Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,mos...Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,most often presenting as posterior or panuveitis in late or latent syphilis of unknown duration.Untreated ocular syphilis may lead to permanent vision loss,underscoring the importance of appropriate evaluation and treatment of ocular syphilis.Case Description:In a retrospective,non-contiguous case series,we highlight four patients diagnosed and treated with ocular syphilis at a single institution.Four presentations of ocular syphilis are illustrated:anterior and intermediate uveitis,optic neuritis,posterior uveitis,and panuveitis.All patients initially presented with a decreased visual acuity(VA).One patient had a previous diagnosis of human immunodeficiency virus(HIV).Three patients were treated with intravenous(IV)penicillin and one patient with IV ceftriaxone.All had a return to their baseline VA after their course of treatment.Conclusions:Syphilis may go undetected without a high index of clinical suspicion due to its nonspecific presentations.All patients with ocular inflammation should have syphilis testing as a part of their infectious workup with both treponemal and non-treponemal testing.Patients diagnosed with syphilis and are not known to be HIV-negative should undergo testing for HIV due to the high rate of co-infection.Early diagnosis and prompt treatment after onset of symptoms may contribute to a more favorable prognosis for ocular syphilis.展开更多
骨髓增生异常肿瘤(myelodysplastic neoplasms,MDS)患者的预后与其细胞遗传学和分子遗传学特征密切相关,TP53基因作为MDS最常见的突变基因之一,其异常是MDS独立的不良预后因素以及向急性髓系白血病(acute myeloid leuke⁃mia,AML)转化的...骨髓增生异常肿瘤(myelodysplastic neoplasms,MDS)患者的预后与其细胞遗传学和分子遗传学特征密切相关,TP53基因作为MDS最常见的突变基因之一,其异常是MDS独立的不良预后因素以及向急性髓系白血病(acute myeloid leuke⁃mia,AML)转化的危险因素之一。新近更新的第5版世界卫生组织血液淋巴肿瘤分类标准(the 5th edition of the who classifica⁃tion of haematolymphoid tumours,WHO 2022)以及髓系肿瘤和急性白血病的国际共识分类(international consensus classification of myeloid neoplasms and acute leukemia,ICC)将伴有TP53双等位基因失活(biallelic TP53 inactivation,biTP53)的MDS作为独立的亚型列出,该亚型患者预后极差,生存期极短。目前针对伴TP53基因异常的MDS患者的治疗尚未能有效改善该类患者预后,新型靶向药物、免疫治疗等均在探索中,本文就国内外对伴TP53基因异常的MDS的临床研究进展进行综述。展开更多
目的:探讨TP53突变和缺失对弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma, DLBCL)患者预后的影响。方法:收集我院2017至2020年94例初发DLBCL患者的石蜡病理组织,应用免疫组化及二代测序检测TP53突变,FISH技术检测TP53缺失,分析TP5...目的:探讨TP53突变和缺失对弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma, DLBCL)患者预后的影响。方法:收集我院2017至2020年94例初发DLBCL患者的石蜡病理组织,应用免疫组化及二代测序检测TP53突变,FISH技术检测TP53缺失,分析TP53突变、缺失与临床病理及分子分型的相关性,以及对生存的影响。应用COX回归分析DLBCL的生存影响因素。结果:27.7%(26/94)患者过表达p53,23.5%(19/81)患者存在TP53突变,16.0%(15/94)患者TP53缺失,结外受累(P=0.027)、MUM-1(P=0.04)及p53蛋白(P<0.01)表达在在TP53突变和/或缺失及TP53正常两组中存在明显差异。生存分析显示,“双阳性(TP53突变合并缺失)”组生存最差,“双阴性(无TP53突变及缺失)”组预后最好,TP53突变或缺失则次之,其中单突变与单缺失两组总生存无明显统计学差异(P=0.689),其余各组之间生存有显著差异(P<0.05)。GCB中,TP53突变组预后较差(P=0.046)。多因素分析显示合并B症状、TP53异常及双表达是影响DLBCL生存的独立危险因素。结论:TP53突变或缺失,特别是同时合并突变和缺失是DLBCL的不良预后因素,在新的分子分型中,其预后意义仍值得进一步的深入研究。展开更多
Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of ...Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2<sup>nd</sup> trimester and 17 in 3<sup>rd</sup> trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1<sup>st</sup>-trimester visit, 23 in the 2<sup>nd</sup> trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2<sup>nd</sup> trimester and 2 in the 3<sup>rd</sup> trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1<sup>st</sup> ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.展开更多
文摘Background:The incidence of syphilis has been increasing in the United States over the last two decades,with a more recent increase among women.Ocular syphilis is an uncommon but important complication of syphilis,most often presenting as posterior or panuveitis in late or latent syphilis of unknown duration.Untreated ocular syphilis may lead to permanent vision loss,underscoring the importance of appropriate evaluation and treatment of ocular syphilis.Case Description:In a retrospective,non-contiguous case series,we highlight four patients diagnosed and treated with ocular syphilis at a single institution.Four presentations of ocular syphilis are illustrated:anterior and intermediate uveitis,optic neuritis,posterior uveitis,and panuveitis.All patients initially presented with a decreased visual acuity(VA).One patient had a previous diagnosis of human immunodeficiency virus(HIV).Three patients were treated with intravenous(IV)penicillin and one patient with IV ceftriaxone.All had a return to their baseline VA after their course of treatment.Conclusions:Syphilis may go undetected without a high index of clinical suspicion due to its nonspecific presentations.All patients with ocular inflammation should have syphilis testing as a part of their infectious workup with both treponemal and non-treponemal testing.Patients diagnosed with syphilis and are not known to be HIV-negative should undergo testing for HIV due to the high rate of co-infection.Early diagnosis and prompt treatment after onset of symptoms may contribute to a more favorable prognosis for ocular syphilis.
文摘骨髓增生异常肿瘤(myelodysplastic neoplasms,MDS)患者的预后与其细胞遗传学和分子遗传学特征密切相关,TP53基因作为MDS最常见的突变基因之一,其异常是MDS独立的不良预后因素以及向急性髓系白血病(acute myeloid leuke⁃mia,AML)转化的危险因素之一。新近更新的第5版世界卫生组织血液淋巴肿瘤分类标准(the 5th edition of the who classifica⁃tion of haematolymphoid tumours,WHO 2022)以及髓系肿瘤和急性白血病的国际共识分类(international consensus classification of myeloid neoplasms and acute leukemia,ICC)将伴有TP53双等位基因失活(biallelic TP53 inactivation,biTP53)的MDS作为独立的亚型列出,该亚型患者预后极差,生存期极短。目前针对伴TP53基因异常的MDS患者的治疗尚未能有效改善该类患者预后,新型靶向药物、免疫治疗等均在探索中,本文就国内外对伴TP53基因异常的MDS的临床研究进展进行综述。
文摘目的:探讨TP53突变和缺失对弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma, DLBCL)患者预后的影响。方法:收集我院2017至2020年94例初发DLBCL患者的石蜡病理组织,应用免疫组化及二代测序检测TP53突变,FISH技术检测TP53缺失,分析TP53突变、缺失与临床病理及分子分型的相关性,以及对生存的影响。应用COX回归分析DLBCL的生存影响因素。结果:27.7%(26/94)患者过表达p53,23.5%(19/81)患者存在TP53突变,16.0%(15/94)患者TP53缺失,结外受累(P=0.027)、MUM-1(P=0.04)及p53蛋白(P<0.01)表达在在TP53突变和/或缺失及TP53正常两组中存在明显差异。生存分析显示,“双阳性(TP53突变合并缺失)”组生存最差,“双阴性(无TP53突变及缺失)”组预后最好,TP53突变或缺失则次之,其中单突变与单缺失两组总生存无明显统计学差异(P=0.689),其余各组之间生存有显著差异(P<0.05)。GCB中,TP53突变组预后较差(P=0.046)。多因素分析显示合并B症状、TP53异常及双表达是影响DLBCL生存的独立危险因素。结论:TP53突变或缺失,特别是同时合并突变和缺失是DLBCL的不良预后因素,在新的分子分型中,其预后意义仍值得进一步的深入研究。
文摘Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2<sup>nd</sup> trimester and 17 in 3<sup>rd</sup> trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1<sup>st</sup>-trimester visit, 23 in the 2<sup>nd</sup> trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2<sup>nd</sup> trimester and 2 in the 3<sup>rd</sup> trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1<sup>st</sup> ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.
