ABSTRACT
Estudio comparativo realizado en la ciudad de México, en el que se analizan factores de riesgo para el desarrollo de osteopenia (OP) y la relación que existe entre OP y fracturas de la cadera. Las variables analizadas fueron: edad, sexo, peso, talla, hábitos de tabaquismo y alcoholismo, número de embarazos, lactancia, historia familiar de fracturas, actividad física, enfermedades intercurrentes y hábitos nutricionales relacionados con la ingestión de calcio. Se estudiaron 152 casos y 143 controles, lo que hace una muestra total de 295 individuos. Se aplicó un cuestionario por un encuestador único, en el que se integró acerca de los factores de riesgo comúnmente conocidos. Se utilizó como método de análisis estadístico la Chi cuadrada y la regresión logística. Los resultados más sobresalientes fueron los siguientes: 1)Las mujeres más viejas y menos pesadas tuvieron mayor riesgo de sufrir fracturas (R.R. 0.08). 2)El sobrepeso establece un menor riesgo de fracturas (R.R. 0.04). 3)No hubo diferencia (p < 0.05) entre las mujeres que amamantanron a sus hijos y las que no lo hicieron, asimismo tampoco hubo diferencias entre el número de embarazos y el amamantamiento a sus hijos. 4)El alcoholismo es un factor de riesgo importante (p < 0.05) para las fracturas. 5)Los grupos estudiados tuvieron una ingesta de soló tercio de la cantidad de calcio recomendado, y 6)Hubo una diferencia estadísticamente significativa de menor ingestión de calcio (p < 0.05) en favor de los casos
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Osteogenesis/physiology , Ossification, Heterotopic/etiology , Hip Fractures/etiology , Bone Resorption/etiology , Menopause/physiology , Calcium/deficiency , Ossification, Heterotopic/diagnosis , Hip Fractures/epidemiology , Bone Resorption/physiopathologyABSTRACT
This study was carried out to establish the level of concordance between two observers from two different health institutions in Mexico City, in the diagnosis of acute leukemias and their different varieties. We studied 73 consecutive cases of adults with these diseases. Each one of the two observers established their diagnosis on two occasions at least 15 days apart. They first made their diagnosis taking as a base the neoplastic cells morphology in bone marrow smears, and after that, with morphology plus specific cytochemistry. The outcomes of the two observers were also compared with the official diagnosis. Kappa test was performed to know interobserver and intraobserver concordance. The kappa values for the diagnosis myeloid/lymphoid were found among the highest (51 to 91). Weighted kappa was also applied to know the level of concordance in the diagnosis of the different varieties of acute leukemia, myeloid and lymphoid. In these cases the weighted kappa values were lower compared with the previous values (lymphoid, from 47 to 82; myeloid, from 30 to 66). Cytochemistry paradoxically was a confusing factor when it was used: in these cases the kappa values were lower (32 to 84) than morphology alone (39 to 91). The outcomes showed the subjective level in the diagnosis of the myeloid subtypes was more important in them than in the lymphoid subtypes.
Subject(s)
Bone Marrow Examination/statistics & numerical data , Leukemia/diagnosis , Acute Disease , Adult , Biomarkers, Tumor/analysis , Bone Marrow/pathology , Hematology , Humans , Leukemia/classification , Leukemia/pathology , Neoplastic Stem Cells/chemistry , Neoplastic Stem Cells/pathology , Observer Variation , Prospective Studies , Single-Blind Method , Staining and LabelingABSTRACT
Intramitochondrial lamellar bodies were observed in three cases of acute myeloblastic leukemia. Two of the patients had M1 leukemia and the remaining patient M4 leukemia, by the FAB classification. In all three cases neoplastic cells contained dilated mitochondria that varied in size and shape and contained decreased numbers of cristae. Some mitochondria contained lamellar structures that resembled myelin figures and, occasionally, primary granules; these structures were more conspicuous in the central portion of the mitochondria. Regardless of the proliferating cell type (lymphoblasts, myeloblasts, or monoblasts), there are common ultrastructural changes that represent abnormal metabolic function, such as disorders of intramitochondrial protein synthesis. The exact meaning of these findings is not known; adequate interpretation will require further investigation of the biology of these neoplastic processes.
