ABSTRACT
Objective: Amyotrophic lateral sclerosis [ALS] is the most severe disorder within the spectrum of motor neuron diseases [MND] that has no effective treatment and a progressively fatal outcome. We have conducted two clinical trials to assess the safety and feasibility of intravenous [IV] and intrathecal [IT] injections of bone marrow derived mesenchymal stromal cells [BM-MSCs] in patients with ALS
Materials and Methods: This is an interventional/experimental study. We enrolled 14 patients that met the following inclusion criteria: definitive diagnosis of sporadic ALS, ALS Functional Rating Scale [ALS-FRS] .24, and .40% predicted forced vital capacity [FVC]. All patients underwent bone marrow [BM] aspiration to obtain an adequate sample for cell isolation and culture. Patients in group 1 [n=6] received an IV and patients in group 2 [n=8] received an IT injection of the cell suspension. All patients in both groups were followed at 24 hours and 2, 4, 6, and 12 months after the injection with ALS-FRS, FVC, laboratory tests, check list of side effects and brain/spinal cord magnetic resonance imaging [MRI]. In each group, one patient was lost to follow up one month after cell injection and one patient from IV group died due to severe respiratory insufficiency and infection
Results: During the follow up there were no reports of adverse events in terms of clinical and laboratory assessments. In MRI, there was not any new abnormal finding. The ALS-FRS score and FVC percentage significantly reduced in all patients from both groups
Conclusion: This study has shown that IV and IT transplantation of BM-derived stromal cells is safe and feasible [Registration numbers: NCT01759797 and NCT01771640]
ABSTRACT
The purpose of this study was to determine the prevalence and associated factors for postoperative pulmonary complications [PPCs] and extubation failure in patients having undergone intracranial surgery. In this retrospective study done in Firozgar Hospital during 2008-2010, we followed up 254 patients through a clinical questionnaire and observation of the clinical course of participants in pre- and post-operative periods. Overall, 40 [15.74%] patients had postoperative pulmonary complications. The most common PPC was pneumonia, which was seen in 24 patients [60% of complications]. The average duration of ventilation in patients with PPC was significantly higher [16.8. +/- 10 vs. 5.09 +/- 4.5 days; P=0.001] than patients without the complication. The mean Glasgow coma scale [GCS] after surgery in patients with PPC was significantly lower [11. +/- 4 vs. 13.2 +/- 3; P=0.001] than the rest of the patients. Moreover, the mean age of patients with PPC was significantly higher [64.02 +/- 14 vs. 41.6. +/- 17 years; P=0.001]. Average duration of stay in ICU in patients with PPC was also higher [24. +/- 27 vs. 8.7 +/- 0.5; P=0.001]. GCS before surgery and failed extubation independently of other variables were significantly associated with pulmonary complications independent of other variables
Subject(s)
Humans , Brain/surgery , Postoperative Complications/etiology , Surveys and Questionnaires , Retrospective StudiesABSTRACT
To evaluate the benefits of simultaneous measurement of CA-125 and HE-4 markers while diagnosing malignant epithelial tumors in the ovary. By this, the combined measurement of serum markers will possibly add to the accuracy of diagnosing such ovarian tumor. Performing a cross- sectional study on 87 women with ovarian mass, serum levels of CA125 and HE4 markers were measured before surgery or biopsy. In the wake of the surgery or biopsy, the results obtained from these tests were compared and analyzed with pathological report. The average serum level of CA-125 and HE-4 serum was notably higher in women with ovarian malignancy than in those with benignancy [CA-125: 502 vs. 19.3 v/ml, P < 0.001- HE4: 195 vs. 15.8 P mol/L, P < 0.001]. As the disease stage rises, the level of these markers increases significantly. The two markers were also directly proportionate. [r = 0.85 and P < 0.001]. There is also a meaningful difference between the levels of markers, specifically HE-4, in epithelial and non-epithelial tumors of ovary [HE-4: 195 vs. 93 P mol/L P < 0.001]. The simultaneous measurement of CA-125 and HE-4 increases the sensitivity and specificity of diagnosing malignant epithelial tumors in ovary, compared with one- by- one measurement guideline. The sensitivity and specificity of simultaneous measurement of CA125 and HE4 for diagnosing epithelial ovarian cancer were calculated to be 99.5% and 100%, respectively. Simultaneous measurement of CA-125 and HE-4 increases the sensitivity and keep the specificity still high in diagnosing malignant epithelial tumors in ovary, compared with one-by-one measurement system
ABSTRACT
Ovarian cancer rarely complicates pregnancy. Usually these malignancies consist of germ cell tumors. Preserving maternal safety along with favorable neonatal outcome is a subject of debate in the management of ovarian cancer during pregnancy. In this report, the authors describe a 25-year-old primigravid woman who was diagnosed to with an ovarian immature teratoma which was diagnosed at 13th weeks of pregnancy during a routine sonography. She underwent oophorectomy at week 21 of her gestation. Then she received three cycles of BEP regimen (bleomycin, etoposide, and cisplatin) during her pregnancy until week 37 of gestation. At 36 weeks she delivered a male baby with mild glandular hypospadia who was otherwise normal. Management of immature teratoma after the first trimester of pregnancy is similar to non-pregnant patients and is safe for both the mother and the fetus.