , Scalp Dermatoses/drug therapy , Sunlight , Surveys and Questionnaires , Treatment Outcome
3.
Blood Cancer J ; 6(12): e510, 2016 12 16.
Article in English | MEDLINE | ID: mdl-27983727

ABSTRACT

Acute myeloid leukemia (AML) is a heterogeneous neoplasm characterized by the accumulation of complex genetic alterations responsible for the initiation and progression of the disease. Translating genomic information into clinical practice remained challenging with conflicting results regarding the impact of certain mutations on disease phenotype and overall survival (OS) especially when clinical variables are controlled for when interpreting the result. We sequenced the coding region for 62 genes in 468 patients with secondary AML (sAML) and primary AML (pAML). Overall, mutations in FLT3, DNMT3A, NPM1 and IDH2 were more specific for pAML whereas UTAF1, STAG2, BCORL1, BCOR, EZH2, JAK2, CBL, PRPF8, SF3B1, ASXL1 and DHX29 were more specific for sAML. However, in multivariate analysis that included clinical variables, only FLT3 and DNMT3A remained specific for pAML and EZH2, BCOR, SF3B1 and ASXL1 for sAML. When the impact of mutations on OS was evaluated in the entire cohort, mutations in DNMT3A, PRPF8, ASXL1, CBL EZH2 and TP53 had a negative impact on OS; no mutation impacted OS favorably; however, in a cox multivariate analysis that included clinical data, mutations in DNMT3A, ASXL1, CBL, EZH2 and TP53 became significant. Thus, controlling for clinical variables is important when interpreting genomic data in AML.


Subject(s)
Genomics , Leukemia, Myeloid, Acute/genetics , Neoplasm Proteins/genetics , Prognosis , Adult , Aged , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Leukemia, Myeloid, Acute/pathology , Middle Aged , Mutation/genetics , Nucleophosmin
4.
Adv Hematol ; 2013: 195746, 2013.
Article in English | MEDLINE | ID: mdl-24396345

ABSTRACT

Thrombotic Thrombocytopenic Purpura (TTP) is a rare hematologic emergency, congenital or acquired, characterized by ischemic damage of various organs because of platelet aggregation. It is the common name for adults with microangiopathic hemolytic anemia, thrombocytopenia, with or without neurologic or renal abnormalities, and without another etiology; children without renal failure are also described as TTP. Plasma exchange (PE) is the main stay of treatment in combination with steroids and immunosuppressive therapies. The monoclonal antibody against CD20 Rituximab decreases the production of antibodies from B lymphocytes and it is used for antibodies-mediated diseases including TTP. We present our data on retrospective analysis of rituximab in treatment of TTP at University of Cincinnati in a series of 22 patients from 1997 to 2009. Our results showed that PE with immunosuppressive therapy resulted in decreased duration of PE, relapse rate, and increased duration of remission in patients with TTP.

5.
Am J Trop Med Hyg ; 62(2 Suppl): 80-7, 2000 Feb.
Article in English | MEDLINE | ID: mdl-10813504

ABSTRACT

Qena is the southernmost governorate of Egypt included in the Epidemiology 1, 2, 3 national study. A probability sample selected 17,822 individuals from 2,950 households in 34 ezbas and 10 villages from a total rural target population of 1,731,252 (based on the most recent 1986 census of the population by the Egyptian Central Agency for Public Mobilization And Statistics). Parasitologic examination of urine and stool were made for Schistosoma haematobium and S. mansoni, respectively, and physical and ultrasound examinations were made on a 20% subsample. The overall estimated prevalence of S. haematobium was 4.8 +/- 0.7% (+/-SE) and geometric mean egg count (GMEC) was 7.0 ova per 10 ml of urine. Considerable variation in prevalence was observed between the villages and ezbas, ranging from 0.0% to 20%, with the smaller ezbas having a slightly higher overall prevalence. The age- and sex-specific patterns of S. haematobium showed typical peak prevalence in early adolescence, with males having a higher prevalence than females. A history of hematuria was associated with current infection (odds ratio = 3.6, 95% confidence interval = 2.32-5.63). Hepatomegaly and splenomegaly determined by physical examination present in 7.9% and 3.0%, respectively. Ultrasonography-determined hepatomegaly of the left liver lobe was found in 10.1%. Ultrasonography-detected hepatomegaly in both the left and right lobes increased in prevalence from approximately 5% in children to 15-20% in adults. The prevalence of ultrasonography-detected splenomegaly increased slightly with age. Grade III periportal fibrosis was detected in only 2 individuals in the sample. Bladder wall lesions and obstructive uropathy were also very infrequent. Other associations with these measures are given. Most villages and ezbas had an S. mansoni prevalence of less than 1%. The exception was Nag'a El-Sheikh Hamad, where the prevalence was 10.3 +/- 0.5% (GMEC = 57.4 +/- 2.6). Two other communities also had a prevalence >1% (Ezbet Sarhan and Kom Heitin).


Subject(s)
Schistosomiasis haematobia/epidemiology , Schistosomiasis mansoni/epidemiology , Adolescent , Adult , Age Distribution , Child , Child, Preschool , Egypt/epidemiology , Female , Hepatomegaly/diagnosis , Hepatomegaly/diagnostic imaging , Hepatomegaly/epidemiology , Humans , Infant , Infant, Newborn , Male , Middle Aged , Morbidity , Parasite Egg Count , Prevalence , Risk Factors , Rural Population , Schistosomiasis haematobia/diagnosis , Schistosomiasis haematobia/diagnostic imaging , Schistosomiasis mansoni/diagnosis , Schistosomiasis mansoni/diagnostic imaging , Sex Distribution , Splenomegaly/diagnosis , Splenomegaly/diagnostic imaging , Splenomegaly/epidemiology , Ultrasonography , Urinary Bladder/pathology , Urine/parasitology
6.
Am J Trop Med Hyg ; 57(1): 16-9, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9242311

ABSTRACT

An ultrasonographic urinary bladder morbidity score was developed and tested in 510 patients with schistosomiasis haematobia, and then evaluated for screening 1,134 randomly selected children from villages endemic for Schistosoma haematobium. The ultrasonographic urinary bladder morbidity score had four grades ranging from normal to marked thickening of the urinary bladder wall or any polyps or masses. Among both patients and randomly screened subjects, the ultrasonographic score was greater (P = 0.01 and P < 0.01) in males than in females. Children examined in the clinic had higher (P = 0.03) ultrasonographic scores than adults. Infected subjects in communities were more likely (P < 0.001) to have urinary bladder morbidity than uninfected subjects, and clinic patients with egg counts > or = 20 eggs/10 ml of urine had higher (P = 0.03) ultrasonographic urinary bladder morbidity scores than those with lighter infections. The geometric mean egg count was higher (P = 0.04) in clinic patients with grade II and III lesions than in those with grade 0 and I lesions. There was progressive improvement of the grade of urinary bladder morbidity scores in patients treated with praziquantel at each follow-up examination (P < 0.001) and there was a positive relationship (P < 0.01) between urinary bladder morbidity scores and ultrasonographic-detected renal back pressure changes. The ultrasonographic urinary bladder morbidity score objectively measured the severity of urinary bladder morbidity and correlated with intensity of S. haematobium infection in our subjects. It can be used in evaluating both morbidity in patients and in community surveys and in following the outcome of chemotherapy.


Subject(s)
Schistosomiasis haematobia/diagnostic imaging , Urinary Bladder/diagnostic imaging , Adolescent , Adult , Aging , Animals , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Parasite Egg Count , Praziquantel/therapeutic use , Schistosoma haematobium , Schistosomiasis haematobia/drug therapy , Schistosomicides/therapeutic use , Sex Characteristics , Ultrasonography
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