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Volume 6, Problème 1 (2016)

Article de révision

Immunization for Patients with Asplenia: Importance and Recommendations

Rodero MR, Martins CSF, Zuliani A, Roxo-Junior P

The spleen is an important component of the lympho-hematopoietic complex system, playing a relevant role in the defense against infections. Patients with functional or anatomic asplenia have an increased susceptibility to infections related to the absence or reduction of splenic function. This group of patients is particularly vulnerable to encapsulated bacteria. Therefore, the infectious complications associated with these pathogens are the most threatening in the scenario of spleen function impairment.
Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b are encapsulated bacteria and are considered to be the main factors responsible for infections with high morbidity and mortality in asplenic patients. Thus, immunization against these microorganisms is an indispensable strategy in order to ensure the survival of these individuals.

article de recherche

Rehabilitation of Patients with Peripheral Arterial Disease in IIA Stage According To Leriche-Fontaine

Carmignano SM, Bellomo GR, d'Alessandro A, Mandolesi S, Sablone A, Mandolesi D, Barassi G5 and Saggini R

In the world, a million adults have peripheral artery disease (PAD), a number that is likely to escalate as the population ages. Lower-extremity PAD is a component of systemic atherosclerosis and confers a markedly heightened risk of cardiovascular morbidity and mortality.
Material and Methods: Recruited 48 patients Exercise therapy combined with Nordic Walking and cyclette program in patients with PAD second IIA Stage Leriche Fontaine scale stable for at least six months, with interval free running (IML) between 200 and 300 meters.
Result: In Group A the free shift range test (IML) 137 ± 12 meters in T0, resulting in statistically significant post processing T1 222 ± 10 (p < 0.05). In Group B T0 138 ± 6 meters in T1 IML 212 ± 10 meters (p < 0.05). The results obtained in this study showed that the two types of exercise, at least after a short training period, are similar in terms of increasing the autonomy of the way and improving the quality of life (QoL).
Conclusion: The benefits of regular physical activity and comprehensive secondary prevention have the potential to benefit patients with PAD by preserving or improving functional capacity and reducing cardiovascular events.

article de recherche

Rectal Cancer and Invasion of Veins: Importance in TNM Staging 2

Kiss Lorant, Kiss Roland, Milcioiu Denisa

Summary: Accurate information about infiltration of the tumor to the various layers of the rectal wall is important.
Material and methods: A histopathological study of surgical specimens from 351 surgical specimens from patients with adenocarcinoma of the rectum revealed invasion of veins by primary growth in almost 52%.
Results: Follow-up studies showed that the corrected 5-year survival rate was significantly worse and liver metastases developed more frequently when venous invasion was present.
Invasion of extramural veins was particularly significant whereas spread confined to intramural veins was less important. Invasion of large (thick–walled) veins was of greater consequence than invasion of small (thin-walled) veins and spread into thick–walled extramural veins, had greatest adverse influence of all.
Venous spread of tumor takes place in parallel with local spread as measured by the Dukes’ stage but exerts an influence on prognosis independent of the Dukes’ stage.
Similarly, veins invasion parallels the number of lymph nodes metastases but appears to exert an independent influence on prognosis.
Conclusion: The venous spread provides a precise assessment of the likely behavior of rectal cancer, but does not replace indices such as the Dukes’ stage, or the number of lymph nodes metastases in use.

article de recherche

Reference Values of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Mean Platelet Volume in Healthy Adults in North Central Nigeria

Alexander NI

Background: Recently, Neutrophil-lymphocyte ratio (NLR), Platelet-lymphocyte ratio (PLR) and Mean platelet volume (MPV) have become increasingly useful as predictive and prognostic tools in patients with various medical conditions. To make for easy interpretation and application, the reference values of these parameters in healthy adults need to be established in our environment.
Objectives: To establish the reference values for NLR, PLR and MPV in healthy adults in a tertiary health facility in the North-central Nigeria.
Methods: Venous blood samples from five hundred (500) healthy adults were analyzed using a Sysmex automated haematology analyzer. The NLR and PLR were calculated while the MPV values were recorded from the print outs. The effects of some demographics on these parameters were assessed using the SPSS 19.
Results: The mean value for NLR was 2.8 (reference range, 1.2-4.4), PLR was 137 (reference range, 75-199) and MPV was 10.6 fl (reference range, 9.7-11.5 fl).
Individuals aged 18 to 50 years had significantly lower NLR (p=0.019) and PLR (p<0.05) than older individuals aged 51 to 85 years. PLR was also noted to be significantly higher in males than in females (p=0.003), while NLR and MPV were not affected by gender.
Conclusion: The reference values for NLR vary with age while PLR vary with age and gender. These variations need to be considered while using these parameters for predictive and prognostic purposes in our environment.

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