Association of fatigue and psychological distress with quality of life in patients with a previous venous thromboembolic event

Health-related quality of life (QoL) has been associated with several social and medical conditions in patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). To the best of our knowledge, there is no study investigating the relationship of QoL with psychological variables in this patient population. We assumed as a hypothesis an association between heightened levels of fatigue and psychological distress, as well as decreased QoL in patients with an objectively diagnosed venous thromboembolic event. Study participants were 205 consecutively enrolled out-patients (47.4 years, 54.6% men) with DVT and/or PE. Approximately 10 days before blood collection for thrombophilia work-up, QoL, fatigue, and psychological distress were assessed using the Short Form Health Survey (SF-12), the Multidimensional Fatigue Symptom Inventory Short Form (MFSI-SF) as well as the Hospitality Anxiety and Depression scale (HADS). After controlling for demographic and medical factors, fatigue (p < 0.01) but not psychological distress (p>0.05) was negatively associated with physical QoL, explaining 11.0% of the variance. Fatigue (p < 0.001) and psychological distress (p < 0.001) were significant predictors of mental QoL, explaining an additional 36.2% and 3.6% of the variance. Further analyses revealed that all subscales of the HADS (e.g. anxiety and depression) and of the MFSI-SF (e.g. general fatigue, physical fatigue, emotional fatigue, mental fatigue and vigor) were significant predictors of mental QoL. MFSI-SF subscales also predicted physical QoL. The findings suggest that fatigue and psychological distress substantially predict QoL in patients with a previous venous thromboembolic event above and beyond demographic factors.

BCL2 mutation spectrum in B-cell non-Hodgkin lymphomas and patterns associated with evolution of follicular lymphoma

BCL2 is a target of somatic hypermutation in t(14;18) positive and also in a small fraction of t(14;18) negative diffuse large B-cell lymphoma (DLBCL), suggesting an aberrant role of somatic hypermutation (ASHM). To elucidate the prevalence of BCL2 mutations in lymphomas other than DLBCL, we Sanger-sequenced the hypermutable region of the BCL2 gene in a panel of 69 mature B-cell lymphomas, including Richter's syndrome DLBCL, marginal-zone lymphomas, post-transplant lymphoproliferative disorders, HIV-associated and common-variable immunodeficiency-associated DLBCL, all known to harbour ASHM-dependent mutations in other genes, as well as 16 t(14,18) negative and 21 t(14;18) positive follicular lymphomas (FLs). We also investigated the pattern of BCL2 mutations in longitudinal samples from 10 FL patients relapsing to FL or transforming to DLBCL (tFL). By direct sequencing, we found clonally represented BCL2 mutations in 2/16 (13%) of t(14;18) negative FLs, 2/16 (13%) HIV-DLBCLs, 1/9 (11%) of Richter's syndrome DLBCL, 1/17 (6%) of post-transplant lymphoproliferative disorders and 1/2 (50%) common-variable immunodeficiency-associated DLBCL. The proportion of mutated cases was significantly lower than in FLs carrying the t(14;18) translocation (15/21, 71%). However, the absence of t(14;18) by FISH or PCR and the molecular features of the mutations strongly suggest that BCL2 represents an additional target of ASHM in these entities. Analysis of the BCL2 mutation pattern in clonally related FL/FL and FL/tFL samples revealed two distinct scenarios of genomic evolution: (i) direct evolution from the antecedent FL clone, with few novel clonal mutations acquired by the tFL major clone, and (ii) evolution from a common mutated long-lived progenitor cell, which subsequently acquired distinct mutations in the FL and in the relapsed or transformed counterpart. Copyright © 2014 John Wiley & Sons, Ltd.

A text-book of needlework, knitting, and cutting out : with methods of teaching /

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The fruit garden : a treatise intended to explain and illustrate the physiology of fruit trees, the theory and practice of all operations connected with the propagation, transplanting, pruning and training of orchard and garden trees ... the laying out and arranging different kinds of orchards and gardens ... : illustrated with upwards of 150 figures ... /

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The Burlington Fine Arts Club : 17, Savile Row, W., rules, regulations, and bye-laws with list of members.

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History of the expedition under the command of Captains Lewis and Clarke, to the sources of the Missouri ... : performed during the years 1804, 1805, 1806, by order of the government of the United States /

The chapter on natural history (1st edition, v. 2, chapter 7) is in this edition transferred to the appendix. In this appendix the Estimate of the western Indians is given under the heading: "Enumeration of Indian nations and their places of general residence."

The Shadbhâshâchandrikâ [of Lakshmîdhara]. With a critical notice of manuscripts, introduction, critical and explanatory notes with appendices of the Sutras in order ...

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Multiple neurofibromatosis (von Recklinghausen's disease) and its inheritance. with descriptions of a case,

"Reprinted form the American journal of the medical sciences, October, 1918, no. 4, vol. CLVI, p. 507."

Radford's cyclopedia of cement construction; a general reference work on up-to-date practice in the manufacture and testing of cements; the selection of concreting materials, tools, and machinery; the proportioning, mixing, and depositing of concrete, and its application to all types and reinforced; together with analysis of the principles of constructive design, cost estimating, and the allied branches of stone and brick masonry and steel construction; based on the practical experience of a large staff of experts in actual construction work ...

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The laws of gravitation; memoirs by Newton, Bouguer and Cavendish, together with abstracts of other important memoirs.

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Hill-side and Border sketches. With legends of the Cheviots and the Lammermuir.

The frontispieces are by John Leech; illustrations by G. Measom.