bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer-related venous thromboembolism
Authors: Diab Abdurrahman I. Al 
Published: July 2014

BACKGROUND:
Risk factors for cancer-associated VTE include certain cancer types (e.g. pancreatic adenocarcinoma), chemotherapy, and the use of erythropoiesis-stimulating agents, central venous catheters, and surgery. We studied the risk factors for cancer-associated VTE in our institution.

DESIGN AND SETTING:
Retrospective analysis of patients with solid cancers treated with chemotherapy at King Khalid University Hospital from 2000 to 2010.

METHODS:
We assessed risk factors responsible for VTE, including performance status, age, chemotherapy, use of erythropoietin (EPO), stage of disease and use of a central venous catheter. Patients with other co-morbidities such as diabetes were excluded.

RESULTS:
Forty-three (14%) of 306 patients were identified as having VTE, including 111 males and 195 females with a median age of 38 years (range, 13-18 years). Thirty-nine patients had proximal deep vein thrombosis (DVT) and, 4 had pulmonary embolism with no evidence of DVT. Of the 43 patients, 40 patients had stage III or IV disease at the time of VTE diagnosis. Thirty patients were taking erythropoietin (40 000 units/ week); 25 had a hemoglobin level higher than 12 g/dL. All patients were treated with low molecular weight (LM W) heparin and maintained on LM W heparin or warfarin for minimum of 6 months.

CONCLUSION:
VTE imposes a great risk to life in cancer patients. Risk factors include age more than 40 years, advanced cancer stage, chemotherapy, use of EPO for anemia and underuse of DVT prophylaxis.
Early versus late outset of lymphoproliferative disorders post-heart and lung transplantation
Authors: Khedmat Hossein , Taheri Saeed 
Published: July 2014

BACKGROUND AND OBJECTIVES:
The presentation time of post-transplantation lymphoproliferative disorders (PTLD) are not well described because of the limited number of cases occurring at each center and lack of a reliable and unequivocal classification together with the absence of multi-institutional prospective studies. We gathered information on the histopathological and clinical features and prognosis of the disease in a very large number of heart and lung transplant recipients, with data from 27 previous reports, with an emphasis of time of presentation.

DESIGN AND SETTING:
Retrospective analysis of data for individual patients from published studies, entered into a database and reanalyzed.

METHODS:
A comprehensive review of the literature by PubMed and Google scholar was performed to find all data available reports on PTLD after heart and lung transplantation.

RESULTS:
Data from 288 PTLD patients after heart or lung transplantation from 27 reports were entered into analysis. Heart and lung recipients with early-onset PTLD compared with late-onset PTLD were significantly more likely to be of the B cell type (100% vs. 89.8%, respectively; P=.05). PTLD in patients with early onset was less likely to involve the skin (P=.05) and spleen (P=.015), but more frequently complications of the respiratory tract (P=.002). Morphology of PTLD lesions was significantly different between the two groups with a priority for late-onset PTLD to represent non-Hodgkin lesions (P=.009). No difference was found between the two groups in survival (P=.237). One and five-year survival rates for early-onset PTLD patients were 65% and 46%, respectively; compared to 53% and 41%, respectively, for the late-onset PTLD.

CONCLUSION:
Due to a higher incidence of respiratory tract involvement in the early-onset PTLD patients and skin and spleen involvement in late-onset PTLD, we suggest that all heart/lung graft recipients should be evaluated for potential multiorgan disease based early or late presentation. Further multi-institutional prospective studies are needed to confirm our results.
Higher infused CD34+ cell dose and overall survival in patients undergoing in vivo T-cell depleted, but not t-cell repleted, allogeneic peripheral blood hematopoietic cell transplantation
Authors: Kanate Abraham Sebastian , Craig Michael , Cumpston Aaron , Saad Ayman , Hobbs Gerry , Leadmon Sonia , Bunner Pamela , Watkins Kathy , Bulian Deirdre , Gibson Laura , Abraham Jame , Remick Scot C. , Hamadani Mehdi 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Understanding the effect of cellular graft composition on allogeneic hematopoietic cell transplantation (AHCT) outcomes is an area of great interest. The objective of the study was to analyze the correlation between transplant-related outcomes and administered CD34+, CD3+, CD4+ and CD8+ cell doses in patients who had undergone peripheral blood, AHCT and received either in vivo T-cell depleted or T-cell replete allografts.

DESIGN AND SETTING:
Comparison of consecutive patients who underwent peripheral blood AHCT in our institution between January 2003 and December 2009.

PATIENTS AND METHODS:
The cohort of 149 patients was divided into two groups; non T-cell depleted (NTCD) (n=54) and T-cell depleted (TCD) (n=95). Study endpoints were overall survival (OS), progression free survival (PFS), engraftment kinetics (neutrophil and platelet recovery), incidence of acute graft versus host disease (acute GVHD), chronic GVHD, non relapse mortality (NRM) and disease relapse.

RESULTS:
Multivariate analysis showed that higher infused CD34+ cell dose improved OS (relative risk 0.58, 95% CI 0.34-0.98, P=.04), PFS (relative risk 0.59, 95% CI 0.35-1.00, P=.05) and NRM (relative risk 0.49, 95% CI 0.24-0.99, P=.048) in the TCD group. By multivariate analysis, there was no difference in engraftment, grades II-IV acute GVHD, extensive chronic GVHD and relapse in the two groups relative to the infused cell doses. There was a trend towards improved OS (relative risk 0.54, 95% CI 0.29-1.01, P=.05) with higher CD3+ cell dose in the TCD group.

CONCLUSION:
Our findings suggest that higher CD34+ cell dose imparts survival benefit only to in vivo TCD peripheral blood AHCT recipients.
A population-based study of the epidemiology and clinical features of adults with acute myeloid leukemia in Algeria
Authors: Bekadja Mohamed Amine , Hamladji Rose Marie , Belhani Meriem , Ardjoun Fatima Zohra , Abad Mohand Tayeb , Touhami Hadj , Ait-Ali Hocine , Zouaoui Zahia , Sidimansour Noureddine , Hamdi Selma , Grifi Fatiha , Mesli Naima , Saidi Mahdia , Mehalhal Nemra , Bachiri Aissa , Bouhass Rachid , Said Yousuf Mohamed , Midoun Nouri 
Published: July 2014

BACKGROUND AND OBJECTIVES:
In Algeria, the Incidence of hematologic malignancies has been difficult to estimate for many years. Today, many hematological centers, including 14 university hospitals, have been developed in the entire north and have useful epidemiological data pertinent to acute myeloid leukemia (AML). We studied the incidence of AML and its subtypes, age distribution, geographic distribution and trends in the rate of diagnosis over the last 5 years in Algeria. Secondary goals were to study trends of referral of AML cases from various regions to specific centers to assess the needs for health infrastructure and change of current practices.

DESIGN AND SETTING:
Retrospective analysis of nationwide survey of all adult cases of AML (>16 years) diagnosed between 1 January 2006 and 31 December 2010.

PATIENTS AND METHODS:
A survey form was distributed to all departments of hematology at the 15 participating centers.

RESULTS:
The 1426 cases of AML diagnosed during the study period represented an annual incidence of 0.91/100000 persons with a male to female (M/F) ratio of 1:16 and a median age of 45 years (range, 16-82 years). Nationally, 20% of cases AML were diagnosed in the whole western region of the country, 47% in the central and 33% in the east. There was a trend of continuous increase in the rate with age and in the rate of diagnosis over the last 5 years. The most common subtype was M2, followed by M4 and M5.

CONCLUSION:
An overall increase in the number of AML patients diagnosed nationwide over the last five years indicates a need for additional health care resources including curative and therapy-intense strategies, such as stem cell transplant facilities to optimize outcome. The relatively younger age of patients compared to the Western countries may be due to the demographic composition of our population.
An approach to finding indications and contraindications for nephrectomy in post-transplant renal graft lymphomas
Authors: Gholipour-Shoiili Aghil , Gholipour-Shoiili Hani , Taheri Saeed 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Allograft involvement can occur in some renal transplant recipients who develop post-transplant lymphoproliferative disorders (PTLD). We aimed to find indications and/or contraindications for nephrectomy in renal allograft PTLD based on an outcome analysis of previous reports.

DESIGN AND SETTING:
A comprehensive search of Pubmed and Google scholar was performed to find reports of different treatment strategies addressing PTLD occurring within the allograft after renal transplantation.

PATIENTS AND METHODS:
Patients who underwent nephrectomy due to kidney allograft localization by PTLD were categorized as the case group, and renal recipients with kidney PTLD for whom nonsurgical treatment modalities were used served as controls.

RESULTS:
Survival analysis demonstrated that patients with renal allograft involvement who underwent allograft nephrectomy had a significantly better outcome compared to patients for whom a non-surgical approach was used (P=.03). In patients with disseminated PTLD, nephrectomy was not useful (P>.1). Patients with simultaneous kidney and lung complications by PTLD benefitted from nephrectomy.

CONCLUSIONS:
We found that patients with renal graft complication with disseminated PTLD do not benefit from nephrectomy, which can be considered the only contraindication. However, some particular PTLD colocalizations were not as likely to adversely affect the benefit of nephrectomy in these patients, and these can be considered indications for the procedure. Future multicenter studies are needed to confirm our results.
Cyclophosphamide plus total body irradiation compared with busulfan plus cyclophosphamide as a conditioning regimen prior to hematopoietic stem cell transplantation in patients with leukemia
Authors: Gupta Tejpal , Kannan Sadhana , Dantkale Vandana , Laskar Siddharta 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Cyclophosphamide plus total body irradiation (CYTBI) and oral busulfan plus cyclophosphamide (BUCY) are commonly used conditioning regimens prior to allogeneic hematopoietic stem cell transplantation (HSCT) in patients with leukemia. However, there is conflicting data on the superiority of one regimen over the other. Our aim was to critically appraise and synthesize available evidence regarding the efficacy and safety of CYTBI compared to BUCY as a conditioning regimen.

DESIGN AND SETTING:
systematic review and meta-analysis of randomized, controlled trials (RCTS) comparing BUCY with CYTBI.

METHODS:
We did a systematic search of the indexed medical literature using appropriate keywords to identify potentially relevant articles. The primary outcome of interest was efficacy measured by overall survival (OS) and disease-free survival (DFS). Acute and late toxicity were secondary endpoints. Meta-analysis was attempted only on RCTs. A relative risk or risk ratio (RR) and 95% confidence interval (CI) was calculated for each outcome in the meta-analysis.

RESULTS:
Fifteen non-randomized comparative studies involving 6280 patients were included in a narrative review without attempting a pooled analysis, in view of the potential for significant bias. outcome data from seven RCTs involving 730 patients randomly assigned to either CYTBI or BUCY was pooled using meta-analytic methods. CYTBI was associated with a modest but non-significant reduction in all cause mortality (RR=0.82, 95%CI: 0.64-1.05; P=.12) and relapse of leukemia (RR=0.89, 95%CI: 0.72-1.10; P=.28). Transplant-related mortality (TRM) was significantly lesser with CYTBI compared to oral BUCY (RR-0.53, 95%CI: 0.31-0.90; P=.02). The cumulative incidence of major complications was not significantly different between the two regimens, but specific complications varied according to the conditioning regimen. TBI-based regimens were associated with more severe late effects on growth and development in children.

CONCLUSION:
Th is analysis represents the largest comparative analyses of CYTBi with BUCY as a conditioning regimen prior to HSCT in the indexed medical literature. Conditioning regimen and disease (type and setting) can significantly affect outcomes. TRM is significantly lesser with CYTBi, but this does not translate into a significant survival benefit. There remain valid concerns regarding the late effects of TBI, particularly in children. Although not overly superior, the weight of evidence favors CYTBI over BuCY as a first choice-conditioning regimen in patients with leukemia.
Evidence for the use PET for radiation therapy planning in patients with cervical cancer
Authors: Salem Ahmed , Salem Abdel-Fattah , Al-Ibraheem Akram , Lataifeh Isam , Almousa Abdelatief , Jaradat Imad 
Published: July 2014

BACKGROUND AND OBJECTIVE:
In recent years, the role of positron emission tomography (PET) In the staging and management of gynecological cancers has been increasing. The aim of this study was to systematically review the role of PET in radiotherapy planning and brachytherapy treatment optimization in patients with cervical cancer.

DESIGN AND SETTING:
Systematic l iterature review.

METHODS:
Systematic review of relevant literature addressing the utilization of PET and/or PET-computed tomography (CT) in external-beam radiotherapy planning and brachytherapy treatment optimization. We performed an extensive PubMed database search on 20 April 2011. Nineteen studies, including 759 patients, formed the basis of this systematic review.

RESULTS:
PET/ PET-CT is the most sensitive imaging modality for detecting nodal metastases in patients with cervical cancer and has been shown to impact external-beam radiotherapy planning by modifying the treatment field and customizing the radiation dose. This particularly applies to detection of previously uncovered paraaortic and inguinal nodal metastases. Furthermore, PET/ PET-CT guided intensity-modulated radiation therapy (IMRT) allows delivery of higher doses of radiation to the primary tumor, if brachytherapy is unsuitable, and to grossly involved nodal disease while minimizing treatment-related toxicity. PET/ PET-CT based brachytherapy optimization allows improved tumor-volume dose distribution and detailed 3D dosimetric evaluation of risk organs. Sequential PET/ PET-CT imaging performed during the course of brachytherapy form the basis of “adaptive” brachytherapy in cervical cancer.

CONCLUSIONS:
Th is review demonstrates the effectiveness of pretreatment PET/ PET-CT in cervical cancer patients treated by radiotherapy. Further prospective studies are required to define the group of patients who would benefit the most from this procedure.
Very late onset lymphoproliferative disorders occurring over 10 years post-renal transplantation
Authors: Khedmat Hossein , Taheri Saeed 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Knowledge of the significance of post-transplant lymphoproliferative disorders (PTLD) that occur “very late” or more 10 years after renal transplantation is limited. Thus, we analysed and compared characteristics and prognosis of the disease in renal transplant patients with very late onset PTLD vs. early- and late-onset PTLD.

DESIGN AND SETTING:
Retrospective study of data obtained from comprehensive search of medical literature

PATIENTS AND METHODS:
We searched for available data using the Pubmed and Google scholar search engines for reports of lymphoproliferative disorders occurring in renal transplant patients by disease presentation time.

RESULTS:
We analyzed data from 27 studies that included 303 patients with lymphoproliferative disorders after renal transplantation. Renal graft recipients with very late onset PTLD were significantly less likely to be under mycophenolate mofetil (MMF)- and/or tacrolimus (FK-506) (vs. azathioprine) -based immunosuppression (P=.035) and less likely to have a history of antibody induction immunosuppression (P<.001). Compared to “early onset” disease, “very late” onset PTLD is more likely to develop in older patients (P=.032). Survival analysis did not show any difference in outcome (P=.5). No organ involvement priority was found for this patient group (P>.1 for all).

CONCLUSIONS:
Older renal transplant patients are at increased risk for development of very late onset PTLD, and should be strictly followed. Further multi-institutional prospective studies are needed to confirm our results.
Addition of amifostine to the CHOP regimen in elderly patients with aggressive non-Hodgkin lymphoma
Authors: Gómez Henry L. , Samanéz César , Campana Frank , Neciosup Silvia P. , Vera Luis , Casanova Luis , Leon Jorge , Flores Claudio , de Mendoza Fernando Hurtado , Casteñeda Carlos A. , Pinto Joseph A. , Vallejos Carlos S. 
Published: July 2014

BACKGROUND AND OBJECTIVES:
We report the 8-year follow-up of 34 patients aged ≥ 69 years old with NHL included in a phase llb open-label randomized parallel groups study to evaluate the effectiveness of amifostine in preventing the toxicity of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP regime).

PATIENTS AND METHODS:
Patients were randomized to receive classical CHOP (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 1.4 mg/m2 [maximum 2 mg] on day 1 and prednisone 100 mg/day for 5 days) or CHOP plus amifostine (6 cycles of amifostine 910 mg/m2 on day 1). Efficacy (time to progression, TTP; disease-free survival, DFS; overall survival, OS) and toxicity endpoints were evaluated.

RESULTS:
Thirty-four patients were randomized to A-CHOP (n=18) or CHOP (n=16). Patients with A-CHOP vs CHOP had significantly lower toxicity; neutropenia grade 4 ocurred in 13/92 (13%) vs 23/85 (27%, P=0.007) cycles, febrile neutropenia in 3/92 A-CHOP (3%) vs 8/85 (10%, P=.056) CHOP cycles, hospitalization for toxicity in 4/92 (4%) A-CHOP vs 11/85 (13%, P=.05) CHOP cycles. Median hospitalization stay for toxicity was 5 days with A-CHOP vs 8 days with CHOP (P=.05). There were no significant differences at 8 years in TTP (A-CHOP, 48.9% vs chop, 36.3%; P=.65), dfs (A-CHOP, 72.9% vs chop 55.6%; P=.50) and OS (A-CHOP, 44.3% vs CHOP, 54.4%). There was no long-term toxicity of clinical interest. The only prognostic factor identified to 8 years was the international Prognostic index (IPI low/low intermediate risk vs high intermediate/high risk; HR=2.98; CI 95%:1.01-8.77; P=.048).

CONCLUSION:
These results show that amifostine can be added to the standard CHOP treatment schedule with less acute toxicity and without influencing the outcome.
The effect of low altitude on blood count parameters
Authors: Al-Sweedan Suleimman A , Alhaj Moath 
Published: July 2014

BACKGROUND AND OBJECTIVES:
High altitude has an effect on blood count parameters, but low altitude (especially below sea level) has not been studied.

DESIGN AND SETTING:
A cross-sectional study of aymptomatic subjects aged between 18 to 35 years of age who had reported to the blood bank at the King Abdullah university Hospital (KAUH/Irbid and Ministry of Health, Jordan, during the period between January 2010 to June 2011 for blood donation.

METHODS:
Hematological values were compared in healthy adult blood donors living in areas 200 to 300 meters below sea level and areas 500 to 1500 meters above sea level. The study population consisted of 800 females and 666 males aged between 18 to 35 years.

RESULTS:
The mean values for hemoglobin level, mean corpuscular volume and leukocyte counts were significantly higher in people living above sea level than in people living below sea level (P<.0001), whereas platelet count and red cell distribution width were significantly higher in people living below sea level than in people living above sea level (P<.0001).

CONCLUSION:
We found a significant difference in hematological parameters in healthy adults living above and below sea level. The hematological values presented here are from a large, representative population sample and the first report of people living below sea level.
Lymphoproliferative disorders in pediatric liver allograft recipients
Authors: Khedmat Hossein , Taheri Saeed 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Due to the limited incidence of posttransplant lymphoproliferative disorders (PTLD) in pediatric liver graft recipients, there is a scarcity of data on the characteristics of the disease in this population. We aimed to analyze the special features and behavior of PTLD arising after pediatric liver transplantation.

DESIGN:
A comprehensive search of the literature was conducted for the available data on PTLD in pediatric liver recipients pediatric PTLD through a search of Pubmed and Google scholar using appropriate terms.

METHODS:
We sought data on liver recipients younger than 18 years of age at the time of transplantation. From 51 reports, 43 fulfilled the inclusion criteria. overall 250 cases of PTLD (212 pediatric PTLD) were found from 43 reports. Data on pediatric patients was compared to adults.

RESULTS:
Pediatric PTLD lesions were more likely of the polymorphic type (P=.004) and polyclonal (when age cut-off was defined at 12 years; P=.023). Remission rates, metastasis frequency and organ involvements were not different between the groups (P>.1 for all). survival analysis showed no disparity between pediatric PTLD and adult patients (P>.1); but when data was reanalyzed for patients surviving at least 4 months post diagnosis, the log rank test showed that pediatric patients have a superior outcome compared to adults (P=.045).

CONCLUSIONS:
Pediatric liver recipients developing PTLD have relatively better disease presentation and behavior than that in adults. stomach involvement was also more frequently seen in patients younger than 12 years, and should be more intensively evaluated. Future studies with a prospective approach and larger population size are needed for confirming our results.
RECENT ADVANCEMENTS IN RUBBER NANOCOMPOSITES
Authors: Galimberti Maurizio , Cipolletti Valeria , Musto Sara , Cioppa Serena , Peli Giulia , Mauro Marco , Gaetano Guerra , Agnelli Silvia , Theonis Riccò , Kumar Vineet 
Published: July 2014

ABSTRACTNanocomposites were prepared via melt blending, based on organically modified clays (OC), carbon nanotubes (CNT), and graphitic nanofillers made by a few layers of graphene (nanoG). In particular, nanocomposites based on a hybrid filler system, with a nanostructured filler such as carbon black (CB), are examined. It is shown that low crystalline order in the interlayer space of a layered nanofiller (such as OC and nanoG) leads to easier delamination. Nanofillers give rise to filler networking at low concentration, particularly in the presence of CB. Hybrid filler systems lead to nanocomposites' having initial moduli that are much higher than those calculated through the sum of the initial modulus of composites containing either only CB or only the nanofiller. Nanofillers enhance the matrix modulus by a multiplication factor that depends only on the nanofiller type and content, regardless of whether the matrix is a neat or a CB-filled polymer. Furthermore, the filler–polymer interfacial area is shown to be a parameter able to correlate the mechanical behavior of both nano-CNT and nanostructured (CB) fillers. By plotting values of the composite initial modulus versus the filler–polymer interfacial area, points due to CB, CNT, and the hybrid CB-CNT system lie on the same curve.