Academic literature on the topic '581.956 93'

Abstract Abstract 2389 Autologous hematopoietic cell transplantation (autoHCT) is standard therapy for high-risk hematologic disorders and solid tumors. We assessed whether overall survival (OS) at Day 100, which represents early transplant-related mortality (TRM), and at one year, which represents disease-related mortality and later TRM, had changed over time. The study population was derived from patients undergoing 68,404 first autoHCTs between 1994–2005 in US and Canadian centers reported to the CIBMTR. Statistical significance was measured using Ptrend over 6 time cohorts to test whether the OS estimates were stable (slope = 0), increasing (slope>0) or decreasing (slope<0) over time. The Day 100 and 1-year OS estimates are shown in the Table. Disease and disease status subgroups were defined a priori, and the OS estimates are not adjusted for any covariates such as age, Karnofsky status, etc. Mortality rates at Day 100 were, in general, low for all diseases examined and improved significantly over time for NHL in complete remission (CR) 2/sensitive 1st relapse, for lymphoma in primary induction failure (no prior complete remission) and myeloma in first partial or complete remission. Improvements in 1-year OS were seen for NHL in CR1/sensitive 1st relapse and myeloma in remission at the time of transplant. OS has improved for many patients undergoing autoHCT which likely reflects improvement in supportive care and better patient selection. Day 100 mortality rates in autoHCT patients treated during the most recent period 2004-5 are as low as 2–5% in patients with chemotherapy sensitive disease pre-autoHCT. Even in patients transplanted with resistant disease (no prior CR), the Day 100 mortality rate is only 5% in MM and 9% in HL/NHL patients. Although the 1-year OS has improved over time there is still a significant decline in OS between the Day 100 and 1-year time points, especially for patients with NHL in CR2/sensitive 1st relapse, lymphoma in primary induction failure and myeloma not in remission, suggesting a need for improved disease control in these patients. Table 1: Overall survival (95% CI) estimates over time. Autologous HCT 1994-5 1996-7 1998-9 2000-01 2002-3 2004-5 Ptrend NHL in CR2/Rel 1 sens N 890 1067 1041 1020 946 1116 <0.001 @100 days 89 (87–91) 90 (88–92) 90 (88–92) 94 (92–95) 94 (92–95) 95 (94–97) <0.001 @1 year 68 (65–71) 69 (66–72) 72 (69–75) 77 (75–80) 78 (75–80) 80 (77–83) HL in CR2/Rel1 sens N 384 384 466 435 477 573 0.4758 @100 days 95 (92–97) 95 (92–97) 96 (94–97) 97 (95–98) 96 (94–98) 97 (95–98) 0.1985 @1 year 86 (82–89) 87 (84–91) 87 (83–90) 89 (85–92) 90 (87–93) 91 (88–93) HL or NHL in PIF N 647 708 772 895 570 504 0.0299 @100 days 86 (84–89) 88 (86–90) 87 (84–89) 90 (87–92) 90 (88–93) 91 (89–94) 0.7532 @1 year 69 (65–73) 69 (65–72) 70 (67–74) 72 (68–75) 71 (67–75) 72 (67–76) MM in CR1/PR1/PIF sens N 267 541 718 1567 2423 3192 <0.001 @100 days 96 (94–98) 96 (94–98) 96 (94–97) 97 (96–98) 98 (97–98) 98 (98–99) <0.001 @1 year 83 (79–88) 84 (81–87) 87 (85–90) 90 (89–92) 92 (91–93) 92 (91–93) MM in less than PR N 105 177 392 420 521 586 0.3829 @100 days 92 (85–96) 94 (90–97) 96 (94–98) 96 (94–98) 97 (95–98) 95 (93–97) 0.0857 @1 year 79 (70–87) 79 (73–85) 86 (82–89) 88 (84–91) 88 (85–91) 87 (84–90) NHL – non-Hodgkin lymphoma, HL – Hodgkin lymphoma, MM – myeloma, CR – complete remission, Rel – relapse, PIF – primary induction failure, sens – sensitive Disclosures: No relevant conflicts of interest to declare.

ZusammenfassungZiel der Arbeit war, Referenzwerte für Blutparameter bei Kaninchen verschiedener Rassen mit einer für die Praxis geeigneten Blutentnahmemethode zu erstellen. Zur Sammlung der Daten wurde Blut von 155 klinisch gesunden Kaninchen im Alter von sechs Wochen bis neuneinhalb Jahren aus der V. saphena lateralis entnommen. Für die folgenden Parameter wurden Referenzbereiche bestimmt: Hämatokrit (Hkt; 0,36-0,55 l/l), Hämoglobinkonzentration (Hb; 7,03-10,63 mmol/l), Erythrozytenzahl (5,36-8,13 ×1012/l), Erythrozytenindices (MCHC: 18,4-20,1 mmol/l, MCH: 1,14-1,37 fmol/l, MCV 59,3-69,6 fl), Leukozytenzahl (3,02-11,91 × 109/l), Differenzialblutbild (Monozyten: 0-756 × 106/l [0-12%], Lymphozyten: 1576-7870 × 106/l [32-81%], stabkernige neutrophile Granulozyten: 0 × 106/l (0%), segmentkernige neutrophile Granulozyten: 820-5031 × 106/l [15-61%], eosinophile Granulozyten: 0-82 × 106/l [0-1%], basophile Granulozyten: 0-518 × 106/l [0-7%], Thrombozytenzahl (193-725 × 109/l), die Enzymaktivitäten von Alaninaminotransferase (ALT; 0-61 IU/l), alkalische Phosphatase (AP; 0-397 IU/l), Aspartataminotransferase (AST; 0-28 IU/l), Glutamatdehydrogenase (0-19 IU/l), γ-Glutamyltransferase (γ-GT; 0-13 IU/l), Laktatdehydrogenase (LDH; 0-571 IU/l), Kreatinkinase (CK; 0-958 IU/l), α-Amylase (0-459 IU/l), Lipase (0-1587 IU/l) und Cholinesterase (0-3.564 IU/l), die Konzentrationen der Substrate Glukose (5,83-14,83 mmol/l), Fruktosamin (314-527 µmol/l), Gesamteiweiß (48,9-73,9 g/l) mit Auftrennung durch Elektrophorese (Albumin: 35,6-56,8 g/l [66,7-86,1%], α1-Globulin: 0,1-3,6 g/l [0,1-5,7%], α2-Globulin: 1,7-4,5 g/l [2,9-7,0%], α1-Globulin: 4,1-10,7 g/l [6,9-16,8%], γ-Globulin: 0,5-8,7 g/l [0,9-12,1%]), Cholesterin (0,31 bis 2,66 mmol/l), Triglyzeride (0,45-3,35 mmol/l), Serumgallensäuren (0,0-77,6 µmol/l), Bilirubin (0,29-2,53 µmol/l), Harnstoff (2,05-8,42 mmol/l) und Kreatinin (34-166 µmol/l) sowie der Elektrolyte Kalzium (3,1-3,9 mmol/l), Phosphat (0,81 bis 3,15 mmol/l), Magnesium (0,90-1,66 mmol/l), Natrium (139 bis 149 mmol/l), Kalium (3,7-6,3 mmol/l), Chlorid (93-109 mmol/l) und Eisen (20-59 µmol/l). Alters-(≤ 4 Monate und > 4 Monate) und Geschlechtsabhängigkeiten (männlich/weiblich) wurden ermittelt.

Abstract Background We investigatedthe association between time-averaged area under the curve (AAUC) of cytomegalovirus (CMV) viral load (VL) by day 100 and overall survival (OS) at 1-year after hematopoietic cell transplantation (HCT). Methods In a retrospective cohort study, including patients receiving HCT between June 2010 and December 2017 from Memorial Sloan Kettering Cancer Center, AAUC was calculated for patients with detected VL. Patients were categorized into non-controllers (Q4) and controllers (Q1–Q3) using the highest AAUC quartile as cutoff. Cox models were used to estimate the association between AAUC and OS. Patients with non-detected CMV VL were categorized into elite-controllers (recipient+ [R+] or R−/donor+ [D+]) and R−/D−. Results The study (N = 952) included 282 controllers, 93 non-controllers, 275 elite-controllers, and 302 R−/D−. OS was 80.1% and 58.1% for controllers and non-controllers, respectively. In multivariable models, non-controllers had worse OS versus controllers (adjusted hazard ratio [HR] = 2.65; 95% confidence interval [CI], 1.71–4.12). In landmark analyses, controllers had similar OS as elite-controllers (HR = 1.26; 95% CI, .83–1.91) or R−/D− (HR = 0.98; 95% CI, .64–1.5). Conclusions Non-controllers had worse OS 1-year post-HCT. Controllers had similar OS as elite-controllers or R−/D−. Future studies are needed to validate our AAUC cutoff across different cohorts and CMV management strategies.

9576 Background: Advanced care planning is an essential component of cancer care for patients with incurable malignancies. However, the extent to which clinicians clearly document end-of-life care discussions and code status preferences in ambulatory medical records is unknown. The goal of the study was to investigate the rate of code status documentation in the electronic longitudinal medical record (LMR) of patients with metastatic cancers. Methods: We conducted a retrospective review of outpatient medical records of 2498 patients with metastatic solid tumors seen at an academic cancer center from 10/1/06 through 2/29/08. An electronic database was used to gather information on patient demographics, cancer type, and visits to the cancer center. The sample consisted of patients with metastatic breast, colorectal, non-colorectal gastrointestinal (GI), bladder/kidney, ovarian, prostate, and lung cancers. For the study endpoints, we queried the LMR to determine completion and designation of code status, which could be documented as follows: full code, do not resuscitate (DNR)/do not intubate (DNI), or DNR/DNI with specific resuscitation requests. Multiple logistic regression was used to identify independent predictors of code status completion and resuscitation preference. Results: Among the 2498 patients, 508 (20.3%) had a documented code status. Code status was documented more frequently in patients with metastatic non-colorectal GI (193/609, 31.7%) and lung (179/583, 30.7%) cancers compared to patients with genitourinary malignancies (bladder/kidney [4/89, 4.5%], ovarian [4/93, 4.3%] and prostate [7/365, 1.9%] cancers). Independent predictors of having documented code status included cancer type and a greater number of visits to the cancer center. Younger patients and black patients were less likely to be designated as DNR/DNI. Conclusions: Despite the incurable nature of metastatic cancers, a minority of patients had a code status documented in the outpatient medical record. Given the importance of advanced care planning for those with terminal illness, interventions are needed to encourage discussion and documentation of end-of-life care preferences in patients with advanced cancer. No significant financial relationships to disclose.

AbstractIntroductionCongenital and acquired heart diseases are highly prevalent in developing countries despite limited specialised care. Namibia established a paediatric cardiac service in 2009 with significant human resource and infrastructural constraints. Therefore, patients are referred for cardiac interventions to South Africa.ObjectivesTo describe the diagnoses, clinical characteristics, interventions, post-operative morbidity and mortality, and follow-up of patients referred for care.MethodsDemographics, diagnoses, interventions, intra- and post-operative morbidity and mortality, as well as longitudinal follow-up data of all patients referred to South Africa, were recorded and analysed.ResultsThe total cohort constituted 193 patients of which 179 (93%) had CHD and 7% acquired heart disease. The majority of patients (78.8%) travelled more than 400 km to Windhoek before transfer. There were 28 percutaneous interventions. Palliative and definitive surgery was performed in 27 and 129 patients, respectively. Out of 156 patients, 80 (51.3%) had post-operative complications, of which 15 (9.6%) were a direct complication of surgery. Surgical mortality was 8/156 (5.1%, 95% confidence interval 2.2–9.8), with a 30-day mortality of 3.2%. Prolonged ICU stay was associated with a 5% increased risk of death with hazard ratio 1.05, 95% confidence interval 1.02–1.08, p=0.001. Follow-up was complete in 151 (78%) patients for more than 7 years.ConclusionsDespite the challenges associated with a cardiac programme for referring patients seeking intervention in a neighbouring country and the adverse characteristics of multiple lesions and complexity associated with late presentation, we report good surgical and interventional outcomes. Our goal remains to develop a comprehensive sustainable cardiac service in Namibia.

ObjectiveTo estimate the economic burden to the health service of surgical site infection following caesarean section and to identify potential savings achievable through implementation of a surveillance programme.DesignEconomic model to evaluate the costs and benefits of surveillance from community and hospital healthcare providers’ perspective.SettingEngland.ParticipantsWomen undergoing caesarean section in National Health Service hospitals.Main outcome measureCosts attributable to treatment and management of surgical site infection following caesarean section.ResultsThe costs (2010) for a hospital carrying out 800 caesarean sections a year based on infection risk of 9.6% were estimated at £18 914 (95% CI 11 521 to 29 499) with 28% accounted for by community care (£5370). With inflation to 2019 prices, this equates to an estimated cost of £5.0 m for all caesarean sections performed annually in England 2018–2019, approximately £1866 and £93 per infection managed in hospital and community, respectively. The cost of surveillance for a hospital for one calendar quarter was estimated as £3747 (2010 costs). Modelling a decrease in risk of infection of 30%, 20% or 10% between successive surveillance periods indicated that a variable intermittent surveillance strategy achieved higher or similar net savings than continuous surveillance. Breakeven was reached sooner with the variable surveillance strategy than continuous surveillance when the baseline risk of infection was 10% or 15% and smaller loses with a baseline risk of 5%.ConclusionSurveillance of surgical site infections after caesarean section with feedback of data to surgical teams offers a potentially effective means to reduce infection risk, improve patient experience and save money for the health service.

Objectives: Acute myeloid leukemia (AML) patients with biallelic mutations of CEBPA (bi CEBPA) have a 30-50% relapse rate after standard chemotherapy. This study established the value of multiparameter flow cytometric measurable residual disease (MFC-MRD) detection, mutations based on next-generation sequencing (NGS), and compares the outcomes of risk stratification treatment in adult bi CEBPA AML patients. Methods: From March 2014 to December 2018, 124 patients with newly diagnosed acute myeloid leukemia with bi CEBPA were treated with chemotherapy. Out of these, 93 patients were analyzed further by a sensitive NGS assay for mutations in 87 candidate genes. MRD was detected in all patients by MFC after each cycle of induction and consolidation chemotherapy and every 3 months later. Results: Among these patients, 73 patients were male (58.9%), and median age was 37.5 (16-69) years. The expression of CD34, CD117, CD7, HLA-DR, CD15, CD33 and CD13 in 124 patients were 120 (96.8%), 123 (99.2%), 112 (90.3%), 107 (86.3), 93 (75.0%), 115 (92.7%) and 107 (86.3%) respectively. The most common co-occurring mutations were found in the GATA2 (n=29/93, 31%), WT1 (n=20/93, 21.7%), NRAS (n = 13/93, 14.0%), CSF3R (n = 12/93, 12.9%), and TET2 (n = 9/93, 9.6%) genes. All patients (100%) achieved complete remission (CR) including 114 patients (91.9%) who achieved it with only 1 induction course. The median follow-up was 33.5 (4-69) months. The 3-year Cumulative incidence of relapse (CIR), disease-free survival (DFS) and overall survival (OS) were 32.8%, 64.7%, and 84.3%, respectively. Univariate analysis results shown that WT1 Wild-type was favorable factor of 3-year CIR (23.3% vs. 47.0%, P=0.022) and 3-year DFS (75.5% vs 53.0%; P=0.031), GATA2 Wild-type had good trend for lower CIR and longer DFS and CSF3R Wild-type had inferior trend for higher CIR and shorter DFS. Patients with sustained positive MRD status after 2 consolidation cycles and MRD negative status loses in any time defined as "MRD high risk" had higher CIR (3-year CIR, 100% vs 25.5%; P<0.001; 81.5% vs 6.4%; P<0.001, respectively) and worse DFS and OS (3-year DFS, 0% vs 71.5%; P<0.001; 16.8% vs 90.2%; P<0.001, respectively; 3-year OS, 39.0% vs 89.8%; P<0.001; 72.2% vs 96.5%; P=0.001, respectively ) than those with persistent negative MRD status that defined as "MRD low risk" (Figure). Multivariate analysis showed that MRD low risk was the only favorable factor of CIR, DFS and OS (CIR: HR=37.3, 95%CI: 8.6-161.3, P<0.001;. DFS: HR=24.6, 95%CI: 7.2-84.0, P<0.001; HR=28.2, 95%CI: 2.1-374.1, P=0.011; respectively). Thirty-two (91.4%) MRD high risk patients (P<0.001) relapsed at a median time of 8 months (range: 3-32 months) include 21 patients of MRD negative status loses in any time and 11 patients with positive MRD status after 2 consolidation cycles. In totally 35 relapsed patients, 3 patients give up, 19 (61.3%) patients achieved CR2 after induction again. 15 CR2 and 4 non-remission patients underwent allo-HSCT achieved superior 3-year OS (83.0% vs 5.1%; p= 0.034; 75.0% vs 0%; p=0.006; respectively) than chemotherapy. To assess the role of risk stratification treatment by transplant or non-transplant, the124 patients were divided into 2 groups by the unique risk factor: MRD high risk group (n=43, 34.7%) and MRD low risk group (n=81, 65.3%). In the MRD low risk group (median follow-up: 35 months; range: 4-65 months), there was no significant difference in probabilities of 3-year OS (92.3% vs. 96.9%, P=0.428) between the transplant and non-transplant cohorts. In the MRD high risk group (median follow-up: 30 months; range: 7-69 months), 3-year OS was significantly better in the transplant cohort than in the non-transplant cohort (84.0% vs. 44.3%, p=0.007).Conclusions: MRD high risk may better predict the outcome rather than mutations based on NGS in AML with bi CEBPA, and allo-HSCT may achieve superior survival in MRD high risk patients. Key words: Acute myeloid leukemia with biallelic CEBPA mutations; next-generation sequencing; multiparameter flow cytometric measurable residual disease; allogeneic stem cell transplantation; Chemotherapy Disclosures No relevant conflicts of interest to declare.

Oral streptococci can exchange genetic material with other bacteria colonizing the same loci of the body, their resistance profiles can serve as markers of the risk of the developing resistance to certain antibiotics in closely related bacteria, in particular, Streptococcus pneumoniae. Materials and Methods To describe the species composition of oral streptococci and to detect the profile of their sensitivity to a wide range of antibiotics there were investigated oral streptococcal isolates isolated from oropharyngeal smears sown in children of various ages with acute respiratory infections not receiving antibacterial therapy for selective streptococcal medium with penicillin (Pen, 1 mg/l) or erythromycin (Ery, 2 mg/l). 253 oropharyngeal smears were studied. Results. The most frequent sowings were Pen-resistant and Ery-resistant Streptococcus mitis, found in 158 (62.5%) and 169 (66.8%) studied, respectively. Ery-resistant Streptococcus salivarius group was detected in 107 (42.3%) samples, Pen-resistant streptococcus from this group were found much less frequently in 16 (6.3%) samples. Pen and Eri-resistant isolates of Streptococcus sanguinis group were present in 69 (27.3%) and 49 (19.4%) samples respectively. All the streptococcus specimens studied were sensitive to vancomycin, linezolid and (except for one) levofloxacin; about 90% were sensitive to daptomycin, rifampicin and chloramphenicol. Sensitivity to tetracycline was lower at 57.5%. Multiple drug resistance (MDR; resistance to ≥3 groups of antibiotics) had 93 (58.1%) isolates; the most common combination of penicillin, erythromycin and tetracycline resistance was found in 53 (57%) MDR isolates. Streptococcus mitis/oralis were characterized by higher MPCs of penicillin, ampicillin and ceftriaxone, as well as the frequency of stable forms, including MDR, as compared to other streptococci. Streptococcus mitis, first S. mitis oralis group streptococcus predominate in the species structure of antibiotic-resistant oral streptocococci, among which MDR is widespread, including resistance to β-lactams.

Since 1991 information on yeast isolates from blood cultures has been recorded prospectively from all microbiological laboratories (5 university and 16 county or local hospital laboratories) in Norway (population, 4.3 million). From 1991 to 1996 a total of 571 episodes of fungemia in 552 patients occurred (1991, 109 episodes; 1992, 81 episodes; 1993, 93 episodes; 1994, 89 episodes; 1995, 98 episodes; and 1996, 101 episodes). The fungemia rates per 10,000 patient days were 0.29 in 1991 and 0.27 in 1996. The average rates for the years 1991 to 1996 were 0.37 for the university laboratories and 0.20 for the other laboratories. These rates are low compared to the rate (0.76) in five Dutch university hospitals in 1995 and the rate (2.0) in Iowa in 1991. The four most frequently isolated species wereCandida albicans (66%), Candida glabrata(12.5%), Candida parapsilosis (7.6%), and Candida tropicalis (6.4%). The incidences of both C. albicans (range, 63 to 73%) and C. glabrata (range, 8.4 to 15.7%) varied somewhat throughout this period, but no significant increase or decrease was noted. MICs of amphotericin B, flucytosine, and fluconazole were determined for 89% of the isolates. All were susceptible to amphotericin B, and only 29 (5.6%) strains had decreased susceptibility to flucytosine. All C. albicansisolates were susceptible to fluconazole. The percentage of yeast isolates with decreased susceptibility to fluconazole (MICs, ≥16 μg/ml) did increase, from 9.6% in 1991 and 1992 to 12.2% in 1994, 16.1% in 1995, and 18.6% in 1996. This was largely due to increases in the percentages of resistant C. glabrata andCandida krusei strains in the last 2 years. Compared to the incidence in other countries, it is remarkable that Norway has such a low and constant incidence of fungemia. A possible reason for this difference might be a restricted antibiotic use policy in Norway.

Abstract Background: Numerous recurrent chromosomal abnormalities have been described in adult Ph-negative ALL, often observed in small patient cohorts. In the largest MRC/ECOG study (Moorman, Blood 2007), t(4;11)(q21;q23), 14q32 involvement, complex karyotype (≥5 abnormalities), and low hypodiploidy/near triploidy (Ho-Tr) were associated with shorter event-free survival (EFS), while patients with high hyperdiploidy or del(9p) had a better outcome. We aimed to confirm these observations in 955 adult patients (15-60y; median, 35y) with Ph-negative ALL treated in the pediatric-inspired GRAALL-2003/2005 trials. Patients and Methods: Overall, a karyotype was performed for 946 (611 BCP-ALL, and 335 T-ALL), successful for 811 (523 BCP-ALL and 288 T-ALL) and abnormal in 590 patients (387 BCP-ALL and 203 T-ALL). FISH and/or PCR screening for relevant abnormalities and DNA index were also performed, finally allowing for the identification of cytogenetic abnormalities in 677/955 patients (71%). All were centrally reviewed. Ultimately, 857/955 patients (90%; 542 BCP-ALL and 315 T-ALL) could be classified in 18 exclusive primary cytogenetic subsets as detailed below. Endpoints were cumulative incidence of failure (CIF, including primary refractoriness and relapse) and EFS. With a median follow-up of 4 years, 5-year CIF and EFS were estimated in these patients at 31% and 51%, respectively. As some abnormalities, including MLL rearrangements, Ho/Tr, t(1;19)(q23;p13)/TCF3 and complex karyotypes were used to stratify allogeneic stem cell transplantation (SCT) in GRAALL trials, some comparisons were repeated after censoring patients transplanted in first CR at SCT time. Results: The 542 informative BCP-ALL patients were classified as: t(4;11)(q21;q23)/MLL-AFF1 (n=72; 13%); other MLL+ 11q23 abnormalities (n=11; 2%); t(1;19)(q23;p13)/TCF3-PBX1 (#28; 5%); Ho/Tr (n=33; 6%); high hyperdiploidy (n=36; 7%); abnormal 14q32/IGH translocation (n=27; 5%); t(12;21)(p13;q22)/ETV6-RUNX1 (n=2; 0.4%); iAMP21 (n=3; 0.6%); other abnormalities (n=210; 39%); and no abnormality (n=120; 22%). The 315 informative T-ALL patients were classified as: t(10;14)(q24;q11)/TLX1 (n=64; 20%); other 14q11 or 7q34/TCR (n=31; 10%); t(5;14)(q35;q32)/TLX3 (n=29; 9%); t(10;11)(p12;q14)/PICALM-MLLT10 (n=14; 4%); deletion 1p32/SIL-TAL (n=18; 6%); MLL+ 11q23 abnormalities (n=6; 2%); other abnormalities (n=93; 30%); and no abnormalities (n=60; 19%). A complex karyotype was observed in 27/527 (5%) BCP-ALL and 21/298 (7%) T-ALL patients and a monosomal karyotype (as per Breems, JCO 2008) in 82/518 (16%) BCP-ALL and 26/286 (9%) T-ALL patients. In BCP-ALL, trends towards higher CIF and shorter EFS were observed in t(4;11) patients, with or without SCT censoring (HRs, 1.34 to 1.64; p values <0.10). Shorter EFS was observed in 3 subsets: 14q32 (HR, 2.10; p=0.002), Ho/Tr (HR, 1.45; p=0.10), and monosomal karyotype (HR, 1.42; p=0.029), but CIF were not different. This might be related to the older age of patients in these subsets (medians, 43y, 53y and 44y; p=0.029, <0.001 and <0.001, respectively) and worse treatment tolerance. For instance, higher incidences of non ALL-related deaths were observed in patients with 14q32 abnormalities or monosomal karyotype (p=0.031 and 0.067, respectively). Patients with high hyperdiploidy only tended to have lower CIF and longer EFS. Complex karyotype did not impact CIF and EFS, even after SCT censoring. Conversely, in T-ALL, complex karyotypes were associated with shorter EFS (HR, 2.20; p=0.004), even if the difference in CIF did not reach significance. A worse outcome was also observed in patients with t(10;11)(p12;q14)/PICALM-MLLT10 (HR, 2.45 and 2.14; p=0.016 and 0.021, for CIF and EFS respectively). A longer EFS was observed in patients with t(10;14)(q24;q11)/TLX1 (HR, 0.55; p=0.014), with a trend for lower CIF (HR, 0.59; p=0.070), while no inferior outcome was observed in t(5;14)(q35;q32)/TLX3 patients. Conclusion: These results show that, in the context of an intensified pediatric-inspired protocol designed for adult Ph-negative ALL patients, few cytogenetic subsets remained reliably predictive of response to therapy. Differences observed in EFS might partly be due to treatment-related mortality. Combining cytogenetics, molecular genetics and minimal residual disease monitoring could allow for better individual risk assessment (Beldjord, Blood 2014). Disclosures No relevant conflicts of interest to declare.

5.1 Fascial layers of the neck, 93 5.2 Tissue spaces of the neck, 93 5.3 Triangles of the neck, 94 5.4 Thyroid, 95 5.5 Trachea, 96 5.6 Oesophagus, 96 5.7 Cervical sympathetic trunk, 97 5.8 Root of the neck, 98 5.9 The face, 99 5.10...

Jean Baptiste Joseph Fourier’s powerful idea of decomposition of a signal into sinusoidal components has found application in almost every engineering and science field. An incomplete list includes acoustics [1497], array imaging [1304], audio [1290], biology [826], biomedical engineering [1109], chemistry [438, 925], chromatography [1481], communications engineering [968], control theory [764], crystallography [316, 498, 499, 716], electromagnetics [250], imaging [151], image processing [1239] including segmentation [1448], nuclear magnetic resonance (NMR) [436, 1009], optics [492, 514, 517, 1344], polymer characterization [647], physics [262], radar [154, 1510], remote sensing [84], signal processing [41, 154], structural analysis [384], spectroscopy [84, 267, 724, 1220, 1293, 1481, 1496], time series [124], velocity measurement [1448], tomography [93, 1241, 1242, 1327, 1330, 1325, 1331], weather analysis [456], and X-ray diffraction [1378], Jean Baptiste Joseph Fourier’s last name has become an adjective in the terms like Fourier series [395], Fourier transform [41, 51, 149, 154, 160, 437, 447, 926, 968, 1009, 1496], Fourier analysis [151, 379, 606, 796, 1472, 1591], Fourier theory [1485], the Fourier integral [395, 187, 1399], Fourier inversion [1325], Fourier descriptors [826], Fourier coefficients [134], Fourier spectra [624, 625] Fourier reconstruction [1330], Fourier spectrometry [84, 355], Fourier spectroscopy [1220, 1293, 1438], Fourier array imaging [1304], Fourier transform nuclear magnetic resonance (NMR) [429, 1004], Fourier vision [1448], Fourier optics [419, 517, 1343], and Fourier acoustics [1496]. Applied Fourier analysis is ubiquitous simply because of the utility of its descriptive power. It is second only to the differential equation in the modelling of physical phenomena. In contrast with other linear transforms, the Fourier transform has a number of physical manifestations. Here is a short list of everyday occurrences as seen through the lens of the Fourier paradigm. • Diffracting coherent waves in sonar and optics in the far field are given by the two dimensional Fourier transform of the diffracting aperture. Remarkably, in free space, the physics of spreading light naturally forms a two dimensional Fourier transform. • The sampling theorem, born of Fourier analysis, tells us how fast to sample an audio waveform to make a discrete time CD or an image to make a DVD.

This chapter addresses a case study of long-term assessment of a field application of environmental nanotechnology. Dense Non-Aqueous Phase Liquid (DNAPL) contaminants such as Tetrachloroethene (PCE) and Trichloroethene (TCE) are a type of recalcitrant compounds commonly found at contaminated sites. Recent research has focused on their remediation using environmental nanotechnology in which nanomaterials such as nanoscale Emulsified Zerovalent Iron (EZVI) are added to the subsurface environment to enhance contaminant degradation. Such nanoremediation approach may be mostly applicable to the source zone where the contaminant mass is the greatest and source removal is a critical step in controlling the further spreading of the groundwater plume. Compared to micro-scale and granular counterparts, NZVI exhibits greater degradation rates due to its greater surface area and reactivity from its faster corrosion. While NZVI shows promise in both laboratory and field tests, limited information is available about the long-term effectiveness of nanoremediation because previous field tests are mostly less than two years. Here an update is provided for a six-year performance evaluation of EZVI for treating PCE and its daughter products at a Superfund site at Parris Island, South Carolina, USA. The field test consisted of two side-by-side treatment plots to remedy a shallow PCE source zone (less than 6 m below ground surface) using pneumatic injection and direct injection, separately in October 2006. For the pneumatic injections, a two-step injection procedure was used. First, the formation was fluidized by the injection of nitrogen gas alone, followed by injection of the EZVI with nitrogen gas as the carrier. In the pneumatic injection plot, 2,180 liters of EZVI containing 225 kg of iron (Toda RNIP-10DS), 856 kg of corn oil, and 22.5 kg of surfactant were injected to remedy an estimated 38 kg of chlorinated volatile compounds (CVOC)s. Direct injections were performed using a direct push rig. In the direct injection plot, 572 liters of EZVI were injected to treat an estimated 0.155 kg of CVOCs. Visual inspection of collected soil cores before and after EZVI injections shows that the travel distance of EZVI was dependent on the method of delivery with pneumatic injection achieving a greater distance of 2.1 m than did direct injection reaching a distance of 0.89 m. Significant decreases in PCE and TCE concentrations were observed in downgradient wells with corresponding increases in degradation products including significant increases in ethene. In the pneumatic injection plot, there were significant reductions in the downgradient groundwater mass flux values for chlorinated ethenes (>58%) and a significant increase in the mass flux of ethene (628%). There were significant reductions in total CVOCs mass (78%), which was less than an estimated 86% decrease in total CVOCs made at 2.5 years due to variations in soil cores collected for CVOCs extraction and determination; an estimated reduction of 23% (vs.63% at 2.5 years) in the sorbed and dissolved phases and 95% (vs. 93% at 2.5 years) reduction in the PCE DNAPL mass. Significant increases in dissolved sulfide, volatile fatty acids (VFA), and total organic carbon (TOC) were observed and dissolved sulfate and pH decreased in many monitoring wells. The apparent effective destruction of CVOC was accomplished by a combination of abiotic dechlorination by nanoiron and biological reductive dechlorination stimulated by the oil in the emulsion. No adverse effects of EZVI were observed for the microbes. In contrast, populations of dehalococcoides showed an increase up to 10,000 fold after EZVI injection. The dechlorination reactions were sustained for the six-year period from a single EZVI delivery. Repeated EZVI injections four to six years apart may be cost-effective to more completely remove the source zone contaminant mass. Overall, the advantages of the EZVI technology include an effective “one-two punch” of rapid abiotic dechlorination followed by a sustained biodegradation; contaminants are destroyed rather than transferred to another medium; ability to treat both DNAPL source zones and dissolved-phase contaminants to contain plume migration; ability to deliver reactants to targeted zones not readily accessible by conventional permeable reactive barriers; and potential for lower overall costs relative to alternative technologies such as groundwater pump-and-treat with high operation and maintenance costs or thermal technologies with high capital costs. The main limitations of the EZVI technology are difficulty in effectively distributing the viscous EZVI to all areas impacted with DNAPL; potential decrease in hydraulic conductivity due to iron corrosion products buildup or biofouling; potential to adversely impact secondary groundwater quality through mobilization of metals and production of sulfides or methane; injection of EZVI may displace DNAPL away from the injection point; and repeated injections may be required to completely destroy the contaminants.

The ACL (IL-Automated Coagulation Laboratory from the Fisher Scientific Group) is the first microcentrifugal analyzer incorporating 2 reading channels, a coagulometric channel consisting of a laser light source and a chromogenic channel consisting of a halogen light source. We have evaluated the instrument for precision and accuracy using different reagents for both clotting and the chromogenic assays. Replicate samples were run in both the PT and APTT modes using 4 different reagents. The reagent with the least particles had the greatest precision. The mean values for APTTs and PTs using a particle free reagent were 68.7 ± .83“ for the APTT (C.V. 1.2%), and 30.2 ± .33” (C.V. 1.1%) for the PT. A fibrinogen assay measured on the ACL (delta light scatter of the prothrombin time) was compared to the Clause fibrinogen assay in three population groups: the adult, the newborn and patients receiving thrombolytic therapy. The correlation for the adult and newborn was good with r values of .911 (n = 51) and .96 (n = 36) respectively. The thrombolytic therapy group had poor correlation r = .32. Antithrombin III (ATIII) and a2 antiplasmin (AP) assays were measured on the ACL using IIs chromogenic method. These were compared to an ATIII chromogenic method (Kahle) using a Gilford SBA 300 analyzer and α2 AP assay using a Protopath (Dade). The correlations were ATIII, r=.95 and α2 AP, r=.82. The plasminogen method of Friberger was adapted to the ACL giving us comparable results to those read off the Gilford SBA 300 (r=.93). With the introduction of the ACL we have been able to: 1) reduce the technical time required for assays by one half; 2) reduce reagent costs by one half to three-quarters; 3) reduce the amount of plasma required for screening tests by half the volume, which has greatly facilitated neonatal coagulation testing

Increased plasma levels of Fibronectin (Fn),a well known adesive glycoprotein synthesized in vessel endothelial cells, have been reported in diabetes mellitus (DM). Previously, we provided evidence that in type II DM an elevated storage of Fn is present in endothelial cells. We here report that in diabetic subjects an abnormal synthesis of Fn in endothelial cells could also occur. To verify this hypothesis, in 15 patients affected by type II DM, age ranging 36-59, of both sex, without overt clinical vascular complications and in glycometabolic compensation (Hb Alc 8.9 ± 1.5) we evaluated before and after venostasis repeated at several times 30, 60, 90,180 and 210 min the Fn plasma levels. Five healthy volunteers, age and sex comparaf-h ble, were utilized as normal controls. The venostasis were performed at forearm pressure of 10 mmHg over diastolic x 20 min and blood samples were collected from the same vein at the intervals above indicated. Plasma Fn was evaluated by ELISA immuno-enzymatic tecnique using a commercial kit (Biochemia, Milan). The diabetic patients showed after the first venostasis a significant (p<0.001) increase of Fn (317 ± 103μg/ml) versus the baseline values (225±79 μg/ml)while normal controls did not (before 103 ± 37, after 139±61). Such an increase was also seen in EM after the second venostasis ( 298 ±91 μg/ml, vs 128±58 in controls), whereas at third venostasis plasma Fn levels retoumed to the values comparable to the basal ones both in diabetics (245 ±. 88 μg/ml) and in controls (93±41 μg/ml). After 90 min pause by performing the fourth venostasis we observed in diabetics a further increase pf Fn (298±131μg/ml) which reached:again the values noted after the first. No change, on the contrary,was found in the normal group (95±21). In the last venostasis,carried out 30min from the fourth, the plasna Fn lasted significantly (p<0.001.) increased in diabetics (281±107 μg/ml) respect to normal controls (102±19 μg/ml).Our data, therefore, would suggest that in vascular endothelium cf type II DM an increased synthesis of Fn occurs as well.