Multiple myeloma is an agressive hemato-oncological disease the diagnosis and treatment possibilities of which have been developing for the last 15 years. The diagnostic methods include flow cytometry which uses antigen detection to distinguish between pathological and physiological plasmocytes. One of the monitored markers is marker CD45 which could be, according to our monitoring, of a negative prognostic value. 71 patients in our group were divided according to the intensity of CD45 antigen expression and the group with a lower expression showed a statistically higher risk of relapse within 12 months 62% vs. 25 % (p=0,0011). We did not find any connection with the influences of induction therapy or cytogenetics which are otherwise considered the most important prognostic markers. Multiple myeloma treatment involves a lot of combined protocols; and the repeated autologous transplantation is still considered to be the most efficient. We observed more positive results in planning the second autologous transplant early in patients who reached just partial remission after the 1st autologous transplant - significantly better TFS (treatment free survival) and overall survival (OS) were in the group of patients with early tandem transplantation: 18 months vs. 10 months (p=0.04) and the OS median was not reached...

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Organdonation och transplantation – ett ämne för skolan?Denna uppsats syftar till att belysa ungdomars intresse för, attityder till och kunskaper om organdonationer och transplantationer. Den syftar också till att diskutera vilken plats samhällsfrågor med naturvetenskapligt innehåll har i skolans naturvetenskapliga undervisning med utgångspunkt i undervisning kring organdonationer och transplantationer. Vilken roll våra attityder och förväntningar spelar för våra beslut och vårt agerande behandlas.I två olika skolor genomfördes med alla elever i årskurs 9 på skolorna en enkätstudie som mätte attityder, kunskap och skolans roll inom ämnesområdet. Dessutom intervjuades 17 gymnasieelever med speciellt fokus på skolans undervisning om kontroversiella ämnen samt elevernas uppfattning om ett aktivt ställningstagande kring organdonationer.En majoritet av eleverna i enkätundersökningen var positivt inställda till att donera organ efter sin död. Andelen som kunde tänka sig att donera var större än andelen som var beredda att ta emot organ. Få av eleverna har pratat med sina anhöriga om sin egen eller deras inställning till donation. Det fanns ett samband mellan att känna till vilka organ som kan doneras efter döden och en positiv inställning till donation samt mellan att ha pratat med någon om ämnet och en positiv inställning till donation. Några andra samband med anknytning till kunskap om organdonationer och transplantationer kunde inte fastställas. De elever som är negativa till att donera är också i hög utsträckning negativa till att själva bli transplanterade.Flickor kan i betydligt större omfattning motivera sina ställningstaganden och tre gånger så många av flickorna har pratat med någon om sin inställning.Skolan har inte uppmärksammat ämnesområdet i någon större utsträckning. En majoritet av eleverna vill att mer tid skall ägnas åt frågan. Elever som tagit upp kontroversiella samhällsfrågor med naturvetenskapligt innehåll i skolan efterlyser mer undervisning i samma riktning. Eleverna efterlyser undervisning som belyser fakta för att kunna bilda sin egen uppfattning i kontroversiella frågor. De som tidigare haft inslag av drama och paneldebatter tycker att det är ett utmärkt sätt att träna sin förmåga i argumentation och att kunna förändra attityder. / This essay focuses on young peoples’ interest in, their attitudes towards and their knowledge of organ donation and transplantation. It also discusses the necessity of science for citizenship as an important part of science in school. A survey with 15 year old students and interviews with 17 year old students about organ donation and issues related to that theme has been conducted. A majority of the students in the survey were positive to donating organs after their death. Only 20 % of the youths had talked to anyone about their attitudes towards organ donation. There is a relation between knowledge about what kinds of organs that can be transplanted after death and a positive attitude towards donation. Girls are more interested in the subject and motivated their opinions three times as often as the boys.School has seldom been an area for discussing this subject. Students who have been working with controversial issues in science argued in favour of learning more about socio-scientific issues.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

I conducted a four-month ethnographic fieldwork study to document the stories of thirteen post-kidney-transplant minority patients and three nephrologists at Boston Medical Center. My research explores how patients’ interactions with health professionals, medical regimens, dialysis treatments, and adaptation to living with transplanted kidneys constantly shape their identities and perceptual worlds. Patients’ narratives highlighted the emotional struggles they encountered along the path of End-Stage Renal Disease, which unfolded as distinct experiences influenced by their varied backgrounds. The majority of my patient-participants lived on the verge of poverty, and in some cases, their insurance status caused delays in their being registered on the transplant waiting list, making them endure a long wait. Some patients were afraid of wearing short sleeves because they thought the scars on their arms from dialysis treatment would lead others to think they were gangsters. Instantiations of various theories emerged from the saturated data and narrative analysis, from Bourdieu’s concept of habitus with regard to the process of how patients alter their consciousness through interactions with medicine to Foucault’s ideas of power relations and technologies of the self that address the issues of agency and power that influence the formation of patients’ identities. The intersection of these theoretical frameworks led me to develop the critical medical anthropological-oriented concept of biological citizenship. This paper examines 1) the ways in which “race” interacts with the theoretical concept of biological citizenship and 2) the ways in which socioeconomic status and race tailor a kidney transplant patient’s illness experience, and related discourse.

Indiana University-Purdue University Indianapolis (IUPUI) / The question of growth attenuation of the maxillary complex arises in connection with primary osteoplasty procedure. The deficiencies associated with the development of the jaws in unilateral complete cleft lip and palate (UCLP) children is an ongoing problem in terms of growth inhibition and orthodontic treatment. Retardation of growth can be attributed to intrinsic cleft factors and/or associated with the treatment of the cleft condition. In this study, the extent of such deficiency, if any, was investigated by assessing arch length, arch width, arch symmetry and inter-arch harmony. Seventeen orthodontic casts of UCLP children (mean age 7 years 11 months) were obtained. All were treated with a primary osteoplasty at James Whitcomb Riley Hospital for Children at Indianapolis, Indiana. The sample was compared to an age and sex matched non-cleft control group (n=38). None of the subjects had undergone orthodontic treatment beyond infant maxillary orthopedics. Anatomic landmarks were identified and digitized by means of optical electronics. The data were automatically fed into a computer which executed preprogrammed data manipulation algorithms. Significant (p<0.05) inhibition of growth has taken place in the maxillary arches of the UCLP group in both anteroposterior and transverse directions. lntercanine width (ICW) was reduced on average by 7.6 mm (23.6 percent) while the intermolar width (IMW) was shortened by 3.9 mm (7.8 percent). Sagittal growth was retarded by 5.5 mm (17.4 percent). A gradient of "normalization" originating at a point of surgical insult was observed anteroposteriorly in the transverse maxillary dimension. In the mandible, ICW was retarded by 2.0 mm (7.8 percent) while IMW and A-P growth vectors were not significantly affected. This investigation also revealed significant (p = 0.0001) differences in the size of the maxillary anterior palatal area (cleft mean = 83.5 mm2, non-cleft mean = 133.9 mm2). These findings lead to the conclusion that primary osteoplasty may contribute to maxillary growth attenuation with concomitant mandibular compensatory growth patterns.

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