Objectives In this study, the production of extended spectrum beta-lactamase (ESBL), metallo-betalacatamase (MBL) and AmpC beta-lactamase enzymes of Pseudomonas aeruginosa (P aeruginosa) strains which were isolated from clinical samples were investigated. AmpC gene was also detected by the polymerase chain reaction (PCR) analysis. Methods A hundred strains of P aeruginosa were included in the study. The presence of ESBL was investigated with combined disk confirmation test, MBL was investigated with E-test method and AmpC beta-lactamase was investigated with disk induction test. In order to detect the production of AmpC betalactamase genotypically, the PCR method was used. Results Only one strain was found to be MBL positive. Four per cent of strains were found to be ESBL positive. AmpC beta-lactamase production was positive in 73% of the strains with disk induction test. AmpC gene was detected in 96% of the studied strains with the PCR method. Conclusion While ESBL and MBL rates in this study were significantly lower than those found in other studies, the rate of AmpC beta-lactamase was higher. Although AmpC gene was detected in some strains (23%), they were not found to produce AmpC beta-lactamase with disk induction test.
{"title":"Beta-lactamase Enzymes of Clinical Pseudomonas aeruginosa Strains.","authors":"O. Pasa, B. Ozer, N. Duran, M. Inci, E. Yula","doi":"10.7727/wimj.2014.362","DOIUrl":"https://doi.org/10.7727/wimj.2014.362","url":null,"abstract":"Objectives\u0000In this study, the production of extended spectrum beta-lactamase (ESBL), metallo-betalacatamase (MBL) and AmpC beta-lactamase enzymes of Pseudomonas aeruginosa (P aeruginosa) strains which were isolated from clinical samples were investigated. AmpC gene was also detected by the polymerase chain reaction (PCR) analysis.\u0000\u0000\u0000Methods\u0000A hundred strains of P aeruginosa were included in the study. The presence of ESBL was investigated with combined disk confirmation test, MBL was investigated with E-test method and AmpC beta-lactamase was investigated with disk induction test. In order to detect the production of AmpC betalactamase genotypically, the PCR method was used.\u0000\u0000\u0000Results\u0000Only one strain was found to be MBL positive. Four per cent of strains were found to be ESBL positive. AmpC beta-lactamase production was positive in 73% of the strains with disk induction test. AmpC gene was detected in 96% of the studied strains with the PCR method.\u0000\u0000\u0000Conclusion\u0000While ESBL and MBL rates in this study were significantly lower than those found in other studies, the rate of AmpC beta-lactamase was higher. Although AmpC gene was detected in some strains (23%), they were not found to produce AmpC beta-lactamase with disk induction test.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129449938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Arjomandzadegan, R. Nazari, M. Zolfaghari, M. Taherahmadi, M. Sadrnia, L. Titov, A. Ahmadi, M. Shojapoor
INTRODUCTION The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was employed for rapid detection of ethambutol (EMB) resistant clinical isolates of Mycobacterium tuberculosis. MATERIALS AND METHODS From 182 clinical isolates of M tuberculosis collected from different regions, 103 strains were entered in the investigation. DNA was extracted by Chelex 100 method and PCR was performed using specific primers for embB gene. Polymerase chain reaction products were digested with HaeIII and NlaII restriction endonucleases and the patterns of restriction fragments were analysed. Some randomly selected samples were sequenced. RESULTS Out of 103 studied strains, 52 were resistant to EMB. The cases of secondary tuberculosis were 53 (51.50 ± 1.77%), and primary cases 50 (48.50 ± 1.77%; p > 0.05). From 63 extensively drug-resistant (XDR), pre-XDR and multidrug-resistant (MDR) isolates, 27 (87%), 18 (81.8%) and 7 (70%) strains were resistant to EMB, respectively. Results of PCR-RFLP method showed that from 27R EMB XDR isolates, 13 (sensitivity 48% with CI: 0.307, 0.66 and specificity 100%), from 18R EMB pre-XDR strains, 4 (sensitivity 22% with CI: 0.09, 0.45 and specificity 100%) and of 7R EMB MDR, 2 (sensitivity 28% with CI: 0.082, 0.64 and specificity 100%) had mutation in ATG-Met codon 306. Results of sequencing were concordant with RFLP method. Overall, sensitivity of the molecular method was 36.5% (CI: 0.09, 0.45) and specificity 100%. None of the 40 pansusceptible strains was embB306 mutants. Extensively drug-resistant strains had a higher proportion of embB306 mutants (43%) than pre-XDR and MDR isolates (odds ratio 6.78; p < 0.001). CONCLUSION Fast detection of susceptibility to EMB drug is possible by PCR-RFLP. The embB306 locus is a candidate marker for rapid prediction of high resistance consisting of MDR and XDR forms to anti-tuberculosis drugs using this method.
{"title":"Performance Assessment of the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism Method for Rapid Detection of Susceptibility to Ethambutol and Molecular Prediction of Extensively Drug-resistant Tuberculosis in Clinical Isolates of Mycobacterium tuberculosis.","authors":"M. Arjomandzadegan, R. Nazari, M. Zolfaghari, M. Taherahmadi, M. Sadrnia, L. Titov, A. Ahmadi, M. Shojapoor","doi":"10.7727/wimj.2014.022","DOIUrl":"https://doi.org/10.7727/wimj.2014.022","url":null,"abstract":"INTRODUCTION\u0000The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was employed for rapid detection of ethambutol (EMB) resistant clinical isolates of Mycobacterium tuberculosis.\u0000\u0000\u0000MATERIALS AND METHODS\u0000From 182 clinical isolates of M tuberculosis collected from different regions, 103 strains were entered in the investigation. DNA was extracted by Chelex 100 method and PCR was performed using specific primers for embB gene. Polymerase chain reaction products were digested with HaeIII and NlaII restriction endonucleases and the patterns of restriction fragments were analysed. Some randomly selected samples were sequenced.\u0000\u0000\u0000RESULTS\u0000Out of 103 studied strains, 52 were resistant to EMB. The cases of secondary tuberculosis were 53 (51.50 ± 1.77%), and primary cases 50 (48.50 ± 1.77%; p > 0.05). From 63 extensively drug-resistant (XDR), pre-XDR and multidrug-resistant (MDR) isolates, 27 (87%), 18 (81.8%) and 7 (70%) strains were resistant to EMB, respectively. Results of PCR-RFLP method showed that from 27R EMB XDR isolates, 13 (sensitivity 48% with CI: 0.307, 0.66 and specificity 100%), from 18R EMB pre-XDR strains, 4 (sensitivity 22% with CI: 0.09, 0.45 and specificity 100%) and of 7R EMB MDR, 2 (sensitivity 28% with CI: 0.082, 0.64 and specificity 100%) had mutation in ATG-Met codon 306. Results of sequencing were concordant with RFLP method. Overall, sensitivity of the molecular method was 36.5% (CI: 0.09, 0.45) and specificity 100%. None of the 40 pansusceptible strains was embB306 mutants. Extensively drug-resistant strains had a higher proportion of embB306 mutants (43%) than pre-XDR and MDR isolates (odds ratio 6.78; p < 0.001).\u0000\u0000\u0000CONCLUSION\u0000Fast detection of susceptibility to EMB drug is possible by PCR-RFLP. The embB306 locus is a candidate marker for rapid prediction of high resistance consisting of MDR and XDR forms to anti-tuberculosis drugs using this method.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127818967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Left atrial isomerism (LAI) is a rare congenital anomaly usually associated with major or minor congenital cardiac lesions. Presentation beyond childhood is unusual as there is usually high morbidity of 63% associated with the co-morbid major congenital cardiac lesions in the first year of life. The four index cases highlight the myriad cardiac lesions facilitating survival into adolescence and adulthood of this rare cardiac condition. Presented are markedly different echocardiographic findings of four cases of LAI in Afro-Caribbeans who had no intervention. Their diagnostic transthoracic echocardiographic findings are the focussed features of this article and the first documentation of isolated patent ductus arteriosus with LAI. Fascinating diagnostic chest X-ray findings of the LAI index cases are presented. They are the first cases of LAI documented in Afro-Caribbeans.
{"title":"Left Atrial Isomerism in Afro-Caribbean Adolescents and Adults with no Intervention: Echocardiographic Findings.","authors":"S. Williams-Phillips, M. Hoo Sang","doi":"10.7727/wimj.2015.300","DOIUrl":"https://doi.org/10.7727/wimj.2015.300","url":null,"abstract":"Left atrial isomerism (LAI) is a rare congenital anomaly usually associated with major or minor congenital cardiac lesions. Presentation beyond childhood is unusual as there is usually high morbidity of 63% associated with the co-morbid major congenital cardiac lesions in the first year of life. The four index cases highlight the myriad cardiac lesions facilitating survival into adolescence and adulthood of this rare cardiac condition. Presented are markedly different echocardiographic findings of four cases of LAI in Afro-Caribbeans who had no intervention. Their diagnostic transthoracic echocardiographic findings are the focussed features of this article and the first documentation of isolated patent ductus arteriosus with LAI. Fascinating diagnostic chest X-ray findings of the LAI index cases are presented. They are the first cases of LAI documented in Afro-Caribbeans.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124652506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Rezaei, Fereshteh Karimi, N. Shariatifar, Issa Mohammadpourfard, Malekabad Es
The increasing incidence of drug-resistant pathogens and toxicity of existing antibacterial compounds has drawn attention toward the antimicrobial activity of natural products. The purpose of this study is to evaluate the antimicrobial activity of the essential oil of the leaves and seeds of Coriandrum sativum. The five strains of bacteria comprising Escherichia coli, Staphylococcus aureus, Yersinia enterocolitica, Salmonella enterica and Vibrio cholerae were used for the antibacterial tests. In this study, antimicrobial effects of the essential oil from the leaves and seeds of Coriandrum sativum are evaluated by determining the minimum inhibitory concentration (MIC), the inhibition zone and minimum bactericidal concentration (MBC). The essential oil from Coriandrum sativum was extracted by steam distillation. The results indicate that the antimicrobial activities against the five pathogens were in the range of 2.5- 320 µg/mL. Increase in essential oil concentration caused significant increase in inhibitory feature. The essential oil of the leaves and seeds of Coriandrum sativum showed antimicrobial activity against the food-borne pathogenic bacteria. Thus, its oil can be used as an alternative to synthetic food preservative without toxic effects. Also, it can be used in biotechnological fields as ingredients in antibiotics and the pharmaceutical industry. These results suggest that the essential oil of C sativum leaves and seeds may have potential use in pharmaceutical and food industries for preservatives or antimicrobial agents.
{"title":"Antimicrobial Activity of the Essential Oil from the Leaves and Seeds of Coriandrum sativum toward Food-borne Pathogens.","authors":"Mohammad Rezaei, Fereshteh Karimi, N. Shariatifar, Issa Mohammadpourfard, Malekabad Es","doi":"10.7727/wimj.2014.162","DOIUrl":"https://doi.org/10.7727/wimj.2014.162","url":null,"abstract":"The increasing incidence of drug-resistant pathogens and toxicity of existing antibacterial compounds has drawn attention toward the antimicrobial activity of natural products. The purpose of this study is to evaluate the antimicrobial activity of the essential oil of the leaves and seeds of Coriandrum sativum. The five strains of bacteria comprising Escherichia coli, Staphylococcus aureus, Yersinia enterocolitica, Salmonella enterica and Vibrio cholerae were used for the antibacterial tests. In this study, antimicrobial effects of the essential oil from the leaves and seeds of Coriandrum sativum are evaluated by determining the minimum inhibitory concentration (MIC), the inhibition zone and minimum bactericidal concentration (MBC). The essential oil from Coriandrum sativum was extracted by steam distillation. The results indicate that the antimicrobial activities against the five pathogens were in the range of 2.5- 320 µg/mL. Increase in essential oil concentration caused significant increase in inhibitory feature. The essential oil of the leaves and seeds of Coriandrum sativum showed antimicrobial activity against the food-borne pathogenic bacteria. Thus, its oil can be used as an alternative to synthetic food preservative without toxic effects. Also, it can be used in biotechnological fields as ingredients in antibiotics and the pharmaceutical industry. These results suggest that the essential oil of C sativum leaves and seeds may have potential use in pharmaceutical and food industries for preservatives or antimicrobial agents.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124970350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Johnson, J. Jaggon, J. Campbell, C. Bruce, D. Ferron-Boothe, K. James, I. Crandon, D. Eldemire-Shearer
OBJECTIVE Glioblastoma multiforme (GBM) is the most malignant and most common primary brain tumour worldwide. This study was undertaken to investigate the demographics of this tumour in Jamaica as there is to date no such published data. Data from the recently started Intracranial Tumour Registry (ITR) at the University Hospital of the West Indies was used. METHODS All cases of GBM entered into the ITR between 2005 and 2012 were gathered. Of these, only patients with pathologically proven diagnoses were entered into the study. Demographic data, including age and gender, were recorded. The distribution of the tumours by anatomic location was also documented. RESULTS Of the 602 patients entered into the ITR up to that time, 42 were found to have histologically proven GBM with a male to female ratio of 2.2:1. There was an age range of 8-92 years with a mean age of diagnosis of 48 years. The majority of the tumours (66.7%) occurred in the left cerebral hemisphere with the most common lobe being the temporal lobe. Two patients (4.8%) had lesions spanning both hemispheres. CONCLUSIONS This preliminary study reveals that there is a similar gender distribution of GBM within our population compared with the rest of the world. It, however, revealed that the mean age of diagnosis in our population (48 years) is lower than that quoted in the worldwide literature (53 to 64 years). One possible explanation for this is the possibility that many of our GBMs are actually secondary tumours which are thought to arise from less malignant, undiagnosed precursors. The percentage of GBMs occurring in the paediatric population was similar to the rest of the world.
{"title":"Profile of a Malignant Brain Tumour in Jamaica: An Eight-year Review, 2005 to 2012.","authors":"P. Johnson, J. Jaggon, J. Campbell, C. Bruce, D. Ferron-Boothe, K. James, I. Crandon, D. Eldemire-Shearer","doi":"10.7727/wimj.2014.094","DOIUrl":"https://doi.org/10.7727/wimj.2014.094","url":null,"abstract":"OBJECTIVE\u0000Glioblastoma multiforme (GBM) is the most malignant and most common primary brain tumour worldwide. This study was undertaken to investigate the demographics of this tumour in Jamaica as there is to date no such published data. Data from the recently started Intracranial Tumour Registry (ITR) at the University Hospital of the West Indies was used.\u0000\u0000\u0000METHODS\u0000All cases of GBM entered into the ITR between 2005 and 2012 were gathered. Of these, only patients with pathologically proven diagnoses were entered into the study. Demographic data, including age and gender, were recorded. The distribution of the tumours by anatomic location was also documented.\u0000\u0000\u0000RESULTS\u0000Of the 602 patients entered into the ITR up to that time, 42 were found to have histologically proven GBM with a male to female ratio of 2.2:1. There was an age range of 8-92 years with a mean age of diagnosis of 48 years. The majority of the tumours (66.7%) occurred in the left cerebral hemisphere with the most common lobe being the temporal lobe. Two patients (4.8%) had lesions spanning both hemispheres.\u0000\u0000\u0000CONCLUSIONS\u0000This preliminary study reveals that there is a similar gender distribution of GBM within our population compared with the rest of the world. It, however, revealed that the mean age of diagnosis in our population (48 years) is lower than that quoted in the worldwide literature (53 to 64 years). One possible explanation for this is the possibility that many of our GBMs are actually secondary tumours which are thought to arise from less malignant, undiagnosed precursors. The percentage of GBMs occurring in the paediatric population was similar to the rest of the world.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121874567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehmet Tan, M. Kalcioglu, M. Akarçay, Y. Toplu, S. Karaca
OBJECTIVE This paper deals with the investigation of the effects of nasal septal deviation evaluated by acoustic rhinometry (ARM) in the success of tympanoplasty surgery. SUBJECT AND METHODS All patients who underwent tympanoplasty surgery by the same surgeon were reviewed. The patients with nasopharyngeal or nasal masses, polyps, symptoms of allergic rhinitis or rhinosinusitis, or concha bullosa were excluded from the study. Forty patients who underwent tympanoplasty at least one year ago were included in the study. The patients were divided into two groups according to the graft success results. Acoustic rhinometry evaluations of the patients were performed. RESULTS There were 25 and 15 cases in the intact graft (group A) and re-perforated group (group B), respectively. For the same side of the operated ear, ARM values of group A were 0.47 cm², at the first narrowest cross-sectional area (MCA 1), 0.43 cm² at the second narrowest cross-sectional area (MCA 2), 1.51 cm³ volume at the first 2 cm of the nasal cavity (Vol 1) and 3.33 cm³ volume between the second and fifth cm of the nasal cavity (Vol 2). Acoustic rhinometry values of group B were 0.50 cm², 0.47 cm², 1.60 cm³ and 3.19 cm³ for MCA 1, MCA 2, Vol 1 and Vol 2, respectively. CONCLUSION The results of this study showed that nasal septal deviation may not affect the success of tympanoplasty surgery, and septoplasty may not be necessary before ear surgery.
{"title":"Does Nasal Septal Deviation Affect the Success of Tympanoplasty Surgery?","authors":"Mehmet Tan, M. Kalcioglu, M. Akarçay, Y. Toplu, S. Karaca","doi":"10.7727/wimj.2014.182","DOIUrl":"https://doi.org/10.7727/wimj.2014.182","url":null,"abstract":"OBJECTIVE\u0000This paper deals with the investigation of the effects of nasal septal deviation evaluated by acoustic rhinometry (ARM) in the success of tympanoplasty surgery.\u0000\u0000\u0000SUBJECT AND METHODS\u0000All patients who underwent tympanoplasty surgery by the same surgeon were reviewed. The patients with nasopharyngeal or nasal masses, polyps, symptoms of allergic rhinitis or rhinosinusitis, or concha bullosa were excluded from the study. Forty patients who underwent tympanoplasty at least one year ago were included in the study. The patients were divided into two groups according to the graft success results. Acoustic rhinometry evaluations of the patients were performed.\u0000\u0000\u0000RESULTS\u0000There were 25 and 15 cases in the intact graft (group A) and re-perforated group (group B), respectively. For the same side of the operated ear, ARM values of group A were 0.47 cm², at the first narrowest cross-sectional area (MCA 1), 0.43 cm² at the second narrowest cross-sectional area (MCA 2), 1.51 cm³ volume at the first 2 cm of the nasal cavity (Vol 1) and 3.33 cm³ volume between the second and fifth cm of the nasal cavity (Vol 2). Acoustic rhinometry values of group B were 0.50 cm², 0.47 cm², 1.60 cm³ and 3.19 cm³ for MCA 1, MCA 2, Vol 1 and Vol 2, respectively.\u0000\u0000\u0000CONCLUSION\u0000The results of this study showed that nasal septal deviation may not affect the success of tympanoplasty surgery, and septoplasty may not be necessary before ear surgery.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114810324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a patient with relapse of B-cell non-Hodgkin's lymphoma in the breast that was clinically presented as a primary breast cancer. A 72-year old female was treated with chemotherapy and monoclonal antibodies (anti-CD20) due to diffuse large B-cell non-Hodgkin's lymphoma. Complete remission was achieved. Three years later, she was presented with a palpable left breast lump in the perimammillar area of the left breast, dimensions up to 3 cm. Laboratory results were within normal range. Mammography re-vealed a solitary, bilobulated, non-calcified mass of the left breast. On ultrasound, the lesion was hypo-echoic with blurred edges, with posterior acoustic enhancement, measuring 2 × 3 × 7 × 2 cm. Histological findings of ultrasound-guided fine needle aspiration and core needle biopsy were corre-spondent to diffuse large B-cell lymphoma. Pathohistological report showed cells with CD20+/Bcl- 2+/Bcl-6-/MUM-1+/CD3- imunophenotype. The breast parenchyma was infiltrated with B-cell lym-phoma. After diagnosis was confirmed, radiotherapy was initiated. Repeat ultrasound studies showed complete regression of the left breast lesion as did positron emission tomography- computed tomography (PET/CT) scan three months after therapy. In conclusion, the relapse of lymphoma in the breast is very rare. In patients previously treated for lymphoma, differential diagnosis should always include relapse, although it clinically presents itself as a primary breast cancer.
{"title":"Case Report of Patient with Relapse of B-cell Lymphoma in the Breast Parenchyma.","authors":"D. Grebić, P. V. Zujic, N. Trbojević","doi":"10.7727/wimj.2014.190","DOIUrl":"https://doi.org/10.7727/wimj.2014.190","url":null,"abstract":"We present a patient with relapse of B-cell non-Hodgkin's lymphoma in the breast that was clinically presented as a primary breast cancer. A 72-year old female was treated with chemotherapy and monoclonal antibodies (anti-CD20) due to diffuse large B-cell non-Hodgkin's lymphoma. Complete remission was achieved. Three years later, she was presented with a palpable left breast lump in the perimammillar area of the left breast, dimensions up to 3 cm. Laboratory results were within normal range. Mammography re-vealed a solitary, bilobulated, non-calcified mass of the left breast. On ultrasound, the lesion was hypo-echoic with blurred edges, with posterior acoustic enhancement, measuring 2 × 3 × 7 × 2 cm. Histological findings of ultrasound-guided fine needle aspiration and core needle biopsy were corre-spondent to diffuse large B-cell lymphoma. Pathohistological report showed cells with CD20+/Bcl- 2+/Bcl-6-/MUM-1+/CD3- imunophenotype. The breast parenchyma was infiltrated with B-cell lym-phoma. After diagnosis was confirmed, radiotherapy was initiated. Repeat ultrasound studies showed complete regression of the left breast lesion as did positron emission tomography- computed tomography (PET/CT) scan three months after therapy. In conclusion, the relapse of lymphoma in the breast is very rare. In patients previously treated for lymphoma, differential diagnosis should always include relapse, although it clinically presents itself as a primary breast cancer.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133571510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
X. Zeng, C. Xu, M. Li, J. Xia, M. Liu, P. Zhu, D. Xiang, Y. Wang
Objective Significant liver fibrosis is recognized as the key link of therapy and prognosis in patients with chronic hepatitis B infection (CHB). The present study is designed to estimate the benefits of FibroScan (FS) in diagnosing significant fibrosis in patients with CHB. Methods Two hundred and eight consecutive CHB patients, who underwent liver biopsy, FS and laboratory tests, were recruited. The receiver operating characteristic (ROC) curves were generated to assess the performance of non-invasive models. Results Liver stiffness measurement (LSM) and aspartate transaminase (AST) to platelet (PLT) ratio index (APRI), but not age-platelet index (API) or AST to alanine aminotransferase (ALT) ratio (AAR), were closely correlated with significant fibrosis; areas under ROC curves (AUROC) were 0.817 (p < 0.001), 0.705 (p = 0.003), 0.626 (p = 0.065) and 0.631 (p = 0.055), respectively. When combining LSM with APRI, the AUROC was 0.813, p < 0.001. Conclusion FibroScan can predict the presence of significant liver fibrosis, so as to avoid liver biopsy. It seems that the combination of FS and APRI does not significantly improve the ability to predict significant fibrosis.
{"title":"The Diagnostic Value of FibroScan in Assessing Significant Liver Fibrosis in Patients with Chronic Hepatitis B.","authors":"X. Zeng, C. Xu, M. Li, J. Xia, M. Liu, P. Zhu, D. Xiang, Y. Wang","doi":"10.7727/wimj.2014.150","DOIUrl":"https://doi.org/10.7727/wimj.2014.150","url":null,"abstract":"Objective\u0000Significant liver fibrosis is recognized as the key link of therapy and prognosis in patients with chronic hepatitis B infection (CHB). The present study is designed to estimate the benefits of FibroScan (FS) in diagnosing significant fibrosis in patients with CHB.\u0000\u0000\u0000Methods\u0000Two hundred and eight consecutive CHB patients, who underwent liver biopsy, FS and laboratory tests, were recruited. The receiver operating characteristic (ROC) curves were generated to assess the performance of non-invasive models.\u0000\u0000\u0000Results\u0000Liver stiffness measurement (LSM) and aspartate transaminase (AST) to platelet (PLT) ratio index (APRI), but not age-platelet index (API) or AST to alanine aminotransferase (ALT) ratio (AAR), were closely correlated with significant fibrosis; areas under ROC curves (AUROC) were 0.817 (p < 0.001), 0.705 (p = 0.003), 0.626 (p = 0.065) and 0.631 (p = 0.055), respectively. When combining LSM with APRI, the AUROC was 0.813, p < 0.001.\u0000\u0000\u0000Conclusion\u0000FibroScan can predict the presence of significant liver fibrosis, so as to avoid liver biopsy. It seems that the combination of FS and APRI does not significantly improve the ability to predict significant fibrosis.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114107164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SA El Tarhouny, SS Zakaria, A. Abdu-Allah, KM Hadhoud, MI Hanafi, OM Al Nozha ArBIM
OBJECTIVES Conditions of hypoandrogenism in men have been linked to insulin resistance, suggesting that alterations in normal sex steroid physiology could play a role in the pathogenesis of Type 2 diabetes mellitus (T2DM). Sex hormone-binding globulin (SHBG) gene polymorphisms may be the cause of sex steroid alteration. The aim of this work is to study the effect of SHBG gene polymorphisms on the risk of T2DM through its impact on testosterone and oestradiol level in Egyptian men. SUBJECTS AND METHODS A case control study was performed in the diabetes clinic at Zagazig University Hospital on 185 males with Type 2 diabetes and their matched healthy controls. Two polymorphisms (rs6257 and rs6259) of the gene encoding SHBG were genotyped and serum levels of SHBG, testosterone and oestradiol were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS Carriers of rs6257 variant allele (CC or CT) and carriers of rs6259 wild allele (GG) appear to have a high risk of diabetes than carriers of other alleles (OR 2.241, 1.585 and 2.391, respectively). They also showed a significant decrease in plasma level of both SHBG and testosterone and a significant increase in oestradiol blood level compared with carriers of other alleles. CONCLUSIONS Sex hormone-binding globulin gene polymorphisms at position rs6257 and rs6259 are associated with higher risk of T2DM in Egyptian men, through lowering circulating levels of SHBG and consequently, lowering testosterone and elevating oestradiol level.
{"title":"Study of Sex Hormone-binding Globulin Gene Polymorphism and Risk of Type 2 Diabetes Mellitus in Egyptian Men.","authors":"SA El Tarhouny, SS Zakaria, A. Abdu-Allah, KM Hadhoud, MI Hanafi, OM Al Nozha ArBIM","doi":"10.7727/wimj.2014.088","DOIUrl":"https://doi.org/10.7727/wimj.2014.088","url":null,"abstract":"OBJECTIVES\u0000Conditions of hypoandrogenism in men have been linked to insulin resistance, suggesting that alterations in normal sex steroid physiology could play a role in the pathogenesis of Type 2 diabetes mellitus (T2DM). Sex hormone-binding globulin (SHBG) gene polymorphisms may be the cause of sex steroid alteration. The aim of this work is to study the effect of SHBG gene polymorphisms on the risk of T2DM through its impact on testosterone and oestradiol level in Egyptian men.\u0000\u0000\u0000SUBJECTS AND METHODS\u0000A case control study was performed in the diabetes clinic at Zagazig University Hospital on 185 males with Type 2 diabetes and their matched healthy controls. Two polymorphisms (rs6257 and rs6259) of the gene encoding SHBG were genotyped and serum levels of SHBG, testosterone and oestradiol were measured by enzyme-linked immunosorbent assay (ELISA).\u0000\u0000\u0000RESULTS\u0000Carriers of rs6257 variant allele (CC or CT) and carriers of rs6259 wild allele (GG) appear to have a high risk of diabetes than carriers of other alleles (OR 2.241, 1.585 and 2.391, respectively). They also showed a significant decrease in plasma level of both SHBG and testosterone and a significant increase in oestradiol blood level compared with carriers of other alleles.\u0000\u0000\u0000CONCLUSIONS\u0000Sex hormone-binding globulin gene polymorphisms at position rs6257 and rs6259 are associated with higher risk of T2DM in Egyptian men, through lowering circulating levels of SHBG and consequently, lowering testosterone and elevating oestradiol level.","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122848010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bridgelal-Nagassar Rj, K. James, Nagassar Rp, S. Maharaj
Objective To determine the association between health insurance/health benefit and medication adherence amongst adult diabetic patients in Kingston, Jamaica. Methods This was a cross-sectional study. The target population was diabetics who attended the diabetic outpatient clinics in health centres in Kingston. Two health centres were selectively chosen in Kingston. All diabetic patients attending the diabetic clinics and over the age of 18 years were conveniently sampled. The sample size was 260. An interviewer-administered questionnaire was utilized which assessed health insurance/health benefit. Adherence was measured by patients' self-reports of medication usage in the previous week. The Chi-squared test was used to determine the significance of associations. Results Sample population was 76% female and 24% male. Type 2 diabetics comprised 93.8%. More than 95% of patients were over the age of 40 years. Approximately 32% of participants were employed. Approximately 75% of patients had health insurance/health benefit. Among those who had health insurance or health benefit, 71.5% were adherent and 28.5% were non-adherent. This difference was statistically significant (χ2 = 6.553, p = 0.01). Prevalence of medication non-adherence was 33%. Conclusions AIn Kingston, diabetic patients who are adherent are more likely to have health insurance/health benefit (p = 0.01).
目的了解牙买加金斯敦市成年糖尿病患者健康保险/健康福利与药物依从性之间的关系。方法采用横断面研究。目标人群是在金斯敦保健中心糖尿病门诊就诊的糖尿病患者。在金斯敦有选择地选择了两个保健中心。所有在糖尿病门诊就诊且年龄在18岁以上的糖尿病患者均被方便地抽样。样本量为260人。使用了一份由访谈者填写的问卷来评估健康保险/健康福利。依从性是通过患者前一周的药物使用自我报告来衡量的。使用卡方检验来确定关联的显著性。结果样本人群中女性占76%，男性占24%。2型糖尿病患者占93.8%。超过95%的患者年龄在40岁以上。大约32%的参与者有工作。大约75%的病人有健康保险/健康津贴。在有健康保险或健康福利的人中，71.5%的人坚持，28.5%的人没有坚持。差异有统计学意义(χ2 = 6.553, p = 0.01)。药物依从率为33%。结论在Kingston，坚持治疗的糖尿病患者更有可能获得健康保险/健康福利(p = 0.01)。
{"title":"Medication Adherence and Health Insurance/Health Benefit in Adult Diabetics in Kingston, Jamaica.","authors":"Bridgelal-Nagassar Rj, K. James, Nagassar Rp, S. Maharaj","doi":"10.7727/wimj.2014.282","DOIUrl":"https://doi.org/10.7727/wimj.2014.282","url":null,"abstract":"Objective\u0000To determine the association between health insurance/health benefit and medication adherence amongst adult diabetic patients in Kingston, Jamaica.\u0000\u0000\u0000Methods\u0000This was a cross-sectional study. The target population was diabetics who attended the diabetic outpatient clinics in health centres in Kingston. Two health centres were selectively chosen in Kingston. All diabetic patients attending the diabetic clinics and over the age of 18 years were conveniently sampled. The sample size was 260. An interviewer-administered questionnaire was utilized which assessed health insurance/health benefit. Adherence was measured by patients' self-reports of medication usage in the previous week. The Chi-squared test was used to determine the significance of associations.\u0000\u0000\u0000Results\u0000Sample population was 76% female and 24% male. Type 2 diabetics comprised 93.8%. More than 95% of patients were over the age of 40 years. Approximately 32% of participants were employed. Approximately 75% of patients had health insurance/health benefit. Among those who had health insurance or health benefit, 71.5% were adherent and 28.5% were non-adherent. This difference was statistically significant (χ2 = 6.553, p = 0.01). Prevalence of medication non-adherence was 33%.\u0000\u0000\u0000Conclusions\u0000AIn Kingston, diabetic patients who are adherent are more likely to have health insurance/health benefit (p = 0.01).","PeriodicalId":104133,"journal":{"name":"The West Indian medical journal","volume":"65 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129961962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：