No abstract

No abstract

The incidence of STIC after RRSO in BRCA mutation carriers is low (0.8%) and it presents an excellent oncological outcome. Patients after RRSO, however, run the risk to develop other types of cancer during follow-up and should be properly advised before the prophylactic surgery.

Twenty-three patients undergoing induction therapy for acute myelogenous leukemia (AML) received a total of 191 combined prophylactic granulocyte (PMN) and platelet (PLT) concentrates on alternate days (median 8, range 3-12 per patient). Each transfusion was assessed by monitoring the patient for reactions and by estimating the recovery of PMN in the circulation at 1 hour and of PLT at 1 and 20 hours. Seventeen patients developed alloimmunization to PLT from at least one donor, defined as either a PLT recovery of less than 15 percent at 1 hour and/or less than 10 percent at 20 hours. In this group there was a progressive reduction in PMN and PLT recovery with increasing transfusion number, strongly suggesting alloimmunization to both cells. Thirty-four transfusions were accompanied by transfusion reactions, thirty-two of which occurred in ten patients who had PMN recoveries of less than 5 percent after at least one transfusion (median 2.5, range 1-6 transfusions per patient). Actuarial calculations predicted that 70 percent of patients would become alloimmunized to PLT from at least two individuals after receiving 11 transfusions. These results suggest that combined PMN and PLT transfusion are associated with the rapid development of alloimmunization.

to a value more characteristic of an elderly patient.5 Our patient's diet was also deficient in vitamin D. The combination of nutritional deficiency and barbiturate habituation may cause more morbidity in the elderly than is generally recognised.Although several indices of enzyme induction rely on a single estimation (serum GGT, urinary 24-hour glutaric acid, or 6r-OHcortisol excretion) they are non-specific and correlate poorly in individual subjects. Antipyrine half life is widely used as an index of drug oxidation but the need for serial blood samples is time consuming and unpleasant for the patient. The use of saliva samples overcomes both problems and provides accurate estimations of half life.3 The simplicity of sample collection makes it analogous to glucose tolerance tests by finger prick, which can be performed by paramedical staff, and it could have wider clinical application than plasma half life estimations.

No abstract

No abstract