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Purpose: Assessment of individual VTE risk in cancer patients prior to chemotherapy is critical for determining necessity of interventions. Risk assessment models (RAM) are available but have not been validated for haematological malignancy. We aimed to assess the validity of the Vienna Cancer and Thrombosis Study (V-CATS) score in prediction of VTE in a variety of haematological malignancies. Methods: This is a prospective cohort study conducted on 81 newly diagnosed cancer patients undergoing chemotherapy. Demographic, clinical and cancer related data were collected, patients were followed up for 6 months, and VTE events were recorded. Khorana score (KS) was calculated. Plasma D-dimer and sP-selectin were measured, and then, V-CATS score was calculated. Receiver operator curve (ROC) was used to assess the sensitivity and specificity of RAMs. A modified V-CATS was generated and subsequently assessed by using new cut-off levels of d-dimer and sP-selectin based on ROC curve of the patients' results and compared the probability of VTE occurrence using all three RAMs. Results: Among the 81 patients included in this study, a total of 2.7% were diagnosed with advanced metastatic cancer. The most frequent cancer was non-Hodgkin lymphoma (39.5%), and 8 patients (9.8%) developed VTE events. The calculated probability of VTE occurrence using KS, V-CATS and modified V-CATS scores at cut-off levels ≥ 3 was 87.5%, 87.5% and 100%, respectively. The AUC in ROC curve of modified Vienna CATS score showed significant difference when compared to that of V-CATS and KS (P = 0.047 and 0.029, respectively). Conclusion: The findings of our study highlight the value of three VTE risk assessment models in haematological malignancies. The modified V-CATS score demonstrated higher specificity compared to both V-CATS and KS, while all three scores exhibited similar sensitivity. We encourage the implementation of RAMs in haematological cancers for an appropriate use of thromboprophylaxis. [ABSTRACT FROM AUTHOR]

Background The quality of life (QoL) of the patient is a reflection of the severity of multiple sclerosis (MS) and predicts its prognosis; it is related to various factors that vary across cultures. Objective The aim of the current study was to evaluate the QoL of ambulatory and mildly disabled patients with relapsing remitting multiple sclerosis (RRMS), and explore the related factors and cultural characteristics. Patients and methods Sixty Egyptian patients with a definitive diagnosis of RRMS were recruited and assessed for disability using Expanded Disability Status Scale, their QoL using Multiple Sclerosis Quality of Life Inventory (MSQLI), and depression using the Beck Depression Inventory scale. Patients' QoL was compared with that of 30 matched controls. Results The QoL of MS patients was significantly impaired in all domains compared with that of controls (P<0.001), except for Social Functioning. Most of the physical components of the QoL were strongly correlated with Expanded Disability Status Scale, fatigue, and perceived cognitive impairment, and mental components were correlated with depression (P<0.001), fatigue, and perceived cognitive impairment. An overall 81% of MS patients had depression that correlated with disability (P=0.012) and fatigue (P=0.001), and correlated moderately with perceived cognitive impairment. Women reported more anxiety (P=0.038) and less perceived social support (P=0.012), whereas men stated more sexual dissatisfaction (P=0.001). Conclusion Mildly disabled Egyptian patients with RRMS have a high prevalence of depression and considerable impairment of mental and physical components of the QoL, such as disease disability, depression, fatigue, and perceived cognitive impairment. [ABSTRACT FROM AUTHOR]

Purpose To assess fronto-temporal connectivity in never-medicated patients with first episode schizophrenia (FES). Material and methods Twelve never-medicated patients (median age = 25.5 y) with first episode schizophrenia (according to DSM-IV system) and sixteen demographically matched controls were enrolled in the study. Conventional MRI sequences were obtained. Single shot echo-planar DTI was acquired in 32 non-collinear directions. Tractography of the direct pathway of the superior longitudinal fasciculus (SLFd) and uncinate fasciculus of both hemispheres was performed, and ROIs at the anterior cingulum and external capsule of both hemispheres were drawn. Fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD) and Trace of the ROIs and reconstructed tracts were calculated. Group comparison was performed using independent sample t -test and Fisher’s exact test. Results Compared to healthy participants, there was significant reduction of FA of the left external capsule ( p = 0.001) with increase in RD and Trace ( p = .004, .048 respectively). However, the right SLFd showed significant reduction of AD ( p = 0.005) and the left SLFd showed significant reduction of its volume ( p = 0.02). Conclusion In patients with FES, impaired white matter connectivity was recognized in the right SLFd and left external capsule associated with reduction in the volume of the left SLFd. [ABSTRACT FROM AUTHOR]

Clinical risk classification is inaccurate in predicting outcome in adult patients with acute lymphoblastic leukemia (ALL), sometimes resulting in patients receiving inappropriate chemotherapy or stem cell transplantation. To identify complementary markers suitable for further treatment stratification in patients with standard-risk (SR)/philadelphia-negative (Ph-negative) precursor B-ALL, we evaluated the predictive value of minimal residual disease (MRD) after induction and consolidation chemotherapy in strictly defined SR/Ph-negative precursor B-ALL patients who were treated with a standard protocol using quantitative real-time polymerase chain reaction with the rearranged immunoglobulin heavy chain gene as a molecular marker. The cytologic complete response (CR) rate was 92.3 % after induction. At this time point, the molecular CR rate was 73.9 %. Patients with molecular CR (MolCR) after induction had a significantly higher probability of disease-free survival (DFS; 78.8 vs 30.8 %; P = .001) and of overall survival (OS; 82.4 vs 41.7 %; P < .0001) compared to patients with molecular failure (MolFail). MRD at end consolidation had the same significance. Quantitative MRD assessment identified patients with MolFail after induction and/or consolidation as a high-risk group, with 3-year DFS and OS rates of 28.6 and 35.7 %, respectively. Patients with MolCR after induction and consolidation were classified as low-risk and had 3-year DFS rate of 89.7 % and OS rate of 93.3 %. Thus, MRD quantification during treatment identified prognostic subgroups within the otherwise homogeneous SR/Ph-negative precursor B-ALL population who may benefit from individualized treatment. [ABSTRACT FROM AUTHOR]

Background: Although it is relatively uncommon form of stroke, cerebral venous thrombosis (CVT) is still with difficulty in diagnosis and management. There is unsolved debate regarding the association of coagulation factor VII (FVII) R353Q polymorphism with venous thrombosis. Objective: We aimed to assess the association of FVII R353Q polymorphism with the risk of CVT. Methods: Patients with CVT and age and sex-matched controls were included in our study. All patients were subjected to history taking, examination, brain computerized tomography scans (CT), Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV). For patients and controls; assay of FVII levels, and FVII R353Q polymorphism were assessed. Results: A total of 32 patients with CVT and 30 age and sex matched healthy subjects were enrolled in the study. There was no statistically significant difference between patients and controls regarding age, sex, body mass index, laboratory tests. Headache was the commonest presentation (91%) of our patients. Superior sagittal sinus thrombosis showed the highest prevalence. There was no statistically significant difference between patients and controls regarding the mean concentration of FVII (p= 0.43). Twenty two percent of our patients had the FVII 353RQ genotype compared to 13% of the control group while 78% of the patients had the 353RR genotype compared to 87% of the controls with no statistically significant difference between patients and controls. Conclusion: The study suggests no association between R353Q polymorphism for factor VII and both its plasma concentration as a risk of venous sinus thrombosis. [ABSTRACT FROM AUTHOR]