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Plasma Cell Neoplasms, Clinicopathological Characteristics and Immunophenotype of 21 Patients

Open Journal of Pathology 2012年第4期2卷 127-132页

作者： Mónica Belinda Romero-Guadarrama Cinthia Adriana Meza Medina elvira aguilar martínez Facultad de Medicina Universidad Autónoma de Nayarit Tepic Mexico Unidad de Hematología del Hospital General de México Mexico City Mexico Unidad de Patología del Hospital General de México Mexico City Mexico

Introduction: Plasma cell neoplasms are monoclonal proliferations characterized by the secretion of an immunoglobulin product known as component "M" or monoclonal. The World Health Organization (WHO 2008) defines as plasma cell neoplasms the following: plasma cell myeloma, plasmacytoma and those syndromes defined by immunoglobulin deposits and primary amyloidosis, The objective of the present work was to correlate their clinical, morphological and phenotype characteristics in 21 patients. Material and Methods: A 2-year retrospective review was performed of the files of the surgical pathology laboratory and of the hematology service of the General Hospital of Mexico, searching for patients with a diagnosis of plasma cell neoplasm. We analyzed the following variables: age, gender, clinical symptoms, evolution, localization, laboratory tests, morphology, and expression of immunohistochemical markers. Of the 21 patients, 12 (57.1%) corresponded to plasma cell myelomas and 9 (42.8%) were plasmacytomas (seven extraosseous and two solitary bone plasmacytoma);women predominated with 61.4% and age ranged between 22 and 84 years. Mass and epistaxis were observed in the patients with plasmacytomas, and symptoms of medullary compression and anemia were observed in those patients with plasma cell myeloma. The time of symptomatology varied from 3 to 12 months. Laboratory tests revealed that lactate dehydrogenase (LDH), beta 2 microglobulin, C-reactive protein were altered and that hypercalcemia and anemia were present more in the systemic form of the disease. Treatment depended on the clinical staging and laboratory data. Mature forms predominated morphologically. Immunohistochemical stain revealed a constant expression for CD 138, six patients expressed CD 56, and expression of the Kappa and Lambda light chains was while.

关键词： Plasma Cell Neoplasms

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Association between lifestyle factors and thyroid function in young euthyroid adults

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Food Science and Human Wellness 2024年第1期13卷 265-275页

作者： Elisa Merchan-Ramirez Guillermo Sanchez-Delgado Lucas Jurado-Fasoli Francisco M Acosta Manuel Munoz-Torres Jose M.Llamas-elvira Jonatan R Ruiz Sport and Health University Research Institute(iMUDS) Faculty of Sports ScienceUniversity of GranadaGranada 18016Spain Pennington Biomedical Research Center Baton Rouge 70808USA Faculty of Medicine University of GranadaGranada 18071Spain Turku PET Centre University of TurkuTurku 20500Finland Turku PET Centre Turku University HospitalTurku 20520Finland Biosanitary Research Institute of Granada(Ibs.Granada) Granada 18012Spain CIBERFES Instituto de Salud CarlosⅢMadrid 28029Spain Endocrinology and Nutrition Service University Hospital San CecilioGranada 18016Spain Nuclear Medicine Service "Virgen de las Nieves"University HospitalGranada 18014Spain

Purpose:The present work examines the associations of dietary habits,sedentarism,physical activity(PA)levels and sleep habits,with thyroid function in young euthyroid ***:A total of 105 young euthyroid adults participated in this cross-sectional *** function was determined in fasting conditions(>6 h).Dietary habits were measured by a food frequency questionnaire and three non-consecutive 24 h recalls,and different dietary intake and patterns were then *** time spent in sedentary,PA levels and sleep habits were objectively measured using a wrist-worn ***:Energy and carbohydrate intake were positively associated with thyroid stimulating hormone(TSH)(β=0.222;R^(2)=0.102;P=0.022 andβ=0.425;R^(2)=0.129;P=0.007,respectively)whereas fat intake was negatively associated with TSH(β=-0.428;R^(2)=0.137;P=0.004).Energy intake was also positively associated with free triiodothyronine(β=0.277;R^(2)=0.137;P=0.004).Further,adherence to the Mediterranean diet was negatively related to TSH and free thyroxine(FT4)(β=-0.221;R^(2)=0.113;P=0.020 andβ=-0.268;R^(2)=0.071;P=0.007,respectively).Vigorous-intensity and overall PA were negatively associated with FT4(β=-0.227;R^(2)=0.052;P=0.022 andβ=-0.204;R^(2)=0.042;P=0.041,respectively).In contrast,no associations were found between sleep parameters and thyroid ***:Lifestyle factors such as dietary intake and PA levels seems to be related to thyroid function even in young euthyroid adults.

关键词： Thyroid hormones Dietary intake Sleep Physical activity Euthyroid

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在成年人的 Non-cycloplegic 球形的相等的折射: 双通行证系统，视网膜镜检法，主观折射和装桌子的 autorefractor 的比较

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International Journal of Ophthalmology(English edition) 2013年第5期6卷 618-625页

作者： Meritxell Vilaseca Montserrat Arjona Jaume Pujol elvira Peris Vanessa martìnez Centre for Sensors Instruments and Systems Development(CD6)Technical University of Catalonia University Vision Centre (CUV) Department of Optics and OptometryTechnical University of Catalonia

AIM:To evaluate the accuracy of spherical equivalent(SE) estimates of a double-pass system and to compare it with retinoscopy,subjective refraction and a table mounted ***:Non-cycloplegic refraction was performed on 125 eyes of 65 healthy adults(age 23.5±3.0 years) from October 2010 to January 2011 using retinoscopy,subjective refraction,autorefraction(Auto kerato refractometer TOPCON KR-8100,Japan) and a double pass system(Optical Quality Analysis System,OQAS,Visiometrics S.L.,Spain).Nine consecutive measurements with the double-pass system were performed on a subgroup of 22 eyes to assess *** evaluate the trueness of the OQAS instrument,the SE laboratory bias between the double pass system and the other techniques was ***:The SE mean coefficient of repeatability obtained was *** correlations could be established between the OQAS and the SE obtained with retinoscopy(r=0.956,P<0.001),subjective refraction(r=0.955,P<0.001) and autorefraction(r=0.957,P<0.001).The differences in SE between the double-pass system and the other techniques were significant(P<0.001),but lacked clinical relevance except for retinoscopy;Retinoscopy gave more hyperopic values than the double-pass system-0.51±0.50D as well as the subjective refraction-0.23±0.50D;More myopic values were achieved by means of autorefraction 0.24±0.49D. CONCLUSION:The double-pass system provides accurate and reliable estimates of the SE that can be used for clinical *** technique can determine the correct focus position to assess the ocular optical ***,it has a relatively small measuring range in comparison with autorefractors(-8.00 to +5.00D),and requires prior information on the refractive state of the patient.

关键词： double-pass system optical quality retinoscopy autorefraction subjective refraction accuracy repeatability trueness

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Current knowledge on the laboratory diagnosis of Clostridium difficile infection

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World Journal of Gastroenterology 2017年第9期23卷 1552-1567页

作者： Adrián martínez-Meléndez Adrián Camacho-Ortiz Rayo Morfin-Otero Héctor Jesús Maldonado-Garza Licet Villarreal-Trevino elvira Garza-González Departamento de Microbiología e Inmunología Facultad de Ciencias BiológicasUniversidad Autónoma de Nuevo León.Pedro de Alba S/NCiudad UniversitariaSan Nicolás de los Garza Servicio de Infectología Hospital Universitario“Dr.JoséEleuterio González”Universidad Autónoma de Nuevo León.Av.Francisco I.Madero Pte.S/NCol.Mitras Centro.Monterrey Hospital Civil de Guadalajara “Fray Antonio Alcalde”e Instituto de Patología Infecciosa y ExperimentalCentro Universitario de Ciencias de la SaludUniversidadde Guadalajara.Sierra Mojada 950Col.Independencia Servicio de Gastroenterología Hospital Universitario“Dr.JoséEleuterio González”Universidad Autónoma de Nuevo León.Av.Francisco I.Madero Pte.S/NCol.Mitras Centro.Monterrey

Clostridium difficile (C. difficile) is a spore-forming, toxin-producing, gram-positive anaerobic bacterium that is the principal etiologic agent of antibiotic-associated diarrhea. Infection with C. difficile (CDI) is characterized by diarrhea in clinical syndromes that vary from selflimited to mild or severe. Since its initial recognition as the causative agent of pseudomembranous colitis, C. difficile has spread around the world. CDI is one of the most common healthcare-associated infections and a significant cause of morbidity and mortality among older adult hospitalized patients. Due to extensive antibiotic usage, the number of CDIs has increased. Diagnosis of CDI is often difficult and has a substantial impact on the management of patients with the disease, mainly with regards to antibiotic management. The diagnosis of CDI is primarily based on the clinical signs and symptoms and is only confirmed by laboratory testing. Despite the high burden of CDI and the increasing interest in the disease, episodes of CDI are often misdiagnosed. The reasons for misdiagnosis are the lack of clinical suspicion or the use of inappropriate tests. The proper diagnosis of CDI reduces transmission, prevents inadequate or unnecessary treatments, and assures best antibiotic treatment. We review the options for the laboratory diagnosis of CDI within the settings of the most accepted guidelines for CDI diagnosis, treatment, and prevention of CDI.

关键词： Clostridium 顽固 Toxigenic 文化 Nucleic 酸扩大测试酶免疫分析诊断 Glutamate 脱氢酶

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Risk factors associated with the development of ischemic colitis

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World Journal of Gastroenterology 2010年第36期16卷 4564-4569页

作者： Joaquín Cubiella Fernández Luisa Núez Calvo elvira González Vázquez Maria Jesús García García Maria Teresa Alves Pérez Isabel martínez Silva Javier Fernández Seara Department of Gastroenterology Complexo Hospitalario de Ourense32005 OurenseSpain Department of Internal Medicine Complexo Hospitalario de Ourense32005 OurenseSpain Department of Internal Medicine Fundación Pública Hospitalaria de Verín32600 VerinSpain Research Support Unit Complexo Hospitalario de Orense32005 OurenseSpain Biostatistic Unit University of Santiago de Compostela15703 Santiago de CompostelaSpain

AIM:To ascertain the role of cardiovascular risk factors,cardiovascular diseases,standard treatments and other diseases in the development of ischemic colitis(IC).METHODS:A retrospective,case-control study was designed,using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through *** was diagnosed on the basis of endoscopic findings and diagnostic or compatible *** were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy,excluding those with diagnosis of *** were matched with controls(ratio 1:2),by age and sex.A conditional logistic regression was ***:A total of 483 patients(161 cases,322 con-trols)were included;mean age 75.67±10.03 years,55.9%*** principal indications for colonos-copy in the control group were lower gastrointestinal hemorrhage(35.4%),anemia(33.9%),abdominal pain(19.9%)and diarrhea(9.6%).The endoscopic findings in this group were hemorrhoids(25.5%),diverticular disease(30.4%),polyps(19.9%)and colorectal cancer(10.2%).The following variables were associated with IC in the univariate analysis:arterial hypertension(P= 0.033);dyslipidemia(P<0.001);diabetes mellitus(P =0.025);peripheral arterial disease(P=0.004);heart failure(P=0.026);treatment with hypotensive drugs(P=0.023);angiotensin-converting enzyme inhibitors;(P=0.018);calcium channel antagonists(P=0.028);and acetylsalicylic acid(ASA)(P<0.001).Finally,the following variables were independently associated with the development of IC:diabetes mellitus[odds ratio(OR)1.76,95%confidence interval(CI):1.001-3.077,P=0.046];dyslipidemia(OR 2.12,95%CI:1.26-3.57,P=0.004);heart failure(OR 3.17,95%CI:1.31-7.68,P=0.01);peripheral arterial disease(OR 4.1,95%CI:1.32-12.72,P=0.015);treatment with digoxin(digitalis)(OR 0.27,95%CI:0.084-0.857,P=0.026);and ASA(OR 1.97,95%CI:1.16-3.36,P=0.012).CONCLUSION:The development of an episode of IC was independently associat

关键词： Ischemic colitis Diabetes mellitus Dyslipidemia Acetylsalicylic acid Peripheral arterial disease Digoxin

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Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival

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World Journal of Gastrointestinal Oncology 2022年第1期14卷 295-318页

作者： Ramón Cantero-Cid Karla Marina Montalbán-Hernández Jenny Guevara Alejandro Pascual-Iglesias Elisa Pulido JoséCarlos Casalvilla Cristóbal Marcano Cristina Barragán Serrano Jaime Valentín Gloria Cristina Bonel-Pérez JoséAvendaño-Ortiz Verónica Terrón Roberto Lozano-Rodríguez Alejandro martín-Quirós elvira Marín Eva Pena Laura Guerra-Pastrián Eduardo López-Collazo Luis Augusto Aguirre Tumor Immunology Laboratory The Innate Immune Response GroupHospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Digestive Surgery Service La Paz University HospitalMadrid 28046Spain Emergency Department and Emergent Pathology Research Group Hospital La Paz Institute for Health Research(IdiPAZ)Madrid 28046Spain Pathologic Anatomy Service Hospital La PazMadrid 28046Spain

BACKGROUND Colorectal cancer(CRC)accounts for 9.4%of overall cancer deaths,ranking second after lung *** the large number of factors tested to predict their outcome,most patients with similar variables show big differences in ***,right-sided CRC(RCRC)and left-sided CRC(LCRC)patients exhibit large differences in outcome after surgical intervention as assessed by preoperative blood leukocyte *** hypothesised that stronger indexes than circulating(blood)leukocyte ratios to predict RCRC and LCRC patient outcomes will result from combining both circulating and infiltrated(tumour/peritumour fixed tissues)concentrations of *** To seek variables involving leukocyte balances in peripheral blood and tumour tissues and to predict the outcome of CRC *** Sixty-five patients diagnosed with colon adenocarcinoma by the Digestive Surgery Service of the La Paz University Hospital(Madrid,Spain)were enrolled in this study:43 with RCRC and 22 with *** were followed-up from January 2017 to March 2021 to record overall survival(OS)and recurrence-free survival(RFS)after surgical *** concentrations in peripheral blood were determined by routine laboratory ***-fixed samples of tumour and peritumoural tissues were assessed for leukocyte concentrations by immunohistochemical detection of CD4,CD8,and CD14 marker *** of leukocyte concentration in blood and tissues were calculated and evaluated for their predictor values for OS and RFS with Spearman correlations and Cox univariate and multivariate proportional hazards regression,followed by the calculation of the receiver-operating characteristic and area under the curve(AUC)and the determination of Youden’s optimal cutoff values for those variables that significantly correlated with either RCRC or LCRC patient *** patients from the cohort were randomly assigned to modelling and validation sets,and clinician-friendly nomogra

关键词： Left colorectal cancer Leukocyte ratios Prognostic variables Recurrence-free survival Right colorectal cancer Overall survival

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Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation

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Journal of Geriatric Cardiology 2020年第3期17卷 141-148,I0005-I0007页

作者： Gines elvira-Ruiz Cesar Caro-martinez Pedro JoseFlores-Blanco Juan JoseCerezo-Manchado Helena Albendin-Iglesias Alejandro Lova-Navarro Francisco Arregui-Montoya Francisca Maria Munoz-Franco Natalia Garcia-Iniesta Arcadio Garcia-Alberola JoseLuis Bailen-Lorenzo Domingo Andres Pascual-Figal Sergio Manzano-Fernández Department of Cardiology University Hospital Virgen de la ArrixacaMurciaSpain Instituto Murciano de Investigación en Biomedicina(IMIB) MurciaSpain Department of Cardiology University Hospital Morales MeseguerMurciaSpain Department of Hematology University Hospital Virgen de la ArrixacaMurciaSpain Department of Internal Medicine University Hospital Virgen de la ArrixacaMurciaSpain School of Medicine University of MurciaMurciaSpain Department of Cardiology Hospital Vega BajaAlicanteSpain

Background The identification of modifiable bleeding risk factors may be of *** aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(MB)in non-valvular atrial fibrillation(AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagulation between January 2013 and December *** was defined as moderate or severe according to European echocardiography guidelines ***,ATRIA and ORBIT scores were used to evaluate the bleeding *** was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of *** 168(5.8%)patients had *** with AS had higher risk for MB compared to those without AS(HR=2.13,95%CI:1.40-3.23,P<0.001).Patients without AS and low-intermediate bleeding risk(0 points)showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk(2 points)was the highest *** and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of *** In this population,AS was associated with an increased risk for MB at midterm *** three scoring systems showed a moderate discriminatory ability for ***,the addition of AS was associated with a significant improvement in their predictive *** suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment.

关键词： Anticoagulants Aortic stenosis Atrial fibrillation Major bleeding Valvular disease

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What is the optimal level of vitamin D in non-dialysis chronic kidney disease population?

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World Journal of Nephrology 2016年第5期5卷 471-481页

作者： Pablo Molina JoséL Górriz Mariola D Molina Sandra Beltrán Belén Vizcaíno Verónica Escudero Julia Kanter Ana Iávila Jordi Bover elvira Fernández Javier Nieto Secundino Cigarrán Enrique Gruss Gema Fernández-Juárez Alberto martínez-Castelao Juan F Navarro-González Ramón Romero Luis M Pallardó Department of Nephrology Dr Peset University Hospital46017 ValenciaSpain Department of Medicine Universitat de València46005 ValenciaSpain Department of Mathematics Universidad de AlicanteSan Vicente del Raspeig03690 AlicanteSpain Department of Nephrology FundacióPuigvert080348 BarcelonaSpain Department of Nephrology Hospital Uni-versitari de LleidaIRBlleida(Institut de Reserca Biomèdica de Lleida)25198 LleidaSpain Department of Nephrology Hospital General Universitario de Ciudad Real13005 Ciudad RealSpain Department of Nephrology Hospital da Costa Burela7880 LugoSpain Department of Nephrology Hospital Universitario Fundación Alcorcón28922 MadridSpain Department of Nephrology Hospital Universitario de BeellvitgeIDIBELLL'Hospitalet de Llobregat08907 BarcelonaSpain Research Unit and Department of Nephrology University Hospital Nuestra Senora de Candelaria38010 Santa Cruz de TenerifeSpain Department of Medicine Universitat Autònoma de Barcelona08193 BarcelonaSpain

AIM To evaluate thresholds for serum 25(OH)D concentrations in relation to death, kidney progression and hospitalization in non-dialysis chronic kidney disease(CKD) *** Four hundred and seventy non-dialysis 3-5 stage CKD patients participating in OSERCE-2 study, a prospective, multicenter, cohort study, were prospectively evaluated and categorized into 3 groups according to 25(OH)D levels at enrollment(less than 20 ng/mL, between 20 and 29 ng/mL, and at or above 30 ng/mL), considering 25(OH)D between 20 and 29 ng/mL as reference group. Association between 25(OH)D levels and death(primary outcome), and time to first hospitalization and renal progression(secondary outcomes) over a 3-year followup, were assessed by Kaplan-Meier survival curves and Cox-proportional hazard models. To identify 25(OH)D levels at highest risk for outcomes, receiver operating characteristic(ROC) curves were *** Over 29 ± 12 mo of follow-up, 46(10%) patients dead, 156(33%) showed kidney progression, and 126(27%) were hospitalized. After multivariate adjustment, 25(OH)D < 20 ng/mL was an independent predictor of all-cause mortality(HR = 2.33; 95%CI: 1.10-4.91; P = 0.027) and kidney progression(HR = 2.46; 95%CI: 1.63-3.71; P < 0.001), whereas the group with 25(OH)D at or above 30 ng/mL did not have a different hazard for outcomes from the reference group. Hospitalization outcomes were predicted by 25(OH) levels(HR = 0.98; 95%CI: 0.96-1.00; P = 0.027) in the unadjusted Cox proportional hazards model, but not after multivariate adjusting. ROC curves identified 25(OH)D levels at highest risk for death, kidney progression, and hospitalization, at 17.4 ng/mL [area under the curve(AUC) = 0.60; 95%CI: 0.685-0.69; P = 0.027], 18.6 ng/mL(AUC = 0.65; 95%CI: 0.60-0.71; P < 0.001), and 19.0 ng/m L(AUC = 0.56; 95%CI: 0.50-0.62; P = 0.048), ***25(OH)D < 20 ng/mL was an independent predictor of death and progression in patients with stage 3-5 CKD, with no addit

关键词： Vitamin D Chronic kidney disease Mortality Renal progression Hospitalization

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