This study shows the long-term updated outcomes of a multicenter retrospective study which analyzed 843 patients with myelodysplastic syndrome (MDS) who underwent transplantation with an HLA-identical sibling donor with either reduced-intensity conditioning (RIC) in 213 patients, or standard myeloablative conditioning (MAC) in 630 patients. In multivariate analysis, the 13-year relapse rate was significantly increased after RIC (31% after MAC vs 48% in RIC; HR, 1.5; 95% CI, 1.1-1.9; P=0.04), but with no differences in overall survival (OS) (30% after MAC vs 27% in RIC; P=0.4) and PFS (29 vs 21%, respectively, P=0.3). Non-relapse mortality was higher in MAC (40 vs 31%; P=0.1), especially in patients older than 50 years (50 vs 33%, P<0.01). In addition, long-term follow-up confirms the importance of other variables on 13-year OS, mainly MDS risk category, disease phase, cytogenetics and receiving a high donor cell dose, irrespective of the conditioning regimen used.
- MeSH
- analýza přežití MeSH
- dárci tkání MeSH
- lidé středního věku MeSH
- lidé MeSH
- myelodysplastické syndromy mortalita terapie MeSH
- následné studie MeSH
- příprava pacienta k transplantaci metody mortalita MeSH
- retrospektivní studie MeSH
- senioři MeSH
- sourozenci MeSH
- studie případů a kontrol MeSH
- testování histokompatibility MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
[Evaluation of sensitivity of cough reflex in humans]
Úlohou práce bolo modifikovať jednodychový kapsaicínový test na vyšetrenie citlivosti kašľového reflexu, aby sa na tento cieľ mohol použiť bežne dostupný nebulizátor PARI Provocation Test. U zdravých dobrovoľníkov sa zisťoval vplyv vdychovania rôzneho objemu aerosólu (medián = 1,2 μm) a rozdielneho spôsobu jeho inhalácie (ústami a nosom) na prah dráždivosti nervových zakončení dýchacích ciest zodpovedriých za kašel. Použil sa roztok kapsaicínu (8-metyl-N-vanilyl-6-nonenamid) s postupne sa zvyšujúcimi koncentráciami (0,049 až 12,5 μmol.1). Vyšetrenie sa skončilo, ked pri vdýchnutí určitej koncentrácie vznikol spontánny kašel: uvedená koncentrácia predstavovala prahovú hodnotu. Prvá skupina probandov, ktorá vdychovala 3 litre aerosólu, mala prahovú koncentráciu (geometrický priemer s 95 % intervalom spoľahlivosti) signifikantne nižšiu pri inhalácii ústami ako cez nosovú dutinu (2,06 (1,14-3,74) μmol.1 oproti 5.44 (3,91-7,58) μmol.l'; p < 0,01). Druhá skupina dobrovoľníkov vdychovala 2 litre aerosólu cez náustok a ich prahová koncentrácia (2,55 (1,41-4,63) pmol.1 sa signifikantne neodlišovala od hodnoty prvej skupiny sledovanej počas inhalácie cez ústa. Kapsaicín nevyvolal ani u jedného vyšetrovaného subjektívny poCit sťaženého dýchania. „Škrabanie" v hrdle uvádzali 2/3 vyšetrených, ostatní tento pocit lokalizovali za sternom. Na základe získaných výsledkov možno odporučiť na objektívne vyšetrenie citlivosti kašľového reflexu jednodychový test inhalovaním kapsaicínu cez ústa s použitím nebulizátora PARI Provocation Test.
The authors modified a single-breath capsaicin test for the evaluation of the sensitivity of cough reflex. They used for this purpose a jet nebuliser PARI Provocation Test. The effect of inhalation of various volumes of aerosol (mass median diameter = 1.2 μm) and the effect of two different ways of inhalation (through the mouth and nose, respectively) on the sensitivity of nerve endings in airways responsible for cough were studied in health volunteers. Capsaicin (8-Methyl-N-Vanillyl-6-Nonenamide) of gradually doubled concentrations (from 0.049 to 12.5 μmol.l') was used. The test was ended when the inhalation ot particuiar concentration of capsaicin elicited spontaneous coughing: this concentration represented the threshold for cough irritation. In the first group of volunteers (they were inhaling 3 litres of aerosol by single breath) threshold concentration (geometric mean + 95 % Confidence Interval) was significantly lower when aerosol was inhaled through the mouth than through the nose 12.06 (1.14-3.74) μmol.1vs. 5.44 (3.91-7.58) μmol.l': p < 0.011. Volunteers in the second group inhaled 2 litres of aerosol through the mouth. Their threshold concentration (2.55 (1.41-4.63) μmol.1) was not significantly different from that obtained 1 the first group when capsaicin was inhaled through the mouth. No subjective respiratory distress were registered during inhalation of capsaicin. Only tickling localised either in throat (65 % of volunteers) or in trachea (35 % of volunteers) was stated. Authors recommend to use jet nebuliser PARI Provocation Test for single-breath capsaicin test for the evaluation of the sensitivity of cough reflex.
3. Aufl. 706 s. : il.
