Arch Iran Med
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Review Case Reports
CD56-Positive Acute Myeloid Leukemia Following Treatment of Hairy Cell Leukemia with Cladribine - Report of 2 Cases and Review of the Literature.
Treatment of hairy cell leukemia (HCL) with alfa-interferon and purine analogs significantly prolongs survival in these patients. However, with life prolongation, an increased risk of secondary malignancies has been reported. Acute myeloid leukemia (AML), as a second malignancy after HCL treatment is extremely rare and has been reported in only 12 cases so far. ⋯ The second patient responded to chemotherapy and was successfully allo-transplanted. Three years later, the patient is in stable clinical remission, which is a unique case in the literature. In conclusion, it is not clear whether development of AML in HCL patients is caused by mutagenic potential of the applied chemotherapy or by immune suppression/ perturbations as a characteristic of the underlying disease.
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Despite all the problems caused by the imposed war, sanctions and accidents after the Islamic Revolution, materializing primary health care (PHC) in Iran through establishing the National Health Network (NHN) has had substantial gains. Many health indicators in Iran have undergone significant changes. As an example, the change in death of children under the age of 5 years has been studied by adjusting the economic status, and it is estimated that about 2 million deaths in this age group were avoided within 30 years after the Islamic Revolution. ⋯ With the emergence of chronic conditions and new technologies, health expenditures have become a major concern. Meanwhile, in the 2000s, the revision at PHC was aimed at strengthening through the universal health coverage (UHC). Therefore, UHC is along the PHC and not against it.
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Aging is significantly related to multiple comorbidities. Even with a good performance score, some elderly patients may have poor survival outcomes. We aimed to evaluate the prognostic value of the Charlson comorbidity index (CCI) for mortality and toxicity in elderly patients with locally advanced rectal cancer (LARC). ⋯ Although CCI score was not significantly associated with both toxicity and disease-free survival (DFS), we suggest that baseline CCI score might be a valuable prognostic indicator for physicians to evaluate elderly patiens with LARC for optimal treatment.
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Intravenous immunoglobulin (IVIG) is an immunomodulating agent that has several actions. The aim of this study was to investigate the indications of IVIG according to available evidence and the cost in our center. ⋯ One important aspects of this study was the use of IVIG in cases other than on-label indications. Although a number of studies support IVIG therapy in some diseases, further trials are needed to establish efficacy and safety in these fields.
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We aimed to identify the association of degree of renal failure in chronic kidney disease patients who underwent percutaneous coronary intervention (PCI) at our center with 5-year major adverse cardiac events (MACE). ⋯ GFR <30 mL/min was a strong predictor for 5-year MACE. Moreover, in patients with GFR > 30 mL/min, PCI is a more applicable approach.