Hereditary fructose intolerance(HFI) is an underrecognized,preventable life-threatening condition.It is an autosomal recessive disorder with subnormal activity of aldolase B in the liver,kidney and small bowel.Symptom...Hereditary fructose intolerance(HFI) is an underrecognized,preventable life-threatening condition.It is an autosomal recessive disorder with subnormal activity of aldolase B in the liver,kidney and small bowel.Symptoms are present only after the ingestion of fructose,which leads to brisk hypoglycemia,and an individual with continued ingestion will exhibit vomiting,abdominal pain,failure to thrive,and renal and liver failure.A diagnosis of HFI was made in a 50-year-old woman on the basis of medical history,response to fructose intolerance test,demonstration of aldolase B activity reduction in duodenal biopsy,and molecular analysis of leukocyte DNA by PCR showed homozygosity for two doses of mutant gene.HFI may remain undiagnosed until adult life and may lead to disastrous complications following inadvertent fructose or sorbitol infusion.Several lethal episodes of HFI following sorbitol and fructose infusion have been reported.The diagnosis can only be suspected by taking a careful dietary history,and this can present serious complications.展开更多
The aim of the study was to evaluate Paraoxonase-I (PON-1), resistin and bone mineral markers (Parathyroid Hormone (PTH), Ca++ and P) levels as biochemical marker for patients with Chronicrenal Failure (CRF)...The aim of the study was to evaluate Paraoxonase-I (PON-1), resistin and bone mineral markers (Parathyroid Hormone (PTH), Ca++ and P) levels as biochemical marker for patients with Chronicrenal Failure (CRF). The sample of this study consists of 100 patients and 100 apparently healthy individuals. All patients were those who were receiving Hemodialysis (HD) therapy in the dialysis unit in Kirkuk general. The levels of PON-1, Ca++ were significantly lower in CRF patients pre HD when compared with healthy controls, and significantly increased in post HD as compared to pre HD, but still lower than normal controls. Serum P, resistin and PTH levels were significantly higher in CRF patients pre HD process when compared with healthy controls, and their levels were significantly decreased after HD as compared to pre HD, but remained higher than controls. PON-1 was negatively correlated with the resistin, Blood Urea (BU), Creatinine (Cr), PTH, but positively correlated with Ca++. PON-I activity was significantly decreased in CRF patients before HD and increased after HD, but remained lower than controls. PON-1 was negatively correlated with the Body Max Index (MBI), resistin, BU, Cr, PTH, but significantly and positively correlated with Ca++.展开更多
The world is experiencing aging of its population. Age-specific incidence rates of cancer are higher and cancer is now recognized as a part of aging. Treating older patients can be challenging. The clinical behavior o...The world is experiencing aging of its population. Age-specific incidence rates of cancer are higher and cancer is now recognized as a part of aging. Treating older patients can be challenging. The clinical behavior of some tumors changes with age and the aging process itself brings physiological changes leading to decline in the function of organs. It is essential to identify those patients with longer life expectancy, potentially more likely to benefit from aggressive treatment vs. those that are more vulnerable to adverse outcomes. A primary determination when considering therapy for an older cancer patient is a patient's physiologic, rather than chronologic age. In order to differentiate amongst patients of the same age, it is useful to determine if a patient is fit or frail. Frail older adults have multiple chronic conditions and difficulties maintaining independence. They may be more vulnerable to therapy toxicities, and may not have substantial lasting benefits from therapy. Geriatric assessment(GA) may be used as a tool to determine reversible deficits and devise treatment strategies to mitigate such deficits. GA is also used in treatment decision making by clinicians, helping to risk stratify patients prior to potentially high-risk therapy. An important practical aspect of GA is the feasibility of incorporating it into a busy oncology practice. Key considerations in performing the GA include: available resources, patient population, GA tools to use, and who will be responsible for using the GA results and develop care plans. Challenges in implementing GA in clinical practice will be discussed.展开更多
文摘Hereditary fructose intolerance(HFI) is an underrecognized,preventable life-threatening condition.It is an autosomal recessive disorder with subnormal activity of aldolase B in the liver,kidney and small bowel.Symptoms are present only after the ingestion of fructose,which leads to brisk hypoglycemia,and an individual with continued ingestion will exhibit vomiting,abdominal pain,failure to thrive,and renal and liver failure.A diagnosis of HFI was made in a 50-year-old woman on the basis of medical history,response to fructose intolerance test,demonstration of aldolase B activity reduction in duodenal biopsy,and molecular analysis of leukocyte DNA by PCR showed homozygosity for two doses of mutant gene.HFI may remain undiagnosed until adult life and may lead to disastrous complications following inadvertent fructose or sorbitol infusion.Several lethal episodes of HFI following sorbitol and fructose infusion have been reported.The diagnosis can only be suspected by taking a careful dietary history,and this can present serious complications.
文摘The aim of the study was to evaluate Paraoxonase-I (PON-1), resistin and bone mineral markers (Parathyroid Hormone (PTH), Ca++ and P) levels as biochemical marker for patients with Chronicrenal Failure (CRF). The sample of this study consists of 100 patients and 100 apparently healthy individuals. All patients were those who were receiving Hemodialysis (HD) therapy in the dialysis unit in Kirkuk general. The levels of PON-1, Ca++ were significantly lower in CRF patients pre HD when compared with healthy controls, and significantly increased in post HD as compared to pre HD, but still lower than normal controls. Serum P, resistin and PTH levels were significantly higher in CRF patients pre HD process when compared with healthy controls, and their levels were significantly decreased after HD as compared to pre HD, but remained higher than controls. PON-1 was negatively correlated with the resistin, Blood Urea (BU), Creatinine (Cr), PTH, but positively correlated with Ca++. PON-I activity was significantly decreased in CRF patients before HD and increased after HD, but remained lower than controls. PON-1 was negatively correlated with the Body Max Index (MBI), resistin, BU, Cr, PTH, but significantly and positively correlated with Ca++.
基金supported in part by Beatrice & Samuel A Seaver Foundationby the Memorial Sloan Kettering Cancer and Aging Research Program
文摘The world is experiencing aging of its population. Age-specific incidence rates of cancer are higher and cancer is now recognized as a part of aging. Treating older patients can be challenging. The clinical behavior of some tumors changes with age and the aging process itself brings physiological changes leading to decline in the function of organs. It is essential to identify those patients with longer life expectancy, potentially more likely to benefit from aggressive treatment vs. those that are more vulnerable to adverse outcomes. A primary determination when considering therapy for an older cancer patient is a patient's physiologic, rather than chronologic age. In order to differentiate amongst patients of the same age, it is useful to determine if a patient is fit or frail. Frail older adults have multiple chronic conditions and difficulties maintaining independence. They may be more vulnerable to therapy toxicities, and may not have substantial lasting benefits from therapy. Geriatric assessment(GA) may be used as a tool to determine reversible deficits and devise treatment strategies to mitigate such deficits. GA is also used in treatment decision making by clinicians, helping to risk stratify patients prior to potentially high-risk therapy. An important practical aspect of GA is the feasibility of incorporating it into a busy oncology practice. Key considerations in performing the GA include: available resources, patient population, GA tools to use, and who will be responsible for using the GA results and develop care plans. Challenges in implementing GA in clinical practice will be discussed.