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Infection in Multiple Myeloma: Microbiological Profile and Prognosis in Senegalese Patients

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Open Journal of Blood Diseases 2024年第2期14卷 47-58页

作者： Seynabou Fall El Hadj Daouda Niang Khadim Sarr lolita Mariéme Camara-Tall Modou Moustapha Ciss Amy Thiam Aminata Dakono Awa Ndiaye Fatou Samba Diago Ndiaye Clinical Hematology Department of Dalal Jamm Hospital Gudiawaye Dakar Sngal Hematology Clinic Unit of Aristide Le Dantec Hospital Dakar Sngal

Introduction: Infections are additional factors of morbidity and mortality in multiple myeloma (MM), and the current recommendation is antibiotic prophylaxis. In sub-Saharan Africa, few data on infectious complications of MM are available. We aim to describe the microbiological features of infections in MM, and their impact on survival in Senegalese patients. Methods: A retrospective (January 2005-January 2022), analytic, multicenter study on infections in patients followed for MM (IMWG criteria) in Senegalese clinical hematology services. The socio-epidemiological, diagnostic, microbiological, evolutionary and survival aspects were analyzed. Results: The study included 106 patients with multiple myeloma who had an infection at admission or during the treatment. Ten patients have the comorbidity (hypertension, lupus, type 2 diabetes). These patients had 136 infectious events identified at diagnosis (79.2%) or during chemotherapy (20.8%). The sites of infection are lung (42.6%), urinary (29.4%), dermatological (6.6%), digestive (5.2%), osteoarticular (4.4%), ear, nose and throat (3.7%), central nervous system (1.5%), or without site. We recorded 26.4% of patients with multi-site infections. The causal pathogens are bacteria (Gram-negative bacilli: 22.1%;Gram positive bacilli: 9.5%, Mycobacterium tuberculosis: 13.3%), parasitique (plasmodium falciparum 6.6%), viruses (SARS-COV2: 2.9%, VZV: 2.2%) and fungal (2.9%). Survival was reduced in patients who had an infection at the time of multiple myeloma diagnosis (p: 0.189) and those who had multiple infectious foci (p: 0.011). Conclusion: Infections in multiple myeloma are more frequent at diagnosis. The germs are varied and mostly bacteria, particularly gram-negative bacteria, and Kochs bacillus. Our study reveals that multiple infectious foci are a poor prognosis factor. It is necessary to evaluate the infectious risk early, and to adopt an antibiotic prophylaxis based on our tropical environment.

关键词： Multiple Myeloma Infections Tuberculosis Senegal

Using Bayesian multitemporal classification to monitor tropical forest cover changes in Kalimantan,Indonesia

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International Journal of Digital Earth 2022年第1期15卷 2061-2077页

作者： Inggit lolita Sari Christopher J.Weston Glenn J.Newnham Liubov Volkova Faculty of Science School of Ecosystem and Forest SciencesThe University of MelbourneCreswickAustralia Research Center for Remote Sensing National Research and Innovation Agency (BRIN)JakartaIndonesia CSIRO Land and Water Clayton SouthAustralia

Significant areas of native forest in Kalimantan,on the island of Borneo,have been cleared for the expansion of plantations of oil palm and *** this study multisource remote sensing was used to develop a time series of land cover maps that distinguish native forest from *** a study area in east Kalimantan,Landsat images were combined with either ALOS PALSAR or Sentinel-1 images to map four land cover classes(native forest,oil palm plantation,rubber plantation,non-forest).Bayesian multitemporal classification was applied to increase map accuracy and maps were validated using a confusion matrix;final map overall accuracy was>90%.Over 18 years from 2000 to 2018 nearly half the native forests in the study area were converted to either non-forest or plantations of either rubber or oil palm,with the highest losses between 2015 and *** upwards from 2008 large areas of degraded or cleared forests,mapped as non-forest,were converted to oil palm *** of native forests to plantation mainly occurred in lowland and wetland forest,while significant forest regrowth was detected in degraded *** maps will help Indonesia with strategies and policies for balancing economic growth and conservation.

关键词： Multitemporal classification Bayesian networks Landsat ALOS PALSAR sentinel-1 Indonesia

下壁心肌梗死患者Ⅰ导联ST段压低、V1导联ST段抬高在识别右冠状动脉为罪犯血管中的临床意义

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下壁心肌梗死患者Ⅰ导联ST段压低、V1导联ST段抬高在识别右冠状动...

作者： Pek Jeanne lolita 吉林大学

学位级别：硕士

目的:在某些国家,用于评估急性心肌梗死患者的侵入性手术,如冠状动脉造影并不普遍。因此,依靠心电图识别急性心肌梗死患者的血管和狭窄区域是至关重要的。本研究的主要目的是评估Ⅰ导联ST段压低和V1导联ST段抬高对预测右冠状动脉近端病... 详细信息

目的:在某些国家,用于评估急性心肌梗死患者的侵入性手术,如冠状动脉造影并不普遍。因此,依靠心电图识别急性心肌梗死患者的血管和狭窄区域是至关重要的。本研究的主要目的是评估Ⅰ导联ST段压低和V1导联ST段抬高对预测右冠状动脉近端病变的临床意义,并与侵入性手术,如冠脉造影进行比较。背景:心脏是位于胸腔的肌肉器官,其基本功能是推动血液流经全身。心脏本身是由冠状动脉供血的,冠状动脉的主要分支是右冠状动脉、左前降支和左旋动脉。这些动脉的持续供氧是心肌细胞发挥功能的基础。因此,这些血管的任何形式的阻塞或狭窄都可能导致心肌缺血或心肌梗死。在大约80%的人群中,心脏下壁是由右冠状动脉通过后降动脉供应的。然而,在大约6-10%的人群中,左旋冠状动脉供给后降动脉。下壁心肌梗塞IWMI可见累及心脏下半部和后部。心电图（ECG）是评估和指导疑似AMI患者治疗的主要诊断依据,通常12导联心电图表现为Ⅱ导联、Ⅲ导联和aVF导联ST段抬高。右心电导联可用于评估右心室功能。心脏生物标志物在急性心肌梗死的诊断中也具有重要的临床意义。心脏生物标志物升高与既往心绞痛症状、心电图、超声心动图表现阳性相关,此外,高风险评分可帮助医生决定是否进行紧急血管造影。临床使用的心肌坏死生物标志物有:CK-MB;肌红蛋白和肌钙蛋白。非侵入性的检测,如CT心脏扫描或钙评分可以帮助评估心肌梗死的风险。冠状动脉造影是冠状动脉疾病评估的基础。约40-50%的心肌梗死与下壁有关。右冠状动脉近端pRCA狭窄常累及右心室（RV）,通常伴有较差的预后。因此,要对这类患者进行的适当治疗,对罪犯血管的定位是首要的。由于某些地区（如发展中国家）的心血管护理人源供应不足,心血管介入并不容易获得,这就更加强调了心电图评估这一技术定位罪犯血管的重要性。方法:我们收集了2017年1月至2017年12月吉林大学第一医院心血管内科收治并行PCI的150例急性下壁心肌梗死患者的临床资料作回顾性研究。我们选择了符合我们纳入标准的150名患者（106名男性和44名女性）,即入院前有30分钟以上胸痛,肌钙蛋白Ⅰ水平升高,心电导联Ⅱ、Ⅲ、aVF,ST段升高,冠状动脉造影显示RCA或LCX单个血管完全闭塞或严重阻塞。排除标准包括:完全性束支传导阻滞或心室起搏、既往心肌梗死史、入院前曾行PCI或冠状动脉搭桥术（CABG）。患者分为两组,RCA近端组和RCA中、远端及LCX组（MDL）。近端组70例（46.7%）;MDL组80例（53.3%）。收集两组患者年龄、性别、危险因素史（高血压、糖尿病、高脂血症、吸烟）、肌钙蛋白Ⅰ、EF、心电图标准（V1导联ST段抬高;Ⅰ导联ST段压低）等资料进行比较。在研究之前,已获得机构伦理委员会（IEC）的伦理批准。结果:我们收集了150例诊断为下壁心肌梗死的患者,在评价过去的医疗、临床、实验室和调查记录后,所有150例患者均纳入进一步分析。男性106例（70.7%）,女性44例（29.3%）。在危险因素方面,93例（62%）患者主要危险因素为吸烟,68例（45.3%）患者存在高血压,36例（24%）患者存在高脂血症,31例（20.7%）患者存在糖尿病。冠状动脉造影显示RCA近端狭窄患者的平均年龄为60.16岁,RCA中、远端或LCX狭窄患者的平均年龄为57.46岁。RCA近端狭窄患者中男性49例（70%）,女性21例（30%）。RCA中、远端或LCX狭窄的患者中男性57例（71.2%）,女性23例（28.8%）。RCA近端狭窄的患者肌钙蛋白I均值为56.45（10.45～110.75）,RCA、远端或LCX狭窄患者肌钙蛋白I均值为36.75（9.53～93.42）。RCA近端狭窄的患者射血分数（EF）平均值为56（50.75～58.25）,而RCA中、远端或LCX狭窄患者EF平均值为56（52.0～58.75）。在被评估的患者中,年龄（P=0.98）、性别（P=0.867）、高血压（P=0.220）、糖尿病（P=0.306）、高脂血症（P=0.939）、吸烟（P=0.059）、EF（P=0.635）、肌钙蛋白I（P=0.628）在RCA近端组、RCX中端、远端或LCX狭窄组的差异均无统计学意义。但结果提示I导联ST段压低,V1导联ST段抬高并结合了两个心电图标准是其影响因素（P＜0.05）。观察到RCA近端狭窄患者以I导联ST段压低和V1导联ST段抬高更为常见。因此,通过分析准确性,敏感性,特异性,阳性预测值（PPV）和阴性预测值（NPV）来评估诊断性能。尽管特异性高,但敏感性低使这些标准值得怀疑。结论:综上所述,Ⅰ导联ST段压低和V1导联ST段抬高有助于预测下壁心肌梗死患者的pRCA闭塞。然而,这些标准的敏感性较低,因此不适合进行筛选。冠状动脉造影仍然是定位病变血管和狭窄区域的金标准。吸烟和高血

关键词：下壁心肌梗塞肌钙蛋白冠状动脉造影肌酸激酶 STEMI

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小白兔历险记

快乐童话故事 2009年第11期 33-36页

作者： lolita

阳光从窗户缝里洒进了小白兔落落的漂亮的房间里，照在了小落落的脸上，小落落柔柔眼睛，伸伸懒腰，四处张望了一下，下床，洗漱完毕后，来到客厅。爸爸妈妈已经把早餐给她摆好了，照旧的牛奶加面包，小落落觉得每天都吃一样的东西，感... 详细信息

阳光从窗户缝里洒进了小白兔落落的漂亮的房间里，照在了小落落的脸上，小落落柔柔眼睛，伸伸懒腰，四处张望了一下，下床，洗漱完毕后，来到客厅。爸爸妈妈已经把早餐给她摆好了，照旧的牛奶加面包，小落落觉得每天都吃一样的东西，感到非常的厌烦。于是，她找了个地方偷偷地把它们藏了起来，以免被爸爸妈妈发现。

关键词：历险记兔妈妈

Analysis of the Ambient Air Quality of Tarlac City： Baseline Data for Environmental Management Plan

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材料科学与工程（中英文A版） 2011年第1X期1卷 64-70页

作者： Xyris Gerard A. Fernandez lolita V. Sicat Maria Elena D. David Research Office Tarlac State University Tarlac City Philippines Vice President Academic Affairs Tarlac State University Tarlac City Philippines

This study aimed to monitor the level of air pollutants in the ambient air of Tarlac City. Samples were collected from different parts of the city to evaluate what area of the city (categorized as to: Station 1-highly active interchange, Station 2-bus interchange, Station 3-city center hub, and station 4- school community) has the highest level of pollution. The results were compared and interpreted based on the standard procedures specified under Republic Act 8749 otherwise known as the Philippine Clean Air Act of 1999. Total suspended particulates at stations 1 (over by 547.77 μg/Ncm), 2 (over by 41.01 μg/Ncm), and 3 (over by 150.51 μg/Ncm) exceeded the maximum allowable limit as described in the DENR standard. This may pose an unhealthy environment particularly to people with respiratory ailments such as asthma and allergies. Among the four stations, Station 1exhibited the highest levels in terms of TSP, NO2 and CO.

关键词：环境管理计划空气质量分析基准数据空气污染物环境空气监测城市中心呼吸系统疾病总悬浮微粒

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时间的玩伴

课堂内外(初中版) 2016年第9期 51-53页

作者： Sarita lolita 天真

阳台和课桌上,还摆着自己曾经精心呵护的绿植,翠绿的叶和挺拔的茎,总是让稍欠饱和的生活充满了成就感。猫咪时而跳上膝盖,懒散地打个盹,或躺睡在作业本上,四仰八叉,妨碍我与学习的深度沟通。可是慢慢地,他们都老了,叶不再绿,猫的步子蹒... 详细信息

阳台和课桌上,还摆着自己曾经精心呵护的绿植,翠绿的叶和挺拔的茎,总是让稍欠饱和的生活充满了成就感。猫咪时而跳上膝盖,懒散地打个盹,或躺睡在作业本上,四仰八叉,妨碍我与学习的深度沟通。可是慢慢地,他们都老了,叶不再绿,猫的步子蹒跚。时光带走了生机,青春不被独享。我的玩伴也是时间的玩伴,每一位都值得好好珍惜。

关键词：精心呵护深度沟通

Lineage structure of the human antibody repertoire in response to influenza vaccination

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医用生物力学 2013年第S1期28卷 36-37页

作者： Ning Jiang Jiankui He Joshua A.Weinstein lolita Penland Sanae Sasaki Xiao-Song He Patrick C.Wilson Harry B.Greenberg Mark M.Davis Daniel S.Fisher Stephen R.Quake Department of Biomedical Engineering the University of Texas at AustinAustinTXUSA Department of Bioengineering Stanford University School of MedicineStanfordCaliforniaUSA Biophysics Graduate Program Stanford UniversityStanfordCaliforniaUSA Department of Immunology and Microbiology Stanford University School of MedicineStanfordCaliforniaUSA VA Palo Alto Health Care System Palo AltoCaliforniaUSA Department of Medicine Stanford University School of MedicineStanfordCaliforniaUSA Department of Medicine University of Chicago Pritzker School of MedicineChicagoIllinoisUSA Howard Hughes Medical Institute Department of Applied Physics Stanford UniversityStanfordCaliforniaUSA Department of Biology Stanford UniversityStanfordCaliforniaUSA

The adaptive immune system produces a large and diverse set of antibodies,each with an individual evolutionary and clonal *** so called"antibody repertoire"protects each individual against insults such as infection and cancer,and responds to vaccination with B cell proliferation in response to the antigenic *** and antigen-specific FACSbased analysis have given us much insight on how the immune system generates the complex and diverse immune response required to protect the body from the wide variety of potential ***,these methods have not been sufficient to make global and unbiased characterizations of the clonal structure of the immune system of a particular individual。

关键词： vaccination clonal antigenic diverse insight stimulation evolutionary immunized protect vaccine

A New Observation of Bone Marrow Involvement by Diffuse Large B-Cell Lymphoma Mimicking Myelofibrosis

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Open Journal of Blood Diseases 2022年第2期12卷 39-44页

作者： Fall Seynabou Alioune Badara Diallo Dibor Niang El Hadji Daouda Niang Khadim Sarr Marième lolita Camara Abibatou Sall Fatou Samba Ndiaye Department of Hematology Cheikh Anta Diop University Dakar Senegal Department of Pathology Gaston Berger University Saint-Louis Senegal

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, characterized by high clinical and biological heterogeneity. Patients typically present with progressive lymphadenopathy, extranodal disease and may also experience fever, night sweats and unexplained weight loss. We report here the case of a 16-year-old female with osteoarticular pain, dizziness, and dyspnea on exertion. Clinical examination showed no lymphadenopathy. Complete blood count (CBC) revealed pancytopenia and marrow smears found to be hypocellular. Initial diagnosis favored secondary myelofibrosis. Diagnosis of bone marrow involvement by DLBCL was retained on bone marrow histology and immunohistochemistry which showed infiltration of large B lymphoid cells. The patient was treated by immunochemotherapy R-CHOP regimen. This case highlights a very rare and atypical circumstance of discovery of DLBCL with myelofibrosis as an initial symptom. Prognosis value of this presentation and management difficulties are also discussed.

关键词： Diffuse Large B-Cell Lymphoma Myelofibrosis Rituximab

从南北两极看地球——从极地角度讲授全球气候变化知识

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中国科技教育 2018年第10期 30-36页

作者： Natalie Harr Ylizarde lolita Cariaso Kiorpes 熊侃(翻译) 美国马里兰大学帕克分校美国马里兰州华德福北角中学中国科协青少年科技中心

地球正在经历着人类活动导致的全球变暖，这是气候学家达成的共识（Cook等人，2016）。气候变化在极地地区尤为明显，气温升高导致冰川融化，生态系统也在变化。

关键词：全球气候变化地球知识讲授全球变暖人类活动生态系统气候学