To compare the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube test (QFG) for the detection of latent tuberculosis infection among patients with immune-mediated inflammatory diseases before antitumor necrosis factor-α therapy. A prospective study including 153 consecutive patients with rheumatoid arthritis (n = 53), psoriasis (n = 45), inflammatory bowel disease (n = 25), and spondyloarthropathy (n = 22) were included. QFG and TST were performed simultaneously. TST was positive in 43/153 (28.1 %) patients. QFG (cutoff ≥ 0.35 IU/ml) was positive in 15/153 (9.8 %) patients, and indeterminate in one (0.7 %). QFG (cutoff ≥ 0.10 IU/ml) was positive in 25/153 (16.3 %). 59.5 % of the patients were on immunosuppressive therapy at the time of testing. There was a significant difference in the rate of positive QFG between patients with and without immunosuppressive therapy after adjustment for age and gender (cutoff ≥ 0.35 IU/ml, 4.6 vs. 17.4 %; adjusted odds ratio [AOR], 0.2; 95 % confidence interval [CI], 0.06-0.8; p = 0.03 and cutoff ≥ 0.10 IU/ml, 11.2 vs. 24.2 %; AOR, 0.3; 95 % CI, 0.1-0.93; p = 0.04). Agreement between TST and QFG was 'fair' (κ = 0.354 and κ = 0.365, for cutoffs ≥ 0.35 and ≥0.10 IU/ml, respectively). Among patients without immunosuppressive therapy, the concordance between TST and QFG was 'moderate-substantial' (κ = 0.593 and κ = 0.690, for cutoffs ≥ 0.35 IU/ml and ≥0.10 IU/ml, respectively). By contrast, among patients on immunosuppressive therapy the concordance was 'poor' (κ = 0.085; κ = 0.041, respectively). Immunosuppressive therapy affects negatively QFG performance. In patients with immune-mediated inflammatory diseases, QFG may have a limited role for screening of latent tuberculosis infection.
Agricultural activity in Galicia, North West Spain, is carried out on farms that are characterized by a diversity of land use and production models, a variety of farm sizes, and considerable geographical dispersion. Any attempt of Agricultural Production Planning aimed at characterizing production models requires a method of analysing data and obtaining technicaleconomic results from farms in the different areas. Models based on average statistical data are limited because they represent farms that do not exist in reality. This study develops a methodology to characterize and group dairy farms into different types according to the following basic variables: land use, size classes and production systems. The information used in this study was microdata from the 1999 Census of Agriculture. The methodology developed was also applied to microdata from the 1989 Census of Agriculture, thus obtaining significant information about the evolution of agricultural activity. The tools used in the analysis were Microsoft Access and Excel, and an application that was developed using Microsoft Visual Basic. The methodology presented can be used to analyse the evolution of the sector or to model future trends.
Purpose CRS and HIPEC has been used in adults with ovarian carcinoma proving overall survival benefit in randomized trials, but, measured in months. Diffuse peritoneal disease from pediatric type ovarian tumors is rare. We applied CRS and HIPEC to pediatric girls with diffuse peritoneal disease as part of a clinical trial. Methods In all patients complete cytoreduction was followed by HIPEC using 100mg/M2 of Cisplatin for 90 minutes in a closed technique. All received neoadjuvant chemotherapy. Patients with disease outside of the abdominal cavity were excluded. Results Of 101 pediatric CRS and HIPEC operations, 8 had ovarian primary tumors and multifocal peritoneal disease. There were 3 yolk sac tumors( germ cell, mixed teratoma), one Sertoli-Leydig, one PNET of the ovary, one choriocarcinoma, one juvenile granulosa cell tumor and one adenocarcinoma. Age ranged 4 to 18 years. Three of the 8 (37%) recurred and died. The remaining 63% are disease free 2 to 6 years post HIPEC. Overall survival and relapse free survival in this cohort was 64% and 62% respectively. [CI 0.64(0.34,1);0.62(0.37,1)] Conclusions This is the first report of CRS and HIPEC in pediatric ovarian tumors. HIPEC may be effective in pediatric-type ovarian tumors. More study is needed in a larger cohort.
Resumen En el presente trabajo se aborda el significado de los límites de la dialéctica en el pensa-miento de Marx, lo que permite determinar la diferencia fundamental que separa la concep-ción marxiana de la dialéctica de la concepción hegeliana. Para analizar lo que significa para Marx este concepto es necesario distinguir entre el desarrollo conceptual de la exposición y el lugar que le corresponde a la investigación de la evolución histórica, de lo cual nos ocupa-mos en los primeros apartados del trabajo. A partir de aquí, examinamos en los siguientes apartados el sentido y las implicaciones teóricas de los límites de la exposición dialéctica. Abstract This work deals with the meaning of the limits of the dialectic in Marx's thought, which allows to determine the fundamental difference between Marx's notion and Hegel's notion of the dialectic. To analyze what this concept means for Marx, it is necessary to distinguish between the conceptual development of the exposition and the place that belongs to the investigation of the historical evolution, to which we devote the first sections of this paper. Then we examine in the following sections the sense and the theoretical implications of the limits of the dialectical exposition.
Objective: To report four cases of orbital metastases and review the literature related to this condition. Methods:We reviewed the clinical records of the four patients and the appropriate world literature. Results: Two women 51 and 82 years old presented with orbital metastases from a primary breast tumour and a third woman (45 years old) had orbital metastases from a primary lung tumour. One man 60 years old presented with a metastases from a renal tumour. Two patients, one with breast metastases and the one with lung metastases, died of their disease. The remaining two patients are still alive with stable disease at the time of writing this report. Conclusion:The metastases in our series originated from tumours that frequently produce orbital metastases-the breast, lung and kidney. The clinical characteristics of the orbital syndromes they caused were similar to those reported in the literature. The clinical presentation was torpid in three cases and had a fulminating course in the ORIGINAL ARTICLE RESUMEN Objetivo: Describir cuatro casos clínicos de metás-tasis orbitarias y hacer una revisión de la literatura sobre esta patología. Métodos: Revisión de historias clínicas y de la bibliografía. Resultados: Dos mujeres de 51 y 82 años de edad presentaron una metástasis orbitaria procedente de un tumor de mama y una tercera (45 años de edad) de una neoplasia pulmonar. Un paciente varón de 60 años de edad presentó una metástasis orbitaria procedente de un tumor renal. Dos de los pacientes, una paciente con metástasis de tumor de mama y la paciente con metás-tasis de tumor pulmonar, fallecieron a consecuencia de su tumor primario, la primera a los dos años y medio y la segunda dos meses después de los primeros signos de metástasis orbitaria. Los otros dos pacientes continúan vivos en situación estable. Conclusiones: Las metástasis en nuestra serie se originaron en tumores de mama, pulmón y riñón, que se encuentran entre los tumores que con más frecuencia producen metástasis orbitarias. Las características clínicas del síndrome orbitario coin-452 ARCH SOC ESP OFTALMOL 2006; 81: 451-462 GONZÁLEZ F, et al.
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