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  1. Article: Prognostic categorization of intensive care septic patients.

    Moemen, Mohamed Ezzat

    World journal of critical care medicine

    2012  Volume 1, Issue 3, Page(s) 67–79

    Abstract: Sepsis is one of the leading worldwide causes of morbidity and mortality in critically-ill patients. Prediction of outcome in patients with sepsis requires repeated clinical interpretation of the patients' conditions, clinical assessment of tissue ... ...

    Abstract Sepsis is one of the leading worldwide causes of morbidity and mortality in critically-ill patients. Prediction of outcome in patients with sepsis requires repeated clinical interpretation of the patients' conditions, clinical assessment of tissue hypoxia and the use of severity scoring systems, because the prognostic categorization accuracy of severity scoring indices alone, is relatively poor. Generally, such categorization depends on the severity of the septic state, ranging from systemic inflammatory response to septic shock. Now, there is no gold standard for the clinical assessment of tissue hypoxia which can be achieved by both global and regional oxygen extractabilities, added to prognostic pro-inflammatory mediators. Because the technology used to identify the genetic make-up of the human being is rapidly advancing, the structure of 30 000 genes which make-up the human DNA bank is now known. This would allow easy prognostic categorization of critically-ill patients including those suffering from sepsis. The present review spots lights on the main severity scoring systems used for outcome prediction in septic patients. For morbidity prediction, it discusses the Multiple Organ Dysfunction score, the sequential organ failure assessment score, and the logistic organ dysfunction score. For mortality/survival prediction, it discusses the Acute Physiology and Chronic Health Evaluation scores, the Therapeutic Intervention Scoring System, the Simplified acute physiology score and the Mortality Probability Models. An ideal severity scoring system for prognostic categorization of patients with systemic sepsis is far from being reached. Scoring systems should be used with repeated clinical interpretation of the patients' conditions, and the assessment of tissue hypoxia in order to attain satisfactory discriminative performance and calibration power.
    Language English
    Publishing date 2012-06-04
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2220-3141
    ISSN 2220-3141
    DOI 10.5492/wjccm.v1.i3.67
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Novel mutations of the nucleophosmin (NPM-1) gene in Egyptian patients with acute myeloid leukemia: a pilot study.

    Kassem, Neemat / Hamid, Alaa Abel / Attia, Tarek / Baathallah, Sherif / Mahmoud, Somaya / Moemen, Eman / Safwat, Ezzat / Khalaf, Mohamed / Shaker, Olfat

    Journal of the Egyptian National Cancer Institute

    2011  Volume 23, Issue 2, Page(s) 73–78

    Abstract: Unlabelled: Mutations of the nucleophosmin (NPM-1) gene have been reported in 50-60% of acute myeloid leukemia (AML) patients with normal karyotype. This work was designed to study the prevalence and nature of NPM1 gene mutations in a group of Egyptian ... ...

    Abstract Unlabelled: Mutations of the nucleophosmin (NPM-1) gene have been reported in 50-60% of acute myeloid leukemia (AML) patients with normal karyotype. This work was designed to study the prevalence and nature of NPM1 gene mutations in a group of Egyptian patients with AML to get an idea about the profile of NPM1 gene mutations in our society. In 45 previously untreated patients with de novo AML, peripheral blood and/or bone marrow samples from all patients were subjected to microscopic morphologic examination, cytochemical analysis, immunophenotyping and karyotyping. Patients with normal cytogenetic results were selected for molecular analysis of NPM1 exon 12 by PCR amplification followed by DNA sequencing of the amplified product. Twenty-one patients (46.7%) had abnormal karyotype: six cases with t(15;17), five cases with t(8;21), five cases had trisomy 8, two cases carrying inv(3) and three cases had monosomy 7. The remaining 24 patients (53.3%) had normal karyotype. These patients were then subjected to molecular analysis. Out of these 24 patients with normal karyotype, mutant NPM-1 was detected in 11 patients (45.8%) by DNA sequencing; 2 cases showed type A mutation, 2 cases were harboring [ins 1015-1019 (CACG)], with point mutation [1006C>G], while the remaining 7 cases showed heterozygous deletion of nt A [del 1178 (A)].
    Conclusion: Two novel NPM1 gene mutations were detected among our study population of AML patients identified as: the insertion CACG associated with point mutation, deletion of one base, or associated with point mutation. NPM1 gene mutations may become a new tool for monitoring minimal residual disease in AML with normal karyotype. Whether these previously unreported NPM-1 mutations will confer the same better outcome as previously reported mutations is currently unknown and warrants a larger study.
    Conclusion: Two novel NPM1 gene mutations were detected among our study population of AML patients identified as: the insertion CACG associated with point mutation, deletion of one base, or associated with point mutation. NPM1 gene mutations may become a new tool for monitoring minimal residual disease in AML with normal karyotype. Whether these previously unreported NPM-1 mutations will confer the same better outcome as previously reported mutations is currently unknown and warrants a larger study.
    MeSH term(s) Abnormal Karyotype ; Adolescent ; Adult ; Base Sequence ; DNA Mutational Analysis ; Egypt ; Female ; Genetic Association Studies ; Humans ; INDEL Mutation ; Leukemia, Myeloid, Acute/genetics ; Male ; Middle Aged ; Nuclear Proteins/genetics ; Pilot Projects ; Young Adult
    Chemical Substances Nuclear Proteins ; nucleophosmin (117896-08-9)
    Language English
    Publishing date 2011-10-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1176790-x
    ISSN 2589-0409 ; 1110-0362
    ISSN (online) 2589-0409
    ISSN 1110-0362
    DOI 10.1016/j.jnci.2011.09.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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