-Martínez, jlfm@uniovi.es, 0034 985 103 199.
AbstractPurpose: The cure rate in Hodgkin Lymphoma is high, but the response along the treatment is still unpredictable and is highly variable among patients. Detecting those patients that do not respond to the treatment at early stages could bring improvements in their treatment. This research tries to identify the main biological prognostic variables currently gathered at diagnosis, and designing a simple machine learning methodology to help physicians improving the treatment response assessment. Methods: We carried out a retrospective analysis of the response to treatment for a cohort of 263 Caucasians who were diagnosed with Hodgkin Lymphoma in Asturias (Spain). For that purpose, we used a list of 35 clinical and biological variables that are currently measured at diagnosis, before any treatment begins. To establish the list of most discriminatory prognostic variables for the treatment response we designed a machine learning approach based on two different feature selection methods (Fisher's ratio and Maximum Percentile Distance) and recursive feature elimination using a nearest-neighbor classifier (k-NN). The weights of the k-NN classifier are optimized using different terms of the confusion matrix (true and false positive rates) in order to minimize risk in the decisions. Results and conclusions: We found that the optimum strategy to predict treatment response in Hodgkin lymphoma consists in solving two
We report three patients aged 75-80 years observed in the Emergency Room with severe anaemia (requiring transfusion) due to a large abdominal wall haematoma while receiving standard prophylaxis against venous thromboembolism (40 mg/day enoxaparin for 6 days on average). All of them concomitantly received 100 mg/day aspirin because of previous ischaemic heart disease and presented similar clinical features: sudden onset of abdominal pain during a severe cough episode due to bronchial infection. A giant haematoma in the rectus abdominis muscle was recognized (by computed tomography) in every case. The cough has been related with this complication in some reports but its association with antiplatelet drugs and low molecular weight heparin could increase the risks in older patients. Sudden abdominal pain must alert the clinician to the rectus muscle sheath haematoma in order to avoid the risks of an exploratory laparotomy.
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