We examine the problem of discriminating between two groups in the context of multivariate response curves observed over a specified time interval. We propose a descriptive solution for the case where one can determine the response curves by linear interpolation between successive observations. Unlike most previously reported methods that use only the current multivariate observation, our approach accounts for the history of the process. Moreover the method has the potential advantage of being applicable dynamically, as one observes the multivariate response curve. Finally, the method demonstrates simplicity and flexibility, two important features for successful, routine, clinical application.

Humans↗

PubMedDate not supplied

A multicentric study of 41 cases of B-prolymphocytic leukemia: two evolutive forms.

B-prolymphocytic leukemia (B-PLL) is an infrequent disease with a poor prognosis. We present the clinical and biological features of 41 patients. Median age was 67 years [42-89] and male-female sex ratio was 2.4. The immunophenotyping revealed B-cell phenotype, with a high level expression of surface IgM and/or IgD in all cases, FMC7+ in 76 % of cases and CD5+ in 67%. Marked spontaneous in-vitro apoptosis was observed in most cases tested (n = 12). The median overall survival time was 5 years and the event-free survival time was 37 months. As detected by univariate and multivariate analysis, the only variables associated with a poor prognosis were advanced age and anemia. No significant difference was observed between de novo PLL (n = 27) and prolymphocytoid transformation of chronic lymphocytic leukemia (n = 14). Two groups of patients were individualized according to their clinical course: patients who died within one year of diagnosis (n = 14) and patients who had a prolonged survival (n = 23) without any treatment in some cases. The comparison between the 2 groups showed that they differed in age (p = 0.01) and anemia (p = 0.02). We also observed that the patients with p53 mutations had a worse clinical outcome. Taken together these data confirm that B-PLL should be regarded as a distinct form of chronic lymphoproliferative disorder and suggest the existence of two patterns of clinical evolution.

Adult↗

PubMedDate not supplied

The rural health clinic.

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Ambulatory Care Facilities↗

PubMedDate not supplied

We must never forget what nursing is about.

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Humans↗

PubMedDate not supplied

[Analysis of minor complications in copper IUD wearers].

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Age Factors↗

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[Diagnostic, symptomatic and sanitary assessment of schizophrenic patients in Liege psychiatric institutions].

This study was designed to provide a diagnostic, symptomatologic and sanitary assessment of schizophrenic patients in the network of institutions of the Plate-Forme Psychiatrique Liégeoise (Liège, Belgium). The diagnosis of schizophrenia was based on the DSM IV. Demographic, social and global functioning (GAF scale) data were collected from the Résumé Psychiatrique Minimum (RPM) , a clinical summary which has been imposed for each psychiatric hospital stay by the Belgian Ministry of Public Health. Symptoms components were derived from the Psychosis Evaluation tool for Commom Use by Caregivers (PECC). In the 44 participating institutions, 793 cases of schizophrenia were reported (533 men and 260 women) with a mean age of 46.1 14.4 years. The study confirmed the predominance of men in schizophrenia (67%) but revealed that women were about 6 years higher than men. PECC symptoms were studied in a random sample of 184 patients extracted from the 793 initial patients and analysed with respect to age, sex and type of care (full-time or part-time hospitalization, ambulatory care). Negative, cognitive and total PECC scores did not vary with sex but were positively correlated with age. Hospitalized patients were significantly older than the others. The cognitive deficit was significantly higher in hospitalized patients than in other patients, while the perception of the disease tended to be more apparent in ambulatory than in hospitalized patients. Data were also related to social information and global functioning. The GAF scores increased with age but were comparable in men and women. Moreover, GAF scores were significantly lower in catatonic type schizophrenia patients than in others.

Adult↗

PubMedDate not supplied

[Gray platelet syndrome].

BACKGROUND: Gray platelet syndrome is a rare (about 40 cases published), inherited disorder characterized by a marked decrease or absence of platelet alpha-granules and platelet specific alpha-granule proteins. CASE REPORT: A boy, aged 4 years, presented with frequent ecchymoses. Acute idiopathic thrombocytopenia purpura was diagnosed because of his reduced platelet count (36,000/mm3) and recent viral infection. Intravenous gammaglobulin infusion was followed by a small rise in the platelet count (125,000/mm3). The patient was reinvestigated a few months later because of persistent thrombocytopenia and the failure of the immunologic treatment. The bleeding time was long and the platelets on blood smears appeared gray. Electron microscopy revealed numerous vacuoles and very few or no alpha-granules. Platelet aggregation and adhesion were normal, but stimulated platelets failed to liberate factor 4 and beta-thromboglobulin, while the plasma levels of beta-thromboglobulin were elevated. CONCLUSION: The frequency of gray platelet syndrome is probably underestimated in those diseases resulting in thrombocytopenia and this will continue until blood smears are thoroughly examined. Synthesis of platelet specific alpha-granule proteins seems normal; but these proteins cannot be stored as there are very few, or no alpha-granules. This abnormality could lead to increased levels of such proteins in the plasma.

Blood Platelet Disorders↗

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Comparison of monooxygenase activities and cytochrome P-450 isozyme concentrations in human liver microsomes.

Concentrations of three human liver microsomal cytochrome P-450 isozymes and 20 different monooxygenase activities were determined in human liver microsomal preparations. The results of correlation analysis suggest that: there are important variations in the amounts of the three cytochrome P-450 isozymes measured, particularly P-450(8) and P-450(9); aldrin epoxidase, d-benzphetamine N-demethylase, and S-warfarin 4-hydroxylase activities are linked to cytochrome P-450(5); aryl hydrocarbon (benzo(a)pyrene) hydroxylase and 4-nitroanisole-O-demethylase activities are linked to P-450(8); hydroxylations at the 4'-, 6-, 7-, and 8-positions of R-warfarin are closely linked to each other but are not correlated with other measured monooxygenase activities or P-450 isozyme levels; and P-450(9) is not related to any of the catalytic activities tested. Thus, certain monooxygenase activities can be attributed to specific cytochrome P-450 isozymes. This approach should be useful in suggesting the roles of different cytochromes P-450 in drug metabolism in man which can be further examined using in vitro and in vivo methods.

Adult↗

PubMedDate not supplied

MRI of optic chiasm and optic pathways.

Eight verified lesions of the optic chiasm were examined on 0.5 T magnetic resonance (MR) and GE 9800, 8800 computed tomographic (CT) scanners. Enlargement of the optic chiasm was demonstrated in all cases. There was some change of MR signal compared with brain in all but one case, which had no resemblance to contrast enhancement on CT scans. The signal was specific for hematoma in one case. Abnormal signal, probably signifying tumor spread into the optic radiation, was detected on T2-weighted images in one case. The resolution of MR scans is similar or superior to CT, and sagittal views are most useful in evaluating lesions in this location.

Adolescent↗