Pub Date : 2021-06-01DOI: 10.21203/RS.3.RS-523176/V1
A. Alemayehu, T. Yohanes, T. Shibiru, Z. Hailemariam
Introduction: Peripheral blood smear examination is a vital hematological test for diagnosis and monitoring of disorders in blood. Despite the considerable benefits of this test in the battle against the growing burden of communicable and non-communicable diseases, its rate of provision is low. This study aimed to assess the rate of peripheral blood smear examination service provision and its barriers among public hospitals in southern Ethiopia.Method: We have conducted a descriptive cross-sectional study from January 01 to March 31, 2019, among five public hospitals in Southern Ethiopia. We collected socio-demographic data from patients and healthcare providers. We prepared peripheral blood smears from 423 patients with abnormal complete blood cell count. We examined a wright’s stained peripheral blood smear under the microscope to identify abnormality in the morphology of blood cells. We conducted key informant interviews with healthcare providers. We assessed health facilities using a standard checklist. We did descriptive statistical analysis for quantitative data using Statistical Package for Social Sciences (SPSS) version 20.0 software. We transcribed, categorized, and thematically analyzed the qualitative data. We presented the results in tables and figures.Result: The rate of provision of peripheral blood smear examination service was 11.6% (n= 49). Nearly 90% of the eligible patients did not receive this service. Relatively better rate of service provision was seen among hospitals with essential resources for the service, and those participating in Hematology external quality assurance. Lack of training, shortage of laboratory supplies, and inadequate supportive supervision were identified as barriers to regularly provide peripheral blood smear examination service.Conclusion: Rate of peripheral blood smear examination service provision is low. A large proportion of eligible patients missed the deserved service. Adequate laboratory supplies, training, and continued supportive supervision should be considered to improve the provision of this service.
{"title":"Rate of Peripheral Blood Smear Examination Service Provision and Its Barriers Among Public Hospitals in Southern Ethiopia: A Mixed-Methods Study","authors":"A. Alemayehu, T. Yohanes, T. Shibiru, Z. Hailemariam","doi":"10.21203/RS.3.RS-523176/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-523176/V1","url":null,"abstract":"\u0000 Introduction: Peripheral blood smear examination is a vital hematological test for diagnosis and monitoring of disorders in blood. Despite the considerable benefits of this test in the battle against the growing burden of communicable and non-communicable diseases, its rate of provision is low. This study aimed to assess the rate of peripheral blood smear examination service provision and its barriers among public hospitals in southern Ethiopia.Method: We have conducted a descriptive cross-sectional study from January 01 to March 31, 2019, among five public hospitals in Southern Ethiopia. We collected socio-demographic data from patients and healthcare providers. We prepared peripheral blood smears from 423 patients with abnormal complete blood cell count. We examined a wright’s stained peripheral blood smear under the microscope to identify abnormality in the morphology of blood cells. We conducted key informant interviews with healthcare providers. We assessed health facilities using a standard checklist. We did descriptive statistical analysis for quantitative data using Statistical Package for Social Sciences (SPSS) version 20.0 software. We transcribed, categorized, and thematically analyzed the qualitative data. We presented the results in tables and figures.Result: The rate of provision of peripheral blood smear examination service was 11.6% (n= 49). Nearly 90% of the eligible patients did not receive this service. Relatively better rate of service provision was seen among hospitals with essential resources for the service, and those participating in Hematology external quality assurance. Lack of training, shortage of laboratory supplies, and inadequate supportive supervision were identified as barriers to regularly provide peripheral blood smear examination service.Conclusion: Rate of peripheral blood smear examination service provision is low. A large proportion of eligible patients missed the deserved service. Adequate laboratory supplies, training, and continued supportive supervision should be considered to improve the provision of this service.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123418216","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}
Objective: Assiduous depiction of recurrent pregnancy loss (RPL) in patients after in vitro fertilisation (IVF). Material and Method: Women undergoing IVF treatment who had experienced two or more consecutive pregnancy losses before 20 weeks’ gestation with or without a history of implantation failure. Systematic review resulting in specific data bases such as Pub Med and Cochrane data base. Results: Factors associated with RPL after IVF consist mainly genetic origin (approx. 30%) due to aneuploid embryos, followed by thrombophilia and autoimmune factors. Mainly predisposition factors associated with high risk of recurrent miscarriages include obesity, advanced maternal age, anatomic defects of the uterus and endocrine disorders. On the contrary, 10-15% of cases of RPL represent idiopathic origin (Unexplained RPL). The evaluation of preimplantation genetic testing (PGT) remains a controversial entity. Conclusion: The aim of our study is focusing on the pathophysiologic mapping, presented in current literature, concerning RPL after IVF. Although IVF procedures, including assisted hatching, PGT and immunologic therapy have been suggested to improve live birth rates, their efficacy is controversial, since the factors related to RPL after spontaneous abortion or IVF do not reveal any statistic differences. Additionally, assisted reproductive technique (ART) cannot be supported as a treatment intervention for couples with unexplained RPL, due to the lack of adequate clinical studies.
{"title":"Recurrent pregnancy loss resulting in IVF (In Vitro Fertilization) series. Pathophysiologic mapping. A systematic review","authors":"","doi":"10.33140/ahor.04.01.02","DOIUrl":"https://doi.org/10.33140/ahor.04.01.02","url":null,"abstract":"Objective: Assiduous depiction of recurrent pregnancy loss (RPL) in patients after in vitro fertilisation (IVF). Material and Method: Women undergoing IVF treatment who had experienced two or more consecutive pregnancy losses before 20 weeks’ gestation with or without a history of implantation failure. Systematic review resulting in specific data bases such as Pub Med and Cochrane data base. Results: Factors associated with RPL after IVF consist mainly genetic origin (approx. 30%) due to aneuploid embryos, followed by thrombophilia and autoimmune factors. Mainly predisposition factors associated with high risk of recurrent miscarriages include obesity, advanced maternal age, anatomic defects of the uterus and endocrine disorders. On the contrary, 10-15% of cases of RPL represent idiopathic origin (Unexplained RPL). The evaluation of preimplantation genetic testing (PGT) remains a controversial entity. Conclusion: The aim of our study is focusing on the pathophysiologic mapping, presented in current literature, concerning RPL after IVF. Although IVF procedures, including assisted hatching, PGT and immunologic therapy have been suggested to improve live birth rates, their efficacy is controversial, since the factors related to RPL after spontaneous abortion or IVF do not reveal any statistic differences. Additionally, assisted reproductive technique (ART) cannot be supported as a treatment intervention for couples with unexplained RPL, due to the lack of adequate clinical studies.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125691464","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}
Background: Cyclophosphamide (CP) is a drug with a wide spectrum of clinical uses. Zinc oxide is the most widely used nanoparticles. Nanoparticles could induce oxidative stress that eventually leads to cell toxicity, inflammation and hemolysis. Objectives: The objective of this study was to evaluate the hematological changes induced by Zn-O nano-particles and/or Cyclophosphamide in male rats. Materials and Methods: Twenty four adult male rats (Sprague Dawley) were grouped randomly into four groups of six rats each. Group I. Control group: Received 0.2 ml saline /day i.p. injection for 14 days (day by day), group II (CP group): Received CP 20 mg/kg/day body weight (b.w.) day by day for 14 days by intraperitoneal injection, Group III (nZnO group): Received nZnO (5 mg/kg)/day b.w., intraperitoneally for 14 days. Group IV (CP + ZnO NPs group): Received nZnO group: Received nZnO (5 mg/kg/day) b.w., intraperitoneally for 14 days, plus CP 20mg/kg/day body weight (b.w.) day by day for 14 days by intraperitoneal injection. At the end of the experimental period, rats were anesthetized using light ether. Blood samples were taken for hematological evaluation. Results: Red blood cells count, hemoglobin concentration, and white blood cells count were significantly decline in rats treated with CP in comparison to control group, while combination of nZnO with CP reduced changes in red bood cells and hemoglobin values. Neutrophils, lymphocytes, eosinophils, and monocytes count were significantly decreased in CP-immunosuppressed group when compared with the control group. In CP-immunosuppressed animals treated with nZnO, these parameters were improved when compared with CP treated groups. Conclusion: It can be concluded that CP induced changes in the hematological parameters. Treatment of rats with zinc oxide nano-particles and CP together ameliorated the toxicity induced by CP. These results may provide further visions into proper treatment of patients by improving side effects of chemotheraby. However further studies are necessary to establish optimal doses of nZnO and receive the best safety profile.
{"title":"Ameliorating Effect of Zinc Oxide Nanoparticles against Hematotoxicity Induced by Cyclophosphamide in Male Albino Rats","authors":"","doi":"10.33140/ahor.03.01.07","DOIUrl":"https://doi.org/10.33140/ahor.03.01.07","url":null,"abstract":"Background: Cyclophosphamide (CP) is a drug with a wide spectrum of clinical uses. Zinc oxide is the most widely used nanoparticles. Nanoparticles could induce oxidative stress that eventually leads to cell toxicity, inflammation and hemolysis. Objectives: The objective of this study was to evaluate the hematological changes induced by Zn-O nano-particles and/or Cyclophosphamide in male rats. Materials and Methods: Twenty four adult male rats (Sprague Dawley) were grouped randomly into four groups of six rats each. Group I. Control group: Received 0.2 ml saline /day i.p. injection for 14 days (day by day), group II (CP group): Received CP 20 mg/kg/day body weight (b.w.) day by day for 14 days by intraperitoneal injection, Group III (nZnO group): Received nZnO (5 mg/kg)/day b.w., intraperitoneally for 14 days. Group IV (CP + ZnO NPs group): Received nZnO group: Received nZnO (5 mg/kg/day) b.w., intraperitoneally for 14 days, plus CP 20mg/kg/day body weight (b.w.) day by day for 14 days by intraperitoneal injection. At the end of the experimental period, rats were anesthetized using light ether. Blood samples were taken for hematological evaluation. Results: Red blood cells count, hemoglobin concentration, and white blood cells count were significantly decline in rats treated with CP in comparison to control group, while combination of nZnO with CP reduced changes in red bood cells and hemoglobin values. Neutrophils, lymphocytes, eosinophils, and monocytes count were significantly decreased in CP-immunosuppressed group when compared with the control group. In CP-immunosuppressed animals treated with nZnO, these parameters were improved when compared with CP treated groups. Conclusion: It can be concluded that CP induced changes in the hematological parameters. Treatment of rats with zinc oxide nano-particles and CP together ameliorated the toxicity induced by CP. These results may provide further visions into proper treatment of patients by improving side effects of chemotheraby. However further studies are necessary to establish optimal doses of nZnO and receive the best safety profile.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"94 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122698791","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}
Brunner’s gland adenoma is a rare benign, proliferative lesion arising from the Brunner’s gland of the duodenum and is known by various names as Brunneroma or polypoidal hamartoma. Brunner gland adenoma was first reported by Cruveilhier in 1835 [1]. We report Brunner’s gland adenoma in a 50-year-old female who presented with melena and review briefly Brunner’s gland adenoma’s clinical presentations, radiological, pathological features and therapy.
{"title":"A Rare Case of Brunner’s Gland Adenoma causing Melena","authors":"","doi":"10.33140/ahor.03.01.13","DOIUrl":"https://doi.org/10.33140/ahor.03.01.13","url":null,"abstract":"Brunner’s gland adenoma is a rare benign, proliferative lesion arising from the Brunner’s gland of the duodenum and is known by various names as Brunneroma or polypoidal hamartoma. Brunner gland adenoma was first reported by Cruveilhier in 1835 [1]. We report Brunner’s gland adenoma in a 50-year-old female who presented with melena and review briefly Brunner’s gland adenoma’s clinical presentations, radiological, pathological features and therapy.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126479641","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}
Introduction: Highly active antiretroviral therapy (HAART) played a critical role in the medical management of HIV infected individuals by restoring the immune function and minimizes HIV related outcomes. But treatment failure minimized these advantages and leads to an increment of morbidity and mortality with poor quality of life in all HIV patients. The aim at this study was to assess the prevalence of HIV-1 treatment failure and its determinants factors among children on first line HAART at Felegehiwot Referral Hospital. Methods: Cross sectional study was conducted on 238 children who had on first line HAART regimen using the inclusion criteria. Data were collected from patients’ chart starting from ART commencement (baseline data and other information) and interviewed using structured questionnaire. CD4 T-cells from whole blood and viral load from separated plasma were analyzed according to protocols. The collected data were analyzed using SPSS packages version 20. Descriptive statistics, odds ratio, bi-variate and multiple logistic regression analysis were used to show determinant factors association. Independent associations were considered with p<0.05. Result: Among the 238 participants enrolled, 137(57.6%) were females. The mean ages were 8.09 years and the median months on HAART from initiation were 51.93 months. A total of 25 (10.5%) participants were found to have virologic/treatment failure. The mean CD4 T-cells at base line were 342.33 cells/ml and 672.13 cells/ml respectively. Long duration on treatment, sub-optimal drug adherence, conducting faith healing, high medication dosage and ambulatory functional status at baseline were found to be significant predictors of treatment failure and showed positive odds ratio. Conclusion: This study demonstrates high virologic failure and the determinant factors of virologic failures among HAART first line children are still changing. Therefore, evidence-based intervention and early detection of treatment failure must be made to further identify the potential causes and set standardized protective mechanisms of virologic failures.
{"title":"Virologic Failure and its Determinant Factors among Children in First Line on Highly Active Anti Retroviral Therapy at Felegehiwot Referral Hospital, Bahir Dar, Northwest, Ethiopia: cross-sectional study","authors":"","doi":"10.33140/ahor.03.01.03","DOIUrl":"https://doi.org/10.33140/ahor.03.01.03","url":null,"abstract":"Introduction: Highly active antiretroviral therapy (HAART) played a critical role in the medical management of HIV infected individuals by restoring the immune function and minimizes HIV related outcomes. But treatment failure minimized these advantages and leads to an increment of morbidity and mortality with poor quality of life in all HIV patients. The aim at this study was to assess the prevalence of HIV-1 treatment failure and its determinants factors among children on first line HAART at Felegehiwot Referral Hospital. Methods: Cross sectional study was conducted on 238 children who had on first line HAART regimen using the inclusion criteria. Data were collected from patients’ chart starting from ART commencement (baseline data and other information) and interviewed using structured questionnaire. CD4 T-cells from whole blood and viral load from separated plasma were analyzed according to protocols. The collected data were analyzed using SPSS packages version 20. Descriptive statistics, odds ratio, bi-variate and multiple logistic regression analysis were used to show determinant factors association. Independent associations were considered with p<0.05. Result: Among the 238 participants enrolled, 137(57.6%) were females. The mean ages were 8.09 years and the median months on HAART from initiation were 51.93 months. A total of 25 (10.5%) participants were found to have virologic/treatment failure. The mean CD4 T-cells at base line were 342.33 cells/ml and 672.13 cells/ml respectively. Long duration on treatment, sub-optimal drug adherence, conducting faith healing, high medication dosage and ambulatory functional status at baseline were found to be significant predictors of treatment failure and showed positive odds ratio. Conclusion: This study demonstrates high virologic failure and the determinant factors of virologic failures among HAART first line children are still changing. Therefore, evidence-based intervention and early detection of treatment failure must be made to further identify the potential causes and set standardized protective mechanisms of virologic failures.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127515375","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}
Background: Catastrophic thrombotic syndrome (CTS) is a rare life-threatening condition defined as rapid onset of multi-organ thrombosis affecting diverse vascular beds. Predisposing conditions include catastrophic antiphospholipid syndrome (APS), atypical thrombotic thrombocytopenic purpura (TTP), delayed heparin-induced thrombocytopenia and Trousseau syndrome. Patients who do not meet any of these criteria are diagnosed with idiopathic catastrophic thrombotic syndrome. Case description: A 44-year-old Caucasian woman with type II diabetes and hypothyroidism presented with acute onset of myalgia and extensive bruising over a period of four days. Physical exam revealed hypotension, tachycardia, and extensive purpuric and bullous skin lesions. Laboratory evaluation demonstrated microangiopathic hemolysis, thrombocytopenia, elevated D-dimer and coagulopathy suggesting disseminated intravascular coagulation (DIC) along with acute kidney injury (AKI) and transaminitis. Aggressive transfusions including packed red blood cells, fresh frozen plasma, platelets and cryoprecipitate were required to reverse her severe coagulopathy. Ultrasound showed occlusive thrombus in the left basilic vein and the greater saphenous veins bilaterally and heparin infusion was started. IV methylprednisolone, all-trans retinoic acid and doxycycline were empirically given. Workup was negative for any coagulation factor deficiency or hypercoagulable state although heterozygous factor V Leiden (FVL) mutation was found. Bone marrow biopsy was normal. Infectious and auto-immune workups were unremarkable. Skin biopsy showed diffuse intravascular thrombi but no evidence of vasculitis. Two weeks later, she developed Enterobacter bacteremia from infection of her bullous lesions. She was started on broad spectrum antibiotics and transferred to a burn unit. Eventually, her coagulopathy, bacteremia, AKI and transaminitis resolved, she was discharged with indefinite anticoagulation. Discussion: CTS presented in our patient with rapidly progressive thrombosis with consumptive coagulopathy. No obvious instigating source was found, her clinical presentation was out of proportion for the isolated heterozygous FVL mutation. Anticoagulation remained the main therapy in the acute setting and aggressive supportive care in multi-disciplinary setting to manage acute and late complications was required. Conclusion: Through this report, we emphasize the need for early recognition of CTS with this constellation of clinical findings and advocate for urgent interventions to prevent untoward outcomes.
{"title":"A Case Report of Idiopathic Catastrophic Thrombotic Syndrome with Purpura Fulminans","authors":"","doi":"10.33140/ahor.03.01.04","DOIUrl":"https://doi.org/10.33140/ahor.03.01.04","url":null,"abstract":"Background: Catastrophic thrombotic syndrome (CTS) is a rare life-threatening condition defined as rapid onset of multi-organ thrombosis affecting diverse vascular beds. Predisposing conditions include catastrophic antiphospholipid syndrome (APS), atypical thrombotic thrombocytopenic purpura (TTP), delayed heparin-induced thrombocytopenia and Trousseau syndrome. Patients who do not meet any of these criteria are diagnosed with idiopathic catastrophic thrombotic syndrome. Case description: A 44-year-old Caucasian woman with type II diabetes and hypothyroidism presented with acute onset of myalgia and extensive bruising over a period of four days. Physical exam revealed hypotension, tachycardia, and extensive purpuric and bullous skin lesions. Laboratory evaluation demonstrated microangiopathic hemolysis, thrombocytopenia, elevated D-dimer and coagulopathy suggesting disseminated intravascular coagulation (DIC) along with acute kidney injury (AKI) and transaminitis. Aggressive transfusions including packed red blood cells, fresh frozen plasma, platelets and cryoprecipitate were required to reverse her severe coagulopathy. Ultrasound showed occlusive thrombus in the left basilic vein and the greater saphenous veins bilaterally and heparin infusion was started. IV methylprednisolone, all-trans retinoic acid and doxycycline were empirically given. Workup was negative for any coagulation factor deficiency or hypercoagulable state although heterozygous factor V Leiden (FVL) mutation was found. Bone marrow biopsy was normal. Infectious and auto-immune workups were unremarkable. Skin biopsy showed diffuse intravascular thrombi but no evidence of vasculitis. Two weeks later, she developed Enterobacter bacteremia from infection of her bullous lesions. She was started on broad spectrum antibiotics and transferred to a burn unit. Eventually, her coagulopathy, bacteremia, AKI and transaminitis resolved, she was discharged with indefinite anticoagulation. Discussion: CTS presented in our patient with rapidly progressive thrombosis with consumptive coagulopathy. No obvious instigating source was found, her clinical presentation was out of proportion for the isolated heterozygous FVL mutation. Anticoagulation remained the main therapy in the acute setting and aggressive supportive care in multi-disciplinary setting to manage acute and late complications was required. Conclusion: Through this report, we emphasize the need for early recognition of CTS with this constellation of clinical findings and advocate for urgent interventions to prevent untoward outcomes.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122194575","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}
Rationale and Objectives: Subcutaneous panniculitic T-cell lymphoma (SPTCL) is a rare neoplasm accounting for less than 1% of pediatric Non-Hodgkin Lymphomas. It is most common in young adults with predominance of female cases at 0.5. Symptoms include multiple nodules involving the subcutaneous tissues of the extremities and trunk, neck and face. B symptoms such as fever, chills, night sweats and weight loss, have been reported. Rare extra-cutaneous manifestations include edema, involvement of the bone marrow, lymph nodes, liver, spleen, lungs and viscera. Laboratory abnormalities such as cytopenias and elevated lactate dehydrogenase have been recorded. Hemophagocytic syndrome (HPS) occurs in 33% of cases, which were correlated with fatal outcome. Case Report: We present a rare case of a 17 year-old male diagnosed with subcutaneous pannicultic T-cell lymphoma manifesting with prolonged fever, weight loss, and multiple subcutaneous nodules. He also presented with extra-cutaneous manifestations of facial edema, pleural effusion and ascites, lymph node enlargement, hepatosplenomegaly with jaundice and pancytopenia. Conclusion and Summary: Subcutaneous Panniculitic T-Cell Lymphoma may present with an unusual finding of facial edema, ascites and pleural effusion, lymph node enlargement, hepatosplenomegaly with jaundice and pancytopenia alongside skin manifestations of subcutaneous panniculitis. HPS may complicate the course, treatment decisions and outcome of the disease.
{"title":"Subcutaneous Panniculitic T-Cell Lymphoma in an Adolescent: A Case Report","authors":"","doi":"10.33140/ahor.03.01.02","DOIUrl":"https://doi.org/10.33140/ahor.03.01.02","url":null,"abstract":"Rationale and Objectives: Subcutaneous panniculitic T-cell lymphoma (SPTCL) is a rare neoplasm accounting for less than 1% of pediatric Non-Hodgkin Lymphomas. It is most common in young adults with predominance of female cases at 0.5. Symptoms include multiple nodules involving the subcutaneous tissues of the extremities and trunk, neck and face. B symptoms such as fever, chills, night sweats and weight loss, have been reported. Rare extra-cutaneous manifestations include edema, involvement of the bone marrow, lymph nodes, liver, spleen, lungs and viscera. Laboratory abnormalities such as cytopenias and elevated lactate dehydrogenase have been recorded. Hemophagocytic syndrome (HPS) occurs in 33% of cases, which were correlated with fatal outcome. Case Report: We present a rare case of a 17 year-old male diagnosed with subcutaneous pannicultic T-cell lymphoma manifesting with prolonged fever, weight loss, and multiple subcutaneous nodules. He also presented with extra-cutaneous manifestations of facial edema, pleural effusion and ascites, lymph node enlargement, hepatosplenomegaly with jaundice and pancytopenia. Conclusion and Summary: Subcutaneous Panniculitic T-Cell Lymphoma may present with an unusual finding of facial edema, ascites and pleural effusion, lymph node enlargement, hepatosplenomegaly with jaundice and pancytopenia alongside skin manifestations of subcutaneous panniculitis. HPS may complicate the course, treatment decisions and outcome of the disease.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130698031","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}
Background: Advanced breast cancer causes problems in morbidity, mortality, quality of life, and low survival rate. Hence, a biomarker to predict the progression of cancer is needed. Plasminogen activator inhibitor-1 (PAI-1) has been known as one of the prognostic factors. However, in vivo studies indicated that PAI-1 has controversial roles. Whether PAI-1 suppresses or promotes the development of cancer, is still being the question. The study aims to examine the role of PAI-1 in predicting the survival rate and its association with clinicopathologic factors in advanced breast cancer. Materials and Methods: The historical cohort analytic method in advanced breast cancer patients was conducted at Dharmais National Cancer Center Hospital. Clinical data were obtained from patients’ medical records. The expression of PAI-1 was assessed through immunohistochemistry assay staining of breast cancer tissue using antibody PAI-1 Santa Cruz Biotechnology, Inc., PAI-1 C-9 sc5297. Survival analysis was done to obtain the prognostic data. Moreover, its association with clinicopathologic factors was analyzed. Results: Fifty-eight subjects were included in this study. There was a significant association between the expression of PAI-1 and survival rate (hazard ratio [HR] = 4.08, 95% confidence interval [CI] = 1.75 - 9.50, p = 0.001). The Kaplan-Meier method indicated significant differences in survival rate between subjects with high expression of PAI1 and those with low expression in advanced breast cancer (p = 0.001). PAI-1 expression had a sensitivity of 84.7% and specificity of 60% based on immunohistochemical score cut off of 90. Furthermore, the expression of PAI-1 showed no significant association with clinicopathological factors except for histopathology grade. (Relative risk [RR] = 1.5, 95%, CI = 1.2 - 1.8, p = 0.047). Conclusion: Advanced breast cancer patients with high expression of PAI-1 have better survival. PAI-1 expression is not associated with clinicopathological factors, except for the histopathological grade.
背景:晚期乳腺癌在发病率、死亡率、生活质量、生存率等方面存在问题。因此，需要一种生物标志物来预测癌症的进展。纤溶酶原激活物抑制剂-1 (PAI-1)被认为是影响预后的因素之一。然而，体内研究表明PAI-1的作用存在争议。PAI-1是否抑制或促进了癌症的发展，仍然是一个问题。本研究旨在探讨PAI-1在预测晚期乳腺癌患者生存率中的作用及其与临床病理因素的关系。材料与方法:采用历史队列分析法对达摩斯国立肿瘤中心医院晚期乳腺癌患者进行分析。临床资料来源于患者的医疗记录。通过使用抗体PAI-1 Santa Cruz Biotechnology, Inc.， PAI-1 C-9 sc5297对乳腺癌组织进行免疫组化染色，评估PAI-1的表达。进行生存分析以获得预后数据。并分析其与临床病理因素的关系。结果:本研究共纳入58名受试者。PAI-1的表达与生存率有显著相关性(风险比[HR] = 4.08, 95%可信区间[CI] = 1.75 ~ 9.50, p = 0.001)。Kaplan-Meier法显示，晚期乳腺癌患者中PAI1高表达与低表达的生存率差异有统计学意义(p = 0.001)。免疫组化评分为90分，PAI-1表达敏感性为84.7%，特异性为60%。此外，PAI-1的表达与除组织病理分级外的临床病理因素无显著相关性。(相对危险度[RR] = 1.5, 95%， CI = 1.2 ~ 1.8, p = 0.047)。结论:PAI-1高表达的晚期乳腺癌患者生存率较高。PAI-1的表达与临床病理因素无关，除了组织病理分级。
{"title":"The Potential of Plasminogen Activator Inhibitor-1 as Prognostic Factor of Advanced Breast Cancer","authors":"","doi":"10.33140/ahor.03.01.09","DOIUrl":"https://doi.org/10.33140/ahor.03.01.09","url":null,"abstract":"Background: Advanced breast cancer causes problems in morbidity, mortality, quality of life, and low survival rate. Hence, a biomarker to predict the progression of cancer is needed. Plasminogen activator inhibitor-1 (PAI-1) has been known as one of the prognostic factors. However, in vivo studies indicated that PAI-1 has controversial roles. Whether PAI-1 suppresses or promotes the development of cancer, is still being the question. The study aims to examine the role of PAI-1 in predicting the survival rate and its association with clinicopathologic factors in advanced breast cancer. Materials and Methods: The historical cohort analytic method in advanced breast cancer patients was conducted at Dharmais National Cancer Center Hospital. Clinical data were obtained from patients’ medical records. The expression of PAI-1 was assessed through immunohistochemistry assay staining of breast cancer tissue using antibody PAI-1 Santa Cruz Biotechnology, Inc., PAI-1 C-9 sc5297. Survival analysis was done to obtain the prognostic data. Moreover, its association with clinicopathologic factors was analyzed. Results: Fifty-eight subjects were included in this study. There was a significant association between the expression of PAI-1 and survival rate (hazard ratio [HR] = 4.08, 95% confidence interval [CI] = 1.75 - 9.50, p = 0.001). The Kaplan-Meier method indicated significant differences in survival rate between subjects with high expression of PAI1 and those with low expression in advanced breast cancer (p = 0.001). PAI-1 expression had a sensitivity of 84.7% and specificity of 60% based on immunohistochemical score cut off of 90. Furthermore, the expression of PAI-1 showed no significant association with clinicopathological factors except for histopathology grade. (Relative risk [RR] = 1.5, 95%, CI = 1.2 - 1.8, p = 0.047). Conclusion: Advanced breast cancer patients with high expression of PAI-1 have better survival. PAI-1 expression is not associated with clinicopathological factors, except for the histopathological grade.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124656198","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}
Breast cancer is the first and most common cancer in women and represents the leading cause of female cancer death. To treat cancer, the treatment that is giving more results is the conventional poly-chemotherapy with numerous other substances that have specific action, called target therapy. During the treatment of breast cancer, chemotherapy drugs lead to the frequent detection of side effects, first of all, the Oral Mucositis. Oral mucositis (OM) is a common in cancer therapy, found in a percentage of 15-40%, and cause severe sequelae and strong impact on a patient’s quality of life (QoL), health care costs, and ultimately outcome by influencing the treatment dose. There are some and limited therapeutic options to help reduce the severity of OM. Our study evaluated the action of a mix of natural supplements (swallowable solution, Orasol plus®, for reduction of mucositis during chemotherapy, with Lapacho (Tabebuia Avellanedae Lorentz ex Griseb.), Camellia Sinensis L. Kuntze, Calendula Officinalis L, Malva Sylvestris L, Sisymbrium Officinale (L) Scop, Plantago Major L e Propoli) in 15 breast cancer patients under treatment with chemotherapy and target therapy. No patients had stopped the treatment because of mucositis. From 11 patients that have mucositis during treatment, 5 had complete remission at the and of the first cycle in the 4 patients who took Orasol Plus®, as a preventive measure, none developed mucositis during antiblastic treatments. The data of our study depose for the effectiveness of Orasol Plus® in the treatment of oral mucositis, in patients undergoing chemotherapy for breast cancer. They need a larger study to insert Orasol Plus® in a standardized pathway in the treatment of oral mucositis during chemotherapy.
乳腺癌是妇女中最常见的癌症，也是女性癌症死亡的主要原因。为了治疗癌症，效果更好的治疗方法是传统的多药化疗，其中包括许多其他具有特定作用的物质，称为靶向治疗。在乳腺癌的治疗过程中，化疗药物导致的副作用频繁被发现，首先是口腔黏膜炎。口腔黏膜炎(OM)在癌症治疗中很常见，占15-40%的比例，会引起严重的后遗症，并通过影响治疗剂量对患者的生活质量(QoL)、医疗保健费用和最终结果产生强烈影响。有一些有限的治疗选择可以帮助减轻OM的严重程度。我们的研究评估了15名接受化疗和靶向治疗的乳腺癌患者在化疗期间使用天然补充剂(可吞溶液Orasol plus®，用于减少黏膜炎)、拉帕柯(Tabebuia Avellanedae Lorentz ex Griseb.)、山茶花(Camellia Sinensis L. Kuntze)、金盏花(Calendula Officinalis L)、金盏花(Malva Sylvestris L)、西芹(Sisymbrium Officinale (L) scopp、车前草(Plantago Major L e Propoli)的混合作用。没有患者因黏膜炎而停止治疗。在治疗期间发生粘膜炎的11例患者中，4例服用Orasol Plus®的患者中有5例在第一个周期结束时完全缓解，作为预防措施，在抗母细胞炎治疗期间没有发生粘膜炎。我们的研究数据为Orasol Plus®治疗乳腺癌化疗患者口腔黏膜炎的有效性提供了依据。他们需要更大的研究来将Orasol Plus®插入化疗期间口腔黏膜炎的标准化途径中。
{"title":"Evaluation of the use of Orasol Plus®, A Mouthwash Based on Plant Extracts, in Mucositis in Patients with Breast Cancer Receiving Chemotherapy","authors":"M. Bonucci","doi":"10.33140/ahor.03.01.08","DOIUrl":"https://doi.org/10.33140/ahor.03.01.08","url":null,"abstract":"Breast cancer is the first and most common cancer in women and represents the leading cause of female cancer death. To treat cancer, the treatment that is giving more results is the conventional poly-chemotherapy with numerous other substances that have specific action, called target therapy. During the treatment of breast cancer, chemotherapy drugs lead to the frequent detection of side effects, first of all, the Oral Mucositis. Oral mucositis (OM) is a common in cancer therapy, found in a percentage of 15-40%, and cause severe sequelae and strong impact on a patient’s quality of life (QoL), health care costs, and ultimately outcome by influencing the treatment dose. There are some and limited therapeutic options to help reduce the severity of OM. Our study evaluated the action of a mix of natural supplements (swallowable solution, Orasol plus®, for reduction of mucositis during chemotherapy, with Lapacho (Tabebuia Avellanedae Lorentz ex Griseb.), Camellia Sinensis L. Kuntze, Calendula Officinalis L, Malva Sylvestris L, Sisymbrium Officinale (L) Scop, Plantago Major L e Propoli) in 15 breast cancer patients under treatment with chemotherapy and target therapy. No patients had stopped the treatment because of mucositis. From 11 patients that have mucositis during treatment, 5 had complete remission at the and of the first cycle in the 4 patients who took Orasol Plus®, as a preventive measure, none developed mucositis during antiblastic treatments. The data of our study depose for the effectiveness of Orasol Plus® in the treatment of oral mucositis, in patients undergoing chemotherapy for breast cancer. They need a larger study to insert Orasol Plus® in a standardized pathway in the treatment of oral mucositis during chemotherapy.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131174205","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}
Introduction: Merkel cell carcinoma (MCC) is a rare cutaneous indolent neuroendocrine cancer, arising from the Merkel cells of the stratum basalis, of the epidermis. This type of tumor commonly arises in sun-exposed areas, such as head, neck, and lower extremities. Here, we describe a rare presentation of non-indolent proliferative type Merkel cell carcinoma. Case Report: This is a case-report of a 70-year-old Caucasian man with no pertinent past medical history, presenting as a large painless violaceous necrotic irregular bordered rapidly growing lesion, reaching to 8x10x15 cm3, within one-year period, on the lower back region with surface ulceration. Pelvic MRI showed a multilobulated enhancing soft tissue mass measuring 8.7x10.4x15.1 cm3 at the left gluteal region with exophytic extension to the left paraspinal muscles. The patient was admitted, tangential surgical excision and debridement of left flank wound was performed with partial primary closure. Pathology showed features of Merkel cell, show diffuse dot-like positivity with CK20 and are negative for CK7, there is diffuse positivity with NSE, synaptophysin and CD56 with strong diffuse Ki-67 positivity noted in >65% of tumor cells. CD99 shows diffuse small faint dot-like paranuclear positivity. Discussion: Merkel cell carcinoma (MCC) is a rare, aggressive tumor that generally arises in sun-exposed regions. After an initial course of slow growth, starting as a painless violaceous non-pruritic domed-shaped lesion, the tumor becomes more aggressive, rapidly growing, with metastasis with local lymph nodes and regional tissue invasion. Sixty percent of tumors can rapidly grow within a three-month period after initial diagnosis. MCC is also clonally associated with is polyomavirus. MCC Contributing molecular pathogenesis is imperative to determining the causation of rare non-indolent MCC tumors, and its association with prognosis and treatment. In polyomavirus negative patients, consideration for molecular pathogenesis as etiology is imperative.
{"title":"Merkel Cell Carcinoma: A Case-Report of Rare Presentation of Merkel Cell Carcinoma, Non-Indolent Proliferative Type, Polyomavirus-Negative: Hypothesis of MolecularPathogenesis","authors":"","doi":"10.33140/ahor.03.01.05","DOIUrl":"https://doi.org/10.33140/ahor.03.01.05","url":null,"abstract":"Introduction: Merkel cell carcinoma (MCC) is a rare cutaneous indolent neuroendocrine cancer, arising from the Merkel cells of the stratum basalis, of the epidermis. This type of tumor commonly arises in sun-exposed areas, such as head, neck, and lower extremities. Here, we describe a rare presentation of non-indolent proliferative type Merkel cell carcinoma. Case Report: This is a case-report of a 70-year-old Caucasian man with no pertinent past medical history, presenting as a large painless violaceous necrotic irregular bordered rapidly growing lesion, reaching to 8x10x15 cm3, within one-year period, on the lower back region with surface ulceration. Pelvic MRI showed a multilobulated enhancing soft tissue mass measuring 8.7x10.4x15.1 cm3 at the left gluteal region with exophytic extension to the left paraspinal muscles. The patient was admitted, tangential surgical excision and debridement of left flank wound was performed with partial primary closure. Pathology showed features of Merkel cell, show diffuse dot-like positivity with CK20 and are negative for CK7, there is diffuse positivity with NSE, synaptophysin and CD56 with strong diffuse Ki-67 positivity noted in >65% of tumor cells. CD99 shows diffuse small faint dot-like paranuclear positivity. Discussion: Merkel cell carcinoma (MCC) is a rare, aggressive tumor that generally arises in sun-exposed regions. After an initial course of slow growth, starting as a painless violaceous non-pruritic domed-shaped lesion, the tumor becomes more aggressive, rapidly growing, with metastasis with local lymph nodes and regional tissue invasion. Sixty percent of tumors can rapidly grow within a three-month period after initial diagnosis. MCC is also clonally associated with is polyomavirus. MCC Contributing molecular pathogenesis is imperative to determining the causation of rare non-indolent MCC tumors, and its association with prognosis and treatment. In polyomavirus negative patients, consideration for molecular pathogenesis as etiology is imperative.","PeriodicalId":134553,"journal":{"name":"Advances in Hematology and Oncology Research","volume":"54 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114091540","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}
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