Sixty-eight previously untreated patients with primary gastric non-Hodgkin's lymphoma (NHL) available for analysis, were entered in a study in which the prognostic significance of serum beta 2 microglobulin levels were evaluated. The serum beta 2 microglobulin was the most significant prognostic factor. Patients with high levels (greater than 3.5 micrograms/mL) had a relapse-free survival (RFS) of 36 months, while the median RFS has not been reached in patients with normal levels (p less than 0.001). The 5-year survival was 80 per cent for patients with normal levels, statistically significant when compared to patients with high levels: 38 per cent (p less than 0.001). Serum beta 2 microglobulin should be included in the initial staging of patients with primary extranodal NHL and patients with high levels should be treated more aggressively.

Age Factors↗

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Angiocentric T-cell lymphoma of the nose, paranasal sinuses and hard palate.

Sixty-five cases of malignant lymphoma of the nose, paranasal sinuses and hard palate were retrospectively analysed to identify the presence or absence of angiocentric lesions. We observed that the 23 patients with angiocentric lesions had a worse prognosis with a shorter duration of response and also a shorter duration of survival, compared with 42 cases of malignant lymphoma of the same anatomical region but without angiocentric lesions. Patients with angiocentric lymphoma were associated with other bad prognostic factors such as elevated levels of lactic dehydrogenase and beta 2 microglobulin, local bone destruction and lymphopenia. Immunophenotyping studies showed that most patients with angiocentric lesions had T cell lymphomas (18 of 23, 78 per cent). We believe that patients with angiocentric T cell lymphomas of the nose, paranasal sinuses and hard palate represent a distinctive clinico-pathological entity with different clinical presentation and outcome. Patients with angiocentric T cell lymphomas had frequent relapse at extranodal sites and combined therapy should be considered as the initial therapeutic approach.

Adult↗

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Diagnosis of typhoid fever by two serologic methods. Enzyme-linked immunosorbent assay of antilipopolysaccharide of Salmonella typhi antibodies and Widal test.

Serum samples from 85 patients with proven typhoid fever, 11 patients with p-typhoidal fever, 101 patients with febrile non-typhoidal, and 130 healthy subjects were tested for immunoglobulin G (IgG), IgA, and IgM antilipopolysaccharide (LPS) of Salmonella typhi antibodies by enzyme-linked immunosorbent assay (ELISA) and Widal test. The levels of all three classes of immunoglobulin anti-LPS of S. typhi were higher in typhoid patients than in healthy or febrile nontyphoidal groups; we selected various combinations between the three classes of immunoglobulin to obtain the best combination of sensitivity and specificity. The sum of the absorbance values obtained from the ELISA assay for IgG+IgA+IgM (sigma lgs) was the best choice for diagnostic utility for typhoid fever. We selected a positive test at a decision level of sigma lgs > or = 1.2 with a sensitivity of 94% and a specificity of 92% with a frequency of false negative of 5.9%. The frequency of false positives for healthy controls was 7.7% and, for the febrile nontyphoidal group, it was 7.9%. We also compared receiver (or relative) operating characteristic (ROC) curves for the diagnostic usefulness of the ELISA with that of the Widal test, whose merits and limitations, especially in endemic regions, are discussed. The ELISA assay was much more sensitive and specific than any combination of the Widal test, and hence it could be a useful tool for the serologic diagnosis of typhoidal fever with a single blood sample.

Agglutination Tests↗

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Packaging yourself for success as a CNE presenter.

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Clinical Competence↗

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Using visualization as a teaching technique.

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Attention↗

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Creating a clinical development plan for acute care nurses.

This article explores the rationale and creation of Clinical Development plans for acute care nursing staff development. The Clinical Development Plan is suggested as a method of determining the learning needs of nurses on various acute care nursing units by identifying required performance. Development is covered from novice to expert levels. Competencies are categorized into technical, interpersonal, and critical thinking skills. Such a plan is helpful for identifying ongoing training needs of nursing personnel.

Education, Nursing, Continuing↗

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