1. Overall survival (OS) results of a phase III randomized trial of standard-of-care therapy with or without enzalutamide for metastatic hormone-sensitive prostate cancer (mHSPC): ENZAMET (ANZUP 1304), an ANZUP-led international cooperative group trial. Testosterone suppression (TS) is the backbone of treatment for metastatic hormone-sensitive prostate cancer (mHSPC). Overall survival is improved by the addition of early docetaxel (DOC) or abiraterone to TS. The randomised phase 3 ENZAMET trial assessed the effects of enzalutamide (ENZA), a potent androgen receptor (AR) inhibitor, versus a nonsteroidal anti-androgen (NSAA: bicalutamide, nilutamide, or flutamide) in addition to SOC in mHSPC. Men (1125) with mHSPC were randomly assigned 1:1 to receive TS plus either ENZA (160 mg daily, by mouth, until clinical disease progression or prohibitive toxicity) or NSAA (conventional NSAA, by mouth until clinical disease progression or prohibitive toxicity). All participants were to receive standard background therapy with a LHRHA or surgical castration, as per standard of care. The choice of the LHRHA or surgical castration was at the discretion of the treating clinician. Randomization was stratified by: volume of disease (high vs low, according to CHAARTED); planned early DOC; planned anti-resorptive therapy, comorbidity score (ACE-27), and study site. The primary endpoint was overall survival. Subgroup analyses to assess possible modulation of the treatment effect were specified a priori and included planned early docetaxel (yes vs no) and volume of disease (high vs low). After a median follow-up of 33 months. Overall survival was prolonged by ENZA. At 3 years, 36% NSAA vs 64% ENZA were still on their assigned study treatment. Serious adverse events (regardless of attribution) within 30 days of study treatment occurred in 42% ENZA vs 34% NSAA, commensurate with the different durations of study treatment. ENZA significantly improved OS when added to SOC in mHSPC while the benefits appeared lower in those planned to receive early DOC.
{"title":"Oncology News / Literature Review / July-December 2019","authors":"E. Karatrasoglou, A. Tzovaras","doi":"10.2015/HC.V15I1.887","DOIUrl":"https://doi.org/10.2015/HC.V15I1.887","url":null,"abstract":"1. Overall survival (OS) results of a phase III randomized trial of standard-of-care therapy with or without enzalutamide for metastatic hormone-sensitive prostate cancer (mHSPC): ENZAMET (ANZUP 1304), an ANZUP-led international cooperative group trial. \u0000Testosterone suppression (TS) is the backbone of treatment for metastatic hormone-sensitive prostate cancer (mHSPC). Overall survival is improved by the addition of early docetaxel (DOC) or abiraterone to TS. The randomised phase 3 ENZAMET trial assessed the effects of enzalutamide (ENZA), a potent androgen receptor (AR) inhibitor, versus a nonsteroidal anti-androgen (NSAA: bicalutamide, nilutamide, or flutamide) in addition to SOC in mHSPC. \u0000Men (1125) with mHSPC were randomly assigned 1:1 to receive TS plus either ENZA (160 mg daily, by mouth, until clinical disease progression or prohibitive toxicity) or NSAA (conventional NSAA, by mouth until clinical disease progression or prohibitive toxicity). All participants were to receive standard background therapy with a LHRHA or surgical castration, as per standard of care. The choice of the LHRHA or surgical castration was at the discretion of the treating clinician. Randomization was stratified by: volume of disease (high vs low, according to CHAARTED); planned early DOC; planned anti-resorptive therapy, comorbidity score (ACE-27), and study site. The primary endpoint was overall survival. Subgroup analyses to assess possible modulation of the treatment effect were specified a priori and included planned early docetaxel (yes vs no) and volume of disease (high vs low). \u0000After a median follow-up of 33 months. Overall survival was prolonged by ENZA. At 3 years, 36% NSAA vs 64% ENZA were still on their assigned study treatment. Serious adverse events (regardless of attribution) within 30 days of study treatment occurred in 42% ENZA vs 34% NSAA, commensurate with the different durations of study treatment. \u0000ENZA significantly improved OS when added to SOC in mHSPC while the benefits appeared lower in those planned to receive early DOC.","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"15 1","pages":"33-35"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48783328","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}
N. Viazis, C. Pontas, G. Karampekos, E. Tsoukali, O. Giouleme, G. Theocharis, M. Tzouvala, A. Katsoula, M. Kalafateli, E. Zacharopoulou, E. Archavlis, Angeliki Chistidou, A. Manolakis, G. Mantzaris
Aim: To assess the efficacy of infliximab in ulcerative colitis (UC) patients who had failed therapy with adalimumab or golimumab. Methods: Retrospective analysis of prospectively acquired data of all anti-TNF naive patients with moderate to severe UC who received adalimumab or golimumab in 4 tertiary referral centres. Patients with primary non response or secondary loss of response to adalimumab or golimumab received therapy with infliximab. Clinical response and remission rates were assessed at week 14 and 54 after initiation of infliximab. Results: Between September 2015 and September 2017, 29 of 58 (50%) anti-TNF naive patients with moderate to severe UC failed therapy with adalimumab (n=38) or golimumab (n=20). Twenty one of 29 (72.4%) patients were primary non responders and 8 (27.6%) patients lost response to adalimumab or golimumab. All these 29 patients received infliximab, while 15 (51.7%) were on concomitant azathioprine therapy. Eighteen (62.1%) and 10 (34.5%) patients showed clinical response and clinical remission at week 14 respectively, while 14 (48.3%) patients were on clinical remission at week 54 after initiation of infliximab. Azathioprine co-administration at the start of infliximab was associated with a greater proportion of patients achieving clinical remission at week 54 (10 of 15 patients on combination therapy vs 4 of 14 patients on infliximab monotherapy, p=0.04). Conclusions: A significant proportion of anti-TNF naive patients with moderate to severe UC who have failed 1st course therapy with subcutaneous anti-TNF agents can achieve clinical response and/or remission with 2nd course therapy with infliximab.
{"title":"Efficacy of Infliximab after Failure of Subcutaneous Anti-TNF Agents in Patients with Moderate to Severe Ulcerative Colitis","authors":"N. Viazis, C. Pontas, G. Karampekos, E. Tsoukali, O. Giouleme, G. Theocharis, M. Tzouvala, A. Katsoula, M. Kalafateli, E. Zacharopoulou, E. Archavlis, Angeliki Chistidou, A. Manolakis, G. Mantzaris","doi":"10.2015/HC.V15I1.878","DOIUrl":"https://doi.org/10.2015/HC.V15I1.878","url":null,"abstract":"Aim: To assess the efficacy of infliximab in ulcerative colitis (UC) patients who had failed therapy with adalimumab or golimumab. Methods: Retrospective analysis of prospectively acquired data of all anti-TNF naive patients with moderate to severe UC who received adalimumab or golimumab in 4 tertiary referral centres. Patients with primary non response or secondary loss of response to adalimumab or golimumab received therapy with infliximab. Clinical response and remission rates were assessed at week 14 and 54 after initiation of infliximab. Results: Between September 2015 and September 2017, 29 of 58 (50%) anti-TNF naive patients with moderate to severe UC failed therapy with adalimumab (n=38) or golimumab (n=20). Twenty one of 29 (72.4%) patients were primary non responders and 8 (27.6%) patients lost response to adalimumab or golimumab. All these 29 patients received infliximab, while 15 (51.7%) were on concomitant azathioprine therapy. Eighteen (62.1%) and 10 (34.5%) patients showed clinical response and clinical remission at week 14 respectively, while 14 (48.3%) patients were on clinical remission at week 54 after initiation of infliximab. Azathioprine co-administration at the start of infliximab was associated with a greater proportion of patients achieving clinical remission at week 54 (10 of 15 patients on combination therapy vs 4 of 14 patients on infliximab monotherapy, p=0.04). Conclusions: A significant proportion of anti-TNF naive patients with moderate to severe UC who have failed 1st course therapy with subcutaneous anti-TNF agents can achieve clinical response and/or remission with 2nd course therapy with infliximab.","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"40 1","pages":"24-30"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41293004","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 are all accustomed to face serum cholesterol as a potential threat for our health and so wish and try to have its levels as low as possible. So, in clinical practice we are rather indifferent or even satisfied when we find very low serum cholesterol levels -what we can call “hypocholesterolemia- in a certain individual. Is this practice right or it should be reevaluated? Since cholesterol is an important component of all cell membranes and its concentrations affect membrane permeability and fluidity it is highly probable that very low levels of it may disturb some cell functions and participate in the pathogenesis of diseases. Let’s start with a definition of the term, although this is not generally accepted. It can be described as a serum total cholesterol level under the fifth percentile of a general population adjusted for sex and age.1 In a less complicated manner it can be defined as less than 115 mg/dl. In a study of 7,000 healthy blood donors, a percentage of 7,8% were found to meet the criteria for hypocholesterolemia. Hypocholesterolemia may be congenital or acquired. Congenital conditions are either combined with low LDL- (low density lipoprotein) or low HDL- (high density lipoprotein) cholesterol levels.
{"title":"Hypocholesterolemia: a blessing or a problem?","authors":"A. Yalouris","doi":"10.2015/HC.V15I1.891","DOIUrl":"https://doi.org/10.2015/HC.V15I1.891","url":null,"abstract":"We are all accustomed to face serum cholesterol as a potential threat for our health and so wish and try to have its levels as low as possible. So, in clinical practice we are rather indifferent or even satisfied when we find very low serum cholesterol levels -what we can call “hypocholesterolemia- in a certain individual. Is this practice right or it should be reevaluated? Since cholesterol is an important component of all cell membranes and its concentrations affect membrane permeability and fluidity it is highly probable that very low levels of it may disturb some cell functions and participate in the pathogenesis of diseases. \u0000Let’s start with a definition of the term, although this is not generally accepted. It can be described as a serum total cholesterol level under the fifth percentile of a general population adjusted for sex and age.1 In a less complicated manner it can be defined as less than 115 mg/dl. In a study of 7,000 healthy blood donors, a percentage of 7,8% were found to meet the criteria for hypocholesterolemia. \u0000Hypocholesterolemia may be congenital or acquired. Congenital conditions are either combined with low LDL- (low density lipoprotein) or low HDL- (high density lipoprotein) cholesterol levels.","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"15 1","pages":"3-6"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44386316","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}
I. Patsaki, A. Kyriakopoulos, Martha Katartzi, V. Markaki, Emmanouel Papadopoulos
BackgroundEarly physiotherapy in critical ill patients is a key component to their functional recovery. Burn patients are presented with severe complications that lead to reduced functional ability.ObjectiveThe aim of this paper is to present the case of a 22 year old male patient with a 45% burn of total body surface area, who was admitted in the Intensive Care Unit.MethodsEarly physiotherapy commenced from the early stages of acute illness and involved respiratory and musculoskeletal interventions in order to prevent and address complications from prolonged immobilization and mechanical ventilation. ResultsPatient through his stay in the ICU presented significant clinical improvements. He was successfully liberated from mechanical ventilation and decannulated from tracheostomy tube. Improvements in muscle strength and functional ability was noted once discharged from the ICU to a High Dependence Unit.ConclusionIn the current case study physiotherapy was a vital and effective component of the therapeutic plan of severe burn patient being admitted in a acute care facility and positioning of the upper and lower limbs is of huge importance, in order to minimize and avoid contractures.
{"title":"Physiotherapy in a Burn Patient Admitted in Intensive Care Unit","authors":"I. Patsaki, A. Kyriakopoulos, Martha Katartzi, V. Markaki, Emmanouel Papadopoulos","doi":"10.2015/HC.V15I1.877","DOIUrl":"https://doi.org/10.2015/HC.V15I1.877","url":null,"abstract":"BackgroundEarly physiotherapy in critical ill patients is a key component to their functional recovery. Burn patients are presented with severe complications that lead to reduced functional ability.ObjectiveThe aim of this paper is to present the case of a 22 year old male patient with a 45% burn of total body surface area, who was admitted in the Intensive Care Unit.MethodsEarly physiotherapy commenced from the early stages of acute illness and involved respiratory and musculoskeletal interventions in order to prevent and address complications from prolonged immobilization and mechanical ventilation. ResultsPatient through his stay in the ICU presented significant clinical improvements. He was successfully liberated from mechanical ventilation and decannulated from tracheostomy tube. Improvements in muscle strength and functional ability was noted once discharged from the ICU to a High Dependence Unit.ConclusionIn the current case study physiotherapy was a vital and effective component of the therapeutic plan of severe burn patient being admitted in a acute care facility and positioning of the upper and lower limbs is of huge importance, in order to minimize and avoid contractures.","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"15 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45740212","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}
Anemia is an almost universal phenomenon (ninety five percent) among critically ill patients, especially if they stay in the ICU more than 3 days. Forty to fifty percent of such patients receive red blood cell transfusions. Blood loss (due to blood sampling), iron reduced availability and utilization and cytokine mediated bone marrow suppression account for this loss of red blood cell mass. Anemia is itself associated with worse outcomes, independently of the nature of underlying disease. Transfusion therapy nevertheless, probably is not the ideal solution as it is related to increased mortality and hospital infections. Both the degree of anemia and transfusion intensity could represent either causative influences or merely surrogate markers of severe illness, posing significant difficulties on the interpretation of investigational results. Currently, restriction of red blood cell transfusion threshold to 7g/l has become the standard practice. Following the famous TRICC trial which introduced the low threshold concept, the few predicted exceptions regarding sepsis, hemorrhage or cardiac disease were addressed with new studies. The results of these studies force towards the implementation of the restrictive strategy throughout the whole transfusion indications spectrum in the ICU, with the exception of the symptomatic coronary patients. In order to minimize transfusion intensity however, acute context care must be optimum, multidisciplinary treatment approaches and support being timely provided.
{"title":"Red Blood Cell Unit Utilization in the ICU: Evidence and Confidence","authors":"Dimitrios Zervakis, Stylianos Saridakis","doi":"10.2015/HC.V15I1.811","DOIUrl":"https://doi.org/10.2015/HC.V15I1.811","url":null,"abstract":"Anemia is an almost universal phenomenon (ninety five percent) among critically ill patients, especially if they stay in the ICU more than 3 days. Forty to fifty percent of such patients receive red blood cell transfusions. Blood loss (due to blood sampling), iron reduced availability and utilization and cytokine mediated bone marrow suppression account for this loss of red blood cell mass. Anemia is itself associated with worse outcomes, independently of the nature of underlying disease. Transfusion therapy nevertheless, probably is not the ideal solution as it is related to increased mortality and hospital infections. Both the degree of anemia and transfusion intensity could represent either causative influences or merely surrogate markers of severe illness, posing significant difficulties on the interpretation of investigational results. Currently, restriction of red blood cell transfusion threshold to 7g/l has become the standard practice. Following the famous TRICC trial which introduced the low threshold concept, the few predicted exceptions regarding sepsis, hemorrhage or cardiac disease were addressed with new studies. The results of these studies force towards the implementation of the restrictive strategy throughout the whole transfusion indications spectrum in the ICU, with the exception of the symptomatic coronary patients. In order to minimize transfusion intensity however, acute context care must be optimum, multidisciplinary treatment approaches and support being timely provided.","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"15 1","pages":"7-17"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48519738","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}
Mary Shelley (1797-1851) is an English novelist best known for her Gothic novel* Frankenstein or The Modern Prometheus, written in 1818. In this novel, Victor Frankenstein, an excellent young scientist specialized in chemistry but also connoisseur of other sciences, develops a genius technique to impart life in a huge humanoid that he constructed using parts of dead human bodies. However, when he sees his creature come into life he abandons it terrified. As the creature wanders without an aim or help, it faces human enmity and that transforms it to a maniac for vengeance, extremely directed against its creator. It does not hesitate to murder the persons who are most precious to Victor, including his younger brother and even his bride at the night of their wedding. Victor starts a desperate chase of his creature that leads him to the North Pole, where he dies of exhaustion. The Creature, seeing him dead, mourns for him and, having decided to die too, drifts away on an ice raft and is soon “lost in darkness and distance”, never to be seen again. Although the “Creature” remains nameless in the novel, it is usually referred in every-day practice with the name of its creator. That’s why the name “Frankenstein” is often used metaphorically to describe an evil existence that causes death and destruction (Figure 1)**. Editorial
{"title":"Artificial Intelligence: Are we creating a new Frankenstein?","authors":"A. Yalouris, Mary Shelley","doi":"10.2015/HC.V14I1.867","DOIUrl":"https://doi.org/10.2015/HC.V14I1.867","url":null,"abstract":"Mary Shelley (1797-1851) is an English novelist best known for her Gothic novel* Frankenstein or The Modern Prometheus, written in 1818. In this novel, Victor Frankenstein, an excellent young scientist specialized in chemistry but also connoisseur of other sciences, develops a genius technique to impart life in a huge humanoid that he constructed using parts of dead human bodies. However, when he sees his creature come into life he abandons it terrified. As the creature wanders without an aim or help, it faces human enmity and that transforms it to a maniac for vengeance, extremely directed against its creator. It does not hesitate to murder the persons who are most precious to Victor, including his younger brother and even his bride at the night of their wedding. Victor starts a desperate chase of his creature that leads him to the North Pole, where he dies of exhaustion. The Creature, seeing him dead, mourns for him and, having decided to die too, drifts away on an ice raft and is soon “lost in darkness and distance”, never to be seen again. Although the “Creature” remains nameless in the novel, it is usually referred in every-day practice with the name of its creator. That’s why the name “Frankenstein” is often used metaphorically to describe an evil existence that causes death and destruction (Figure 1)**. Editorial","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"14 1","pages":"3-6"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47265161","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}
C. Giatra, Eirini Tziotziou, K. Psarra, M. Garofalaki, E. Grigoriou, S. Karakatsanis, Evaggelia Nikolou, S. Delimpasi, T. Tzenou, S. Gigantes, I. Baltadakis, D. Karakasis, I. Tsonis, V. Kapsimali, F. Kontopidou, M. Pagoni, T. Karmiris, A. Tsirogianni, N. Harhalakis
OBjeCTive: Immunophenotype has been correlated with molecular aberrations in several studies. The aim of this study was the discovery of immunophenotypic features related to mutations in AML and MDS patients connected to prognostic factors. Moreover, an effort to evaluate a method for the detection of the most common Nucleophosmin (NPM1) mutations of exon12 and Internal Tandem Duplications (ITD) mutations of FLT3 gene by flow cytometry was performed. MeThOd: Patients with de novo myeloid neoplasms [AML and MDS (AML-M3 patients were excluded)] were included. FLT3/ITD/TKD and NPM1 mutations were detected by PCR and fragment analysis. The immunophenotypic analysis was performed by multi-dimensional flow cytometry (FC) with a standardized panel of monoclonal antibodies on peripheral blood or bone marrow samples. Nucleophosmin Antibody and CD135 were used for the mutations immunophenotypic detection. ReSulTS: NPM1 and/or FLT3 mutations correlated with low or no expression of more immature cells markers such as CD34, CD117, HLADR, as well as higher expression of more mature markers such as CD11b. The higher expression of CD33 should be mentioned as well. The presence of NPM1mut and FLT3/ITD does not seem to be detectable by FC at least using these two monoclonal antibodies. The presence of CD7 aberrant lymphoid marker’s expression was associated with FLT3mut, NPM1wt genotype. CD56 or CD2 positivity was found only in patients’ samples negative for NPM1 and/or FLT3 mutations. COnCluSiOnS: Certain immunophenotype findings including the presence of aberrant lymphoid markers may be indicative of the presence of mutations in NPM1 and FLT3 linked to prognosis. ORiginAl ARTiCle Department of HaematologyLymphomas and BMT Unit, “Evangelismos” General Hospital of Athens, Greece Department of Immunology and Histocompatibility, “Evangelismos” General Hospital of Athens, Greece Haematology Department, Hippocratio Hospital Athens Greece, National and Kapodistrian University of Athens Microbiology and Immunology Department, National and Kapodistrian University of Athens Haematology Unit of the 3 Internal Medicine Clinic, Sotiria General Hospital Athens Medical School, Athens Greece HOSPITAL CHRONICLES 2019, 14(1): 13–23 Correspondence to: Eirini Tziotziou, Department of Molecular Biology Lab, Department of Haematology-Lymphomas and BMT Unit, “Evangelismos” General Hospital of Athens, 45-47, Ipsilandou street, 10676 Athens, Greece Tel.: +3
{"title":"Could Immunophenotype Guide Molecular Analysis in Patients with Myeloid Malignancies","authors":"C. Giatra, Eirini Tziotziou, K. Psarra, M. Garofalaki, E. Grigoriou, S. Karakatsanis, Evaggelia Nikolou, S. Delimpasi, T. Tzenou, S. Gigantes, I. Baltadakis, D. Karakasis, I. Tsonis, V. Kapsimali, F. Kontopidou, M. Pagoni, T. Karmiris, A. Tsirogianni, N. Harhalakis","doi":"10.2015/HC.V14I1.860","DOIUrl":"https://doi.org/10.2015/HC.V14I1.860","url":null,"abstract":"OBjeCTive: Immunophenotype has been correlated with molecular aberrations in several studies. The aim of this study was the discovery of immunophenotypic features related to mutations in AML and MDS patients connected to prognostic factors. Moreover, an effort to evaluate a method for the detection of the most common Nucleophosmin (NPM1) mutations of exon12 and Internal Tandem Duplications (ITD) mutations of FLT3 gene by flow cytometry was performed. MeThOd: Patients with de novo myeloid neoplasms [AML and MDS (AML-M3 patients were excluded)] were included. FLT3/ITD/TKD and NPM1 mutations were detected by PCR and fragment analysis. The immunophenotypic analysis was performed by multi-dimensional flow cytometry (FC) with a standardized panel of monoclonal antibodies on peripheral blood or bone marrow samples. Nucleophosmin Antibody and CD135 were used for the mutations immunophenotypic detection. ReSulTS: NPM1 and/or FLT3 mutations correlated with low or no expression of more immature cells markers such as CD34, CD117, HLADR, as well as higher expression of more mature markers such as CD11b. The higher expression of CD33 should be mentioned as well. The presence of NPM1mut and FLT3/ITD does not seem to be detectable by FC at least using these two monoclonal antibodies. The presence of CD7 aberrant lymphoid marker’s expression was associated with FLT3mut, NPM1wt genotype. CD56 or CD2 positivity was found only in patients’ samples negative for NPM1 and/or FLT3 mutations. COnCluSiOnS: Certain immunophenotype findings including the presence of aberrant lymphoid markers may be indicative of the presence of mutations in NPM1 and FLT3 linked to prognosis. ORiginAl ARTiCle Department of HaematologyLymphomas and BMT Unit, “Evangelismos” General Hospital of Athens, Greece Department of Immunology and Histocompatibility, “Evangelismos” General Hospital of Athens, Greece Haematology Department, Hippocratio Hospital Athens Greece, National and Kapodistrian University of Athens Microbiology and Immunology Department, National and Kapodistrian University of Athens Haematology Unit of the 3 Internal Medicine Clinic, Sotiria General Hospital Athens Medical School, Athens Greece HOSPITAL CHRONICLES 2019, 14(1): 13–23 Correspondence to: Eirini Tziotziou, Department of Molecular Biology Lab, Department of Haematology-Lymphomas and BMT Unit, “Evangelismos” General Hospital of Athens, 45-47, Ipsilandou street, 10676 Athens, Greece Tel.: +3","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"14 1","pages":"13-23"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42835539","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}
S. Theodoropoulou, V. Triantafyllou, G. Konstantakopoulos, E. Bellou, A. Yalouris
{"title":"Sustained serotonin syndrome in a treatment-resistant depressed patient during maintenance treatment with combination of three serotonergic agents","authors":"S. Theodoropoulou, V. Triantafyllou, G. Konstantakopoulos, E. Bellou, A. Yalouris","doi":"10.2015/HC.V14I1.857","DOIUrl":"https://doi.org/10.2015/HC.V14I1.857","url":null,"abstract":"","PeriodicalId":91266,"journal":{"name":"Hospital chronicles = Nosokomeiaka chronika","volume":"14 1","pages":"27-30"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49150489","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}
A. Karekla, Charalampia Linardi, A. Morfopoulos, Ioannis K. Lamprinakis
The purpose of this study is to investigate the effect of ultrasound energy used during phacoemulsification on corneal structure, which is the most important refractive part of the eye. This will be achieved with the comparison of preoperative and postoperative parameters related to corneal thickness and endothelium and their correlation with clinical, intrasurgical and imaging diagnostic findings. MeThodS: This is a clinical prospective study conducted in Evangelismos G.H.A. The patients’ enrollment was based on detailed medical history assessment, medication records as well as meticulous slit lamp examination, tonometry, best corrected visual acuity evaluation and thorough fundoscopy. Nuclear cataract sclerosis was evaluated with Lens Opacities Classification System III, and patients were scheduled for surgery. Preoperatively, with the use of specular microscopy (Tomey EM-3000; Tomey, Tennenlohe, Germany), CCT and several endothelial indices were recorded. The same measurements took place the 1, 7 and 30 postoperative day. All the surgical operations were done without complications. ReSulTS: Statistical analysis from preoperative and postoperative data showed that central corneal thickness, although elevated during the 1 and 7 postoperative day, did not present statistical significant difference in the final evaluation, with a mean elevation of only 3,9μm. Endothelial cell density levels though were reduced in all postoperative measurements (p<0,001). The final ECL% was 18,58%, with the most profound loss being accounted in the first postoperative week. Corneal edema and endothelial cell loss were correlated with poor visual acuity, reduced corneal curvature, increased nuclear sclerosis and prolonged time of ultrasound metrics. ConCluSion: The use of confocal microscopy is a useful tool in pointing significant differences of corneal structure after uneventfull cataract phacoemulsification. The evaluation of a larger cohort of patients and a prolonged follow up procedure could give further information concerning corneal alterations after surgery. oRiginAl ARTiCle Ophthalmology Department, “Evangelismos” General Hospital of Athens, Greece HOSPITAL CHRONICLES 2019, 14(1): 7–12 Correspondence to: Charalampia Linardi, MD, PhD, Msc Director of Ophthalmology Department, “Evangelismos” General Hospital of Athens, 45-47, Ipsilandou street, 10676 Athens, Greece Tel.: +30 6944 506360 E-mail: harilinardi@gmail.com Manuscript received March 3, 2018; revised manuscript received June 12, 2019; Accepted June 12, 2019 Key woRdS: Cataract, phacoemulsification, cornea, lens, endothelium, ultrasound, confocal microscopy AbbreviAtion List CCT: central corneal thickness CV: coefficient of variation ECD: endothelial cell density ECL%: endothelial cell loss% SD: standard deviation. The authors declare that there is no financial relationship or conflict of interest to disclose concerning this article
本研究的目的是研究超声乳化过程中使用的超声能量对角膜结构的影响，角膜结构是眼睛最重要的屈光部分。这将通过比较与角膜厚度和内皮相关的术前和术后参数及其与临床、术内和影像学诊断结果的相关性来实现。MeThodS：这是一项在Evangelismos G.H.a.进行的临床前瞻性研究。患者的入组基于详细的病史评估、药物记录以及细致的裂隙灯检查、眼压测量、最佳矫正视力评估和彻底的眼底镜检查。核性白内障硬化症采用晶状体混浊分类系统III进行评估，并安排患者进行手术。术前，使用镜面显微镜（Tomey EM-3000；Tomey，Tennenlohe，德国），记录CCT和几个内皮指数。术后1、7和30天进行了相同的测量。所有的手术都没有并发症。ReSulTS：术前和术后数据的统计分析显示，尽管术后1天和7天角膜中央厚度升高，但在最终评估中没有统计学上的显著差异，平均升高仅为3.9μm。然而，在所有术后测量中，内皮细胞密度水平均降低（p＜0001）。最终ECL%为18,58%，最严重的损失发生在术后第一周。角膜水肿和内皮细胞损失与视力差、角膜曲率降低、核硬化增加和超声测量时间延长有关。结论：共聚焦显微镜是一种有用的工具，可以指出白内障超声乳化术后角膜结构的显著差异。对更大的患者队列进行评估和延长随访程序可以提供有关手术后角膜改变的进一步信息。oRiginAl ARTiCle眼科，“Evangelismos”雅典综合医院，希腊医院2019，14（1）：7-12通讯：Charalampia Linardi，医学博士，博士，雅典“Evangelimsos”综合医院眼科主任，45-47，Ipsilandou街，10676，希腊电话：+30 6944 506360电子邮件：harilinardi@gmail.com手稿于2018年3月3日收到；2019年6月12日收到修订稿；2019年6月12日接受关键工作：白内障，超声乳化，角膜，晶状体，内皮，超声，共聚焦显微镜AbbreviAtion List CCT:角膜中央厚度CV:变异系数ECD:内皮细胞密度ECL%：内皮细胞损失%SD:标准差。作者声明，关于本文，不存在任何财务关系或利益冲突
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