No abstract

Diagnostic features (cytochemistry, immunophenotyping and serum biochemistry) were examined in 51 cases of acute monocytic leukaemia (AMoL). Peroxidase, Sudan black B and alpha naphthyl acetate esterase (ANAE) cytochemical reactions were unrelated to morphological (FAB groups M5a and M5b) or immunological subtype. ANAE cytochemistry, however, indicated that AMoL cases could be subdivided into those with typical (M-type) reactions and those with insignificant staining or monocytic ANAE isoenzymes (defined by IEF). All cases were phenotypically CD13/CD33 positive and, with one exception, had greater than 30% HLA-DR positive cells. Membrane CD14 expression was insignificant or variable in 33% of M5a cases in contrast to 23/24 M5b cases which showed high proportions of CD14-staining cells with at least two monoclonal antibodies. Serum lysozyme, LDH and beta-2 microglobulin (beta 2m) were increased in 88%, 68% and 81% of cases respectively but, with the exception of statistically higher lysozyme levels in CD14+ cases, were unrelated to the morphological, cytochemical or immunological diagnostic subgroups. Clinical and diagnostic features were also examined as possible prognostic indicators. The morphological, cytochemical and immunological subgroups of AMoL were not found to be of prognostic relevance but age (P = 0.004), renal failure (P = 0.005) and serum beta 2m levels (P = 0.002) were related to patient survival. Moreover, renal failure and serum beta 2m remained significant (P = 0.012 respectively) when age was taken into account and were shown to be independent prognostic variables.

Although a common procedure in the care of older people, the insertion of a urinary catheter carries considerable risk--for example, from infection or trauma. Changing demographics mean that the number of older people requiring catheterisation is likely to increase. This article explores the incidence of catheter use and associated complications, and explains the correct procedure for catheter insertion.

Recent research has highlighted the cognitive, physical, emotional, and spiritual benefits of sport and physical activity participation for Indigenous youth (McHugh, Coppola, & Sinclair, 2013; Hanna, 2009; Lavallée, 2007). Despite the importance of Indigenous peoples participating in sport and physical activity (e.g., Forsyth & Giles, 2013), the meaning of youth development in this context is not well understood. The purpose of this research was to understand Indigenous youth development within the context of sport and physical activity through the voices, stories and experiences of Indigenous youth. Participants were 99 Indigenous youth (52 males and 47 females) between the ages of 15 and 25 years who took part in one of 13 sharing circles. Each of the sharing circles was facilitated by a trained Indigenous youth with guidance from an Elder/Traditional person. A Two-Eyed Seeing approach (Bartlett, Marshall, & Marshall, 2012) was used to analyze the sharing circle discussions. This analytical process involved an initial inductive thematic analysis of the transcribed verbatim data followed by an Indigenous symbolic visual analysis of emerging themes using the Medicine Circle. Results revealed that involvement in sport and physical activity impacted Indigenous youth physically, cognitively, and emotionally. The spiritual impact was not as evident. Findings from the research will inform the development of a measure of Indigenous youth development within sport and physical activity settings.

Summary Ninety-seven cases of chronic myelomonocytic leukaemia (CMML) were examined retrospectively for survival and possible prognostic factors including age, total white cell count, peripheral blood and bone marrow monocyte counts, % double esterase (DE) positive cells in bone marrow and serum lysozyme. Age, absolute monocyte counts and serum lysozyme proved to be significant independent prognostic indicators but Cox model analyses showed serum lysozyme to be the most important factor whether taken as a continuous or discrete (two groups) variable. Twelve cases of second malignancy were found, including 2 cases of multiple myeloma, but this was not significantly greater than expected when compared with an age and sex matched group.