33 research outputs found
Chronic lymphocytic leukemia in Kenya: an immunophenotypic and clinicopathologic study
Objective: To define cases of chronic lymphocytic leukemia (CLL) by immunophenotypic criteria and describe the associated clinical features in patients diagnosed at Aga Khan University Hospital, Nairobi.
Background: Rising to the growing cancer challenge will require improved diagnostic services. CLL is common in elderly patients. The current international standard in diagnosis incorporates findings of immunophenotyping. Facilities for immunophenotyping have generally been unavailable in Kenya.
Method: A cross-sectional survey was conducted between August 2011 and April 2012. Potential cases were identified based on morphologic criteria. Consecutive samples were obtained and subjected to 3 colour immunophenotyping on a Cytomics FC 500 cytometer. CLL was defined using the Royal Marsden Hospital scoring system. Baseline clinical and diagnostic data were also obtained.
Results: Forty nine cases met the eligibility criteria. Thirty one were known CLL cases, and 18 were newly diagnosed. Median age at diagnosis was 62 years. Male:female ratio was 1.3:1. Black patients (42/49) were more likely to present with high risk disease (Rai stages III–IV) and with higher lymphocyte counts than non-blacks at diagnosis. Twenty six point five percent of patients in this study were diagnosed in Rai stage 0. The prevalence of CD5/ CD23 co-expression was found to be 95.9%. CD5 was universally expressed, whereas CD23 was present in all but 2 cases. Both were associated with atypical morphology. Complete absence of light chain expression using a monoclonal antibody was found in 12.2% of cases. Five patients had their diagnosis revised. Of 31 patients on follow-up for CLL, only 5 had had any form of immunophenotyping done
Acute Leukemias Immunophenotypes at Agakhan University Hospital, Nairobi
Objective: The aim was to determine relative frequencies of acute leukemia immunophenotypes using commonly expressed markers and to describe the clinicopathological characteristics.Design: This was a prospective cross-sectional study.Setting: The study was based at Aga khan clinical laboratory department.Subjects: One hundred and thirty two (132) consecutive blood and bone marrow specimens from patients suspected to have acute leukemia were analysed for cytomorphological characteristics and immunophenotyping. The clinical-pathological characteristics were also recorded. Immunological category was assigned using the EGIL criteria.Results: There were 88 AML and 42 ALL patients analysed for immunophenotypes. Only tw cases of biphenotypic leukemia were found. The commonest overall AML morphological sub-type was AML-M2, 26 (29.5%). Majority of ALL cases were B-cell immunological sub-type (96.6%). Early pre-B phenotype constituted 62.07% and Common B-cell ALL 37.93%. There were only 4 cases of T-cell ALL. Majority of patientspresented with anaemia with a median hemoglobin of 7.5g/dl (range 2-15g/dl). The median platelet count was 55 (range 4-462 × 109/L).Conclusion: Immunophenotyping of acute leukemia is beneficial in accurate diagnosis of patients with these malignancies in this setup. T-cell ALL, AML-M6 and M7 are less frequent than what has been reported in most studies in Africa.Key words: acute leukemia, immunophenotype, WHO, EGIL, CD marker
High magnetic field studies of the Vortex Lattice structure in YBa2Cu3O7
We report on small angle neutron scattering measurements of the vortex
lattice in twin-free YBa2Cu3O7, extending the previously investigated maximum
field of 11~T up to 16.7~T with the field applied parallel to the c axis. This
is the first microscopic study of vortex matter in this region of the
superconducting phase. We find the high field VL displays a rhombic structure,
with a field-dependent coordination that passes through a square configuration,
and which does not lock-in to a field-independent structure. The VL pinning
reduces with increasing temperature, but is seen to affect the VL correlation
length even above the irreversibility temperature of the lattice structure. At
high field and temperature we observe a melting transition, which appears to be
first order, with no detectable signal from a vortex liquid above the
transition
Unconventional gap structures and the intermediate mixed state: a vortex lattice study of the noncentrosymmetric superconductor BiPd
We report on neutron scattering measurements on the vortex lattice of the
noncentrosymmetric superconductor BiPd. We observe the existence of the
intermediate mixed state, a region where Meissner and vortex lattice phases
coexist, which is a feature of low Type-II superconductors. Following
this, we obtain an estimate of the value of using the extended London
model, which confirms the expectation that should be small. Finally,
we find that the temperature dependence of the vortex lattice form factor fits
well to a model designed to describe singlet-triplet mixing in
non-centrosymmetric superconductors, which may shed light on the question of
the gap structure in BiPd
Background Determination for the LUX-ZEPLIN (LZ) Dark Matter Experiment
The LUX-ZEPLIN experiment recently reported limits on WIMP-nucleus
interactions from its initial science run, down to cm
for the spin-independent interaction of a 36 GeV/c WIMP at 90% confidence
level. In this paper, we present a comprehensive analysis of the backgrounds
important for this result and for other upcoming physics analyses, including
neutrinoless double-beta decay searches and effective field theory
interpretations of LUX-ZEPLIN data. We confirm that the in-situ determinations
of bulk and fixed radioactive backgrounds are consistent with expectations from
the ex-situ assays. The observed background rate after WIMP search criteria
were applied was events/keV/kg/day in the
low-energy region, approximately 60 times lower than the equivalent rate
reported by the LUX experiment.Comment: 25 pages, 15 figure
A search for new physics in low-energy electron recoils from the first LZ exposure
The LUX-ZEPLIN (LZ) experiment is a dark matter detector centered on a
dual-phase xenon time projection chamber. We report searches for new physics
appearing through few-keV-scale electron recoils, using the experiment's first
exposure of 60 live days and a fiducial mass of 5.5t. The data are found to be
consistent with a background-only hypothesis, and limits are set on models for
new physics including solar axion electron coupling, solar neutrino magnetic
moment and millicharge, and electron couplings to galactic axion-like particles
and hidden photons. Similar limits are set on weakly interacting massive
particle (WIMP) dark matter producing signals through ionized atomic states
from the Migdal effect.Comment: 13 pages, 10 figures. See https://tinyurl.com/LZDataReleaseRun1ER for
a data release related to this pape
Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study
Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research
Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.
Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research
New constraints on ultraheavy dark matter from the LZ experiment
Searches for dark matter with liquid xenon time projection chamber experiments have traditionally focused on the region of the parameter space that is characteristic of weakly interacting massive particles, ranging from a few GeV/c2 to a few TeV/c2. Models of dark matter with a mass much heavier than this are well motivated by early production mechanisms different from the standard thermal freeze-out, but they have generally been less explored experimentally. In this work, we present a reanalysis of the first science run of the LZ experiment, with an exposure of 0.9 tonne×yr, to search for ultraheavy particle dark matter. The signal topology consists of multiple energy deposits in the active region of the detector forming a straight line, from which the velocity of the incoming particle can be reconstructed on an event-by-event basis. Zero events with this topology were observed after applying the data selection calibrated on a simulated sample of signal-like events. New experimental constraints are derived, which rule out previously unexplored regions of the dark matter parameter space of spin-independent interactions beyond a mass of 1017 GeV/c2.
Published by the American Physical Society
2024
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