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Pathologists’ Role in the Evaluation of the Prognostic Implications of Circumferential Resection Margin in Resected Rectal Carcinoma 病理学家在直肠癌环切缘预后评估中的作用
Pub Date : 2019-05-15 DOI: 10.11648/J.AJLM.20190402.13
B. Seneviratne
Colorectal cancer is one of the most common malignancies in Sri Lanka as well as in other parts of the world and has a high incidence of cancer related deaths. Recent advances have been made with regard to the biological understanding of this disease and its treatment. Furthermore, new surgical, chemotherapeutic and radiotherapeutic strategies have been developed over the last decade in view of improving the quality of care. The worldwide introduction of total mesorectal excision (TME) in combination with the increasing use of neoadjuvant therapy has significantly improved the overall outcome. An important prognostic factor in rectal cancer is the status of the circumferential resection margin (CRM). The involvement of this margin has been associated with a poor prognosis. Pathologists play a vital role by providing important information for the clinical management of the patient and for the evaluation of health care as a whole. For the patient it confirms the diagnosis and describes the variables that will affect the prognosis, all of which will be relevant for the future management. For health care evaluation, pathology reports provide information for cancer registration and audit related to diagnostic and surgical procedures. Accurate evaluation of CRM in rectal carcinoma is important to determine the risk of local recurrence, which might subsequently be prevented by additional therapy. An increased risk was seen when the distance to CRM was < 2 mm.
结直肠癌是斯里兰卡以及世界其他地区最常见的恶性肿瘤之一,与癌症相关的死亡率很高。最近在对这种疾病的生物学认识及其治疗方面取得了进展。此外,在过去十年中,为了提高护理质量,新的手术、化疗和放射治疗策略也得到了发展。全肠系膜切除术(TME)在世界范围内的推广,以及新辅助治疗的不断增加,显著改善了总体结果。直肠癌预后的一个重要因素是环切缘(CRM)的状态。该切缘受累与预后不良有关。病理学家通过为患者的临床管理和整个医疗保健评估提供重要信息而发挥着至关重要的作用。对于患者来说,它确认了诊断并描述了影响预后的变量,所有这些都将与未来的管理相关。对于医疗保健评估,病理报告为癌症登记和审计提供了与诊断和外科手术相关的信息。准确评估直肠癌的CRM对确定局部复发的风险很重要,随后可能通过额外的治疗来预防局部复发。当距离CRM < 2mm时,风险增加。
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引用次数: 0
Olfactory Neuroblastoma Presenting as a Submandibular Mass 嗅觉神经母细胞瘤表现为下颌骨肿块
Pub Date : 2019-05-09 DOI: 10.11648/J.AJLM.20190402.12
S. Appukutty, S. Palma, S. Whitaker, K. Wood
Background: Olfactory Neuroblastoma is a rare, locally aggressive malignant neoplasm arising from the olfactory epithelium, which causes metastasis by lymphatic and haematogenous routes, with most common site being the cervical lymph nodes. Materials and Methods: Clinical history was retrieved from discussion in the Head and Neck multidisciplinary team meeting and medical records. Routine macroscopic and microscopic histological examination along with appropriate immunohistochemistry was performed. In addition, we include the review of literature of olfactory neuroblastoma metastatic to different sites. Results: A 75 year old female presented with a left submandibular mass which on biopsy was diagnosed as high grade neuroendocrine carcinoma requiring further investigation for characterising it as primary or metastatic. The histological diagnosis proved difficult and doubtful, till after five months when on follow up investigation a skull base lesion was identified, this on biopsy was confirmed to be an olfactory neuroblastoma. Conclusion: It is important to think laterally and consider metastatic tumours when evaluating neuroendocrine lesions in the submandibular region as this can be the first manifestation.
背景:嗅觉神经母细胞瘤是一种罕见的,局部侵袭性的恶性肿瘤,起源于嗅觉上皮,可通过淋巴和血液途径转移,最常见的部位是颈部淋巴结。材料和方法:从头颈部多学科小组会议的讨论和医疗记录中检索临床病史。常规肉眼、显微镜组织学检查及适当的免疫组织化学检查。此外,我们还回顾了嗅觉神经母细胞瘤转移到不同部位的文献。结果:一名75岁女性,左侧下颌下肿块,活检诊断为高级别神经内分泌癌,需要进一步调查其原发性或转移性特征。组织学诊断是困难和可疑的,直到5个月后,随访调查发现颅底病变,活检证实为嗅觉神经母细胞瘤。结论:在评估颌下区神经内分泌病变时,考虑转移性肿瘤是很重要的,因为这可能是第一个表现。
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引用次数: 0
Seroprevalence of Hepatitis C in Chronic Hemodialysis Patients in Marrakesh Region 马拉喀什地区慢性血液透析患者丙型肝炎血清患病率
Pub Date : 2019-04-30 DOI: 10.11648/J.AJLM.20190402.11
L. Arsalane, A. Boukhira, Karima Azizan, Y. Kamouni, S. Zouhair
Infection with the hepatitis C virus (HCV) is a major global public health problem. The objectives of this study are to evaluate the seroprevalence of hepatitis C in chronic hemodialysis patients, a category of patients at particular risk of hepatitis C virus transmission, and to identify the main risk factors for infection. This is a prospective study conducted from January 1st, 2015 to December 31st, 2017, including 600 chronic hemodialysis patients treated at 5 centers in the Marrakech region. Patients were tested for anti-HCV antibodies by chemiluminescent microparticulate immunoassay (CMIA). The confirmation is carried out by ELISA. The statistical analysis was performed using the SPSS statistics 17.0 software. The prevalence of anti-HCV antibodies is 15%. There is no statistically significant difference between the groups of HCV-infected and non-HCV-infected patients in terms of age, sex, and number of RBCs transfused. In contrast, the median hemodialysis duration and the number of attended hemodialysis centers were significantly higher in the HCV + group (p <0.001). The factor transfusion long incriminated, loses its importance. On the other hand, seniority in hemodialysis and the number of centers frequented seem to be contributing factors. Adherence to hygiene measures and the rigorous application of prevention recommendations against HCV transmission could further improve the prevalence of hepatitis C in dialysis units.
丙型肝炎病毒(HCV)感染是一个重大的全球公共卫生问题。本研究的目的是评估慢性血液透析患者(一类具有丙型肝炎病毒传播特别危险的患者)的丙型肝炎血清阳性率,并确定感染的主要危险因素。这是一项前瞻性研究,于2015年1月1日至2017年12月31日进行,包括在马拉喀什地区5个中心接受治疗的600名慢性血液透析患者。采用化学发光微颗粒免疫分析法(CMIA)检测患者的抗hcv抗体。采用酶联免疫吸附试验(ELISA)进行确证。采用SPSS统计17.0软件进行统计分析。抗hcv抗体的患病率为15%。hcv感染组与非hcv感染组在年龄、性别、红细胞输注次数等方面无统计学差异。相比之下,HCV +组的中位血液透析持续时间和参加血液透析中心的次数明显更高(p <0.001)。输血的因素长期受到指责,失去了其重要性。另一方面,血液透析的资历和经常光顾的中心数量似乎是影响因素。坚持卫生措施和严格执行预防丙型肝炎传播的建议可进一步提高丙型肝炎在透析单位的患病率。
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引用次数: 0
Serum Uric Acid and Plasma Glucose Levels in Normal Pregnancy 正常妊娠的血清尿酸和血糖水平
Pub Date : 2019-04-18 DOI: 10.11648/j.ajlm.20190401.14
Agbecha Ayu, A. U. Isaac
There are existing reports of an association of uric acid with glucose metabolism and their impact on adverse pregnancy outcomes. Hyperuricemia is linked to glucose homeostasis and basically to all components of the metabolic syndrome in the general population. Based on this premise, our study aimed at determining the level of serum uric acid and plasma glucose in second and third-trimester normal pregnancies with a view of establishing cut off values in Makurdi, Nigeria. The hospital-based case-control study involved a total of 103 participants aged 18-35 years attending the antenatal and the general health check up clinics. The participants comprised of 81 normal pregnant females in their second and third trimesters compared with 22 non pregnant controls. Their fasting plasma glucose and serum uric acid levels were compared among age-matched non-pregnant women (n=22), second (n=38), and third (n=43) trimester pregnancies. Serum uric acid level in second (5.89±0.85mg/dl) and third (6.23±1.30mg/dl) trimester pregnancies were significantly (p=0.000) higher than the non-pregnant controls (3.80±1.11mg/dl). A significant (p<0.01) increase in plasma glucose was observed in third-trimester pregnancies (5.19±0.64mmol/l) compared to second-trimester pregnancies (4.87±0.79mmol/l) and controls (4.65±0.51mmol/l). The study provided cut-off values for uric acid, glucose, and further points the need for prenatal care in terms of screening and diagnosis of pregnancy complications in all pregnant women including those considered at low risk.
已有报道称尿酸与葡萄糖代谢及其对不良妊娠结局的影响有关。高尿酸血症与葡萄糖稳态有关,基本上与普通人群代谢综合征的所有组成部分有关。基于这一前提,我们的研究旨在确定在尼日利亚马库尔迪正常妊娠中期和晚期的血清尿酸和血浆葡萄糖水平,以期建立截断值。这项以医院为基础的病例对照研究涉及103名年龄在18-35岁之间的参与者,他们参加了产前检查和一般健康检查诊所。参与者包括81名处于妊娠中期和晚期的正常孕妇,与22名未怀孕的对照组相比。他们的空腹血糖和血清尿酸水平在年龄匹配的未怀孕妇女(n=22),第二个(n=38)和第三个(n=43)妊娠三个月进行比较。妊娠中期(5.89±0.85mg/dl)和妊娠晚期(6.23±1.30mg/dl)血清尿酸水平显著高于未妊娠对照组(3.80±1.11mg/dl) (p=0.000)。妊娠晚期血糖(5.19±0.64mmol/l)高于妊娠中期(4.87±0.79mmol/l)和对照组(4.65±0.51mmol/l),差异有统计学意义(p<0.01)。该研究提供了尿酸和葡萄糖的临界值,并进一步指出了在筛查和诊断所有孕妇(包括那些被认为是低风险孕妇)妊娠并发症方面进行产前护理的必要性。
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引用次数: 1
Hematological Malignancies: Epidemiological, Clinical, Biological, Therapeutic and Evolutionary Aspects 血液恶性肿瘤:流行病学、临床、生物学、治疗和进化方面
Pub Date : 2019-04-13 DOI: 10.11648/J.AJLM.20190401.13
Mouhib Hanane, Zahir Hanane, Mouayche Ikhlas, Yahyaoui Hicham, A. A. Mustapha, C. Mohammed
Hematological malignancies are diseases, which include all cancers of blood and lymphoid organs. They result from a proliferation of mature blood cells or immature blood cells. However, in all cases, these blood cells escape the normal regulation. This work aims to determine the types and frequencies of diagnosed malignancies. It’s supported by the clinical hematological department of the Military Hospital Avicenna in Marrakech. We conducted a retrospective study over a period of 4 years from January, 1st 2012 to December, 31st 2015. We used an operating record, which includes epidemiological, clinical, biological, therapeutic and evolutionary criteria. During this period, we found that 70 cases were diagnosed and treated in the clinical hematological department of the HMA. We recorded 26 cases of multiple myeloma (37%), 23 cases of leukemia (33%), 19 cases of lymphoma (including 15 cases of non-Hodgkin lymphoma (21.4%) and 4 cases of Hodgkin lymphoma 5.7 %), 1 case of myelodysplastic syndrome (1.4%) and 1 case of polycythemia vera (1.4%). This work allowed us to note a significant increase in malignancies in this study. Hence the importance of raising the awareness of health professionals and raising awareness on a larger scale of the general population to improve the time of care and indirectly improve the prognosis of these diseases.
血液恶性肿瘤是一种疾病,包括所有血液和淋巴器官的癌症。它们是由成熟血细胞或未成熟血细胞的增殖引起的。然而,在所有情况下,这些血细胞都逃脱了正常的调节。这项工作的目的是确定诊断恶性肿瘤的类型和频率。它由马拉喀什阿维森纳军事医院的临床血液科提供支持。我们从2012年1月1日至2015年12月31日进行了为期4年的回顾性研究。我们使用了一份操作记录,其中包括流行病学、临床、生物学、治疗和进化标准。在此期间,我们发现在HMA临床血液科诊断和治疗了70例。多发性骨髓瘤26例(37%),白血病23例(33%),淋巴瘤19例(其中非霍奇金淋巴瘤15例(21.4%),霍奇金淋巴瘤4例(5.7%),骨髓增生异常综合征1例(1.4%),真性红细胞增多症1例(1.4%)。这项工作使我们注意到在这项研究中恶性肿瘤的显著增加。因此,必须提高卫生专业人员的认识,并在更大范围内提高一般人口的认识,以缩短护理时间,间接改善这些疾病的预后。
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引用次数: 0
Asymptomatic Uropathogenic Bacteriuria Among Pregnant and Non-pregnant Women at St Luke’s Hospital Anua, Offot Ukwa District Uyo: A Reassessment Case-Control Approach Uyo okwa地区阿努瓦圣卢克医院孕妇和非孕妇无症状尿路致病性细菌尿:重新评估病例-对照方法
Pub Date : 2019-03-18 DOI: 10.11648/J.AJLM.20190401.11
N. Akpan, A. Umoyen, Thomas Tentishe Luka, I. Onwuezobe, U. Antia, Abraham Solomon Okon
Asymptomatic bacteriuria is the presence of multiplying bacteria in the absence of any symptoms. The relevance of ASB lies in the insight it provides into symptomatic infections. Physiological and anatomical alterations during pregnancy make women more predisposed to urinary tract infection. This study seeks to determine the prevalence, risk factors, and bacteria profile among pregnant and non-pregnant women. A total of 230 pregnant women and 100 age-matched non-pregnant women were recruited. All pregnant women were recruited from individuals attending antenatal clinic and the controls recruited within the same hospital. Clean catch mid-stream urines ample was collected and microbial analysis done immediately. Significant ASB was identified and antibiotic sensitivity determined by conventional protocols. The overall prevalence of ASB in this study was 29.1% and 15% among pregnant and non-pregnant women respectively. The mean age was 25.3±5.2 and 24.2±5.6years for pregnant and non-pregnant women. Based on their parity among pregnant women, 112 (48.7%), 61(26.5%) and 57 (24.8%) were nulliparous, monoparous and multiparous respectively. Also, 37(16.1%), 70(30.4%) and 123(53.5%) of the pregnant women were in the 1st, 2nd and 3rd trimester. Sixty-seven (29.1%), 125 (54.3%) and 37 (16.1%) pregnant subjects were housewives, self-employed and civil servants in their occupation. Trimester was a risk factor for asymptomatic bacteriuria in the 2nd and 3rd trimester. There was association between age, parity, trimester and ASB. The most common isolate in this study was Escherichia coli (28.4%), followed by Klebsiella pneumonia (23.9%). The Escherichia coli and other uropathogens isolates were multiple drug sensitive between 50-100%. Previous bacteriuria treatment seeking pattern among the pregnant women was 138(60%), 42(18.3%), 32(13.9%) and 1(0.4%) for individuals who had sought treatments in hospitals, patent drug dealers (chemists), multi-centres and traditionally respectively. It is recommended that routine urine culture screening be conducted for all pregnant women at least in the second and third trimesters and positive ASB promptly treated.
无症状细菌性尿症是指在没有任何症状的情况下存在大量细菌。ASB的相关性在于它提供了对症状性感染的洞察。怀孕期间生理和解剖学的改变使妇女更容易发生尿路感染。本研究旨在确定孕妇和非孕妇的患病率、危险因素和细菌谱。总共招募了230名孕妇和100名年龄匹配的非孕妇。所有孕妇都是从产前诊所招募的,而对照组则是在同一家医院招募的。收集干净的中游尿液样本,并立即进行微生物分析。发现明显的ASB,并按常规方案确定抗生素敏感性。本研究中,ASB在孕妇和非孕妇中的总体患病率分别为29.1%和15%。孕妇和非孕妇的平均年龄分别为25.3±5.2岁和24.2±5.6岁。按胎次分,无产112例(48.7%),单产61例(26.5%),多产57例(24.8%)。妊娠1、2、3月分别为37例(16.1%)、70例(30.4%)和123例(53.5%)。家庭主妇、个体经营者和在职公务员分别占67(29.1%)、125(54.3%)和37(16.1%)。妊娠是妊娠2、3期无症状菌尿的危险因素。年龄、胎次、妊娠期与ASB存在相关性。本研究中最常见的分离物是大肠杆菌(28.4%),其次是肺炎克雷伯菌(23.9%)。大肠杆菌和其他尿路病原菌对多种药物敏感50 ~ 100%。在医院、专利药物经销商(药剂师)、多中心和传统医院寻求治疗的孕妇中,既往寻求细菌尿治疗的个体分别为138(60%)、42(18.3%)、32(13.9%)和1(0.4%)。建议至少在妊娠中期和晚期对所有孕妇进行常规尿培养筛查,并及时治疗ASB阳性。
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引用次数: 5
Community-Based Active Case Finding to Increase Tuberculosis Case Detection and Treatment Success Rate in High Tuberculosis Burden Areas of Arsi Zone, Oromia 奥罗米亚Arsi地区结核病高负担地区以社区为基础的积极病例发现提高结核病病例发现和治疗成功率
Pub Date : 1900-01-01 DOI: 10.11648/j.ajlm.20210606.13
Merga Gonfa Bati, Bizuayehu Gurmessa Ejeta
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引用次数: 0
Serum Vitamin D Level Status by Prostate Cancer Grade and Stage Among Native Africans 非洲原住民前列腺癌分级和分期的血清维生素D水平状况
Pub Date : 1900-01-01 DOI: 10.11648/j.ajlm.20220701.12
C. Amadi, C. Orluwene, Bright Amadi
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引用次数: 0
Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds 资源受限背景下HELLP综合征背景下AKI实验室指标研究
Pub Date : 1900-01-01 DOI: 10.11648/j.ajlm.20210606.16
C. Amadi, Bright Amadi
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引用次数: 0
Excessive Gestational Weight Gain Precedes Incident HELLP Syndrome Among Nigerian Women 尼日利亚妇女妊娠期体重增加过多先于HELLP综合征发生
Pub Date : 1900-01-01 DOI: 10.11648/j.ajlm.20210606.14
C. Amadi, Bright Amadi
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引用次数: 0
期刊
American Journal of Laboratory Medicine
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