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Child and Adolescent Mental Health Assessment
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Margaret J.J. Thompson, Cathy Laver-Bradbury, Christopher Gale
A comprehensive assessment should lead to the CAMHS practitioner developing a working formulation about why the child/young person and family are experiencing difficulties, based on a careful history taking and drawing information from the widest possible range of sources, e.g. school/college or social services. This forms the basis of the intervention options available to the child/young person and their family, that may be offered by a specialist mental health service or other agency, if appropriate.
Lymphoma
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Rodney J Hicks
For a pathological classification to be relevant, it must reflect real clinicopathological entities and should be robust, reproducible, and sufficiently flexible to incorporate new knowledge. In this context, the Rye modification of the Luke–Butler classification of HL has stood the test of time (Tables 25.1 and 25.2) (14,15). By contrast, numerous classifications have been used for NHL. The functional anatomy of the lymph node and its relationship to lymphoma is shown in Figure 25.1. Over 90% of NHL are B-cell lymphomas, and until 1994, the Working Formulation was used to designate each lymphoma by cell type and grade (16). Though therapy was based on grade, the pathogenesis of NHL was unclear and many common entities were not recognized. The Revised European–American Classification of Lymphoid Neoplasms (REAL) classification, introduced by the International Lymphoma Study Group, was a major step forward (17). It is a consensus list of all lymphoid neoplasms that appear to be distinct clinical entities and utilizes morphology, immunophenotype, genetics, and clinical features to define each entity.
Pathology of the Spleen
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
This is a rare disease of elderly women that can be confused with other low-grade lymphomas affecting the spleen. Patients usually present with massive splenomegaly and cytopenias (1). It is generally considered a low-grade lymphoma that corresponds roughly in the Working Formulation with a malignant lymphoma of small lymphocytic type.
Metastatic uveal melanoma managed with best supportive care
Published in Acta Oncologica, 2021
Elina S. Rantala, Micaela M. Hernberg, Mikael Lundin, Johan Lundin, Tero T. Kivelä
In TNM staging, metastatic UM is currently divided in three categories (M1a to M1c) based on LDLM [14]. The PS and serum or plasma alkaline phosphatase (AP) level are additional independent predictors of OS [3,10]. The Helsinki University Hospital Working Formulation (WF) staging uses all three variables and has been validated by the European Ophthalmic Oncology Group (Supplementary Table S1) [10]. We assigned patients to the WF stages IVa, IVb, and IVc [10] by calculating their individual predicted median OS (online calculator available at http://www.prognomics.org/huhwf.aspx). As originally described, the WF stages correspond to median predicted OS of ≥12, <12–6, and <6 months, respectively, based on data at the time of diagnosis of metastases. For primary outcome assessment, we used the same data as available at the time of treatment decision.
Advances in pathological understanding of high-grade B cell lymphomas
Published in Expert Review of Hematology, 2018
Shaoying Li, Pei Lin, L. Jeffrey Medeiros
At least a subset of DLBCL, about 10% of all cases, has morphologic features that are aggressive and suggest that the patient’s prognosis could be poor. These morphologic features include: a prominent starry sky pattern, lymphoma cells that appear to be a mixture of intermediate and large cells, and a very high mitotic and/or proliferation (Ki-67) rate. Some of these features are also observed in BL. Aggressive B-cell lymphomas with these ‘gray zone’ features have been recognized for years and were captured in older lymphoma classification systems using designations, such as undifferentiated, non-Burkitt type (Rappaport); small noncleaved cell lymphoma, non-Burkitt type (Working Formulation); HGBL Burkitt-like (Revised European-American classification); and B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and BL (BCLU) (2008 WHO classification). All of these terms, including the 2008 WHO classification terminology are now obsolete.
Multivesicular liposomes for sustained release of bevacizumab in treating laser-induced choroidal neovascularization
Published in Drug Delivery, 2018
Hongjie Mu, Yiyun Wang, Yongchao Chu, Ying Jiang, Hongchen Hua, Liuxiang Chu, Kaili Wang, Aiping Wang, Wanhui Liu, Youxin Li, Fenghua Fu, Kaoxiang Sun
In this study, several additives were evaluated in preserving the bioactivity of bevacizumab during emulsification. Figure 1(A)-a shows a reduction of bevacizumab activity during emulsification process. However, the activity of bevacizumab gradually increased toward the high concentrations of additive. The bevacizumab activities in all the additive groups were below 40%, except for BSA and HSA groups. These results indicated that the emulsification process adversely affected the antibody activity, especially in the presence of organic/aqueous interface. Hence, 10% BSA or HSA preserved the activity of bevacizumab up to 80%, PVA 22000 or 20% gelatin showed lower protective ability (up to 30% activity), followed by polyethylene glycol (PEG), polysorbate, and poloxamer. Meanwhile, Figure 1(A)-b demonstrates the antibody activity of Bev-MVLs with and without HSA. It is clearly shown that the antibody activity of Bev-MLVs with HSA was well preserved up to 80%, whereas Bev-MVLs without HSA exert only 9% bioactivity. These results suggest that albumin can effectively protect against denaturation and aggregation of antibodies. Since our ultimate goal is to prepare a working formulation for clinical usage, HSA was selected in this study.