Objectives: To study the incidence of toxoplasmosis in pregnant women in Crete and to test a designed protocol for handling those at risk of delivering congenitally infected infants. Study design: Pregnant women were ...Objectives: To study the incidence of toxoplasmosis in pregnant women in Crete and to test a designed protocol for handling those at risk of delivering congenitally infected infants. Study design: Pregnant women were screened serologically over a period of 5 years. Cases with suspected acute toxoplasmosis were treated, peripheral blood (PB), and amniotic fluid (AF)tested by polymerase chain reaction (PCR) and culture, and fetuses monitored by ultrasonography. The absence of congenital infection in infants was confirmed by serology and clinical evaluation. Results: Of the 5532 pregnant women followed, 70.57%remained seronegative, 29.45%were seropositive, and there was direct evidence of seroconversion in six cases. Acute toxoplasmosis was suspected in 185 cases, maternal parasitemia was detected in five cases and positive amniotic fluid in one case. Congenital infection was excluded in all infants followed, based on the absence of ultrasound findings in utero, lack of clinical symptoms at birth, negative Western blotting (WB) at birth and 3 months later, and descending serology for a year. Conclusion: Overall, 29.45%of the pregnant women followed were seropositive, 3.3%with suspected acute toxoplasmosis, and in 0.02%cases there was evidence of maternofetal transmission. The protocol tested allowed differentiation between acute andlatent toxoplasmosis, safe management of the cases at risk and assisted in avoidance of unwarranted pregnancy terminations.展开更多
甲状腺滤泡性癌(FTC)和滤泡性腺瘤(FTA)需组织病理仔细鉴别,前者的预后主要基于肿瘤大小和侵袭范围,而高危病例缺乏精确的免疫组化标记物。作者试图用Ki-67来区分FTC和FTA并识别预后不良的FTC,为此收集了所在单位1999年以来818例甲状腺...甲状腺滤泡性癌(FTC)和滤泡性腺瘤(FTA)需组织病理仔细鉴别,前者的预后主要基于肿瘤大小和侵袭范围,而高危病例缺乏精确的免疫组化标记物。作者试图用Ki-67来区分FTC和FTA并识别预后不良的FTC,为此收集了所在单位1999年以来818例甲状腺滤泡性肿瘤,其中包括516例FTA、252例FTC、50例恶性潜能未定的滤泡性肿瘤(FT-UMP)。研究仅包括真性无功能的滤泡性肿瘤,而毒性腺瘤、玻璃样梁状肿瘤、低分化成分和/或乳头状甲状腺癌与髓样癌共存,以及恶性潜能未定的高分化肿瘤(WDT-UMPs)均被排除在外。结果显示,嗜酸细胞肿瘤或“Hürthle细胞”滤泡性甲状腺肿瘤共75例。FTC通常体积大于FTA(41 mm vs.31 mm,P<0.001),FTC患者平均年龄比FTA的大(55岁vs.50岁,P<0.001),而FTC和FTUMP之间无显著差异。在分析了患者手术年龄、性别、原发肿瘤大小、Ki-67增殖指数、有无甲状腺外播散(ETE)、包膜侵犯、血管侵犯、嗜酸细胞分化及pTNM分期各个参数后,发现手术年龄、Ki-67增殖指数和ETE的存在是转移/复发性疾病(无病生存)独立预测因子,而Ki-67增殖指数和手术时年龄是预测患者死于疾病的独立因素。血管浸润被定义为血管内瘤栓外层与纤维蛋白相连或轮廓超出肿瘤包膜,若判定困难,可水平切片、van Gieson染色和/或行内皮免疫组化标记。展开更多
老年多器官功能不全综合征（multiple organ dysfunction syndrome in the elderly,MODSE）是老年肺部感染的最严重并发症之一,MODSE一旦发生,临床救治往往十分困难。因此,早期预测老年肺部感染病人的MODSE发病、及早采取综合干预措施...老年多器官功能不全综合征（multiple organ dysfunction syndrome in the elderly,MODSE）是老年肺部感染的最严重并发症之一,MODSE一旦发生,临床救治往往十分困难。因此,早期预测老年肺部感染病人的MODSE发病、及早采取综合干预措施显得尤为重要。展开更多
文摘Objectives: To study the incidence of toxoplasmosis in pregnant women in Crete and to test a designed protocol for handling those at risk of delivering congenitally infected infants. Study design: Pregnant women were screened serologically over a period of 5 years. Cases with suspected acute toxoplasmosis were treated, peripheral blood (PB), and amniotic fluid (AF)tested by polymerase chain reaction (PCR) and culture, and fetuses monitored by ultrasonography. The absence of congenital infection in infants was confirmed by serology and clinical evaluation. Results: Of the 5532 pregnant women followed, 70.57%remained seronegative, 29.45%were seropositive, and there was direct evidence of seroconversion in six cases. Acute toxoplasmosis was suspected in 185 cases, maternal parasitemia was detected in five cases and positive amniotic fluid in one case. Congenital infection was excluded in all infants followed, based on the absence of ultrasound findings in utero, lack of clinical symptoms at birth, negative Western blotting (WB) at birth and 3 months later, and descending serology for a year. Conclusion: Overall, 29.45%of the pregnant women followed were seropositive, 3.3%with suspected acute toxoplasmosis, and in 0.02%cases there was evidence of maternofetal transmission. The protocol tested allowed differentiation between acute andlatent toxoplasmosis, safe management of the cases at risk and assisted in avoidance of unwarranted pregnancy terminations.
文摘甲状腺滤泡性癌(FTC)和滤泡性腺瘤(FTA)需组织病理仔细鉴别,前者的预后主要基于肿瘤大小和侵袭范围,而高危病例缺乏精确的免疫组化标记物。作者试图用Ki-67来区分FTC和FTA并识别预后不良的FTC,为此收集了所在单位1999年以来818例甲状腺滤泡性肿瘤,其中包括516例FTA、252例FTC、50例恶性潜能未定的滤泡性肿瘤(FT-UMP)。研究仅包括真性无功能的滤泡性肿瘤,而毒性腺瘤、玻璃样梁状肿瘤、低分化成分和/或乳头状甲状腺癌与髓样癌共存,以及恶性潜能未定的高分化肿瘤(WDT-UMPs)均被排除在外。结果显示,嗜酸细胞肿瘤或“Hürthle细胞”滤泡性甲状腺肿瘤共75例。FTC通常体积大于FTA(41 mm vs.31 mm,P<0.001),FTC患者平均年龄比FTA的大(55岁vs.50岁,P<0.001),而FTC和FTUMP之间无显著差异。在分析了患者手术年龄、性别、原发肿瘤大小、Ki-67增殖指数、有无甲状腺外播散(ETE)、包膜侵犯、血管侵犯、嗜酸细胞分化及pTNM分期各个参数后,发现手术年龄、Ki-67增殖指数和ETE的存在是转移/复发性疾病(无病生存)独立预测因子,而Ki-67增殖指数和手术时年龄是预测患者死于疾病的独立因素。血管浸润被定义为血管内瘤栓外层与纤维蛋白相连或轮廓超出肿瘤包膜,若判定困难,可水平切片、van Gieson染色和/或行内皮免疫组化标记。
文摘老年多器官功能不全综合征（multiple organ dysfunction syndrome in the elderly,MODSE）是老年肺部感染的最严重并发症之一,MODSE一旦发生,临床救治往往十分困难。因此,早期预测老年肺部感染病人的MODSE发病、及早采取综合干预措施显得尤为重要。
