{"title":"Central nervous system","authors":"Christopher J. Hurt, D. Yousem, N. Beauchamp","doi":"10.1002/9781119548461.ch5","DOIUrl":"https://doi.org/10.1002/9781119548461.ch5","url":null,"abstract":"","PeriodicalId":286643,"journal":{"name":"Rapid Clinical Pharmacology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114481338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Routbort, K. Young, S. Wang, D. Hoehn, G. Tang, C. Bueso-Ramos, R. Miranda, L. Medeiros
{"title":"Infections","authors":"M. Routbort, K. Young, S. Wang, D. Hoehn, G. Tang, C. Bueso-Ramos, R. Miranda, L. Medeiros","doi":"10.1002/9781119548461.ch6","DOIUrl":"https://doi.org/10.1002/9781119548461.ch6","url":null,"abstract":"1614 Negative TdT Expression Predicts Adverse Treatment Outcome in T-Lymphoblastic Leukemia/Lymphoma in Adults Y Zhou, M Routbort, KH Young, S Wang, D Hoehn, G Tang, C Bueso-Ramos, CC Yin, RN Miranda, LJ Medeiros, P Lin. The University of Texas, MD Anderson Cancer Center, Houston, TX. Background: T-lymphoblastic leukemia/lymphoma (T-ALL/LBL) is an aggressive disease that requires intensive chemotherapy regimens such as hyperfractionated cyclophosphamide, vincristine, adriamycin, and dexamethasone (Hyper-CVAD). With this therapy, approximately 90% of the patients initially achieve complete remission. Nevertheless, a signifi cant subset of patients relapses and succumbs to recurrent disease. Unlike patients with B-ALL/LBL, there is currently no risk stratifi cation scheme for T-ALL/LBL patients. To identify the high-risk patients who may benefi t from stem cell transplant during the fi rst remission is clinically challenging. A readily accessible prognostic marker for high-risk T-ALL/LBL is essential for risk-adapted therapy and improved outcome. Design: We reviewed available data of T-ALL/LBL patients treated at our institution between 2003 and 2011 (n=106), and identifi ed TdT negative cases. Negative TdT immunoreactivity was defi ned as <10% neoplastic cells positive by combined fl ow cytometric immunophenotyping and immunohistochemical staining. All cases were positive for cytoplasmic CD3. Clinical, morphologic, immunophenotypic and cytogenetic data were reviewed. Relapse-free survival and overall survival were calculated using Kaplan-Meier survival analysis. Results: We identifi ed 17 (16%) cases of TdT-negative T-ALL/LBL: 8 de novo and 9 relapsed. There were 12 men and 5 women with a median age of 30 years (range, 13 to 62). The median follow-up period was 12 mo (range, 2.9 to 42.3 mo). The immunophenotype was pro-T/pre-T (CD34+) in 8 neoplasms, cortical-T (CD1+) in 5, or other (CD34-/CD1-/CD4-/CD8-) in 4. Of 16 cases with cytogenetic data, 11 had a complex karyotype, 4 were diploid, and 1 had isolated add(3). All patients received intensive chemotherapy, including hyper-CVAD, as frontline or salvage treatment. The estimated relapse-free and overall survival at 2 years was 8 % and 24%, respectively. Among the 8 de novo patients, the estimated relapse-free and overall survival at 1 year was about 24%. Relapse-free and overall survival in this patient group was signifi cantly worse than those of age-matched TdT positive T-ALL/LBL patients treated during the same period (p<0.01). Conclusions: About 15% of patients with T-ALL/LBL are negative for TdT immunoreactivity, and respond poorly to intensive chemotherapy. Stem cell transplant during fi rst remission may be benefi cial for this group of patients.","PeriodicalId":286643,"journal":{"name":"Rapid Clinical Pharmacology","volume":"598 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134505868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Respiratory system","authors":"Andrew Davies","doi":"10.1002/9781119548461.ch4","DOIUrl":"https://doi.org/10.1002/9781119548461.ch4","url":null,"abstract":"The Respiratory System presents the fundamentals of respiratory anatomy and physiology and relates those fundamentals to clinical application. The preface acknowledges that the intended audience includes students in allied health fields, such as respiratory care and nursing, who have not yet had clinical experience. The first chapter briefly discusses circulation and cellular respiration, including the role each plays in maintaining homeostasis, and identifies some basic components of a physical examination used to assess the adequacy of ventilation and oxygenation. A brief illustration of chest radiograph interpretation is also included. Basic gas laws are referenced along with common respiratory symbols and terms. Chapter 2 describes the fundamentals of respiratory system anatomy. Upper airway anatomy is effectively introduced through a discussion on obstructive sleep apnea. However, the illustrations in this chapter lacked attention to detail. For example, the 3 components of the pharynx are not defined in Figure 2.1, which illustrates head and neck anatomy. The description of lobar anatomy is also incomplete, as the chapter neglects to state that there are 3 lobes on the right and 2 on the left. Figure 2.12 shows the lobes but does not label them or identify the fissures. The remaining chapters focus on the physiology of disease processes, and numerous clinical scenarios are used as examples. For example, the concepts of the Laplace law and differentiation between static and dynamic lung compliance are introduced through a discussion of elasticity and surface tension as components of lung compliance. The authors describe the pathophysiology of respiratory distress syndrome and show the relevance of the theory. Asthma, as an obstructive disorder, is used to characterize abnormal physiology of airflow, airway resistance, and work of breathing. There is also a discussion of common bronchodilators and inflammatories. In defining lung volumes and capacities the text uses case studies of pneumothorax and pneumonia to underscore the importance of understanding nonuniform distribution of ventilation within the lungs and its effect on gas diffusion during disease. Oxygen delivery is presented through a description of cardiopulmonary circulation, with pulmonary embolus setting the stage nicely for a clinical discussion of ventilation-perfusion mismatch and shunting theories. The Fick law is incorporated to explain the relationship between the variables that influence the rate of diffusion. Abnormalities in gas diffusion and oxygen distribution to the cellular level are clinically depicted with a discussion on fibrosing alveolitis. The description of the oxyhemoglobin dissociation curve identifies conditions (eg, carbon monoxide poisoning) that alter its shape. Also discussed are myoglobin, fetal hemoglobin, various abnormal hemoglobins, and carbon dioxide transport, including the dynamic buffering system and the Henderson-Hasselbalch equation. There is","PeriodicalId":286643,"journal":{"name":"Rapid Clinical Pharmacology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115522632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Eye","authors":"A. Sivakumar","doi":"10.1002/9781119548461.ch11","DOIUrl":"https://doi.org/10.1002/9781119548461.ch11","url":null,"abstract":"The Global Initiative for the Elimination of Avoidable Blindness (Vision 2020: The Right to Sight) sets a major challenge requiring a significant increase in the provision and uptake of eye care services. If the increasing trend in blindness is to be reversed, then access to eye care services needs to be made more widely available. One of the most significant barriers to accessing these services is affordability. The shrinking economies of many of the world’s poorest countries is placing increasing pressure on health care budgets that are already severely over stretched. Competing demands from life threatening diseases such as AIDS, malaria, and TB are pushing eye health services further down the agenda list of public health priorities. Simultaneously, the increasing cost of health care is forcing many governments to reform the structure of their health delivery systems. Many are choosing to introduce cost recovery mechanisms, as a means of controlling the overall rising costs of providing health care services. Articles in this issue focus primarily on the supply issues of service delivery, looking particularly at how increasing operational and manufacturing efficiencies can reduce costs to an affordable level. But to place affordability within the reach of ordinary people, their families and the communities in which they live, we also need to understand the demand issues which place additional cost burdens that do not allow access to eye care. The costs are many and complex and the intention of this article is to explore what these might be (direct and indirect), and to offer some suggestions as to what might be done in order to make eye care more affordable to those who can least afford it.","PeriodicalId":286643,"journal":{"name":"Rapid Clinical Pharmacology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123944681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Malignant disease and immunosuppression","authors":"D. Richards, J. Aronson, D. Reynolds, J. Coleman","doi":"10.1093/MED/9780199562855.003.0253","DOIUrl":"https://doi.org/10.1093/MED/9780199562855.003.0253","url":null,"abstract":"","PeriodicalId":286643,"journal":{"name":"Rapid Clinical Pharmacology","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116821940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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