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Sample records for adverse prognosis factor

  1. The Analysis of the Risk Factors of Adverse Prognosis of Myocardial Infarction in the Acute Period

    Directory of Open Access Journals (Sweden)

    A. E. Zakharova

    2016-01-01

    Full Text Available The aim was to identify the risk factors contributed to adverse outcome of myocardial infarction (MI in the acute period of the disease at a prehospital stage.Materials and methods. The study included the call cards of specialized resuscitation and anesthesia units of the budgetary institution A. S. Puchkov «Station of emergency medical care», to patients with complicated MI. The study included two groups of patients. The first group comprized of patients with complicated MI which resulted in circulatory arrest (n=184, the second group (the group of comparison included patients with com plicated MI without the outcome in circulatory arrest (n=271. Statistical processing of the material: significance of differences between two binomial observations was evaluated by the Barnard's Exact Test.The results of the research. The presence of risk of MI complication as a stopping of blood circulation was confirmed in patients of the age group of 40—60 years (P=0.01. Patients with MI complicated by a circulatory arrest was characterized by a significantly greater intensity of pain syndrome (the pain intensity of 9—10 points was typ ical for 11,2% and 3% of patients of the group with circulatory arrest and the group of comparison, respectively; P< 0.001. The combination of clinical manifestations of alveolar pulmonary edema and arrhythmia occurred in 50% of patients with circulatory arrest, resulted in poor prognosis (the frequency of same parameters in a control group was 28,7%, P=0.018. Tachysystolic arrhythmia was the most common form of alteration at a circulatory arrest.Conclusions. The risk factors for MI adverse outcome in acute period included age from 40 to 60 years, pain of high intensity, presence of cardiogenic shock in combination with alveolar pulmonary edema and tachyarrhythmia.

  2. Adverse psychosocial factors predict poorer prognosis in HIV disease: a meta-analytic review of prospective investigations.

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    Chida, Yoichi; Vedhara, Kavita

    2009-05-01

    There is a growing epidemiological literature focusing on the association between psychosocial stress and human immunodeficiency virus (HIV) disease progression or acquired immunodeficiency syndrome (AIDS), but inconsistent findings have been published. We aimed to quantify the association between adverse psychosocial factors and HIV disease progression. We searched Medline; PsycINFO; Web of Science; PubMed up to 19 January 2009, and included population studies with a prospective design that investigated associations between adverse psychosocial factors and HIV disease progression or AIDS. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. The overall meta-analysis examined 36 articles including 100 psychosocial and disease related relationships. It exhibited a small, but robust positive association between adverse psychosocial factors and HIV progression (correlation coefficient as combined size effect 0.059, 95% confidence interval 0.043-0.074, pHIV disease progression than stress stimuli per se, and that all of the immunological and clinical outcome indicators (acquired immunodeficiency syndrome stage, CD4+ T-cell decline, acquired immunodeficiency syndrome diagnosis, acquired immunodeficiency syndrome mortality, and human immunodeficiency virus disease or acquired immunodeficiency syndrome symptoms) except for viral load exhibited detrimental effects by adverse psychosocial factors. In conclusion, the current review reveals a robust relationship between adverse psychosocial factors and HIV disease progression. Furthermore, there would appear to be some evidence for particular psychosocial factors to be most strongly associated with HIV disease progression.

  3. MDM2 gene amplification: a new independent factor of adverse prognosis in non-small cell lung cancer (NSCLC).

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    Dworakowska, Dorota; Jassem, Ewa; Jassem, Jacek; Peters, Brigitte; Dziadziuszko, Rafał; Zylicz, Maciej; Jakóbkiewicz-Banecka, Joanna; Kobierska-Gulida, Grazyna; Szymanowska, Amelia; Skokowski, Jan; Roessner, Albert; Schneider-Stock, Regine

    2004-03-01

    The prognostic impact of MDM2 amplification in non-small cell lung cancer (NSCLC) remains unknown. In this study, we investigated the occurrence of MDM2 amplification in surgically treated NSCLC patients. Molecular data were correlated with clinicopathological factors and evaluated for their prognostic value. The study group included 116 NSCLC patients who underwent pulmonary resection between 1996 and 1999. MDM2 amplification was assessed by real-time PCR using hybridization probe format on a LightCycler (Roche). The calculated ratio was a MDM2 value normalized to the amplification of the housekeeping gene phenylalaninhydroxylase (PAH). Survival curves were drawn according to the Kaplan-Meier method and compared with the use of the log-rank test. Multivariate analysis was based on Cox regression analysis. MDM2 amplification was found in 24 patients (21%). There was no relationship between MDM2 amplification and clinicopathological factors, such as sex, age and stage of disease, pT, pN, histology and tumor differentiation. Median disease-free survival (DFS) in patients with and without MDM2 amplification was 3 and 31 months, and 5-year DFS 24 and 33%, respectively (log-rank, P = 0.02). Likewise, median overall survival (OS) in patients with and without MDM2 amplification was 9 and 33 months, respectively, and 5-year OS 24 and 39%, respectively (log-rank, P = 0.01). The strong prognostic relevance of MDM2 amplification for both DFS and OS was confirmed in multivariate analysis (P < 0.01 for both comparisons). Our results suggest that MDM2 gene amplification analysis provides additional prognostic information in surgically treated NSCLC patients.

  4. Pregnancy after treatment of breast cancer in young women does not adversely affect the prognosis.

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    Córdoba, Octavi; Bellet, Meritxell; Vidal, Xavier; Cortés, Javier; Llurba, Elisa; Rubio, Isabel T; Xercavins, Jordi

    2012-06-01

    We assessed whether pregnancy after breast cancer in patients younger than 36 years of age affects the prognosis. Of 115 women with breast cancer followed for a mean of 6 years, 18 became pregnant (median time between diagnosis and the first pregnancy 44.5 months). Voluntary interruption of pregnancy was decided by 8 (44.4%) women. Significant differences in prognostic factors between pregnant and non-pregnant women were not observed. Pregnant women showed a lower frequency of positive estrogen receptors (41%) than non-pregnant (64%) (P=0.06). At 5 years of follow-up, 100% of women in the pregnant group and 80% in the non-pregnant group were alive. The percentages of disease-free women were 94% and 64%, respectively (P=0.009). Breast cancer patients presented a high number of unwanted pregnancies. Pregnancy after breast cancer not only did not adversely affect prognosis of the neoplasm but also may have a protective effect.

  5. Mitochondrial cytochrome c oxidase subunit II variations predict adverse prognosis in cytogenetically normal acute myeloid leukaemia.

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    Silkjaer, Trine; Nyvold, Charlotte Guldborg; Juhl-Christensen, Caroline; Hokland, Peter; Nørgaard, Jan Maxwell

    2013-10-01

    Alterations in the two catalytic genes cytochrome c oxidase subunits I and II (COI and COII) have recently been suggested to have an adverse impact on prognosis in patients with acute myeloid leukaemia (AML). In order to explore this in further detail, we sequenced these two mitochondrial genes in diagnostic bone marrow or blood samples in 235 patients with AML. In 37 (16%) patients, a non-synonymous variation in either COI or COII could be demonstrated. No patients harboured both COI and COII non-synonymous variations. Twenty-four (10%) patients had non-synonymous variations in COI, whereas 13 (6%) patients had non-synonymous variations in COII. The COI and COII are essential subunits of cytochrome c oxidase that is the terminal enzyme in the oxidative phosphorylation complexes. In terms of disease course, we observed that in patients with a normal cytogenetic analysis at disease presentation (CN-AML) treated with curative intent, the presence of a non-synonymous variation in the COII was an adverse prognostic marker for both overall survival and disease-free survival (DFS) in both univariate (DFS; hazard ratio (HR) 4.4, P = 0.006) and multivariate analyses (DFS; HR 7.2, P = 0.001). This is the first demonstration of a mitochondrial aberration playing an adverse prognostic role in adult AML, and we argue that its role as a potentially novel adverse prognostic marker in the subset of CN-AML should be explored further.

  6. Factors predicting poor prognosis in ischemic colitis

    Institute of Scientific and Technical Information of China (English)

    Ramón A(n)ón; Marta Maia Boscá; Vicente Sanchiz; Joan Tosca; Pedro Almela; Cirilo Amorós; Adolfo Benages

    2006-01-01

    ). Stenosis was the only endoscopic finding that appeared more frequently in seriously ill patients than in slightly ill patients (66.6% vs 17.3%, P = 0.017).CONCLUSION: The factors that can predict poor prognosis of IC are the absence of hematochezia, tachycardia and peritonism, anemia and hyponatremia and stenosis.

  7. Prognosis related clinical and molecular factors in malignant pleural mesothelioma

    Institute of Scientific and Technical Information of China (English)

    王玉艳

    2013-01-01

    Objective To identify potential prognosis related clinical and molecular factors in malignant pleural mesothelioma(MPM).Methods Seventy-nine patients with MPM treated in Beijing Cancer Hospital from June 1996

  8. Risk Factors Analysis on Traumatic Brain Injury Prognosis

    Institute of Scientific and Technical Information of China (English)

    Xiao-dong Qu; Resha Shrestha; Mao-de Wang

    2011-01-01

    To investigate the independent risk factors of traumatic brain injury (TBI) prognosis.Methods A retrospective analysis was performed in 885 hospitalized TEl patients from January 1,2003 to January 1, 2010 in the First Affiliated Hospital of Medical College of Xi' an Jiaotong University. Single-factor and logistic regression analysis were conducted to evaluate the association of different variables with TBI outcome.Results The single-factor analysis revealed significant association between several variables and TEl outcome, including age (P=0.044 for the age group 40-60, P<0.001 for the age group ≥60), complications (P<0.001), cerebrospinal fluid leakage (P<0.001), Glasgow Coma Scale (GCS) (P<0.001), pupillary light reflex (P<0.001), shock (P<0.001), associated extra-cranial lesions (P=0.01), subdural hematoma (P<0.001), cerebral contusion (P<0.001), diffuse axonal injury (P<0.001), and subarachnoid hemorrhage (P<0.001), suggesting the influence of those factors on the prognosis of TBI. Furthermore, logistic regression analysis identified age, GCS score, pupillary light reflex, subdural hematoma, and subarachnoid hemorrhage as independent risk factors of TEl prognosis.Conclusion Age, GCS score, papillary light reflex, subdural hematoma, and subarachnoid hemorrhage may be risk factors influencing the prognosis of TEl. Paying attention to those factors might improve the outcome of TBI in clinical treatment.

  9. Treeline advance - driving processes and adverse factors

    OpenAIRE

    2007-01-01

    The general trend of climatically-driven treeline advance is modified by regional, local and temporal variations. Treelines will not advance in a closed front parallel to the shift of any isotherm to higher elevations and more northern latitudes. The effects of varying topography on site conditions and the after-effects of historical disturbances by natural and anthropogenic factors may override the effects of slightly higher average temperatures. Moreover, the varying treeline-forming specie...

  10. Treeline advance - driving processes and adverse factors

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    F.-K. Holtmeier

    2007-06-01

    Full Text Available The general trend of climatically-driven treeline advance is modified by regional, local and temporal variations. Treelines will not advance in a closed front parallel to the shift of any isotherm to higher elevations and more northern latitudes. The effects of varying topography on site conditions and the after-effects of historical disturbances by natural and anthropogenic factors may override the effects of slightly higher average temperatures. Moreover, the varying treeline-forming species respond in different ways to a changing climate. Forest advance upwards and northwards primarily depends on successful regeneration and survival of young growth rather than on increasing growth rates of mature trees. Every assessment of treeline response to future climate change must consider the effects of local site conditions and feedbacks of in-creasing tree population in modulating the climatically-driven change. Treeline-shift will influence regional and local climates, pedogenesis, plant communities, animal populations and biodiversity as well as having a considerable effect on economic changes in primary production. A better understanding of the functional relationships between the many treeline-relevant factors and treeline dynamics can be achieved only by extensive research at different scales within different climatic regions supported by as many as possible experimental studies in the field together with laboratory and remote sensing techniques.

  11. SULFs in human neoplasia: implication as progression and prognosis factors

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    Schved Jean-François

    2011-05-01

    Full Text Available Abstract Background The sulfation pattern of heparan sulfate chains influences signaling events mediated by heparan sulfate proteoglycans located on cell surface. SULF1 and SULF2 are two endosulfatases able to cleave specific 6-O sulfate groups within the heparan chains. Their action can modulate signaling processes, many of which with key relevance for cancer development and expansion. SULF1 has been associated with tumor suppressor effects in various models of cancer, whereas SULF2 dysregulation was in relation with protumorigenic actions. However, other observations argue for contradictory effects of these sulfatases in cancer, suggesting the complexity of their action in the tumor microenvironment. Methods We compared the expression of the genes encoding SULF1, SULF2 and heparan sulfate proteoglycans in a large panel of cancer samples to their normal tissue counterparts using publicly available gene expression data, including the data obtained from two cohorts of newly-diagnosed multiple myeloma patients, the Oncomine Cancer Microarray database, the Amazonia data base and the ITTACA database. We also analysed prognosis data in relation with these databases. Results We demonstrated that SULF2 expression in primary multiple myeloma cells was associated with a poor prognosis in two independent large cohorts of patients. It remained an independent predictor when considered together with conventional multiple myeloma prognosis factors. Besides, we observed an over-representation of SULF2 gene expression in skin cancer, colorectal carcinoma, testicular teratoma and liver cancer compared to their normal tissue counterpart. We found that SULF2 was significantly over-expressed in high grade uveal melanoma compared to low grade and in patients presenting colorectal carcinoma compared to benign colon adenoma. We observed that, in addition to previous observations, SULF1 gene expression was increased in T prolymphocytic leukemia, acute myeloid leukemia

  12. Prognosis and prognostic factors in inflammatory bowel disease

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    Thompson Nicholas

    1995-01-01

    Full Text Available The chance of normal survival for patients with inflammatory bowel disease is generally good. There may be a small excess mortality for those with Crohn′s disease; however recent studies do not confirm this trend. For those with ulcerative colitis, there may be an excess mortality in the first two years after diagnosis, especially in those who undergo surgery. The necessity for an operation varies, but at least 50% of patients with Crohn′s disease will be an operation in the first 10 years; whereas only about 20% of patients with ulcerative colitis will require a colectomy. Most patients with inflammatory bowel disease are able to lead a normal life and are not disabled by their disease. The prognosis in the elderly is usually good; however there is an increased mortality over younger patients, which is probably due to the presence of coexistent disease. Children also have a slightly higher mortality; this may be due to the relative frequency of a particularly extensive disease and the development of colorectal cancer. Growth retardation occurs in up to one-third of children with Crohn′s disease, but it may be resol" d if remission can be obtained. Pregnancy has not been shown to have an impact on inflammatory bowel disease, but its onset during pregnancy confers a significant risk for both mother and child. Extensive involvement is a poor prognosis factor in both diseases; conversely, isolated small bowel Crohn′s disease and ulcerative proctitis carry particularly good prognoses. A short clinical history, fistulae or abscesses at presentation probably represent an aggressive form of Crohn′s disease. Hypoalbuminemia, anemia and raised inflammatory markers are laboratory markers which suggest a worse prognosis in the short and possibly long-term.

  13. Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Denollet, Johan; Erdman, Ruud A M;

    2009-01-01

    risk (HR: 2.40; 95% CI: 0.82-7.01). These results remained, adjusting for baseline characteristics and depressive symptoms. These findings testify to the importance of identifying patients with co-occurring risk factors, as they likely require special management in clinical practice in addition...

  14. Risk factors and prognosis for salivary gland adenoid cystic carcinoma in southern china

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    Ouyang, Dai-qiao; Liang, Li-zhong; Zheng, Guang-sen; Ke, Zun-fu; Weng, De-sheng; Yang, Wei-fa; Su, Yu-xiong; Liao, Gui-qing

    2017-01-01

    Abstract Adenoid cystic carcinoma (ACC) is characterized by slow growth, frequent local recurrences, and high incidence of distant metastasis (DM). The aim of this study was to evaluate predictive factors for local-regional (LR) recurrence, DM, and survival in ACC. A retrospective review of the medical records for patients with salivary glands ACC from 1990 to 2015 was performed. The clinical parameters were assessed to identify correlations with the development of LR recurrence, DM, and survival of these patients. Among 228 patients who underwent surgery as definitive treatment, 210 (92.1%) were followed up in the study. DM was detected in 64 (30.5%) patients, LR recurrence was detected in 58 (27.6%) patients. The estimated 5, 10, and 15-year overall survival rates were 84.7%, 70.8%, and 34.0%, respectively. Multivariate analysis revealed that the presence of lymphovascular invasion and a high T classification were very strong adverse factors, which independently influenced LR recurrence, DM, and survival of ACC patients. Positive/close margin and N+ status were independent risk factors for DM and LR recurrence, respectively. Survival of ACC patents was also affected by tumor location. Presence of lymphovascular invasion and a high T classification were very strong adverse factors and independent predictors for ACC patients’ prognosis, which influenced LR control, DM control, and survival. PMID:28151884

  15. Risk Factors of Poor Prognosis after Whiplash Injury

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    Samy Suissa

    2003-01-01

    Full Text Available Whiplash, a common injury following motor vehicle crashes, is associated with high costs and a prognosis that is variable and difficult to predict. In this paper, we review findings from the Quebec cohort epidemiological study on predictive factors of recovery from whiplash injury after a motor vehicle crash. We formed a population-based incident cohort of all 4,759 individuals who sustained a whiplash injury resulting from a motor vehicle crash in the province of Québec, Canada, in 1987, and followed these patients for up to seven years. The data were obtained from the universal automobile insurance plan (SAAQ that covers all seven million residents of the Province for all vehicular-related injuries. From this cohort, we formed the cohort of 3,014 for whom a police report was completed. For this cohort, we obtained data on crash-related factors directly from the police report. We also formed the cohort of 2,627 subjects who had strictly a whiplash injury, without associated injuries. For this cohort, the data on signs and symptoms were obtained from the medical charts kept by the SAAQ. For both cohorts, data on the outcome, the recovery time from whiplash, was obtained from the SAAQ databases. The crash-related cohort study found that socio-demographic factors associated with a longer recovery from whiplash include older age, female sex, having dependents and not being employed full time and that each decreases the rate of recovery by 14 to 16 per cent. Factors related to the crash conditions indicate that being in a truck or bus, with a decrease of 52% in the rate of recovery, being a passenger in the vehicle (15%, colliding with a moving vehicle (16%, and a side or frontal collision (15% all decrease the rate of recovery. We introduce a combined risk score that predicts longer recovery. In the cohort of subjects with signs and symptoms, the median recovery time was 32 days and 12% of subjects had still not recovered after 6 months. The signs

  16. Risk Factors and Prognosis of Surgery for Spinal Metastasis

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    HuiminTao; ZhengmingYang; ZhaomingYe; DishengYang; WeixuLi

    2004-01-01

    OBJECTIVE To evaluate the risk factors and prognosis of surgery for spinal metastasis.METHODS A retrospective analysis was performed for 63 patients with spinal metastasis who underwent surgical treatment between June 1992 and June 2002. Forty-one patients underwent anterior en-bloc or partial resection, decompression and reconstruction with internal fixation of the spine.Laminectomy and decompression with internal fixation were done in patients. One-stage anterior-posterior en-bloc resection and decompression followed by reconstructive stabilization were conducted in 14 patients.RESULTS After follow-up for more than 6 months, postoperative radiological evaluation revealed that spinal stabilization was evident in all patients. Fiftyseven (91.9%) patients benefited with quality of life significantly improved through pain alleviation, and 41 (66.1%) patients improved in theirneurological status. No serious complications were observed in surgery. The mean survival time after surgery was 6 months in patients with lung and liver carcinoma, 15 months with breast, prostate, and stomach carcinoma as well as the other miscellaneous malignancies, and 28 months with thyroid and kidney carcinoma. Differences were significant among the 3 groups (P<0.01).CONCLUSION Surgical treatment for spinal metastasis is able to relieve neurological symptoms and improve the quality of life. The survival time is related to the site of the primary tumor; shorter survival in lung and liver carcinoma, longer in breast, prostate, stomach carcinoma and longest In thyroid and kidney carcinoma.

  17. [Adverse drug reaction - Definitions, risk factors and pharmacovigilance].

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    Krähenbühl, Stephan

    2015-12-01

    Adverse drug reactions (ADR} are the downside of active pharmacotherapies and can only partially be avoided. Risk factors have been identified for certain ADR which should be taken into account for the choice and dosing of critical drugs. Medical staff have a legal obligation to report severe ADR and ADR caused by newly licensed drugs. Such reports are important for monitoring the safety of drugs that are on the market.

  18. Prognosis of unprotected left main coronary artery stenting and the factors affecting the outcomes in Chinese

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background The long term prognosis of unprotected left main coronary artery (LMCA) stenting is controversial This study was conducted to evaluate the immediate and long term outcomes of LMCA stenting in Chinese patients and to determine which factors affect the outcomes. Methods From May 1997 to March 2003,224 patients in 23 hospitals underwent elective unprotected LMCA stenting with bare metal stents. Their clinical records were analysed to ascertain immediate and long term outcomes of LMCA stenting as well as factors influencing the prognosis .Results Stents were implanted into LMCA successfully in 223 cases (99.6 %). One death (0.5%) and one case of non-Q wave nonfatal myocardial infarction (MI) occurred in hospital. The mean follow-up time was (15.6±12.3) months. Cardiac death developed in 10 cases (4.5%), noncardiac death in 2 cases (0.9%), nonfatal MI in 4 cases (1.8%), target lesion revascularization (TLR) of LMCA in 26 cases (11.7%) and TLR of nonLMCA in 37 cases (16.5%). Univariate analysis showed that cardiac death correlated with left ventricular ejection fraction (LVEF < 40%), female gender and LMCA combined with multivessel disease; that major adverse cardiac events (MACE) correlated with LVEF < 40%, bifurcation lesion and incomplete revascularization. Logistic regression analysis revealed that LVEF < 40% and female gender were independent predictors of cardiac death and MACE. Follow-up angiography was performed in 102 cases (45.7%). The restenosis rate was 31.4%. Conclusions Long-term outcomes of stenting for selected patients with unprotected LMCA stenosis is acceptable. It should be performed in inoperable or low risk patients with LVEF ≥ 40% and isolated LMCA disease or LMCA combined with multivessel diseases in whom complete revascularization can be obtained.

  19. Adverse pregnancy outcomes and cardiovascular risk factor management.

    Science.gov (United States)

    Mehta, Puja K; Minissian, Margo; Bairey Merz, C Noel

    2015-06-01

    Cardiovascular disease (CVD) is the leading health threat to American women. In addition to establish risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman's risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early. Embedding preventive care providers such as nurse practitioners or physician assistants within OB/GYN practices can be considered, with referral to family medicine or internist for ongoing risk assessment and management. The American Heart Association (AHA)/American Stroke Association (ASA) stroke prevention guidelines tailored to women recommend that women with a history of pre-eclampsia can be evaluated for hypertension and other CVD risk factors within 6 months to 1-year post-partum. Given the burden and impact of CVD on women in our society, the entire medical community must work to establish feasible practice and referral patterns for assessment and treatment of CVD risk factors.

  20. Short-term prognosis and risk factors of ventricular septal rupture following acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    胡小莹

    2013-01-01

    Objective To analyze the short-term prognosis and risk factors of ventricular septal rupture(VSR)following acute myocardial infarction(AMI).Methods A total of 70 consecutive VSR patients following AMI hospitalized in

  1. Short-term prognosis and risk factors of ventricular septal rupture following acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    胡小莹

    2013-01-01

    Objective To analyze the short-term prognosis and risk factors of ventricular septal rupture(VSR)following acute myocardial infarction(AMI).Methods A total of 70 consecutive VSR patients following AMI

  2. Functional constipation in children : a systematic review on prognosis and predictive factors

    NARCIS (Netherlands)

    Pijpers, M.A.M.; Bongers, M.E.J.; Benninga, M.A.; Berger, M.Y.

    2010-01-01

    Background and Aim: Knowledge regarding prognosis and factors influencing the clinical course of functional constipation in children is important to enable general practitioners and paediatricians to give accurate patient information, to compare treatment strategies, and identify children with high

  3. Clinical factors adversely affecting early outcome after brain infarction

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    Charles André

    1994-06-01

    Full Text Available PURPOSE AND METHODS: One-hundred-and-nine consecutive patients admitted during the acute phase of a CT-confirmed brain infarction (BI were studied. Putative adverse influence of demographic and stroke risk factors, previous medical history, clinical presentation, initial and follow-up neurological examination, initial general evaluation, laboratory findings, chest X-ray and electrocardiographic findings, treatment, and topography and etiology of the ischemic insult was analysed. The end-point for assessment was early death (within 30 days. Statistical analysis was performed with univariate analysis and multiple regression. RESULTS: The main adverse factors related to an increased death risk during the first 30 days were, in decreasing order of importance: coma 48-72 hours after admission; stroke occuring in already hospitalized patients; Babinski sign on admission; minor degrees of impairment of consciousness 48-72 hours after admission; stroke related to large artery atherothrombosis and to embolism; a history of early impairment of consciousness; cardiac failure on admission. In 53 lucid patients on admission, only a history of congestive heart failure (CHF was associated with a reduced survival rate. In 56 patients with impaired consciousness, the presence of a Babinski sign increased death risk, but the main factor predicting a high case-fatality rate was the persistence of consciousness disturbances after48-72 hours. CONCLUSIONS: The presence of impairment of consciousness, especially coma, 2-3 days after disease onset, and a history of CHF greatly increase the early case fatality rate in patients with acute BI presenting with or without consciousness disturbances at admission, respectively. The use of a prognostic algorythm considering these few variables seems to predict the approximate 30-day fatality rates.

  4. Ceratocone: fatores prognósticos Keratoconus: prognosis factors

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    Rosana Molina Saraiva Elias

    2005-08-01

    keratoconus disease carrier patients in an age range under the usual one and try to detect any factor which can influence in disease evolution and prognosis. METHODS: Patients under 15 years old with a keratoconus diagnosis where analyzed. All of them answered a questionnaire, and were submitted to ocular examination and also computerized ceratoscopy. These patients were divided into three groups and went through a contact lens test: 1 it was possible for this group to adapt to contact lenses; 2 a cornea transplant for this group was recommended; 3 for this group it was suggested that they use glasses. RESULTS: Patients who had 20/40 or greater visual acuity usually did not progress to transplant in the studied period. On the other hand, patients who had 20/60 or less acuity, progress to a deep transplant very quickly. Other cases, related to a lower age range (10-15 years old pregressed to a transplant. We can observe that the cornea apex has a very unsteady location, which explains the different difficulty levels regarding adaptation to contact lenses. In all patients who had a superior out of place apex and values greater than 66 D adaptation was successful. In the central apex eyes the adaptation was easier. In the inferior apex eyes it was not possible to set a standard to indicate the person for surgery. In the eyes which were adapted to the contact lenses and whose curvature was smaller than 51.10 D there were fewer chances of evolution to a cornea transplant, on comparison with patients who had a curvature of 57.60 or even greater. CONCLUSION: Patients who have curvatures greater than 57.40, acuity lower than 20/60 and are under 18 years old have more chances to evolve to a cornea transplant. When the ceratocone apex is central the contact lens adaptation becomes easier.

  5. Inflammation-based factors and prognosis in patients withcolorectal cancer

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Several parameters for predicting survival in patientswith colorectal cancer have been identified, includingthe performance status, age, gender and tumor-nodemetastasis(TNM) stage. Although the TNM stage isimportant and useful for predicting the prognosis anddetermining the appropriate treatment, it is well knownthat the survival time varies widely, even in patients withthe same stage of disease. Therefore, the identificationof new parameters capable of more precisely predictingpatient survival is needed to help select the optimaltreatment, especially in patients in the advanced stageof disease. Although the TNM stage reflects the tumorcharacteristics, cancer progression and survival are notdetermined solely based on the local characteristics ofthe tumor, but also the host systemic immune/inflammatoryresponse. Therefore, using a combination ofparameters that reflect both tumor characteristics andthe host systemic inflammatory status is thought to beimportant for accurately predicting patient survival.

  6. Prognosis Research Strategy (PROGRESS 2: prognostic factor research.

    Directory of Open Access Journals (Sweden)

    Richard D Riley

    Full Text Available Prognostic factor research aims to identify factors associated with subsequent clinical outcome in people with a particular disease or health condition. In this article, the second in the PROGRESS series, the authors discuss the role of prognostic factors in current clinical practice, randomised trials, and developing new interventions, and explain why and how prognostic factor research should be improved.

  7. Prognosis and risk factors for intrauterine growth retardation

    DEFF Research Database (Denmark)

    Sehested, Line Thousig; Pedersen, Pernille

    2014-01-01

    focusing on risk factors, catch up and neonatal outcome. MATERIAL AND METHODS: This was a retrospective descriptive study of IUGR neonates with a birth weight below 70% of the expected whose mothers were admitted to the Neonatal Ward at Hvidovre Hospital during 2007-2009. Obstetrical and maternal risk...... factors and neonatal growth and outcome at six weeks, five months and 12 months of age were collected. RESULTS: A total of 73 neonates and their mothers were included. Caesarean delivery was given in 78% of the cases. Maternal risk factors included gestational hypertension (33%), smoking (24...

  8. Back and neck pain : factors of importance for the prognosis

    OpenAIRE

    2013-01-01

    Back pain and neck pain are very common and among the most frequent causes of sick-leave and disability pension, thereby greatly affecting the individual and the community. This stresses the need for prognostic research regarding these conditions. Aim: The main aim of the present work was to study prognostic factors, including manual therapy, for back and neck pain. The specific aims were, to investigate the influence of regular leisure physical activity and the body mass index (BMI) on...

  9. Analysis of related factors affecting prognosis of shunt surgery in patients with secondary normal pressure hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    WANG Cheng; DU Hang-gen; YIN Li-chun; HE Min; ZHANG Guo-jun; TIAN Yong; HAO Bi-lie

    2013-01-01

    Objective:The management of secondary normal pressure hydrocephalus (sNPH) is controversial.Many factors may affect the surgery effect.The purpose of this study was to identify the possible factors influencing prognosis and provide theoretical basis for clinical treatment of sNPH.Methods:A retrospective study was carried out to investigate the results of 31 patients with sNPH who underwent ventriculoperitoneal shunt surgery from January 2007 to December 2011.We processed the potential influencing factors by univariate analysis and the result further by multivariate logistic regression analysis.Results:Factors including age,disease duration and Glasgow coma scale (GCS) score before surgery significantly influenced the prognosis of sNPH (P<0.05).Further logistic regression analysis showed that all the three factors are independent influencing factors.Conclusion:Age,disease duration and GCS score before surgery have positive predictive value in estimating favorable response to surgical treatment for sNPH.

  10. Analysis of factors influencing prognosis in foals with septic arthritis

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    Vos Nicolas J

    2008-02-01

    Full Text Available Abstract The purpose of this paper was to identify factors that would positively or negatively affect the short-term survival rate of foals with septic arthritis. Medical records of 81 foals (≤seven months of age with a clinical diagnosis of septic arthritis, referred to the equine hospital at Cornell University Hospital for Animals, between 1994 and 2003 were reviewed. Signalment, age at presentation, number of affected joints, joint fluid parameters, bacterial agents, treatment modalities and year of treatment were compared between survivors and nonsurvivors. Sixty-two of 81 foals (77% were discharged from the hospital and classified as 'survivors'. Multiple joint involvement and detection of intra-articular Gram-negative, mixed bacterial infection and degenerate neutrophils were negatively associated with short-term survival. Initiation of treatment within 24 hrs of onset of clinical signs and combination of treatment modalities were positively correlated with survival. Further investigation is needed to determine if these two factors have a similar influence on athletic performance.

  11. A Research on Factors Influencing the Clinical Prognosis of Acute Stroke Patie.patients

    Institute of Scientific and Technical Information of China (English)

    Luo Zuming; Li Manli

    2000-01-01

    Object: To search for the factors significantly influencing the clinical prognosis of acute stroke patients. Background: There are lack of prospective multivariate analysis research m acute stroke in the world. Method: We chose 17 factors possibly influencing the prognosis of acute patients, took Barthel′s Index at the end of 2 months after stroke onset and decreased percentage of neurological deficit scores (MESSS) between 72h after hospitalization and 2 months after onset as gold standard, to have a prospective, multivariate analysis research combined with univariate analysis. Results: Multivariate analysis of 106 acute stroke patients combined with univariate analysis showed the factors significantly influencing the clinical prognosis of acute stroke patients were: initial MESSS score、 age、 complication、 mass effect、 stroke location、 time of delay before emergency arrival (BDT). Time of delay after emergency arrival was not found to be a significant prognostic factor. Discussion: Barthel Index at the end of 1 month after stroke onset was strongly related to that at the end of 2 month after onset, as was the same with MESSS score. It showed there was no significant difference between 1 month and 2 months after stroke onset when we choose time interval in evaluating prognosis of acute stroke patients.Conclusion: BDT、 initial MESSS score、 age、 stroke location、 mass effect、 complication were important factors of acute stroke patients. Avoid the delay before emergency arrival after onset, prevent and treat complications after stroke, more carefully treat acute stroke patients with advanced age, advanced age, high initial MESSS scores and those with mass effect reported by CT, we can improve the outcome of stroke patients.

  12. Prostate Cancer; Metabolic Risk Factors, Drug Utilisation, Adverse Drug Reactions

    OpenAIRE

    Grundmark, Birgitta

    2013-01-01

    Increased possibilities during the last decades for early detection of prostate cancer have sparked research on preventable or treatable risk factors and on improvements in therapy. Treatments of the disease still entail significant side effects potentially affecting men during the rest of their lives. The studies of the present thesis concern different aspects of prostate cancer from etiological risk factors and factors influencing treatment to an improved methodology for the detection of tr...

  13. Naprapathic manual therapy and other factors of importance for the prognosis of neck and back ain

    OpenAIRE

    2014-01-01

    Introduction: Neck and back pain common health problems causing economic burden and individual suffering worldwide. Aim: The overall aim of this thesis was to increase understanding of naprapathic manual therapy and other factors of potential importance for the prognosis of back and neck pain. Specific aims: Study I: 1) to assess and compare the sex-specific recovery from spinal pain and psychological distress as single and comorbid conditions, 2) to describe the interrelationships bet...

  14. Contribution of Educational Factors in the Capacity to Overcome Adversity

    Science.gov (United States)

    Palomar, Joaquina; Montes de Oca, Sandra

    2011-01-01

    The objective of this study was to identify factors that predict resilience and social mobility in persons living in extreme poverty in Mexico by analyzing an extensive set of school-related variables. A total of 913 adults were surveyed, with 65.2% women and an average age of 43.71 years. Significant correlations were found between the seven…

  15. Analysis of related factors affecting prognosis of shunt surgery in patients with secondary normal pressure hydrocephalus

    Directory of Open Access Journals (Sweden)

    WANG Cheng

    2013-08-01

    Full Text Available 【Abstract】Objective: The management of se-condary normal pressure hydrocephalus (sNPH is controversial. Many factors may affect the surgery effect. The purpose of this study was to identify the possible fac-tors influencing prognosis and provide theoretical basis for clinical treatment of sNPH. Methods: A retrospective study was carried out to investigate the results of 31 patients with sNPH who under-went ventriculoperitoneal shunt surgery from January 2007 to December 2011. We processed the potential influencing factors by univariate analysis and the result further by mul-tivariate logistic regression analysis. Results: Factors including age, disease duration and Glasgow coma scale (GCS score before surgery significantly influenced the prognosis of sNPH (P<0.05. Further logistic regression analysis showed that all the three factors are independent influencing factors. Conclusion: Age, disease duration and GCS score before surgery have positive predictive value in estimating favorable response to surgical treatment for sNPH. Key words: Hydrocephalus, normal pressure; Ventriculoperitoneal shunt; Regression analysis

  16. Cutaneous adverse events of epidermal growth factor receptor inhibitors: A retrospective review of 99 cases

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    Kumutnart Chanprapaph

    2015-01-01

    Full Text Available Background: Previous reports regarding the cutaneous adverse events of epidermal growth factor receptor inhibitors are mostly limited to small case reports and case series, mainly involving Caucasian patients. Aims: We describe the trends in the clinical presentation of Asian patients who had cutaneous adverse events induced by epidermal growth factor receptor inhibitors and to explore the relationship between skin adverse events and tumor response. Methods: From 2006 to 2010, medical records of Thai patients with non-small cell lung cancer receiving epidermal growth factor receptor inhibitors were retrieved and analyzed. Results: In all, 99 patients were reviewed and analyzed. Erlotinib and gefitinib were commenced in 75 (75.8% and 24 (24.2% patients, respectively. Cutaneous adverse events occurred in 43 (57.3% patients receiving erlotinib and in 15 (62.5% patients receiving gefitinib. The most common adverse event was xerosis (52.5%. Less common adverse events included papulo-pustular eruption (27.3%, erythematous maculopapular rash (11.1%, mucositis (6.7%, paronychia (5.1%, and trichomegaly (2%. Elderly patients had a higher occurrence of xerosis. The presence of cutaneous adverse events was significantly higher in subjects who had a tumor response. Limitations: The limitations of study include its retrospective nature, and the initial screening of cutaneous adverse events was done by non-dermatologists. Conclusions: Cutaneous adverse events due to epidermal growth factor receptor inhibitors are not uncommon in the Asian population. We found a positive correlation between the occurrences of cutaneou adverse events and tumor response supporting the view that they are surrogate markers for therapeutic response.

  17. Prognosis and risk factors for deterioration in patients admitted to a medical emergency department

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Brabrand, Mikkel; Lassen, Annmarie Touborg

    2014-01-01

    OBJECTIVE: Patients that initially appear stable on arrival to the hospital often have less intensive monitoring of their vital signs, possibly leading to excess mortality. The aim was to describe risk factors for deterioration in vital signs and the related prognosis among patients with normal...... rate, Glasgow Coma Scale, oxygen saturation and temperature) were within the normal range at arrival. Deterioration was defined as a deviation from the defined normal range 2-24 hours after arrival. RESULTS: 4292 of the 6257 (68.6%) admitted to the MED had a full set of vital signs at first...

  18. Childhood adverse life events and parental psychopathology as risk factors for bipolar disorder.

    Science.gov (United States)

    Bergink, V; Larsen, J T; Hillegers, M H J; Dahl, S K; Stevens, H; Mortensen, P B; Petersen, L; Munk-Olsen, T

    2016-10-25

    Childhood adverse events are risk factors for later bipolar disorder. We quantified the risks for a later diagnosis of bipolar disorder after exposure to adverse life events in children with and without parental psychopathology. This register-based population cohort study included all persons born in Denmark from 1980 to 1998 (980 554 persons). Adversities before age 15 years were: familial disruption; parental somatic illness; any parental psychopathology; parental labour market exclusion; parental imprisonment; placement in out-of-home care; and parental natural and unnatural death. We calculated risk estimates of each of these eight life events as single exposure and risk estimates for exposure to multiple life events. Main outcome variable was a diagnosis of bipolar disorder after the age of 15 years, analysed with Cox proportional hazard regression. Single exposure to most of the investigated adversities were associated with increased risk for bipolar disorder, exceptions were parental somatic illness and parental natural death. By far the strongest risk factor for bipolar disorder in our study was any mental disorder in the parent (hazard ratio 3.53; 95% confidence interval 2.73-4.53) and the additional effects of life events on bipolar risk were limited. An effect of early adverse life events on bipolar risk later in life was mainly observed in children without parental psychopathology. Our findings do not exclude early-life events as possible risk factors, but challenge the concept of adversities as important independent determinants of bipolar disorder in genetically vulnerable individuals.

  19. The study of risk factors affecting the prognosis of lung abscess

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    Aghajan Zadeh M

    2000-09-01

    Full Text Available In spite the emergence of potent and broad spectrum antibiotics and recent advances in bronchoscopy and pulmonary physiotherapy, still there is a high rate of morbidity and mortality because of lung abscess. The objective of this study is the indication of risk factors, which have undesirable effects on the prognosis of lung abscess. In a retrospective study, all cases of lung abscess who was confined to bed during 1994 to 1999 in Rasht were collected and analyzed. From 52 cases, 40 (77% were male and 12 (23% were female. The mean duration of stay was 20 day (15 to 35. The secondary cause for lung abscess was as follows: 10 cases (19% COPD, 10 cases (19% preumonia, 15 cases (29% bronchiectasia 2 cases lung cancer, 2 cases lung hydatid cyst and 3 cases atelectasia. Extrapulmonary causes of lung abscess were consist of: 10 case (10% aspiration, 10 case (19% esophageal diseases tending to reflux, 5 case (9% periodontal disease. The factors, which had underiable effects on prognosis of disease were lung cancer, anemia, hypoalbuminemia, age over 60, abscess with pseudomonas, abscess cavity greater thus 8 cm, lower lobe in right lung and TB. Because of high mortality and morbidity of lung abscess, due attention for internal drainage, bronchoscopy, physiotherapy and timed surgery are seriously indicated.

  20. Myocardial Infarction in the "Young": Risk Factors, Presentation, Management and Prognosis.

    Science.gov (United States)

    Shah, Nadim; Kelly, Anne-Maree; Cox, Nicholas; Wong, Chiew; Soon, Kean

    2016-10-01

    Myocardial infarction (MI) in the "young" is a significant problem, however there is scarcity of data on premature coronary heart disease (CHD) and MI in the "young". This may lead to under-appreciation of important differences that exist between "young" MI patients versus an older cohort. Traditional differences described in the risk factor profile of younger MI compared to older patients include a higher prevalence of smoking, family history of premature CHD and male gender. Recently, other potentially important differences have been described. Most "young" MI patients will present with non-ST elevation MI but the proportion presenting with ST-elevation MI is increasing. Coronary angiography usually reveals less extensive disease in "young" MI patients, which has implications for management. Short-term prognosis of "young" MI patients is better than for older patients, however contemporary data raises concerns regarding longer-term outcomes, particularly in those with reduced left ventricular systolic function. Here we review the differences in rate, risk factor profile, presentation, management and prognosis between "young" and older MI patients.

  1. FOXP3 Transcription Factor: A Candidate Marker for Susceptibility and Prognosis in Triple Negative Breast Cancer

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    Leandra Fiori Lopes

    2014-01-01

    Full Text Available Triple negative breast cancer (TNBC is a relevant subgroup of neoplasia which presents negative phenotype of estrogen and progesterone receptors and has no overexpression of the human epidermal growth factor 2 (HER2. FOXP3 (forkhead transcription factor 3 is a marker of regulatory T cells (Tregs, whose expression may be increased in tumor cells. This study aimed to investigate a polymorphism (rs3761548 and the protein expression of FOXP3 for a possible involvement in TNBC susceptibility and prognosis. Genetic polymorphism was evaluated in 50 patients and in 115 controls by allele-specific PCR (polymerase chain reaction. Protein expression was evaluated in 38 patients by immunohistochemistry. It was observed a positive association for homozygous AA (OR = 3.78; 95% CI = 1.02–14.06 in relation to TNBC susceptibility. Most of the patients (83% showed a strong staining for FOXP3 protein in the tumor cells. In relation to FOXP3-positive infiltrate, 47% and 58% of patients had a moderate or intense intratumoral and peritumoral mononuclear infiltrate cells, respectively. Tumor size was positively correlated to intratumoral FOXP3-positive infiltrate (P=0.026. In conclusion, since FOXP3 was positively associated with TNBC susceptibility and prognosis, it seems to be a promising candidate for further investigation in larger TNBC samples.

  2. Brain-derived neurotrophic factor Val66Met polymorphism and early life adversity affect hippocampal volume.

    Science.gov (United States)

    Carballedo, Angela; Morris, Derek; Zill, Peter; Fahey, Ciara; Reinhold, Elena; Meisenzahl, Eva; Bondy, Brigitta; Gill, Michael; Möller, Hans-Jürgen; Frodl, Thomas

    2013-03-01

    The interaction between adverse life events during childhood and genetic factors is associated with a higher risk to develop major depressive disorder (MDD). One of the polymorphisms found to be associated with MDD is the Val66MET polymorphism of brain-derived neurotrophic factor (BDNF). The aim of our two-center study was to determine how the BDNF Val66Met polymorphism and childhood adversity affect the volumetric measures of the hippocampus in healthy individuals and people with MDD. In this two-center study, 62 adult patients with MDD and 71 healthy matched controls underwent high-resolution magnetic resonance imaging. We used manual tracing of the bilateral hippocampal structure with help of the software BRAINS2, assessed childhood adversity using the Childhood Trauma Questionnaire and genotyped Val66Met BDNF SNP (rs6265). MDD patients had smaller hippocampal volumes, both in the left and right hemispheres (F = 5.4, P = 0.022). We also found a significant interaction between BDNF allele and history of childhood adversity (F = 6.1, P = 0.015): Met allele carriers in our samples showed significantly smaller hippocampal volumes when they did have a history of childhood adversity, both in patients and controls. Our results highlight how relevant stress-gene interactions are for hippocampal volume reductions. Subjects exposed to early life adversity developed smaller hippocampal volumes when they carry the Met-allele of the BDNF polymorphism.

  3. Growth Factor Receptors and Apoptosis Regulators: Signaling Pathways, Prognosis, Chemosensitivity and Treatment Outcomes of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Siddik Sarkar

    2009-01-01

    Full Text Available Biomarkers of breast cancer are necessary for prognosis and prediction to chemotherapy. Prognostic biomarkers provide information regarding outcome irrespective of therapy, while predictive biomarkers provide information regarding response to therapy. Candidate prognostic biomarkers for breast cancers are growth factor receptors, steroid receptors, Ki-67, cyclins, urokinase plasminogen activator, p53, p21, pro- and anti-apoptotic factors, BRCA1 and BRCA2. But currently, the predictive markers are Estrogen and Progesterone receptors responding to endocrine therapy, and HER-2 responding to herceptin. But there are numerous breast cancer cases, where tamoxifen is ineffective even after estrogen receptor positivity. This lead to search of new prognostic and predictive markers and the number of potential markers is constantly increasing due to proteomics and genomics studies. However, most biomarkers individually have poor sensitivity or specificity, or other clinical value. It can be resolved by studying various biomarkers simultaneously, which will help in better prognosis and increasing sensitivity for chemotherapeutic agents. This review is focusing on growth factor receptors, apoptosis markers, signaling cascades, and their correlation with other associated biomarkers in breast cancers. As our knowledge regarding molecular biomarkers for breast cancer increases, prognostic indices will be developed that combine the predictive power of individual molecular biomarkers with specific clinical and pathologic factors. Rigorous comparison of these existing as well as emerging markers with current treatment selection is likely to see an escalation in an era of personalized medicines to ensure the breast cancer patients receive optimal treatment. This will also solve the treatment modalities and complications related to chemotherapeutic regimens.

  4. Impact of reversionary and other etiological factors on prognosis and course of schizophrenia

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    Ifeta Ličanin

    2010-08-01

    Full Text Available Aim To identify the presence of schizophrenia among patients andtheir relatives, factors affecting duration and prognosis of the disease and other etiological factors related to schizophrenia.Methods This retrospective, descriptive, analytical and epidemiological research, which was conducted at the Psychiatric hospital of the Clinical Center of the University of Sarajevo during 2007, covered randomly selected 100 hospitalized patients with schizophrenia according to diagnostic criteria of the Diagnostic andStatistical Manual of Mental Disorders (DSM-IV. Diagnosis of schizophrenia among relatives was based on anamnesis- Structural Clinical Interview (SCID and it was applied to confirm DSM-IV diagnosis of schizophrenia. Results The presence of schizophrenia among patient relatives was the most important in etiology of schizophrenia (62%, and etiological factors were represented in 38 % of examinees (p=0,0001. Among relatives of examinees aged 20 – 30 years, schizophrenia was present in 37 (59.7% cases. Schizophrenia among relatives caused earlier appearance of the disease. Duration of hospitalization of over 60 days was in the group of examinees which have the relatives with schizophrenia, 18 (29.0%; multiple hospitalizations were noted in the group of relatives in 40 (64.5% cases; in one case (8.3% traumatic experience was noted, in three (42.8% acute stress, and in four 4 cases (28.6% non-adequate living conditions. Conclusions The results of this study show that reversionary factors are responsible for inducing schizophrenia, which leads towards chronic course of the disease and worsened prognosis.

  5. Circulating Angiogenic Factors and the Risk of Adverse Outcomes among Haitian Women with Preeclampsia.

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    Melissa I March

    Full Text Available Angiogenic factors are strongly associated with adverse maternal and fetal outcomes among women with preterm preeclampsia (PE in developed countries. We evaluated the role of angiogenic factors and their relationship to adverse outcomes among Haitian women with PE.We measured plasma antiangiogenic soluble fms-like tyrosine kinase 1 (sFlt1 and proangiogenic placental growth factor (PlGF levels in women with PE (n=35 compared to controls with no hypertensive disorders (NHD (n=43 among subjects with singleton pregnancies that delivered at Hospital Albert Schweitzer (HAS in Haiti. We divided the preeclamptic women into two groups, early onset (≤ 34 weeks and late onset (>34 weeks and examined relationships between sFlt1/PlGF ratios on admission and adverse outcomes (abruption, respiratory complications, stroke, renal insufficiency, eclampsia, maternal death, birth weight 34 weeks with no adverse outcome.PE-related adverse outcomes are common in women in Haiti and are associated with profound angiogenic imbalance regardless of gestational age at presentation.

  6. Fibroblast growth factor receptor 4 promotes progression and correlates to poor prognosis in cholangiocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Yun-Fei [Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University (China); Yang, Xiao-Qing [Department of Pathology, Shandong University (China); Lu, Xiao-Fei [Department of Gastrointestinal Surgery, Jinan Central Hospital (China); Guo, Sen; Liu, Yi; Iqbal, Mohammad; Ning, Shang-Lei; Yang, Hui [Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University (China); Suo, Ning [Department of Anatomy, Shandong University (China); Chen, Yu-Xin, E-mail: yxu8@bidmc.harvard.edu [Department of Hepatobiliary Surgery, Qilu Hospital of Shandong University (China)

    2014-03-28

    Highlights: • FGFR4 is significantly related with N stage in IHCC, with T stage and TNM stage in PHCC. • FGFR4 is an independent prognostic factor in IHCC and PHCC. • FGFR4 promotes proliferation, invasion and EMT in cholangiocarinoma cell lines. • Inhibitor AP24354 can decrease proliferation, invasion and induce apoptosis of CCA. - Abstract: Fibroblast growth factor receptor 4 (FGFR4) is related to poor prognosis of several cancers, but the correlation between FGFR4 expression and cholangiocarcinoma (CCA) has not been well elucidated. We investigated the expression of FGFR4 in 83 intrahepatic cholangiocarcinomas (IHCCs), 75 perihilar cholangiocarcinomas (PHCCs) and 41 distal cholangiocarcinomas (DCCs) by immunohistochemistry (IHC), and subsequently evaluated association of FGFR4 with clinicopathologic parameters and survival rate. The rate of FGFR4 higher expression was 61.4% (51/83) in IHCCs, 53.3% (40/75) in PHCCs and 56.1% (23/41) in DCCs. FGFR4 expression was significantly related to poor prognosis of IHCC (P = 0.002) and PHCC (P = 0.019) with univariate analysis, and also identified as an independent prognostic factor in IHCC (P = 0.045) and PHCC (P = 0.049) with multivariate analysis. Additionally, with functional assays in vitro, we found FGFR4 can induce proliferation, invasion and epithelial–mesenchymal transition (EMT) of CCA cell lines with FGF19 stimulation. Moreover, FGFR4 inhibitor AP24354 can suppress proliferation, invasion and induce apoptosis of CCA cells. In conclusion, FGFR4 expression can be identified as a significant independent prognostic biomarker of IHCC and PHCC. FGFR4 played a pivotal role in proliferation, invasion and EMT of CCA. FGFR4 inhibitor can suppress proliferation, invasion and induce apoptosis of CCA, indicating that FGFR4 may act as a potential therapeutic target.

  7. Epidermal Growth Factor Receptor Inhibitors: A Review of Cutaneous Adverse Events and Management

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    K. Chanprapaph

    2014-01-01

    Full Text Available Epidermal growth factor inhibitors (EGFRI, the first targeted cancer therapy, are currently an essential treatment for many advance-stage epithelial cancers. These agents have the superior ability to target cancers cells and better safety profile compared to conventional chemotherapies. However, cutaneous adverse events are common due to the interference of epidermal growth factor receptor (EGFR signaling in the skin. Cutaneous toxicities lead to poor compliance, drug cessation, and psychosocial discomfort. This paper summarizes the current knowledge concerning the presentation and management of skin toxicity from EGFRI. The common dermatologic adverse events are papulopustules and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis, and postinflammatory hyperpigmentation. Radiation enhances EGFRI rash due to synergistic toxicity. There is a positive correlation between the occurrence and severity of cutaneous adverse effects and tumor response. To date, prophylactic systemic tetracycline and tetracycline class antibiotics have proven to be the most effective treatment regime.

  8. Resilience and Stuttering: Factors that Protect People from the Adversity of Chronic Stuttering

    Science.gov (United States)

    Craig, Ashley; Blumgart, Elaine; Tran, Yvonne

    2011-01-01

    Purpose: Chronic disorder can impose a significant negative mental health burden. This research was conducted to explore factors that may protect people from the adversity of chronic stuttering. Method: The study employed a population group cohort design. Participants included 200 adults who have stuttered since childhood, and the sample was…

  9. Adverse drug reactions in internal medicine units and associated risk factors

    OpenAIRE

    Sánchez Muñoz-Torrero, Juan Francisco; Barquilla, Paloma; Velasco, Raul; Fernández Capitan, Maria Del Carmen; Pacheco, Nazaret; Vicente, Lucia; Chicón, Jose Luis; Trejo, Sara; Zamorano, Jose; Lorenzo Hernandez, Alicia

    2010-01-01

    Abstract Objectives This study was designed to assess the prevalence of adverse drug reactions (ADRs) in the internal medicine wards of two teaching Hospitals, identify the most common ADRs, the principal medications involved, and determine the risk factors implicated in the occurrence of such ADRs. Methods All admissions over 10 weeks were followed prospectively using an intensive drug surveillance method...

  10. Perceived Adverse Drug Events in Heart Failure Patients' Perception and Related Factors

    NARCIS (Netherlands)

    De Smedt, Ruth H. E.; Haaijer-Ruskamp, Flora M.; Groenier, Klaas H.; van der Meer, Klaas; Jaarsma, Tiny

    2011-01-01

    Background: Patients with heart failure (HF) often perceive adverse drug events (ADEs), affecting quality of life. For weighing the benefits and burden of medication in HF care, knowledge on patients' perception of ADEs is needed. Our aim was to assess these ADE perceptions and to identify factors r

  11. Causal Factors Influencing Adversity Quotient of Twelfth Grade and Third-Year Vocational Students

    Science.gov (United States)

    Pangma, Rachapoom; Tayraukham, Sombat; Nuangchalerm, Prasart

    2009-01-01

    Problem statement: The aim of this research was to study the causal factors influencing students' adversity between twelfth grade and third-year vocational students in Sisaket province, Thailand. Six hundred and seventy two of twelfth grade and 376 third-year vocational students were selected by multi-stage random sampling techniques. Approach:…

  12. Presence of a high-grade component in gastric mucosa-associated lymphoid tissue (MALT) lymphoma is not associated with an adverse prognosis.

    Science.gov (United States)

    Ang, Mei-Kim; Hee, Siew Wan; Quek, Richard; Yap, Swee Peng; Loong, Susan; Tan, Leonard; Tao, Miriam; Lim, Soon Thye

    2009-05-01

    Gastric mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B cell lymphoma (DLBCL) show a spectrum of disease characterized by varying proportions of low-grade and high-grade components. While the natural history and optimum treatment for low-grade gastric MALT lymphoma and DLBCL is well established, the prognosis and optimal treatment of patients with both low- and high-grade components is not well established. The purpose of our study was to evaluate the clinical characteristics, survival outcomes, and prognostic factors of patients with gastric MALT lymphoma and gastric DLBCL. A retrospective review of patients with gastric MALT lymphoma, gastric DLBCL, or MALT lymphoma with a high-grade component treated at our centers from 1994 to 2006 was performed. Patients were divided into three categories: "pure MALT lymphoma," "MALT lymphoma with high-grade component" (mixed), and "pure DLBCL." Seventy-six patients were included in our study-26 with pure MALT, 22 with MALT with high-grade component ("mixed"), and 28 with pure DLBCL. Pure MALT lymphoma and mixed lymphoma patients had similar clinical characteristics, whereas pure DLBCL patients had less favorable disease characteristics with significantly poorer performance status, higher number of extranodal sites of disease, higher stage, and larger proportion of bone marrow involvement and international prognostic index (IPI) scores compared with mixed lymphoma. The majority of mixed lymphoma (72.7%) and DLBCL patients (71.4%) were treated with chemotherapy. Of patients receiving chemotherapy, a higher proportion of mixed lymphoma and DLBCL patients received anthracycline-based combination chemotherapy regimens compared with MALT lymphoma (73% vs 71% vs 8%) whereas the proportion of mixed lymphoma and DLBCL patients was similar (p = 0.919). At a median follow-up of 37 months, the 5-year overall survival was 66.9%. The 5-year overall survival was 78% for MALT lymphoma, 84% for mixed lymphoma, and 45

  13. RISK FACTORS AND PROGNOSIS OF EPILEPSY IN CHILDREN WITH HEMIPARETIC CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Parvaneh KARIMZADEH

    2010-12-01

    Full Text Available ObjectiveEpilepsy is reported in 15-90% of the children with Cerebral Palsy (CP but its clinical course is not well defined.We conducted a retrospective study on children with hemiparetic CP who were referred to Pediatric Neurology Department of Mofid Hospital. The aim of our study was to evaluate the risk factors and prognosis of epilepsy in children with hemiparetic CP.Materials & MethodsWe evaluated 64 children with hemiparetic CP who were referred to Pediatric Neurology Department of Mofid Hospital between 2006 and 2008.According to our protocol, patients were divided into two groups: 34 children in the case group (hemiparetic patients with epilepsy and 30 children in the control group (hemiparetic patients without epilepsy.ResultsPrenatal, perinatal and postnatal events, maternal age at the time of delivery, socioeconomic status of the family, familial history of epilepsy, neuroimaging findings, side of the hemiparesia and age at diagnosis of hemiparesis were not considered as risk factors for epilepsy in hemiparetic children, but microcephaly, severity of hemiparetic CP and mental retardation were significantly associated with an increased risk of epilepsy in children with hemiparetic CP.ConclusionOur study showed that microcephaly, severity of hemiparesis and mental retardation were risk factors for developing epilepsy in children with hemiparetic CP; furthermore, they had negative effects on rehabilitation outcome in these patients.Keyword:Hemiparetic Cerebral Palsy, Epilepsy, Children, Microcephaly, Mental Retardation

  14. RISK FACTORS AND PROGNOSIS OF EPILEPSY IN CHILDREN WITH HEMIPARETIC CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    Seyyed Hassan TONEKABONI

    2010-11-01

    Full Text Available AbstractObjectiveEpilepsy is reported in 15-90% of the children with Cerebral Palsy (CP but its clinical course is not well defined.We conducted a retrospective study on children with hemiparetic CP who were referred to Pediatric Neurology Department of Mofid Hospital. The aim of our study was to evaluate the risk factors and prognosis of epilepsy in children with hemiparetic CP.Materials & MethodsWe evaluated 64 children with hemiparetic CP who were referred to Pediatric Neurology Department of Mofid Hospital between 2006 and 2008.According to our protocol, patients were divided into two groups: 34 children in the case group (hemiparetic patients with epilepsy and 30 children in the control group (hemiparetic patients without epilepsy.ResultsPrenatal, perinatal and postnatal events, maternal age at the time of delivery, socioeconomic status of the family, familial history of epilepsy, neuroimaging findings, side of the hemiparesia and age at diagnosis of hemiparesis were not considered as risk factors for epilepsy in hemiparetic children, but microcephaly, severity of hemiparetic CP and mental retardation were significantly associated with an increased risk of epilepsy in children with hemiparetic CP.ConclusionOur study showed that microcephaly, severity of hemiparesis and mental retardation were risk factors for developing epilepsy in children with hemiparetic CP; furthermore, they had negative effects on rehabilitation outcome in these patients.

  15. Lung cancer associated hypercalcemia: An analysis of factors influencing survival and prognosis in 34 cases

    Directory of Open Access Journals (Sweden)

    Su-jie ZHANG

    2012-06-01

    Full Text Available Objectives  To explore the factors influencing survival time in lung cancer associated hypercalcemia patients. Methods  Thirty-four patients with pathologically confirmed lung cancer complicated with hypercalcemia, who were treated at the Department of Oncology in General Hospital of PLA from Jan. 2001 to Dec. 2010, were enrolled in this study. The clinical data analyzed included sex, age, pathological type of the malignancies, organ metastasis (bone, lung, liver, kidney, brain, number of distal metastatic site, mental status, interval between final diagnosis of lung cancer and of hypercalcemia, peak value of blood calcium during the disease course, treatment methods and so on. Survival analysis was performed with the Kaplan-Meier method and Cox analysis with statistic software SPSS 18.0 to identify the potential prognostic factors. Results  The highest blood calcium level ranged from 2.77 to 4.87mmol/L, and the median value was 2.94mmol/L. The patients' survival time after diagnosis of hypercalcemia varied from 1 day to 1067 days, and the median survival time was 92 days. With the log-rank test, age above 50 years old, hypercalcemia occurring over 90 days after diagnosis of cancer, central nervous system symptoms and renal metastasis were predictors for poor survival (P=0.048, P=0.001, P=0.000, P=0.003. In the COX proportional hazard model analysis, age above 50 years old, hypercalcemia occurring over 90 days after cancer diagnosis, central nervous system symptoms and renal metastasis were significant prognostic factors for poor survival (HR=11.483, P=0.006; HR=4.371, P=0.002; HR=6.064, P=0.026; HR=8.502, P=0.011. Conclusions  Patients with lung cancer associated hypercalcemia have a shorter survival time and poor prognosis. Age above 50 years old, hypercalcemia occurring over 90 days after cancer diagnosis, central nervous system symptoms and renal metastasis are significant factors of poor prognosis.

  16. Childhood adverse life events and parental psychopathology as risk factors for bipolar disorder

    DEFF Research Database (Denmark)

    Bergink, Veerle; Tidselbak Larsen, Janne; Hillegers, M H J

    2016-01-01

    Childhood adverse events are risk factors for later bipolar disorder. We quantified the risks for a later diagnosis of bipolar disorder after exposure to adverse life events in children with and without parental psychopathology. This register-based population cohort study included all persons born...... in Denmark from 1980 to 1998 (980 554 persons). Adversities before age 15 years were: familial disruption; parental somatic illness; any parental psychopathology; parental labour market exclusion; parental imprisonment; placement in out-of-home care; and parental natural and unnatural death. We calculated...... risk estimates of each of these eight life events as single exposure and risk estimates for exposure to multiple life events. Main outcome variable was a diagnosis of bipolar disorder after the age of 15 years, analysed with Cox proportional hazard regression. Single exposure to most...

  17. Adverse events of anti-tumor necrosis factor α therapy in ankylosing spondylitis.

    Directory of Open Access Journals (Sweden)

    Qiang Tong

    Full Text Available This study aims to investigate the prevalence of short-term and long-term adverse events associated with tumor necrosis factor-α (TNF-α blocker treatment in Chinese Han patients suffering from ankylosing spondylitis (AS.The study included 402 Chinese Han AS patients treated with TNF-α blockers. Baseline data was collected. All patients were monitored for adverse events 2 hours following administration. Long-term treatment was evaluated at 8, 12, 52 and 104 weeks follow-up for 172 patients treated with TNF-α blockers.Short-term adverse events occurred in 20.15% (81/402, including rash (3.5%; 14/402, pruritus (1.2%; 5/402, nausea (2.2%; 9/402, headache (0.7%; 3/402, skin allergies (4.0%; 16/402, fever (0.5%; 2/402, palpitations (3.0%; 12/402, dyspnea (0.5%; 2/402, chest pain (0.2%; 1/402, [corrected] abdominal pain (1.0%; 4/402, hypertension (2.2%; 9/402, papilledema (0.5%; 2/402, laryngeal edema (0.2%; 1/402 and premature ventricular contraction (0.2%; 1/402. Long-term adverse events occurred in 59 (34.3%; 59/172 patients, including pneumonia (7.6%; 13/172, urinary tract infections (9.9%; 17/172, otitis media (4.7%; 8/172, tuberculosis are (3.5%; 6/172 [corrected], abscess (1.2%; 2/172, oral candidiasis (0.6%; 1/172, elevation of transaminase (1.7%; 3/172, anemia (1.2%; 2/172, hematuresis (0.6%; 1/172, constipation (2.3%; 4/172, weight loss (0.6%; 1/172, exfoliative dermatitis (0.6%; 1/172. CRP, ESR and disease duration were found to be associated with an increased risk of immediate and long-term adverse events (P<0.05. Long-term treatment with Infliximab was associated with more adverse events than rhTNFR-Fc (P<0.01.This study reports on the prevalence of adverse events in short-term and long-term treatment with TNF-α blocker monotherapy in Chinese Han AS patients. Duration of disease, erythrocyte sedimentation rate, and c-reactive protein serum levels were found to be associated with increased adverse events with anti-TNF-α therapy. Long

  18. Adverse Childhood Experiences and Adult Risk Factors for Age-Related Disease

    Science.gov (United States)

    Danese, Andrea; Moffitt, Terrie E.; Harrington, HonaLee; Milne, Barry J.; Polanczyk, Guilherme; Pariante, Carmine M.; Poulton, Richie; Caspi, Avshalom

    2013-01-01

    Objective To understand why children exposed to adverse psychosocial experiences are at elevated risk for age-related disease, such as cardiovascular disease, by testing whether adverse childhood experiences predict enduring abnormalities in stress-sensitive biological systems, namely, the nervous, immune, and endocrine/metabolic systems. Design A 32-year prospective longitudinal study of a representative birth cohort. Setting New Zealand. Participants A total of 1037 members of the Dunedin Multidisciplinary Health and Development Study. Main Exposures During their first decade of life, study members were assessed for exposure to 3 adverse psychosocial experiences: socioeconomic disadvantage, maltreatment, and social isolation. Main Outcome Measures At age 32 years, study members were assessed for the presence of 3 age-related-disease risks: major depression, high inflammation levels (high-sensitivity C-reactive protein level >3 mg/L), and the clustering of metabolic risk biomarkers (overweight, high blood pressure, high total cholesterol, low high-density lipoprotein cholesterol, high glycated hemoglobin, and low maximum oxygen consumption levels. Results Children exposed to adverse psychosocial experiences were at elevated risk of depression, high inflammation levels, and clustering of metabolic risk markers. Children who had experienced socioeconomic disadvantage (incidence rate ratio, 1.89; 95% confidence interval, 1.36–2.62), maltreatment (1.81; 1.38–2.38), or social isolation (1.87; 1.38–2.51) had elevated age-related-disease risks in adulthood. The effects of adverse childhood experiences on age-related-disease risks in adulthood were nonredundant, cumulative, and independent of the influence of established developmental and concurrent risk factors. Conclusions Children exposed to adverse psychosocial experiences have enduring emotional, immune, and metabolic abnormalities that contribute to explaining their elevated risk for age-related disease. The

  19. Risk factors for recurrence and prognosis of low-grade endometrial adenocarcinoma; vaginal versus other sites.

    Science.gov (United States)

    Moschiano, Elizabeth J; Barbuto, Denise A; Walsh, Christine; Singh, Kanwaljit; Euscher, Elizabeth D; Roma, Andres A; Ali-Fehmi, Rouba; Frauenhoffer, Elizabeth E; Montiel, Delia P; Kim, Insun; Djordjevic, Bojana; Malpica, Anais; Hong, Sung Ran; Silva, Elvio G

    2014-05-01

    Endometrial adenocarcinoma is the most common gynecologic cancer in the United States. The prognosis is generally favorable, however, a significant number of patients do develop local or distant recurrence. The most common site of recurrence is vaginal. Our aim was to better characterize patients with vaginal recurrence of low-grade endometrioid adenocarcinoma with respect to associated tumor parameters and clinical outcome. We compiled 255 cases of low-grade (FIGO Grade I or II) endometrioid adenocarcinoma on hysterectomy specimens with lymph node dissection. A total of 113 cases with positive lymph nodes or recurrent disease were included in our study group. Seventy-three cases (13 Grade 1, 60 Grade 2) developed extravaginal recurrence and 40 cases (7 Grade 1, 33 Grade 2) developed vaginal recurrence. We evaluated numerous tumor parameters including: percentage myoinvasion, presence of microcystic, elongated, and fragmented pattern of myoinvasion, lymphovascular space invasion, and cervical involvement. Clinical follow-up showed that 30% (34/113) of all patients with recurrent disease died as a result of their disease during our follow-up period, including 31 (42.5%) with extravaginal recurrence and 3 (7.5%) with primary vaginal recurrence (P=0.001). The 3 patients with vaginal recurrence developed subsequent extravaginal recurrence before death. Vaginal recurrence patients show increased cervical involvement by tumor, but lack other risk factors associated with recurrent disease at other sites. There were no deaths among patients with isolated vaginal recurrence, suggesting that vaginal recurrence is not a marker of aggressive tumor biology.

  20. Characterization and prognosis factors of cerebro-vascular disease in Cienfuegos province.

    Directory of Open Access Journals (Sweden)

    Rubén Bembibre Taboada

    2004-08-01

    Full Text Available Fundaments: Cerebrovascular disease constitutes the third cause of death and the first cause of severe discapacity in adults in those countries that have a developed health system like ours. Objective: To characterise the patients with cerebrovascular disease and to determine the variables that influence upon their prognosis once it is established. Method: Prospective, descriptive, longitudinal study of a series of cases developed at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Questionnaires were applied to the patients that fitted the inclusion criteria (n 1318 Results: The mean age was 66,08 years with a predominance of white patients ( 75,26 %, mainly males ( 56,67%. The risk factor of highest frequency was hypertension ( 43,24 % The evolution for alive patients without discapacities was 14,71%, alive with discapacities ( 57,96% and death 27,31%. There was a predominance of ischemic cerebrovascular disease (46,13 % of aterothrombotic infarcts and 14,94 % cardioembolic disease. In regards to hemorrhagic disease 13,42 % were intracerebral hemorrhage and 4,55% subarachnoid hemorrhage. There was a prognostic correlation between the clinical variables: consciousness, sight, sensibility, language, tone, Babinski , osteotendious reflexes and muscular force. For the general variables cerebral edema, bacterial bronchopneumonia , displacement of the medial line, diagnosis is some values, CT scan diagnoses in some values for diabetes mellitus and convulsions.

  1. Adverse drug reactions to CT contrast media in south Korea: Incidence and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyung Soo; Jeon, Kyung Nyeo; Moon, Jin Il; Choi, Bo Hwa; Baek, Hye Jin; Cho, Soo Buem [Dept. of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon (Korea, Republic of); Lee, Sang Min; Ha, Ji Young; Choi, Dae Seob; Cho, Jae Min; Na, Jae Beom [Dept. of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of)

    2016-07-15

    To evaluate the incidence, severity, and risk factors of adverse drug reactions (ADR) to intravenous administration of nonionic iodinated contrast media in computed tomography (CT), and to determine the recurrence rate after premedication in patients with a previous history of ADR. We prospectively recorded all ADR to intravenous CT contrast media in 32313 consecutive outpatients (54572 cases) who underwent contrast enhanced CT examinations. Clinical report forms and electronic medical records were reviewed to search for the incidence of ADR, treatment, and clinical outcome of patients. The risk factors of ADR to CT contrast media (age, sex, history of previous ADR, season) were evaluated using statistical analysis. Of the 54572 cases, a total of 191 (0.35%) had adverse reactions. Of the 191 cases, 157 (82%) were categorized as mild reactions, 29 (15%) were moderate, and 5 (3%) were severe. A total of 165 (86.4%) cases had acute adverse reactions (which occurred within 1 hour after administration), while 26 (13.6%) had delayed adverse reactions (occurred 1 hour after the administration). The rate of ADR was significantly higher in females [relative risk (RR) = 2.05, 95% confidence interval (CI) 1.53-2.75], patients under the age of 60 years (RR = 1.45, 95% CI 1.07-1.98), patients with a history of previous ADR (RR = 6.51, 95% CI 3.13-13.57), and in the spring season (RR = 1.44, 95% CI 1.07-1.95). The recurrence rate after premedication in patients with previous ADR to CT contrast media was 3.2% (8/247). No deaths occurred that were attributed to the contrast media. The incidence of ADR to nonionic CT contrast media was 0.35%; most of which were mild reactions. Risk factors for ADR included female gender, an age of under 60 years, a history of previous ADR, and spring season.

  2. Prognosis factors and characteristics of tumor recurrences in adults treated for a medulloblastoma; Facteurs pronostiques et caracteristiques des rechutes tumorales chez des adultes traites pour un medulloblastome

    Energy Technology Data Exchange (ETDEWEB)

    Chargari, C.; Feuvret, L.; Levy, A.; Lamproglou, I.; Assouline, A.; Lopez, S.; Lang, P.; Simon, J.M.; Mazeron, J.J. [Hopital Pitie-Salpetriere, 75 - Paris (France); Vedrine, L. [Hopital Val-de-Grace, 75 - Paris (France)

    2009-10-15

    The quality of resection is a major prognosis factor. The systematic postoperative MRI allows a precise selection of patients with standard risk medulloblastomas for which the only radiotherapy allows an excellent local control. The radiotherapy stopping and the delay are prognosis factors of neurology recurrence. (N.C.)

  3. Incidence, risk factors, treatment and prognosis of popliteal artery embolization in the superficial femoral artery interventions.

    Directory of Open Access Journals (Sweden)

    Weiwei Wu

    Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb

  4. Expression of transforming growth factors in hepatocellular carcinoma and its relations with clinicopathological parameters and prognosis

    Institute of Scientific and Technical Information of China (English)

    Yun Lu; Li-Qun Wu; Chang-Sheng Li; Shou-Guang Wang; Bing Han

    2008-01-01

    BACKGROUND:Transforming growth factors (TGF)-β1, TGF-βR2 and Smad4 belong to the TGF family, and play important roles in carcinogenesis and the development of carcinoma, especially hepatocellular carcinoma (HCC). TGF-β1 is a multipotent polypeptide, which inhibits the growth of epithelial cells including hepatoma cell lines and hepatocytes by inducing apoptosis. TGF-βR2 forms a heterodimeric complex upon binding to TGF-β, and then generates the ifrst step in the signal transduction pathway leading to growth inhibition in coordination with the type 1 receptor. Smad4 protein is an important mediator in the TGF-β signaling pathway, and negatively regulates the growth of epithelial cells. This study aimed to detect the expression of TGF-β1, TGF-βR2 and Smad4 in HCCs and their adjacent normal tissues, while assessing its relations with the clinicopathological parameters of HCC. METHODS:Forty-seven HCC specimens and their adjacent normal tissues were obtained surgically at the Afifliated Hospital of Medical College, Qingdao University. The expression of TGF-β1, TGF-βR2 and Smad4 was separately detected by immunohistochemistry in all HCC specimens and their adjacent normal tissues, and its relations with the clinicopathological parameters of HCC were assessed. RESULTS:The positive expression of TGF-β1 was 72.34%in the HCC specimens, which was higher than that in the adjacent normal tissues (P CONCLUSIONS:TGF-β1 may play an important role in the occurrence and development of HCC. Combined detection of TGF-β1, TGF-βR2 and Smad4 may be useful for the determination of the degree of malignancy and the prognosis of HCC.

  5. Prognosis and risk factors for deterioration in patients admitted to a medical emergency department.

    Directory of Open Access Journals (Sweden)

    Daniel Pilsgaard Henriksen

    Full Text Available OBJECTIVE: Patients that initially appear stable on arrival to the hospital often have less intensive monitoring of their vital signs, possibly leading to excess mortality. The aim was to describe risk factors for deterioration in vital signs and the related prognosis among patients with normal vital signs at arrival to a medical emergency department (MED. DESIGN AND SETTING: Single-centre, retrospective cohort study of all patients admitted to the MED from September 2010-August 2011. SUBJECTS: Patients were included when their vital signs (systolic blood pressure, pulse rate, respiratory rate, Glasgow Coma Scale, oxygen saturation and temperature were within the normal range at arrival. Deterioration was defined as a deviation from the defined normal range 2-24 hours after arrival. RESULTS: 4292 of the 6257 (68.6% admitted to the MED had a full set of vital signs at first presentation, 1440/4292 (33.6% had all normal vital signs and were included in study, 44.0% were male, median age 64 years (5th/95th percentile: 21-90 years and 446/1440 (31.0% deteriorated within 24 hours. Independent risk factors for deterioration included age 65-84 years odds ratio (OR: 1.79 (95% confidence interval [CI]: 1.27-2.52, 85+ years OR 1.67 (95% CI: 1.10-2.55, Do-not-attempt-to-resuscitate order OR 3.76 (95% CI: 1.37-10.31 and admission from the open general ED OR 1.35 (95% CI: 1.07-1.71. Thirty-day mortality was 7.9% (95% CI: 5.5-10.7% among deteriorating patients and 1.9% (95% CI: 1.2-3.0% among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10. CONCLUSIONS: Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open general ED. Thirty-day mortality among patients with deterioration was four times higher than among non-deteriorating patients. Further research is needed to determine whether

  6. Is overweight a risk factor for adverse events during removal of impacted lower third molars?

    Science.gov (United States)

    de Carvalho, Ricardo Wathson Feitosa; do Egito Vasconcelos, Belmiro Cavalcanti

    2014-01-01

    Being overweight is recognised as a significant risk factor for several morbidities; however, the experience of the dentistry faculties focusing on this population is still low. The aim of the present study was to determine the occurrence of adverse events during removal of impacted lower third molars in overweight patients. A prospective cohort study was carried out involving overweight patients subjected to surgical removal of impacted lower third molar as part of a line of research on third molar surgery. Predictor variables indicative of the occurrence of adverse events during surgery were classified by their demographic, clinical, radiographic, and surgical aspects. Descriptive and bivariate statistics were computed. In total, 140 patients fulfilled the eligibility criteria, and 280 surgeries were performed. Patients' mean age was 25.1±2.2 years, and the proportion of women to men was 3:1. Eight different adverse events during surgery were recorded. These events occurred in approximately 29.3% of cases and were significantly associated with predictor variables (Pimpacted third molar surgery. The study suggests that overweight patients are highly likely to experience morbidities.

  7. Causal Factors and Adverse Conditions of Aviation Accidents and Incidents Related to Integrated Resilient Aircraft Control

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Sandifer, Carl E.; Jones, Sharon Monica

    2010-01-01

    The causal factors of accidents from the National Transportation Safety Board (NTSB) database and incidents from the Federal Aviation Administration (FAA) database associated with loss of control (LOC) were examined for four types of operations (i.e., Federal Aviation Regulation Part 121, Part 135 Scheduled, Part 135 Nonscheduled, and Part 91) for the years 1988 to 2004. In-flight LOC is a serious aviation problem. Well over half of the LOC accidents included at least one fatality (80 percent in Part 121), and roughly half of all aviation fatalities in the studied time period occurred in conjunction with LOC. An adverse events table was updated to provide focus to the technology validation strategy of the Integrated Resilient Aircraft Control (IRAC) Project. The table contains three types of adverse conditions: failure, damage, and upset. Thirteen different adverse condition subtypes were gleaned from the Aviation Safety Reporting System (ASRS), the FAA Accident and Incident database, and the NTSB database. The severity and frequency of the damage conditions, initial test conditions, and milestones references are also provided.

  8. Transarterial Chemoembolization for Hepatocellular Carcinomas with Central Bile Duct Invasion: Safety, Prognosis, and Predictive Factors

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Woo; Chung, Jin Wook, E-mail: chungjw@snu.ac.kr [Seoul National University Hospital, Department of Radiology (Korea, Republic of); Cho, Yun Ku [VHS Medical Center, Department of Radiology (Korea, Republic of); Kim, Yoon Jun; Yoon, Jung-Hwan [Seoul National University Hospital, Department of Internal Medicine (Korea, Republic of); Kim, Hyo-Cheol; Jae, Hwan Jun [Seoul National University Hospital, Department of Radiology (Korea, Republic of)

    2015-08-15

    PurposeTo assess the safety and effectiveness of transarterial chemoembolization (TACE) of patients who have hepatocellular carcinomas (HCCs) with central bile duct invasion.Materials and MethodsThe institutional review board approved this retrospective study and waived informed consent. Fifty-three patients, initially treated with TACE for HCCs with central bile duct invasion from January 1999 to September 2012, were included. Clinical, laboratory, and survival data were reviewed. Complications and hospitalization length were evaluated using the χ{sup 2} test, Fisher’s exact test, and logistic regression analysis. Survival was analyzed using the Kaplan–Meier method with log-rank test and Cox proportional hazard model.ResultsSeven patients experienced TACE-related major complications (severe post-embolization syndrome in 3, non-fatal sepsis in 3, and secondary bacterial peritonitis in 1). The overall major complication rate was 13.2 %, but there were no permanent adverse sequelae or deaths within 30 days. Serum total bilirubin ≥3.0 mg/dL was the only significant risk factor for long hospitalization [hazard ratio (HR) = 4.341, p = .022]. The median survival was 12.2 months. Extrahepatic metastasis (HR = 6.145, p < .001), international normalized ratio (PT-INR) ≥1.20 (HR = 4.564, p < .001), vascular invasion (HR = 3.484, p = .001), and intermediate tumor enhancement (HR = 2.417, p = .019) were significantly associated with shorter survival.ConclusionTACE can be a safe and effective treatment for patients who have HCCs with central bile duct invasion. In particular, long-term survival can be expected if patients have strongly enhancing tumors without poor prognostic factors such as extrahepatic metastasis, PT-INR prolongation, and vascular invasion.

  9. Tumor budding is an independent adverse prognostic factor in pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    O'Connor, Kate; Li-Chang, Hector H; Kalloger, Steven E; Peixoto, Renata D; Webber, Douglas L; Owen, David A; Driman, David K; Kirsch, Richard; Serra, Stefano; Scudamore, Charles H; Renouf, Daniel J; Schaeffer, David F

    2015-04-01

    Tumor budding is a well-established adverse prognostic factor in colorectal cancer. However, the significance and diagnostic reproducibility of budding in pancreatic carcinoma requires further study. We aimed to assess the prognostic significance of tumor budding in pancreatic ductal adenocarcinoma, determine its relationship with other clinicopathologic features, and assess interobserver variability in its diagnosis. Tumor budding was assessed in 192 archival cases of pancreatic ductal adenocarcinoma using hematoxylin and eosin (H&E) sections; tumor buds were defined as single cells or nonglandular clusters composed of <5 cells. The presence of budding was determined through assessment of all tumor-containing slides, and associations with clinicopathologic features and outcomes were analyzed. Six gastrointestinal pathologists participated in an interobserver variability study of 120 images of consecutive tumor slides stained with H&E and cytokeratin. Budding was present in 168 of 192 cases and was associated with decreased overall survival (P=0.001). On multivariable analysis, tumor budding was prognostically significantly independent of stage, grade, tumor size, nodal status, lymphovascular invasion, and perineural invasion. There was substantial agreement among pathologists in assessing the presence of tumor budding using both H&E (K=0.63) and cytokeratin (K=0.63) stains. The presence of tumor budding is an independent adverse prognostic factor in pancreatic ductal carcinoma. The assessment of budding with H&E is reliable and could be used to better risk stratify patients with pancreatic ductal adenocarcinoma.

  10. Predisposing factors, diagnosis, treatment and prognosis of cerebral venous thrombosis during pregnancy and postpartum: a case-control study

    Institute of Scientific and Technical Information of China (English)

    GAO Hui; YANG Bao-jun; JIN Li-ping; JIA Xiao-fang

    2011-01-01

    Background Previous investigations have demonstrated a relatively low incidence of stroke among young women,though both pregnancy and delivery can substantially increase the risk.Cerebral venous thrombosis may manifest different characteristics during pregnancy and postpartum as a result of their specific physiological statuses.This study aimed to identify the clinical manifestations,diagnosis,treatment,and prognosis of cerebral venous thrombosis during pregnancy and postpartum.Methods We conducted a retrospective analysis of 22 patients with cerebral venous thrombosis who were assigned to either group A (during pregnancy) or group B (during postpartum).The relevant risk factors,initiation and development of the disease,clinical presentations,diagnosis,treatment,and prognosis were compared between the two stages.Results Cerebral venous thrombosis occurred during both pregnancy and postpartum,but was more common postpartum.Patients in group A had a longer hospitalization period than those in group B.Confirmed predisposing factors in 85.7% of patients of group A were dehydration,infection,and underlying cerebrovascular disorders.No obvious predisposing factors were identified in group B.The most frequent symptom was headache,with epileptic seizures,hemiparalysis and aphasia being less frequent symptoms.Focal neurological symptoms (P=0.022) and cerebral infarction (P=0.014) occurred more frequently in group A than in group B.Anticoagulation therapy proved to be safe for cerebral venous thrombosis patients during puerperium,regardless of parenchymal hemorrhage.However,more attention should be paid to spontaneous in-site placental hemorrhage in pregnant patients.Both groups had similar prognoses (P=1.000),with 36.3% patients suffering from consequential dysfunction or recurrent intracranial hypertension.Delayed diagnosis was associated with a poorer prognosis.Conclusions Cerebral venous thrombosis manifests different clinical characteristics during pregnancy and

  11. Parental exposure at periconception to environmental adverse factors and early embryo loss in Tianjin, China

    Institute of Scientific and Technical Information of China (English)

    Hou Hai-yan; Wang Dan; Yang Zhen-hua; Zou Xiao-ping; Chen Ya-qiong

    2010-01-01

    Objective: To study the association of environmental adverse factors with early embryo loss, and explore the possible risk factors in daily life. Methods: A questionnaire was administered to 93 new cases of embryo loss (case group) collected in four general hospitals in Tianjin from April 2007 to April 2008 and 93 matched cases of induced abortion (control group) in normal pregnant women who sought the abortion by other reasons. The questionnaire covered information on parental exposure to various environmental factors during and before pregnancy, and the information on daily life. Data were analyzed by single-factor analysis, multiple linear regression and logistic regression analysis. Possible risk factors were identified and odds ratio calculated.Results: Cooking frequently during pregnancy, more daily traffic hours, and decoration history in early pregnancy and paternal exposure to toxic matters three months before pregnancy were associated with early embryo loss, while maternal education was a protective factor. Conclusion: Women exposed to the harmful substances from traffic emissions, cooking and decoration could be at an increased risk of early embryo loss.

  12. Influence of certain factors on the manifestations of the adverse effects of metrizamide myelography

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Y.L.; Du Boulay, G.H.; Paul, E.

    1986-07-01

    Although metrizamide is now being superseded by other contrast media, the mechanisms of its side effects may be of fundamental importance. One hundered and four consecutive patients with suspected cervical cord or root lesion were studied prospectively for factors which might influence the side effects of metrizamide myelography. Elderly patients were more prone to develop mental confusion. An earlier onset of dizziness and/or vertigo was associated with the lumbar route of intrathecal injection. Perhaps surprisingly, phenobarbitone prophylaxis shortened the duration of confusion and delayed the onset of headaches. Other factors, viz. sex, excess intracranial flow of metrizamide and myelographic blockage were not shown to have a signifiant influence on the adverse reactions.

  13. An exploratory factor analysis of the spontaneous reporting of severe cutaneous adverse reactions

    Science.gov (United States)

    Hauben, Manfred; Hung, Eric; Hsieh, Wen-Yaw

    2016-01-01

    Background: Severe cutaneous adverse reactions (SCARs) are prominent in pharmacovigilance (PhV). They have some commonalities such as nonimmediate nature and T-cell mediation and rare overlap syndromes have been documented, most commonly involving acute generalized exanthematous pustulosis (AGEP) and drug rash with eosinophilia and systemic symptoms (DRESS), and DRESS and toxic epidermal necrolysis (TEN). However, they display diverse clinical phenotypes and variations in specific T-cell immune response profiles, plus some specific genotype–phenotype associations. A question is whether causation of a given SCAR by a given drug supports causality of the same drug for other SCARs. If so, we might expect significant intercorrelations between SCARs with respect to overall drug-reporting patterns. SCARs with significant intercorrelations may reflect a unified underlying concept. Methods: We used exploratory factor analysis (EFA) on data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) to assess reporting intercorrelations between six SCARs [AGEP, DRESS, erythema multiforme (EM), Stevens–Johnson syndrome (SJS), TEN, exfoliative dermatitis (ExfolDerm)]. We screened the data using visual inspection of scatterplot matrices for problematic data patterns. We assessed factorability via Bartlett’s test of sphericity, Kaiser-Myer-Olkin (KMO) statistic, initial estimates of communality and the anti-image correlation matrix. We extracted factors via principle axis factoring (PAF). The number of factors was determined by scree plot/Kaiser’s rule. We also examined solutions with an additional factor. We applied various oblique rotations. We assessed the strength of the solution by percentage of variance explained, minimum number of factors loading per major factor, the magnitude of the communalities, loadings and crossloadings, and reproduced- and residual correlations. Results: The data were generally adequate for factor analysis

  14. Adverse drug events associated with vitamin K antagonists: factors of therapeutic imbalance

    Directory of Open Access Journals (Sweden)

    El-Helou N

    2013-03-01

    Full Text Available Nancy El-Helou, Amal Al-Hajje, Rola Ajrouche, Sanaa Awada, Samar Rachidi, Salam Zein, Pascale SalamehClinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, LebanonBackground: Adverse drug events (ADE occur frequently during treatment with vitamin K antagonists (AVK and contribute to increase hemorrhagic risks.Methods: A retrospective study was conducted over a period of 2 years. Patients treated with AVK and admitted to the emergency room of a tertiary care hospital in Beirut were included. The aim of the study was to identify ADE characterized by a high international normalized ratio (INR and to determine the predictive factors responsible for these events. Statistical analysis was performed with the SPSS statistical package.Results: We included 148 patients. Sixty-seven patients (47.3% with an INR above the therapeutic range were identified as cases. The control group consisted of 81 patients (54.7% with an INR within the therapeutic range. Hemorrhagic complications were observed in 53.7% of cases versus 6.2% of controls (P < 0.0001. No significant difference was noticed between cases and controls regarding the indication and the dose of AVK. Patients aged over 75 years were more likely to present an INR above the therapeutic range (58.2%, P = 0.049. Recent infection was present in 40.3% of cases versus 6.2% of controls (P < 0.0001 and hypoalbuminemia in 37.3% of cases versus 6.1% of controls (P < 0.0001. Treatment with antibiotics, amiodarone, and anti-inflammatory drugs were also factors of imbalance (P < 0.0001.Conclusion: Many factors may be associated with ADE related to AVK. Monitoring of INR and its stabilization in the therapeutic range are important for preventing these events.Keywords: adverse drug events, vitamin K antagonists, bleeding risks, therapeutic imbalance

  15. Cytosolic phospholipase A2-alpha expression in breast cancer is associated with EGFR expression and correlates with an adverse prognosis in luminal tumours.

    LENUS (Irish Health Repository)

    Caiazza, F

    2012-02-01

    BACKGROUND: The eicosanoid signalling pathway promotes the progression of malignancies through the production of proliferative prostaglandins (PGs). Cytosolic phospholipase A(2)alpha (cPLA(2)alpha) activity provides the substrate for cyclooxygenase-dependent PG release, and we have previously found that cPLA(2)alpha expression correlated with EGFR\\/HER2 over-expression in a small number of breast cancer cell lines. METHODS: The importance of differential cPLA(2)alpha activity in clinical breast cancer was established by relating the expression of cPLA(2)alpha in tissue samples from breast cancer patients, and two microarray-based gene expression datasets to different clinicopathological and therapeutic parameters. RESULTS: High cPLA(2)alpha mRNA expression correlated with clinical parameters of poor prognosis, which are characteristic of highly invasive tumours of the HER2-positive and basal-like subtype, including low oestrogen receptor expression and high EGFR expression. High cPLA(2)alpha expression decreased overall survival in patients with luminal cancers, and correlated with a reduced effect of tamoxifen treatment. The cPLA(2)alpha expression was an independent predictive parameter of poor response to endocrine therapy in the first 5 years of follow-up. CONCLUSION: This study shows a role of cPLA(2)alpha in luminal breast cancer progression, in which the enzyme could represent a novel therapeutic target and a predictive marker.

  16. [Development and Validation of Estimate Equations for Adverse Drug Reactions Using Risk Factors and Subjective Symptoms].

    Science.gov (United States)

    Suzuki, Ryohei; Ohtsu, Fumiko; Goto, Nobuyuki

    2015-01-01

      The purpose of this study was to develop and validate estimate equations for preventing adverse drug reactions (ADRs). We conducted five case-control studies to identify individual risk factors and subjective symptoms associated with the following five ADRs: drug-induced ischemic heart disease; renal damage; muscle disorder; interstitial pneumonia; and leucopenia. We performed logistic regression analysis and obtained eight regression equations for each ADR. We converted these to ADR estimate equations for predicting the likelihood of ADRs. We randomly selected 50 cases with non-individual ADRs from the Case Reports of Adverse Drug Reactions and Poisoning Information System (CARPIS) database of over 65000 case reports of ADRs, and assigned these cases to a validation case group. We then calculated the predictive probability for 50 cases using the eight estimate equations for each ADR. The highest probability for each ADR was set as the probability of each ADR. If the probability was over 50%, the case was interpreted as ADR-positive. We calculated and evaluated the sensitivity, specificity, and positive likelihood ratio of this system. Sensitivity of the estimate equations for muscle disorder and interstitial pneumonia were ≥90%. Specificity and positive likelihood ratios of estimate equations for renal damage, interstitial pneumonia and leucopenia were ≥80% and ≥5, respectively. Our estimate equations thus showed high validity, and are therefore helpful for the prevention or early detection of ADRs.

  17. Abnormal expression of FLI1 protein is an adverse prognostic factor in acute myeloid leukemia

    Science.gov (United States)

    Qiu, Yi Hua; Zhang, Nianxiang; Singh, Neera; Faderl, Stefan; Ferrajoli, Alessandra; York, Heather; Qutub, Amina A.; Coombes, Kevin R.; Watson, Dennis K.

    2011-01-01

    Friend leukemia virus integration 1 (FLI1), an Ets transcription factor family member, is linked to acute myelogenous leukemia (AML) by chromosomal events at the FLI1 locus, but the biologic impact of FLI1 expression on AML is unknown. FLI1 protein expression was measured in 511 newly diagnosed AML patients. Expression was similar in peripheral blood (PB) and BM and higher at diagnosis than at relapse (P = .02). Compared with normal CD34+ cells, expression in AML was above or below normal in 32% and 5% of patients, respectively. Levels were negatively correlated with an antecedent hematologic disorder (P = .002) but not with age or cytogenetics. Mutated NPM1 (P = .0007) or FLT3-ITD (P 0.3) with 19 others. The FLI1 level was not predictive of remission attainment, but patients with low or high FLI1 expression had shorter remission duration (22.6 and 40.3 vs 51.1 weeks, respectively; P = .01) and overall survival (45.2 and 35.4 vs 59.4 weeks, respectively; P = .03). High FLI1 levels were adverse in univariate and multivariate analysis. FLI1 expression is frequently abnormal and prognostically adverse in AML. FLI1 and/or its response genes may be therapeutically targetable to interfere with AML cell biology. PMID:21917756

  18. Concurrent radiotherapy and intrathecal methotrexate for treating leptomeningeal metastasis from solid tumors with adverse prognostic factors: A prospective and single-arm study.

    Science.gov (United States)

    Pan, Zhenyu; Yang, Guozi; He, Hua; Zhao, Gang; Yuan, Tingting; Li, Yu; Shi, Weiyan; Gao, Pengxiang; Dong, Lihua; Li, Yunqian

    2016-10-15

    The prognosis of leptomeningeal metastasis (LM) from solid tumors is extremely poor, especially for patients with adverse prognostic factors. In this phase II clinical trial, we evaluated the efficacy and safety of intrathecal chemotherapy (IC) combined with concomitant involved-field radiotherapy (IF-RT) for treating LM from solid tumors with adverse prognostic factors. Fifty-nine patients with LM from various solid tumors were enrolled between May 2010 and December 2014. Concurrent therapy consisted of concomitant IC (methotrexate 12.5-15 mg and dexamethasone 5 mg, weekly) and IF-RT (whole brain and/or spinal canal RT, 40 Gy/20f). For patients with low Karnofsky performance status (KPS) score and radiotherapy intolerance, induction IC (1-3 times) was given before concurrent therapy. Thirty-eight patients (64.4%) received subsequent treatments. All patients were followed up at least 6 months after LM diagnosis or until death. Primary endpoint evaluated was clinical response rate. Secondary endpoints were overall survival (OS) and safety. The pathological types included lung cancer (n = 42), breast cancer (n = 11) and others (n = 6). Median KPS score was 40 (range 20-70). Fifty-one patients (86.4%) completed concurrent therapy. The overall response rate was 86.4% (51/59). OS ranged from 0.4 to 36.7 months (median 6.5 months), and 1-year-survival rate was 21.3%. Treatment-related adverse events mainly included acute meningitis, chronic-delayed encephalopathy, radiculitis, myelosuppression and mucositis. Twelve patients (20.3%) had grade III-V toxic reactions. We concluded that IC combined with concomitant IF-RT, with significant efficacy and acceptable toxicity, may be an optimal therapeutic option for treatment of LM from solid tumors with adverse prognostic factors. LM, in which cancer cells spread to membranes enveloping the brain and spinal cord, is a devastating complication of solid cancers. Existing LM therapies center on IC. In this prospective

  19. ACTUAL WAYS FOR OVERCOMING THE FACTORS ADVERSELY AFFECTING THE CHILDREN AND ADOLESCENTS’ HEALTH IN EDUCATIONAL INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    N. N. Malyarchuk

    2014-01-01

    Full Text Available The paper analyzes a widely discussed problem of the negative health dynamics of the growing generation, and points out the necessity of complex consideration of all the factors adversely affecting children’s health. The special emphasis is on the fallowing harmful factors: intensification of training process; discrepancy between the applied training methods and techniques on the one side, and children’s age, sex and functional specifics and capabilities on the other side; shortcomings in organizing children’s physical activities; limitations of the expositive illustrative methods for developing the healthy lifestyle habits. The other group of factors is related to the teaching style and professional characteristics of the teachers. They include the common practice of «stress» tactics; incompetence in health saving technologies; personal indisposition and psychological drawbacks. The situation is exacerbated by the absence of psychologists and pediatricians in educational institutions. The multilevel approach to solving the problems of students’ health preservation and promotion involves the elicitation of objective, subjective, inschool and out-of-school health determining factors. The paper denotes the actual ways of children’s health preservation at the level of related ministries, departments, and educational institutions.

  20. Antiepileptic Drug-Related Adverse Reactions and Factors Influencing These Reactions

    Directory of Open Access Journals (Sweden)

    Parvaneh KARIMZADEH

    2013-08-01

    Full Text Available How to Cite This Article: Karimzadeh P, Bakrani V. Antiepileptic Drug-Related Adverse Reactions And Factors Influencing These Reactions. Iran J Child Neurol. 2013 Summer; 7(3:23-27. ObjectiveAccording to the basic role of drug side effects in selection ofan appropriate drug, patient compliance and the quality of life inepileptic patients, and forasmuch as new dugs with unknown side effect have been produced and introduced, necessity of this research and similar studies is explained. This study was conducted to evaluate the incidence and clinical characteristics of anti epileptic drug (AED related adverse reactions in children treated with AEDs.Material & MethodsIn this descriptive study, children less than 14 years old with AEDside effects referred to the Children’s Medical Center and MofidChilderen’s Hospital (Tehran, Iran were evaluated during 2010-2012.The informations were: sex, age, incriminating drug, type of drug side effect, incubation period, history of drug usage, and patient and family allergy history. Exclusive criterions were age more than 14 years old and reactions due to reasons other than AEDs (Food, bite, non-AEDs, etc..ResultsA total of 70 patients with AED reaction were enrolled in thisstudy. They included 26 (37% females and 44 (63 % males. The maximum rate of incidence was seen at age less than 5 years old. All the patients had cutaneous eruptions that the most common cutaneous drug eruption was maculopapular rash. The incidence of systemic and laboratory adverse events was less than similar studies. The most common culprit was phenobarbital (70% and the least common was lamotrigine (1.4%.ConclusionIn this study, we found higher rates of drug rash in patients treated with aromatic AEDs and lower rates with non-aromatic AEDs. Various endogenous and environmental factors may influence the propensity to develop these reactions. Refrences1. Blume WT, Lu¨ders HO, Mizrahi E, et al. Glossary of descriptive terminology for

  1. Stromal Expression of Hypoxia Regulated Proteins Is an Adverse Prognostic Factor in Colorectal Carcinomas

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    Arjen H. G. Cleven

    2007-01-01

    Full Text Available Background: Hypoxia modifies the phenotype of tumors in a way that promotes tumor aggressiveness and resistance towards chemotherapy and radiotherapy. However, the expression and influence of hypoxia-regulated proteins on tumor biology are not well characterized in colorectal tumors. We studied the role of protein expression of hypoxia-inducible factor (HIF-1α, HIF-2α, carbonic anhydrase 9 (CA9 and glucose transporter 1 (GLUT1 in patients with colorectal adenocarcinomas. Methods: Expression of HIF-1α, HIF-2α, CA9 and GLUT1 was quantified by immunohistochemistry in 133 colorectal adenocarcinomas. The expression of hypoxia markers was correlated with clinicopathological variables and overall patient survival. Results: Expression of these hypoxia markers was detected in the epithelial compartment of the tumor cells as well as in tumor-associated stromal cells. Although tumor cells frequently showed expression of one or more of the investigated hypoxia markers, no correlation among these markers or with clinical response was found. However, within the tumor stroma, positive correlations between the hypoxia markers HIF-2α, CA9 and GLUT1 were observed. Furthermore expression of HIF-2α and CA9 in tumor-associated stroma were both associated with a significantly reduced overall survival. In the Cox proportional hazard model, stromal HIF-2α expression was an independent prognostic factor for survival. Conclusion: These observations show, that expression of hypoxia regulated proteins in tumor-associated stromal cells, as opposed to their expression in epithelial tumor cells, is associated with poor outcome in colorectal cancer. This study suggests that tumor hypoxia may influence tumor-associated stromal cells in a way that ultimately contributes to patient prognosis.

  2. [Pathological anatomical characteristics of Klatskin tumors. Classification, current molecular biological aspects, prognosis factors].

    Science.gov (United States)

    Munding, J; Tannapfel, A

    2012-03-01

    Klatskin tumors are a distinct subgroup of cholangiocarcinomas which are a surgical challenge due to their special localization. Different localizations do not show great differences concerning histomorphology and precursor lesions. With respect to molecular alterations there are only small differences. Accurate clinical and histomorphological diagnosis is important for therapy and especially the prediction of prognosis as well as standardized processing of the resection specimen if the carcinoma is resectable. Additionally, accurate lymph node dissection is necessary. Concerning molecular markers further investigations are needed to develop individualized therapy regimes.

  3. Straightforward factors for predicting the prognosis of blow-out fractures.

    Science.gov (United States)

    Higashino, Takuya; Hirabayashi, Shinichi; Eguchi, Tomoaki; Kato, Yuki

    2011-07-01

    In blow-out fractures, some nonoperative cases have a poor outcome, and a method for accurate prognosis is required. To address this need, we retrospectively reviewed blow-out fractures presenting at Teikyo University Hospital between July 2004 and May 2007 and conducted a survey regarding diplopia and enophthalmos for nonoperative cases. Computed tomographic scan findings were divided according to fracture width and the degree of protrusion of the inferior rectus muscle into the maxillary sinus. We had 106 patients presenting with blow-out fractures, and 89 patients had been treated nonoperatively. In medial orbital wall fractures, no patient had diplopia, and 1 patient had enophthalmos after nonoperative treatment. In punched-out orbital floor fractures, all cases had diplopia when the fracture width was less than half the diameter of the globe, and the protrusion of the inferior rectus muscle into the maxillary sinus was half or more of its section. Even if the fracture width was less than half the diameter of the globe, 2 of 3 patients had enophthalmos when the protrusion of the inferior rectus muscle into the maxillary sinus was half or more of its section. Among the linear orbital floor fractures, 1 case required an emergency operation. We suggest a new algorithm for treatment of blow-out fractures based on computed tomographic scan findings that can also contribute to making a prognosis.

  4. Evaluation of Peritonitis Incidence, Etiology, Associated Factors and Prognosis of Continuous Ambulatory Peritoneal Dialysis Patients

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    Nefise ÖZBALCI

    2013-05-01

    Full Text Available OBJECTIVE: Peritonitis is the most important complication of peritoneal dialysis (PD. We evaluated the incidence of peritonitis, active microorganisms and their susceptibility profile and determine prognosis. MATERIAL and METHODS: One hundred fifty three PD patients were evaluated for aetiology, drug usage, accompanying disease, type, duration and personal preference for PD, care-giver, protein catabolic rate (PCR, residual urine volume, ultrafiltration volume, type of peritoneal membrane transport and baseline laboratory values. RESULTS: The incidence of peritonitis was 0,284 attack/patient/year. The most common organisms were coagulase negative staphylococci (18.3% followed by S. aureus (14.8% and gram-negative bacillus (13.1%. Peritonitis was more common in elderly, those with longer PD duration, low residual urine volume, patients with low PCR and hepatitis C. However, patients using erythropoietin and automated PD had low incidence of peritonitis compared to others. Mortality rate was higher in gram-negative and fungal peritonitis and prognosis was worse in gramnegative peritonitis CONCLUSION: Peritonitis incidence and aetiology were compatible with literature. One must be careful to protect residual renal function (RRF as peritonitis incidence was significantly reduced in patients with RRF. PCR values were significantly lower in peritonitis. Adequate protein intake and nutritional support may be important in this respect.

  5. Correlation of Clinical and Dosimetric Factors With Adverse Pulmonary Outcomes in Children After Lung Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Venkatramani, Rajkumar, E-mail: rvenkatramani@chla.usc.edu [Division of Hematology/Oncology, Children' s Hospital Los Angeles, Los Angeles, California (United States); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Kamath, Sunil [Department of Pulmonology, Children' s Hospital Los Angeles, Los Angeles, California (United States); Wong, Kenneth [Division of Hematology/Oncology, Children' s Hospital Los Angeles, Los Angeles, California (United States); Olch, Arthur J. [Division of Hematology/Oncology, Children' s Hospital Los Angeles, Los Angeles, California (United States); Department of Radiation Oncology, University of Southern California, Los Angeles, California (United States); Malvar, Jemily [Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Sposto, Richard [Division of Hematology/Oncology, Children' s Hospital Los Angeles, Los Angeles, California (United States); Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Goodarzian, Fariba [Department of Radiology, Children' s Hospital Los Angeles, Los Angeles, California (United States); Freyer, David R. [Division of Hematology/Oncology, Children' s Hospital Los Angeles, Los Angeles, California (United States); Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Keens, Thomas G. [Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California (United States); Department of Pulmonology, Children' s Hospital Los Angeles, Los Angeles, California (United States); and others

    2013-08-01

    Purpose: To identify the incidence and the risk factors for pulmonary toxicity in children treated for cancer with contemporary lung irradiation. Methods and Materials: We analyzed clinical features, radiographic findings, pulmonary function tests, and dosimetric parameters of children receiving irradiation to the lung fields over a 10-year period. Results: We identified 109 patients (75 male patients). The median age at irradiation was 13.8 years (range, 0.04-20.9 years). The median follow-up period was 3.4 years. The median prescribed radiation dose was 21 Gy (range, 0.4-64.8 Gy). Pulmonary toxic chemotherapy included bleomycin in 58.7% of patients and cyclophosphamide in 83.5%. The following pulmonary outcomes were identified and the 5-year cumulative incidence after irradiation was determined: pneumonitis, 6%; chronic cough, 10%; pneumonia, 35%; dyspnea, 11%; supplemental oxygen requirement, 2%; radiographic interstitial lung disease, 40%; and chest wall deformity, 12%. One patient died of progressive respiratory failure. Post-irradiation pulmonary function tests available from 44 patients showed evidence of obstructive lung disease (25%), restrictive disease (11%), hyperinflation (32%), and abnormal diffusion capacity (12%). Thoracic surgery, bleomycin, age, mean lung irradiation dose (MLD), maximum lung dose, prescribed dose, and dosimetric parameters between V{sub 22} (volume of lung exposed to a radiation dose ≥22 Gy) and V{sub 30} (volume of lung exposed to a radiation dose ≥30 Gy) were significant for the development of adverse pulmonary outcomes on univariate analysis. MLD, maximum lung dose, and V{sub dose} (percentage of volume of lung receiving the threshold dose or greater) were highly correlated. On multivariate analysis, MLD was the sole significant predictor of adverse pulmonary outcome (P=.01). Conclusions: Significant pulmonary dysfunction occurs in children receiving lung irradiation by contemporary techniques. MLD rather than prescribed

  6. Risk factors for treatment-related adverse events in cancer-bearing dogs receiving piroxicam.

    Science.gov (United States)

    Eichstadt, L R; Moore, G E; Childress, M O

    2016-10-06

    Piroxicam has antitumour effects in dogs with cancer, although side effects may limit its use. The purpose of this study was to retrospectively identify factors predisposing cancer-bearing dogs to adverse events (AEs) following piroxicam therapy. Medical records of dogs presented to the Purdue Veterinary Teaching Hospital between 2005 and 2015 were reviewed, and 137 dogs met the criteria for study inclusion. Toxic effects of piroxicam in these dogs were graded according to an established system. Multivariate logistic regression was used to estimate the extent to which certain factors affected the risk for AEs. Age [odds ratio (OR) 1.250, P = 0.009; 95% confidence interval (CI) 1.057-1.479] and concurrent use of gastroprotectant medications (OR 2.612, P = 0.025; 95% CI 1.127-6.056) significantly increased the risk for gastrointestinal AEs. The results of this study may help inform the risk versus benefit calculation for clinicians considering the use of piroxicam to treat dogs with cancer.

  7. Maternal Factors and Adverse Perinatal Outcomes in Women with Preeclampsia in Maceió, Alagoas

    Directory of Open Access Journals (Sweden)

    Alane Cabral Menezes de Oliveira

    2016-01-01

    Full Text Available Abstract Background: Preeclampsia has been associated with several risk factors and events. However, it still deserves further investigation, considering the multitude of related factors that affect different populations. Objective: To evaluate the maternal factors and adverse perinatal outcomes in a cohort of pregnant women with preeclampsia receiving care in the public health network of the city of Maceió. Methods: Prospective cohort study carried out in 2014 in the public health network of the city with a sample of pregnant women calculated based on a prevalence of preeclampsia of 17%, confidence level of 90%, power of 80%, and ratio of 1:1. We applied a questionnaire to collect socioeconomic, personal, and anthropometric data, and retrieved perinatal variables from medical records and certificates of live birth. The analysis was performed with Poisson regression and chi-square test considering p values < 0.05 as significant. Results: We evaluated 90 pregnant women with preeclampsia (PWP and 90 pregnant women without preeclampsia (PWoP. A previous history of preeclampsia (prevalence ratio [PR] = 1.57, 95% confidence interval [95% CI] 1.47 - 1.67, p = 0.000 and black skin color (PR = 1.15, 95% CI 1.00 - 1.33, p = 0.040 were associated with the occurrence of preeclampsia. Among the newborns of PWP and PWoP, respectively, 12.5% and 13.1% (p = 0.907 were small for gestational age and 25.0% and 23.2% (p = 0.994 were large for gestational age. There was a predominance of cesarean delivery. Conclusion: Personal history of preeclampsia and black skin color were associated with the occurrence of preeclampsia. There was a high frequency of birth weight deviations and cesarean deliveries.

  8. HER-2,P53 and Hormonal Receptors Protein Expression as Predictive Factors in Breast Cancer Prognosis

    Institute of Scientific and Technical Information of China (English)

    seyed Mohanmmad Rabiee Hashemi; Somayeh Rabiee Hashemi

    2008-01-01

    Breast cancer is a heterogeneous disease with vari-able biological and clinical characteristics. We conducted a study to evaluate P53,HER-2/neu and hormonal receptor expression as predictors of prognosis in breast cancer. METHODS In a prospective study, we recruited 81 consecutive patients with primary operable breast cancer who were treated with mastectomy followed by locoregional radiotherapy or che-motherapy and studied the presence of P53,HER-2/neu and hormonal receptors(ER/PR) expression in tumor tissues by im-munohistochemical staining. Associations between these markers expression and clinical outcomes, including local and regional recurrence and metastasis were evaluated. Statistical analysis was performed with the SPSS software. RESUITS The mean time of follow-up was (47.3±4.6)months. Expression of P53, HER-2/neu, Estrogen receptors and progester-one receptors were observed in 31.1%, 38.5%, 31.8%and 51.7%ofthe patients, respectively. P53,HER-2/neu and Negative ER status were potent predictors of local-regional recurrence(P=0.034,0.038,0.044,respectively).Also HER-2/neu,Negative ER and Negative PR status were strong predictors of metastasis(P=0.001,0.042,0.054,respectively).CONCLUSION OP53 and HER-2/neu expression and also steroid receptors status(ER/PR status)have an important role in predict-ing the outcome of breast cancer and thus may be of value in se-lecting suitable therapeutic strategy and determining prognosis in these patients.

  9. Factors modifying stress from adverse effects of immunosuppressive medication in kidney transplant recipients

    NARCIS (Netherlands)

    Rosenberger, J.; Geckova, A.M.; van Dijk, J.P.; Roland, R.; Groothoff, J.W.

    2005-01-01

    Introduction: The adverse effects of immunosuppression appear in the majority of patients with a negative impact on morbidity, mortality and quality of life. The group of adverse symptoms manifested as changes in appearance, mood and energy are often more stressful than serious metabolic changes bec

  10. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  11. Family and personal protective factors moderate the effects of adversity and negative disposition on smoking among Chinese adolescents.

    Science.gov (United States)

    Arpawong, Thalida Em; Sun, Ping; Chang, Megan Chia-Chen; Gallaher, Peggy; Pang, Zengchang; Guo, Qian; Johnson, C Anderson; Unger, Jennifer

    2010-07-01

    Tobacco use among Chinese adolescents is increasing at approximately 80,000 new smokers per day. Assessing the causes for initiating tobacco use in China will be important in developing effective interventions and policies to stem rising prevalence rates. This study tested predictors of Resilience Theory in a sample of 602 Chinese adolescents. Results revealed that prior adversity, measured through school and family-related events, was significantly associated with increased smoking in females. Family factors (i.e., family cohesion, family adaptability, parental monitoring) and one personal factor (i.e., academic score) were associated with lower odds for smoking due to prior adversity and negative disposition.

  12. Major risk factors of maternal adverse outcome in women with two or more previous cesarean sections

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    Egić Amira

    2016-01-01

    Full Text Available Background/Aim. Maternal morbidity is defined as any condition that is attributed to or aggravated by pregnancy and childbirth that has a negative impact on the woman's wellbeing. In recent years, a growing trend of cesarean section rates can be seen throughout the world. The aim of this study was to assess factors that might have major impact on maternal adverse outcome in women with two or more previous cesarean sections. Methods. This retrospective study included women with single term pregnancy after two or more cesarean deliveries in a 10-year period (2004−2013 in the University Clinic “Narodni front” in Belgrade, Serbia. Medical records were reviewed for clinical data for maternal intraoperative and early postoperative complications regarding gestational age at delivery, the number of previous cesarean sections and mode of surgery (elective or emergency. Results. A total of 551 patients were included in the study. At 37 completed weeks delivered 14.1%, at 38 delivered 45.2% and at 39 completed weeks 40.7% patients. Women younger than 35 years more often delivered after 39 completed weeks compared with those over 35 years (69.2% vs 30.8%, p < 0.05. The overall rate of maternal complications in the study group was 16.5% with no statistical difference by gestational age at delivery. The overall rate of maternal adverse outcome was significantly less in the patients with three as compared with those with four or more cesareans (10.4% vs 66.7%, p < 0.05. There was a statistically significant difference between these groups of women regarding complications: scar dehiscence, the presence of adhesions, blood transfusion and admission in intensive care unit. Elective cesarean delivery was with less maternal complications compared with emergency cesarean deliveries (12.9% vs 27.3%, p < 0.05. Conclusion. Termination of pregnancy before completed 39 weeks does not decrease maternal morbidity. The major impact on maternal complications has the

  13. Impact of Serum Vascular Endothelial Growth Factor on Prognosis in Patients with Unresectable Hepatocellular Carcinoma after Transarterial Chemoembolization

    Institute of Scientific and Technical Information of China (English)

    Jian-hai Guo; Xu Zhu; Xiao-ting Li; Ren-jie Yang

    2012-01-01

    Objective:To investigate the expression level of serum vascular endothelial growth factor (VEGF) in patients with unresectable hepatocellular carcinoma (HCC) and its relationship with the clinicopathological characteristics,and to assess the impact of serum VEGF as a predictive factor for HCC prognosis during transarterial chemoembolization (TACE) treatments.Methods:Serum VEGF levels were measured using enzyme-linked immunosorbent assay (ELISA) in 60 random patients who underwent TACE or transarterial infusion (TAI) for unresectable HCC between May and September 2008 and 12 healthy volunteers were also involved in this study to serve as control.All patients' clinicopathological features were retrospectively analyzed.Serum VEGF levels were correlated with clinicopathological features of the HCC patients.The patients' survival rates were analyzed with Kaplan-Meier survival curves and compared by the log-rank test.The prognostic significance of serum VEGF levels and factors related to survival rate were evaluated by univariate and multivariate analysis.Results:The median serum VEGF level in the HCC patients was 285 pg/ml (range 14-1,207 pg/ml),significantly higher than that of healthy controls (P=0.021).The serum VEGF levels were significantly correlated with platelet counts (r=0.396,P=0.002) but not other clinicopathological features.Patients with serum VEGF level >285 pg/ml had worse overall survival compared with those with serum VEGF level <285 pg/ml (P=0.002).By multivariate analysis,the serum VEGF level was a significant prognostic factor.Conclusion:High serum VEGF levels may predict poor prognosis of HCC after TACE.This study highlights the importance of tumor biomarker as a prognostic predictor in TACE therapy for HCC,which has an intrinsic problem of unavailability of histopathological prognostic features.

  14. Prognosis Factors in Patients with Non-Hodgkin’s Lymphoma Presenting with Gastrointestinal Tract Symptoms

    Directory of Open Access Journals (Sweden)

    Brian H Weinerman

    1991-01-01

    Full Text Available Forty-one individuals who presented with symptoms referable to the gastrointestinal tract were extracted from the authors’ total review of non-Hodgkin’s lymphoma in Manitoba from 1968 through 1978. Only cases at stages I to III were included, and there were 22 males and 19 females. Sixteen non-Hodgkin’s lymphomas arose in the small bowel, 15 in the stomach and 10 in the colon. The natural history of this group of gastrointestinal non-Hodgkin’s disease is described, and univariate and multivariate analyses were done using the variables of sex, pathology, stage, resection, site of disease and initial chemotherapy. The median survival of the group was 28 months. Sex and stage appeared to be important prognostically, but after multivariate analysis, only the female sex appear to be a good prognostic variable. There was a suggestion that resection should be attempted in these lesions, but there was not a large sample size in this group. In addition, it was felt that this group of individuals followed the same survival pattern as did poor prognosis non-Hodgkin’s lymphomas of nongastrointestinal origin.

  15. A review of the use of human factors classification frameworks that identify causal factors for adverse events in the hospital setting.

    Science.gov (United States)

    Mitchell, R J; Williamson, A M; Molesworth, B; Chung, A Z Q

    2014-01-01

    Various human factors classification frameworks have been used to identified causal factors for clinical adverse events. A systematic review was conducted to identify human factors classification frameworks that identified the causal factors (including human error) of adverse events in a hospital setting. Six electronic databases were searched, identifying 1997 articles and 38 of these met inclusion criteria. Most studies included causal contributing factors as well as error and error type, but the nature of coding varied considerably between studies. The ability of human factors classification frameworks to provide information on specific causal factors for an adverse event enables the focus of preventive attention on areas where improvements are most needed. This review highlighted some areas needing considerable improvement in order to meet this need, including better definition of terms, more emphasis on assessing reliability of coding and greater sophistication in analysis of results of the classification. Practitioner Summary: Human factors classification frameworks can be used to identify causal factors of clinical adverse events. However, this review suggests that existing frameworks are diverse, limited in their identification of the context of human error and have poor reliability when used by different individuals.

  16. Improved survival and renal prognosis of patients with type 2 diabetes and nephropathy with improved control of risk factors

    DEFF Research Database (Denmark)

    Andrésdóttir, Gudbjörg; Jensen, Majken; Carstensen, Bendix

    2014-01-01

    OBJECTIVE: To evaluate long-term survival, development of renal end points, and decline in glomerular filtration rate (GFR) in patients with type 2 diabetes and diabetic nephropathy (DN) after renin-angiotensin system (RAS) inhibition and multifactorial treatment of cardiovascular risk factors have...... and lower GFR were predictors of mortality, whereas albuminuria, HbA1c, and low GFR predicted ESRD. CONCLUSIONS: Overall prognosis has improved considerably with current multifactorial treatment of DN in type 2 diabetes, including long-term RAS inhibition....... become standard of care. RESEARCH DESIGN AND METHODS: All patients with type 2 diabetes and DN (n = 543) at the Steno Diabetes Center were followed during 2000-2010. GFR was measured yearly with 51Cr-EDTA plasma clearance. Annual decline in GFR was determined in patients with at least three measurements...

  17. An analysis of risk factors and adverse events in ambulatory surgery

    Directory of Open Access Journals (Sweden)

    Kent C

    2014-06-01

    Full Text Available Christopher Kent, Julia Metzner, Laurent BollagDepartment of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USAAbstract: Care for patients undergoing ambulatory procedures is a broad and expanding area of anesthetic and surgical practice. There were over 35 million ambulatory surgical procedures performed in the US in 2006. Ambulatory procedures are diverse in both type and setting, as they span the range from biopsies performed under local anesthesia to intra-abdominal laparoscopic procedures, and are performed in offices, freestanding ambulatory surgery centers, and ambulatory units of hospitals. The information on adverse events from these varied settings comes largely from retrospective reviews of sources, such as quality-assurance databases and closed malpractice claims. Very few if any ambulatory procedures are emergent, and in comparison to the inpatient population, ambulatory surgical patients are generally healthier. They are still however subject to most of the same types of adverse events as patients undergoing inpatient surgery, albeit at a lower frequency. The only adverse events that could be considered to be unique to ambulatory surgery are those that arise out of the circumstance of discharging a postoperative patient to an environment lacking skilled nursing care. There is limited information on these types of discharge-related adverse events, but the data that are available are reviewed in an attempt to assist the practitioner in patient selection and discharge decision making. Among ambulatory surgical patients, particularly those undergoing screening or cosmetic procedures, expectations from all parties involved are high, and a definition of adverse events can be expanded to include any occurrence that interrupts the rapid throughput of patients or interferes with early discharge and optimal patient satisfaction. This review covers all types of adverse events, but focuses on the more

  18. Overexpression of GEFT, a Rho family guanine nucleotide exchange factor, predicts poor prognosis in patients with rhabdomyosarcoma.

    Science.gov (United States)

    Sun, Chao; Liu, Chunxia; Li, Shugang; Li, Hongan; Wang, Yuanyuan; Xie, Yuwen; Li, Bingcheng; Cui, Xiaobin; Chen, Yunzhao; Zhang, Wenjie; Li, Feng

    2014-01-01

    Rhabdomyosarcoma (RMS) is one of the most common soft-tissue sarcomas in children and adolescents with poor prognosis. Yet, there is lack of effective prognostic biomarkers for RMS. The present study, therefore, aimed to explore potential biomarkers for RMS based on our previous findings using array comparative genomic hybridization. We investigated guanine nucleotide exchange factor, GEFT, at expression level in 45 RMS patients and 36 normal striated muscle controls using immunohistochemistry using tissue microarrays. The expression rate of GEFT in RMS samples (42/45, 93.33%) was significantly higher (Prate of GEFT in RMS (31/45, 68.89%) was also significantly higher (P<0.05) than that in normal controls (0/36, 0.00%). Increased expression of GEFT correlated significantly with advanced disease stages (stages III/IV) (P=0.001), lymph node metastasis (P=0.019), and distant metastasis (P=0.004), respectively, in RMS patients. In addition, RMS patients having overexpressed GEFT experienced worse overall survival (OS) than those having low levels of GEFT (P=0.001). GEFT overexpression was determined to be an independent prognostic factor for poor OS in RMS patients (hazard ratio: 3.491, 95% confidence interval: 1.121-10.871, P=0.004). In conclusion, these observations provide the first evidence of GEFT overexpression in RMS and its correlations with disease aggressiveness and metastasis. These findings suggest that GEFT may serve as a promising biomarker predicting poor prognosis in RMS patients, thus implying its potential as a therapeutic target.

  19. Neutralization of IL-8 prevents the induction of dermatologic adverse events associated with the inhibition of epidermal growth factor receptor

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Houtkamp, Mischa; Schuurhuis, Danita H

    2012-01-01

    , characterized by acute follicular neutrophil-rich hair follicle inflammation, and thus mimicked adverse events induced by systemic administration of EGFR inhibitors. In this model, we tested the hypothesis that neutrophils, attracted by IL-8, play a central role in the observed rash. Indeed, concomitant local......Epidermal growth factor receptor (EGFR) inhibitors are widely used in the treatment of cancer. EGFR-targeted treatment is known to be associated with a high incidence of dermatological adverse reactions, including papulopustular rash, which can be dose-limiting and may affect compliance...

  20. Expression of the Stem Cell Factor Nestin in Malignant Pleural Mesothelioma Is Associated with Poor Prognosis.

    Directory of Open Access Journals (Sweden)

    Svenja Thies

    Full Text Available The epithelioid and sarcomatoid histologic variants of malignant pleural mesothelioma (MPM can be considered as E- and M-parts of the epithelial-mesenchymal transition (EMT axis; the biphasic being an intermediate. EMT is associated with an increase of stem cell (SC traits. We correlated the neural crest SC marker nestin and the EMT marker periostin with histology, type of neo-adjuvant chemotherapy (CT and overall survival (OS of MPM patients.Tumor tissues of a historic cohort 1 (320 patients and an intended induction chemotherapy followed by extrapleural pneumonectomy (EPP cohort 2 (145 patients were immunohistochemically H-scored (intensity of immunoreactivity multiplied by frequency of stained cells. Paired chemo-naïve biopsies and -treated surgical specimens were available for 105/145 patients. CT included platinum/gemcitabine (Pla/Gem or platinum/pemetrexed (Pla/Pem.Expression of any cytosolic nestin progressively increased from epithelioid to biphasic to sarcomatoid MPM in cohort 1, whereas the diagnostic markers calretinin and podoplanin decreased. In cohort 2, Pla/Pem CT increased the expression level of nestin in comparison to Pla/Gem, whereas the opposite was found for periostin. In Pla/Pem treated patients, nestin was higher in biphasic MPM compared to epithelioid. In addition to non-epithelioid histology, any expression of nestin in chemo-naïve biopsies (median overall survival: 22 vs. 17 months and chemo-treated surgical specimens (18 vs. 12 months as well as high periostin in biopsies (23 vs. 15 months were associated with poor prognosis. In the multivariate survival analysis, any nestin expression in chemo-naïve biopsies proved to be an independent prognosticator against histology. In both pre- and post-CT situations, the combination of nestin or periostin expression with non-epithelioid histology was particularly/ dismal (all p-values <0.05.The SC marker nestin and the EMT marker periostin allow for further prognostic

  1. Identifying the Prognosis Factors in Death after Liver Transplantation via Adaptive LASSO in Iran

    Directory of Open Access Journals (Sweden)

    Hadi Raeisi Shahraki

    2016-01-01

    Full Text Available Despite the widespread use of liver transplantation as a routine therapy in liver diseases, the effective factors on its outcomes are still controversial. This study attempted to identify the most effective factors on death after liver transplantation. For this purpose, modified least absolute shrinkage and selection operator (LASSO, called Adaptive LASSO, was utilized. One of the best advantages of this method is considering high number of factors. Therefore, in a historical cohort study from 2008 to 2013, the clinical findings of 680 patients undergoing liver transplant surgery were considered. Ridge and Adaptive LASSO regression methods were then implemented to identify the most effective factors on death. To compare the performance of these two models, receiver operating characteristic (ROC curve was used. According to the results, 12 factors in Ridge regression and 9 ones in Adaptive LASSO regression were significant. The area under the ROC curve (AUC of Adaptive LASSO was equal to 89% (95% CI: 86%–91%, which was significantly greater than Ridge regression (64%, 95% CI: 61%–68% (p<0.001. As a conclusion, the significant factors and the performance criteria revealed the superiority of Adaptive LASSO method as a penalized model versus traditional regression model in the present study.

  2. Factors associated with anti-tuberculosis medication adverse effects: a case-control study in Lima, Peru.

    Directory of Open Access Journals (Sweden)

    Kocfa Chung-Delgado

    Full Text Available BACKGROUND: Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. METHODOLOGY AND RESULTS: A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005-2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR and 95% confidence intervals (95%CI. A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65-9.35, overweight/obesity (OR = 2.13; 95%CI: 1.17-3.89, anemia (OR = 2.10; IC95%: 1.13-3.92, MDR-TB medication (OR = 11.1; 95%CI: 6.29-19.6, and smoking (OR = 2.00; 95%CI: 1.03-3.87 were independently associated with adverse drug reactions. CONCLUSIONS: Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients.

  3. Identifying the Prognosis Factors in Death after Liver Transplantation via Adaptive LASSO in Iran.

    Science.gov (United States)

    Raeisi Shahraki, Hadi; Pourahmad, Saeedeh; Ayatollahi, Seyyed Mohammad Taghi

    2016-01-01

    Despite the widespread use of liver transplantation as a routine therapy in liver diseases, the effective factors on its outcomes are still controversial. This study attempted to identify the most effective factors on death after liver transplantation. For this purpose, modified least absolute shrinkage and selection operator (LASSO), called Adaptive LASSO, was utilized. One of the best advantages of this method is considering high number of factors. Therefore, in a historical cohort study from 2008 to 2013, the clinical findings of 680 patients undergoing liver transplant surgery were considered. Ridge and Adaptive LASSO regression methods were then implemented to identify the most effective factors on death. To compare the performance of these two models, receiver operating characteristic (ROC) curve was used. According to the results, 12 factors in Ridge regression and 9 ones in Adaptive LASSO regression were significant. The area under the ROC curve (AUC) of Adaptive LASSO was equal to 89% (95% CI: 86%-91%), which was significantly greater than Ridge regression (64%, 95% CI: 61%-68%) (p LASSO method as a penalized model versus traditional regression model in the present study.

  4. Risk factors and prognosis of ischemic stroke in young patients in Uzbekistan

    Directory of Open Access Journals (Sweden)

    Khurshidakhon Rasulova

    2011-03-01

    Full Text Available Between 2004 and 2008, we studied reasons and risk factors of ischemic stroke in 150 young patients (aged between 17-44 years, compared with those in elderly patients (n=70. According to our data, heredity, arterial hypertension, cerebral vasculitis, thyroid diseases, chronic alcoholism, smoking and long-term use of oral contraceptives are main risk factors of ischemic stroke in the young in Uzbekistan. However, relative risk of stroke in this group of patients is less than in elder patients. In 16% cases, usage of standard diagnostic measures does not lead to identification of the disease cause.

  5. A pooled analysis of post-diagnosis lifestyle factors in association with late estrogen-receptor-positive breast cancer prognosis.

    Science.gov (United States)

    Nechuta, Sarah; Chen, Wendy Y; Cai, Hui; Poole, Elizabeth M; Kwan, Marilyn L; Flatt, Shirley W; Patterson, Ruth E; Pierce, John P; Caan, Bette J; Ou Shu, Xiao

    2016-05-01

    Lifestyle factors have been well studied in relation to breast cancer prognosis overall; however, associations of lifestyle and late outcomes (>5 years after diagnosis) have been much less studied, and no studies have focused on estrogen receptor-positive (ER+) breast cancer survivors, who may have high risk of late recurrence and mortality. We utilized a large prospective pooling study to evaluate the associations of lifestyle factors with late recurrence and all-cause mortality among 6,295 5-year ER+ Stage I-III breast cancer survivors. Pooled and harmonized data were available on clinical factors and lifestyle factors (pre- to post-diagnosis weight change, body mass index (BMI) (kg/m(2)), recreational physical activity, alcohol intake and smoking history), measured on average 2.1 years after diagnosis. Updated information for weight only was available. Study heterogeneity was evaluated by the Q-statistic. Multivariable Cox regression models were stratified by study. Adjusting for clinical factors and potential confounders, ≥ 10% weight gain and obesity (BMI, 30-34.99 and ≥ 35) were associated with increased risk of late recurrence (hazard ratios (95% confidence intervals): 1.24 (1.00-1.53), 1.40 (1.05-1.86) and 1.41 (1.02-1.93), respectively). Daily alcohol intake was associated with late recurrence, 1.28 (1.01-1.62). Physical activity was inversely associated with late all-cause mortality (0.81 (0.71-0.93) and 0.71 (0.61-0.82) for 4.9 to factors were associated with late outcomes among long-term ER+ breast cancer survivors.

  6. Transitional cell carcinoma of the bladder : histopathological and biological factors and prognosis

    NARCIS (Netherlands)

    R.F.M. Schapers

    1993-01-01

    textabstractThe main purpose of the studies reported in this thesis has been to determine the extent to which the behaviour of TCC can be predicted by histopathological and biological characteristics. The potential additional prognostic value of these factors was evaluated by combining them with oth

  7. Infections caused by carbapenemase-producing Enterobacteriaceae: risk factors, clinical features and prognosis.

    Science.gov (United States)

    Paño Pardo, José Ramón; Serrano Villar, Sergio; Ramos Ramos, Juan Carlos; Pintado, Vicente

    2014-12-01

    Infections caused by carbapenem-producing Enterobacteriaceae (CPE) can present as several infectious syndromes, but they primarily present as respiratory, urinary and blood stream infections (primary or catheter-related) that are usually found as nosocomial or healthcare-associated infections. The risk of CPE infection is influenced by individual factors, such as the length of the hospital stay and their exposure to invasive procedures and/or to antimicrobials. Of note, exposure to several antimicrobials, not only carbapenems, has been linked to CPE colonization; the duration of antibiotic exposure is one of the primary drivers of CPE acquisition. Individual risk factors must be considered jointly with the local epidemiology of these microorganisms in healthcare institutions. Overall, these infections have a high associated mortality. Mortality is influenced by host factors (e.g., age, comorbidity and immune deficiency), infection-related variables (e.g., type and severity of the infection) and treatment-related factors such as the delay in the initiation of appropriate antimicrobial therapy and the use or monotherapy or combined antimicrobial therapy. Gaining knowledge concerning the epidemiology, clinical features and prognostic features of CPE infection could be useful for improving infection prevention and for the management of patients with infections caused by these microorganisms.

  8. The insulin-like growth factor 1 axis in prognosis and treatment of breast cancer

    NARCIS (Netherlands)

    Hartog, Hermien

    2014-01-01

    Insulin-like growth factor-1 receptor (IGF-1R) is a tyrosine kinase receptor mediating cell growth and survival. IGF-1R signaling has been implicated in malignant behavior of tumors and drugs targeting the IGF-1R as anticancer treatment have been developed. We aimed to determine clinical indicators

  9. The Role of ADHD in Academic Adversity: Disentangling ADHD Effects from Other Personal and Contextual Factors

    Science.gov (United States)

    Martin, Andrew J.

    2014-01-01

    Students with attention-deficit/hyperactivity disorder (ADHD) experience significant academic difficulties that can lead to numerous negative academic consequences. With a focus on adverse academic outcomes, this study seeks to disentangle variance attributable to ADHD from variance attributable to salient personal and contextual covariates.…

  10. Obesity and smoking are factors associated with poor prognosis in patients with bacteraemia

    Directory of Open Access Journals (Sweden)

    Vuento Risto

    2007-03-01

    Full Text Available Abstract Background Bacteraemia is still a major cause of case fatality in all age groups. Our aim was to identify the major underlying conditions constituting risk factors for case fatality in bacteraemia patients. Methods The study involved 149 patients (79 male and 70 female with bacteraemia caused by Staphylococcus aureus (S. aureus (41 patients, Streptococcus pneumoniae (Str. pneumoniae (42 patients, β-hemolytic streptococcae (β-hml str. (23 patients and Eschericia coli (E. coli (43 patients. Underlying diseases, alcohol and tobacco consumption and body mass index (BMI were registered. Laboratory findings and clinical data were registered on admission and 6 consecutive days and on day 10–14. Case fatality was studied within 30 days after positive blood culture. Associations between underlying conditions and case fatality were studied in univariate analysis and in a multivariate model. Results Nineteen patients (12.8% died of bacteraemia. We found obesity (p = 0.002, RR 9.8; 95% CI 2.3 to 41.3, smoking (p Conclusion Our results indicate that obesity and smoking are prominent risk factors for case fatality in bacteraemic patients. Identification of risk factors underlying fatal outcome in bacteraemia may allow targeting of preventive efforts to individuals likely to derive greatest potential benefit.

  11. APCR, factor V gene known and novel SNPs and adverse pregnancy outcomes in an Irish cohort of pregnant women

    LENUS (Irish Health Repository)

    Sedano-Balbas, Sara

    2010-03-10

    Abstract Background Activated Protein C Resistance (APCR), a poor anticoagulant response of APC in haemostasis, is the commonest heritable thrombophilia. Adverse outcomes during pregnancy have been linked to APCR. This study determined the frequency of APCR, factor V gene known and novel SNPs and adverse outcomes in a group of pregnant women. Methods Blood samples collected from 907 pregnant women were tested using the Coatest® Classic and Modified functional haematological tests to establish the frequency of APCR. PCR-Restriction Enzyme Analysis (PCR-REA), PCR-DNA probe hybridisation analysis and DNA sequencing were used for molecular screening of known mutations in the factor V gene in subjects determined to have APCR based on the Coatest® Classic and\\/or Modified functional haematological tests. Glycosylase Mediated Polymorphism Detection (GMPD), a SNP screening technique and DNA sequencing, were used to identify SNPs in the factor V gene of 5 APCR subjects. Results Sixteen percent of the study group had an APCR phenotype. Factor V Leiden (FVL), FV Cambridge, and haplotype (H) R2 alleles were identified in this group. Thirty-three SNPs; 9 silent SNPs and 24 missense SNPs, of which 20 SNPs were novel, were identified in the 5 APCR subjects. Adverse pregnancy outcomes were found at a frequency of 35% in the group with APCR based on Classic Coatest® test only and at 45% in the group with APCR based on the Modified Coatest® test. Forty-eight percent of subjects with FVL had adverse outcomes while in the group of subjects with no FVL, adverse outcomes occurred at a frequency of 37%. Conclusions Known mutations and novel SNPs in the factor V gene were identified in the study cohort determined to have APCR in pregnancy. Further studies are required to investigate the contribution of these novel SNPs to the APCR phenotype. Adverse outcomes including early pregnancy loss (EPL), preeclampsia (PET) and intrauterine growth restriction (IGUR) were not significantly more

  12. Periodontal Disease: A Possible Risk-Factor for Adverse Pregnancy Outcome

    OpenAIRE

    Parihar, Anuj Singh; Katoch, Vartika; Rajguru, Sneha A; Rajpoot, Nami; Singh, Pinojj; Wakhle, Sonal

    2015-01-01

    Bacterial invasion in subgingival sites especially of gram-negative organisms are initiators for periodontal diseases. The periodontal pathogens with persistent inflammation lead to destruction of periodontium. In recent years, periodontal diseases have been associated with a number of systemic diseases such as rheumatoid arthritis, cardiovascular-disease, diabetes mellitus, chronic respiratory diseases and adverse pregnancy outcomes including pre-term low-birth weight (PLBW) and pre-eclampsi...

  13. Fibroblast growth factor 19 expression correlates with tumor progression and poorer prognosis of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Miura Seiki

    2012-02-01

    Full Text Available Abstract Background Although fibroblast growth factor 19 (FGF19 can promote liver carcinogenesis in mice, its involvement in human hepatocellular carcinoma (HCC has not been well investigated. FGF19, a member of the FGF family, has unique specificity for its receptor FGFR4. This study aimed to clarify the involvement of FGF19 in the development of HCC. Methods We investigated human FGF19 and FGFR4 expression in 40 hepatocellular carcinoma specimens using quantitative real-time reverse transcription polymerase chain reaction (RT-PCR analysis and immunohistochemistry. Moreover, we examined the expression and the distribution of FGF19 and FGFR4 in 5 hepatocellular carcinoma cell lines (HepG2, HuH7, HLE, HLF, and JHH7 using RT-PCR and immunohistochemistry. To test the role of the FGF19/FGFR4 system in tumor progression, we used recombinant FGF19 protein and small interfering RNA (siRNA of FGF19 and FGFR4 to regulate their concentrations. Results We found that FGF19 was significantly overexpressed in HCCs as compared with corresponding noncancerous liver tissue (P FGF19 mRNA expression was an independent prognostic factor for overall and disease-free survival. Moreover, we found that the FGF19 recombinant protein could increase the proliferation (P n = 12 and invasion (P n = 6 capabilities of human hepatocellular carcinoma cell lines and inhibited their apoptosis (P n = 12. Inversely, decreasing FGF19 and FGFR4 expression by siRNA significantly inhibited proliferation and increased apoptosis in JHH7 cells (P n = 12. The postoperative serum FGF19 levels in HCC patients was significantly lower than the preoperative levels (P n = 29. Conclusions FGF19 is critically involved in the development of HCCs. Targeting FGF19 inhibition is an attractive potential therapeutic strategy for HCC.

  14. Divergent effects of insulin-like growth factor-1 receptor expression on prognosis of estrogen receptor positive versus triple negative invasive ductal breast carcinoma

    NARCIS (Netherlands)

    Hartog, Hermien; Horlings, Hugo M; van der Vegt, Bert; Kreike, Bas; Ajouaou, Abderrahim; van de Vijver, Marc J; Boezen, Hendrika; de Bock, Geertruida H; van der Graaf, Wilhelmina; Wesseling, Jelle

    2011-01-01

    The insulin-like growth factor type 1 receptor (IGF1R) is involved in progression of breast cancer and resistance to systemic treatment. Targeting IGF1R signaling may, therefore, be beneficial in systemic treatment. We report the effect of IGF1R expression on prognosis in invasive ductal breast carc

  15. Acute Kidney Injury, Risk Factors, and Prognosis in Hospitalized HIV-Infected Adults in South Africa, Compared by Tenofovir Exposure

    Science.gov (United States)

    Martinson, Neil; Motlhaoleng, Katlego; Abraham, Pattamukkil; Mancama, Dalu; Naicker, Saraladevi; Variava, Ebrahim

    2017-01-01

    Abstract There are limited data describing acute kidney injury (AKI) in HIV-infected adult patients in resource-limited settings where tenofovir disoproxil fumarate (TDF), which is potentially nephrotoxic, is increasingly prescribed. We describe risk factors for and prognosis of AKI in HIV-infected individuals, stratified by those receiving and those naive to TDF. A prospective case cohort study of hospitalized HIV-infected adults with AKI stratified by TDF exposure. Adults (≥18 years) were recruited: clinical and biochemical data were collected at admission; their renal recovery, discharge, or mortality was ascertained as an in-patient and, subsequently, to a scheduled 3-month follow-up. Among this predominantly female (61%), almost exclusively black African cohort of 175 patients with AKI, 93 (53%) were TDF exposed; median age was 41 years (interquartile range 35–50). Median CD4 count and viral load and creatinine at baseline were 116 cells/mm3 and 110,159 copies/ml, respectively. A greater proportion of the TDF group had severe AKI on admission (61% vs. 43%, p = .014); however, both groups had similar rates of newly diagnosed tuberculosis (TB; 52%) and nonsteroidal anti-inflammatory drug (NSAID; 32%) use. Intravenous fluid was the therapeutic mainstay; only seven were dialyzed. Discharge median serum creatinine (SCr) was higher in the TDF group (p = .032) and fewer in the TDF group recovered renal function after 3 months (p = .043). Three-month mortality was 27% in both groups, but 55% of deaths occurred in hospital. Those that died had a higher SCr and more severe AKI than survivors; TB was diagnosed in 33 (70%) of those who died. AKI was more severe and renal recovery slower in the TDF group; comorbidities, risk factors, and prognosis were similar regardless of TDF exposure. Because TB is linked to higher mortality, TB coinfection in HIV-infected patients with AKI warrants more intensive monitoring. In all those with poor renal recovery, our

  16. Nerve growth factor expression in astrocytoma and cerebrospinal fluid: a new biomarker for prognosis of astrocytoma

    Institute of Scientific and Technical Information of China (English)

    LI Qiao-yu; FENG Yun; XU Wen-lin; YANG Yong; ZHANG Yan; ZHANG Zhi-jian; GONG Ai-hua; YUAN Zhi-cheng; LU Pei-song; ZHAN Li-ping; WANG Peng

    2011-01-01

    Background Recent studies have discovered that nuclear translocation of nerve growth factor (NGF) and its receptor fragments function differently from the traditional model. This study aimed to uncover the nuclear expression of NGF in astrocytoma and its biological significance.Methods Ninety-four paraffin-embedded astrocytoma specimens were subjected to immunohistochemical (IHC) and hemotoxylin & eosin (HE) staining. Preoperative cerebrospinal fluid (CSF) specimens and intraoperative snap-frozen astrocytoma tissues were assayed for NGF expression by ELISA and Western blotting. The outcome of patients who contributed samples was tracked. Each ten tissue samples from patients with traumatic brain injury who had received decompression surgery and CSF samples from patients undergoing spinal anesthesia but with no history of nervous system disease were taken as control.Results NGF-positive immunoreactive products were distributed in both the cytoplasm and nucleus of astrocytoma, but were only located in the cytoplasm of traumatic brain injury (TBI) tissue. NGF nuclear-positive rate (NPR) of grades Ⅲ-Ⅳ astrocytomas (70.0%) was higher than that of grades Ⅰ-Ⅱ astrocytoma (28.6%, P<0.05). NGF-NP expression positively correlated with the NGF concentration in cerebrospinal fluid (CSF) (r=0.755, P<0.01). Kaplan-Meier survival analysis indicated that the median survival time was 25 months for NGF-NP astrocytoma grade Ⅰ-Ⅱ patients and 42 months in NGF nuclear negative (NGF-NN) astrocytoma grade Ⅰ-Ⅱ patients (P<0.05). In astrocytoma Ⅲ-Ⅳ patients, the median survival was 7 months for NGF-NP patients and 24 months for NGF-NN patients (P<0.01). Two types of NGF with molecular weights of 13 and 36 kDa were present in astrocytoma, but only the 36 kDa NGF was found in the CSF. NGF expression elevated as the malignancy increased.Conclusions NGF-NP expression and NGF level in CSF were significant prognostic factors in astrocytoma patients.Because of the easy

  17. Obesity might be a good prognosis factor for COPD patients using domiciliary noninvasive mechanical ventilation

    Science.gov (United States)

    Altinoz, Hilal; Adiguzel, Nalan; Salturk, Cuneyt; Gungor, Gokay; Mocin, Ozlem; Berk Takir, Huriye; Kargin, Feyza; Balci, Merih; Dikensoy, Oner; Karakurt, Zuhal

    2016-01-01

    Cachexia is known to be a deteriorating factor for survival of patients with chronic obstructive pulmonary disease (COPD), but data related to obesity are limited. We observed that obese patients with COPD prescribed long-term noninvasive mechanical ventilation (NIMV) had better survival rate compared to nonobese patients. Therefore, we conducted a retrospective observational cohort study. Archives of Thoracic Diseases Training Hospital were sought between 2008 and 2013. All the subjects were prescribed domiciliary NIMV for chronic respiratory failure secondary to COPD. Subjects were grouped according to their body mass index (BMI). The first group consisted of subjects with BMI between 20 and 30 kg/m2, and the second group consisted of subjects with BMI >30 kg/m2. Data obtained at the first month’s visit for the following parameters were recorded: age, sex, comorbid diseases, smoking history, pulmonary function test, 6-minute walk test (6-MWT), and arterial blood gas analysis. Hospital admissions were recorded before and after the domiciliary NIMV usage. Mortality rate was searched from the electronic database. Overall, 118 subjects were enrolled. Thirty-eight subjects had BMI between 20 and 30 kg/m2, while 80 subjects had BMI >30 kg/m2. The mean age was 65.8±9.4 years, and 81% were male. The median follow-up time was 26 months and mortality rates were 32% and 34% for obese and nonobese subjects (P=0.67). Improvement in 6-MWT was protective against mortality. In conclusion, survival of obese patients with COPD using domiciliary NIMV was found to be better than those of nonobese patients, and the improvement in 6-MWT in such patients was found to be related to a better survival. PMID:27578969

  18. Circulating angiogenic factors are related to the severity of gestational hypertension and preeclampsia, and their adverse outcomes

    Science.gov (United States)

    Leaños-Miranda, Alfredo; Méndez-Aguilar, Francisco; Ramírez-Valenzuela, Karla Leticia; Serrano-Rodríguez, Marilyn; Berumen-Lechuga, Guadalupe; Molina-Pérez, Carlos José; Isordia-Salas, Irma; Campos-Galicia, Inova

    2017-01-01

    Abstract Gestational hypertension (GH) and preeclampsia (PE) are characterized by an imbalance in angiogenic factors. However, the relationship among these factors with the severity of hypertensive disorders of pregnancy (HDP) and adverse outcomes are not fully elucidated. We examined whether these biomarkers are related with the severity of HDP and adverse outcomes. Using a cross-sectional design, serum concentrations of placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble endoglin were determined in 764 pregnant women: 75 healthy pregnant, 83 with mild GH (mGH), 105 with severe GH (sGH), 122 with mild PE (mPE), and 379 with severe PE (sPE). All angiogenic factors’ concentrations were significantly different (P ≤ 0.041) in HDP than in healthy pregnancy. In addition, these factors were markedly different in sPE than in mPE, sGH, or mGH (P ≤ 0.027) and in patients with sGH that in those with mPE or mGH (P < 0.05). As compared to mGH and mPE, patients with sGH and sPE had higher rates of both preterm delivery at <34 weeks of gestation and small-for-gestational age infants. Moreover, patients with sPE had higher rates of adverse maternal outcomes (P < 0.001) when compared to patients with mGH, sGH, or mPE. In all cases, levels of sFlt-1/PlGF ratio were significantly higher in patients with sGH and sPE who had adverse perinatal and maternal outcomes than in those with sGH and sPE who did not (P ≤ 0.016). Circulating concentrations of angiogenic factors appear to be suitable markers to assess the severity of GH and PE, and adverse outcomes. PMID:28121958

  19. Obesity might be a good prognosis factor for COPD patients using domiciliary noninvasive mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Altinoz H

    2016-08-01

    Full Text Available Hilal Altinoz,1 Nalan Adiguzel,2 Cuneyt Salturk,2 Gokay Gungor,2 Ozlem Mocin,2 Huriye Berk Takir,2 Feyza Kargin,2 Merih Balci,2 Oner Dikensoy,1 Zuhal Karakurt2 1Pulmonary Division, Acibadem University School of Medicine, 2Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey Abstract: Cachexia is known to be a deteriorating factor for survival of patients with chronic obstructive pulmonary disease (COPD, but data related to obesity are limited. We observed that obese patients with COPD prescribed long-term noninvasive mechanical ventilation (NIMV had better survival rate compared to nonobese patients. Therefore, we conducted a retrospective observational cohort study. Archives of Thoracic Diseases Training Hospital were sought between 2008 and 2013. All the subjects were prescribed domiciliary NIMV for chronic respiratory failure secondary to COPD. Subjects were grouped according to their body mass index (BMI. The first group consisted of subjects with BMI between 20 and 30 kg/m2, and the second group consisted of subjects with BMI >30 kg/m2. Data obtained at the first month’s visit for the following parameters were recorded: age, sex, comorbid diseases, smoking history, pulmonary function test, 6-minute walk test (6-MWT, and arterial blood gas analysis. Hospital admissions were recorded before and after the domiciliary NIMV usage. Mortality rate was searched from the electronic database. Overall, 118 subjects were enrolled. Thirty-eight subjects had BMI between 20 and 30 kg/m2, while 80 subjects had BMI >30 kg/m2. The mean age was 65.8±9.4 years, and 81% were male. The median follow-up time was 26 months and mortality rates were 32% and 34% for obese and nonobese subjects (P=0.67. Improvement in 6-MWT was protective against mortality. In conclusion, survival of obese patients with COPD using domiciliary NIMV was found to be better than those of nonobese patients, and the improvement in 6-MWT in such

  20. Factors Related to Prognosis of Refractory Glaucoma with Diode Laser Transscleral Cyclophotocoagulation Treatment

    Institute of Scientific and Technical Information of China (English)

    Shun-hua Zhang; Fang-tian Dong; Jin Mao; Ai-ling Bian

    2011-01-01

    Objective To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation (TSCP) in a midterm observation.Methods Fifty-four consecutive patients (54 eyes) with refractory glaucoma were enrolled and underwent TSCP (power of 1.5-2.0 W, exposure time of 2 seconds and 20-50 applications). Patients were regularly followed up for 12 months. Intraocular pressure (10P) was measured before TSCP treatment and at each follow-up visit. Patients were divided into the sensitive and insensitive groups according to the effect of a single treatment of TSCP on IOP The success rate was defined as the percentage of eyes achieving an IOP between 5 and 21 mm Hg following TSCP therapy at their final follow up visit. Difference of age between the sensitive and insensitive groups was evaluated with Independent-samples T test and that of gender distribution of two groups was evaluated with Fisher's exact test. The success rate of different types of glaucoma to TSCP was calculated.Results A total of 32 patients were sensitive to TSCP (sensitive group) and 22 patients were insensitive to TSCP (insensitive group). The success rates of female (77.8%, 14/18) and cases being over 50 years (71.4%, 20/28) were higher than those of male (50.0%, 18/36) and ones being under 50 years (46.2%,12/26) (all P>0.05). The age of the sensitive and insensitive groups was 56.0±15.5 and 46.4±15.4 years,respectively (P=0.029). The age (P=0.029) and gender distribution (P=0.046) of the two groups had significant difference. The success rate of neovascular glaucoma, primary angle-closure glaucoma, primary open angle glaucoma, traumatic glaucoma, uveitic glaucoma, and secondary glaucoma after silicone oil injection to TSCP was 57.1%, 100.0%, 50.0%, 20.0%, 81.8%, and 0%, respectively.Conclusion Age, gender, and type of glaucoma appear to be associated with effect of TSCP on 10P control.

  1. The prognosis factor of adjuvant radiation therapy after surgery in uterine sarcomas

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    Hou HL

    2015-08-01

    Full Text Available Hai-Ling Hou, Mao-Bin Meng, Xiu-Li Chen, Lu-Jun Zhao, Li Zhu, Bai-Lin Zhang, Ping Wang Department of Radiation Oncology, CyberKnife Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, People’s Republic of China Objective: This retrospective study evaluated the role of adjuvant radiotherapy (AR after surgery in patients with uterine sarcoma and analyzed the prognostic factors of local-regional failure-free survival (LRFFS and overall survival (OS.Patients and methods: A study of a total of 182 patients with uterine sarcoma was conducted between June 1994 and October 2014. Adjuvant radiotherapy was defined as postoperative external beam radiation to the pelvis (30–50 Gray/10–25 fractions at five fractions/week. The primary end point was LRFFS, and the secondary end point was OS. Kaplan–Meier curves were compared using the log-rank test. Cox regression analyses were used to determine prognosticators for LRFFS and OS.Results: The median follow-up time of all patients was 75 months, with a 5-year LRFFS of 62.1%. The 2-year and 5-year LRFFS rates were longer for those who received AR than for those who did not receive AR (83.4% vs 70.3%; 78% vs 55.3%; P=0.013. The 5-year OS of all patients was 56.2%, and no significant differences were observed in the 2-year and 5-year OS rates between these two groups (82.7% vs 71.4%; 64.1% vs 51.7%; P=0.067. Importantly, in patients with leiomyosarcoma, the 2-year and 5-year LRFFS and OS rates were longer for those who received AR than for those who did not receive AR (P=0.04 and P=0.02 for the 2-year and 5-year LRFFS, respectively.Conclusion: Patients with uterine sarcoma who were treated with AR after surgery demonstrated an improved LRFFS compared with those who were treated with surgery alone, especially those patients with leiomyosarcoma. Therefore, the role of personalized adjuvant

  2. Fulminant sepsis caused by Bacillus cereus in patients with hematologic malignancies: analysis of its prognosis and risk factors.

    Science.gov (United States)

    Inoue, Daichi; Nagai, Yuya; Mori, Minako; Nagano, Seiji; Takiuchi, Yoko; Arima, Hiroshi; Kimura, Takaharu; Shimoji, Sonoko; Togami, Katsuhiro; Tabata, Sumie; Yanagita, Soshi; Matsushita, Akiko; Nagai, Kenichi; Imai, Yukihiro; Takegawa, Hiroshi; Takahashi, Takayuki

    2010-05-01

    Bacillus cereus is a growing concern as a cause of life-threatening infections in patients with hematologic malignancies. However, the risk factors for patients with unfavorable outcomes have not been fully elucidated. At our institution, we observed the growth of B. cereus in blood culture in 68 patients with (23) or without (45) hematologic malignancies treated from September 2002 to November 2009. We defined a case as having sepsis when more than two blood culture sets were positive for B. cereus or only a single set was positive in the absence of other microorganisms in patients who had definite infectious lesions. We determined 12 of 23 patients with hematologic malignancies as having sepsis, as well as 10 of 45 patients without hematologic malignancies (p = 0.012). Of the 12 patients with hematologic malignancies, four patients with acute leukemia died of B. cereus sepsis within a few days. In our cohort, risk factor analysis demonstrated that a neutrophil count of 0/mm(3), central venous (CV) catheter insertion, and the presence of central nervous system (CNS) symptoms were significantly associated with a fatal prognosis (p = 0.010, 0.010, and 0.010, respectively). Analysis of data from our cohort in conjunction with those from 46 previously reported patients with B. cereus sepsis identified similar risk factors, that is, acute leukemia, extremely low neutrophil count, and CNS symptoms (p = 0.044, 0.004, and 0.002, respectively). These results indicate that appropriate prophylaxis and early therapeutic intervention against possible B. cereus sepsis are crucially important in the treatment of hematologic malignancies.

  3. Influence of psychological factors on the prognosis of chronic shoulder pain: protocol for a prospective cohort study

    Science.gov (United States)

    Martinez-Calderon, Javier; Struyf, Filip; Meeus, Mira; Morales-Ascencio, Jose Miguel; Luque-Suarez, Alejandro

    2017-01-01

    Introduction Shoulder pain is a highly prevalent condition. Psychological factors could play an essential role in the prognosis of chronic shoulder pain (CSP). The aims of the study will be to analyse the level of association between psychological factors and pain-disability at baseline and prospectively to assess their prognostic role; to evaluate the association of pain catastrophising and kinesiophobia at baseline and prospectively in the relationship between pain intensity and disability, or between self-efficacy and disability in patients with CSP; to explore the association of self-efficacy at baseline and prospectively in the relationship between pain intensity and disability, in comparison with kinesiophobia and pain catastrophising. Methods and analysis The study is a longitudinal, prospective cohort study with a 12-month follow-up. It will be conducted in 4 primary-care centres and one hospital of the province of Malaga, Spain. 307 participants aged between 18 and 70 years suffering from CSP (3 months or more) will be included. Primary outcomes will include pain, disability and self-efficacy, whereas kinesiophobia, pain-related fear, pain catastrophising, anxiety, depression, patient expectations of recovery, age, gender, duration/intensity of symptoms, educational level and other factors will be predictive measures. Follow-up: baseline, 3, 6 and 12 months. Ethics and dissemination The local ethics committee (The Costa del Sol Ethics Committee, Malaga, 28042016) has approved this protocol. Dissemination will occur through presentations at National and International conferences and publications in international peer-reviewed journals. Trial registration number NCT02738372; pre-results PMID:28264825

  4. Angiogenic and fibrinolytic factors in blood during the first half of pregnancy and adverse pregnancy outcomes.

    NARCIS (Netherlands)

    Coolman, M.; Timmermans, S.; Groot, C.J. de; Russcher, H.; Lindemans, J.; Hofman, A.; Geurts-Moespot, A.; Sweep, F.C.; Jaddoe, V.V.; Steegers, E.A.P.

    2012-01-01

    OBJECTIVE: To estimate whether the imbalance of angiogenic factors (soluble fms-like tyrosine kinase-1, placental growth factor) and fibrinolytic factors (plasminogen activator inhibitor-2 [PAI-2]) might affect placentation in early pregnancy. METHODS: We studied the associations of maternal soluble

  5. Effects of nitrogen on the tolerance of brown planthopper,Nilaparvata Lugens, to adverse environmental factors

    Institute of Scientific and Technical Information of China (English)

    ZHONG-XIANLU; KONG-LUENHEONG; XIAO-PINGYU; CUIHU

    2005-01-01

    The effect of nitrogen content in rice plants on the tolerance of brown planthopper (BPH), Nilaparvata lugens Stal to high temperature, starvation and insecticide, was studied in the laboratory at International Rice Research Institute (IRRI), Philippines. Survival of nymphs and adults, fecundity and egg hatchability were significantly increased by the increase of nitrogen content in host plants at 38℃. Moreover, the survival of nymphs,fecundity and egg hatchability were significantly higher in BPH populations on rice plants with a high nitrogen regimen than those on rice plants with a low nitrogen regimen.Meanwhile, the tolerance of female adults to starvation and nymphs to growth regulator buprofezin on rice plants with a high nitrogen regimen were slightly increased. This indicates that the tolerances of BPH to adverse environmental stresses were positively increased by the application of nitrogenous fertilizer. The outbreak potential of BPH induced by the excessive application of fertilizer in rice fields was also discussed.

  6. TP53 overexpression is an independent adverse prognostic factor in de novo myelodysplastic syndromes with fibrosis.

    Science.gov (United States)

    Loghavi, Sanam; Al-Ibraheemi, Alyaa; Zuo, Zhuang; Garcia-Manero, Guillermo; Yabe, Mariko; Wang, Sa A; Kantarjian, Hagop M; Yin, Cameron C; Miranda, Roberto N; Luthra, Raja; Medeiros, L Jeffrey; Bueso-Ramos, Carlos E; Khoury, Joseph D

    2015-10-01

    Bone marrow (BM) fibrosis is associated with poor prognosis in patients with de novo myelodysplastic syndromes (MDS). TP53 mutations and TP53 (p53) overexpression in MDS are also associated with poor patient outcomes. The prevalence and significance of TP53 mutations and TP53 overexpression in MDS with fibrosis are unknown. We studied 67 patients with de novo MDS demonstrating moderate to severe reticulin fibrosis (MDS-F). Expression of TP53 was evaluated in BM core biopsy specimens using dual-colour CD34/TP53 immunohistochemistry with computer-assisted image analysis. Mutation analysis was performed using next-generation sequencing, or Sanger sequencing methods. TP53 mutations were present in 47·1% of cases. TP53 mutation was significantly associated with TP53 expression (P = 0·0294). High levels of TP53 expression (3 +  in ≥10% cells) were associated with higher BM blast counts (P = 0·0149); alterations of chromosomes 5 (P = 0·0009) or 7 (P = 0·0141); complex karyotype (P = 0·0002); high- and very-high risk IPSS-R groups (P = 0·009); and TP53 mutations (P = 0·0003). High TP53 expression independently predicted shorter overall survival (OS) by multivariate analysis (P = TP53 by CD34-positive cells was associated with shorter OS and leukaemia-free survival (P = 0·0428). TP53 overexpression is a predictor of poor outcome in patients with MDS-F.

  7. Vascular endothelial growth factor C (VEGF-C in esophageal cancer correlates with lymph node metastasis and poor patient prognosis

    Directory of Open Access Journals (Sweden)

    Naganawa Yasuhiro

    2010-06-01

    VEGF-C expression group survived. Conclusions The expression of VEGF-C correlates with lymph node metastasis and poor prognosis. In patients with Tis and T1 esophageal tumors, the expression of VEGF-C may be a good diagnostic factor for determining metastasis of the lymph node.

  8. Risk factors and prognosis of nosocomial bloodstream infections caused by extended-spectrum-beta-lactamase-producing Escherichia coli.

    Science.gov (United States)

    Rodríguez-Baño, Jesús; Picón, Encarnación; Gijón, Paloma; Hernández, José Ramón; Cisneros, Jose M; Peña, Carmen; Almela, Manuel; Almirante, Benito; Grill, Fabio; Colomina, Javier; Molinos, Sonia; Oliver, Antonio; Fernández-Mazarrasa, Carlos; Navarro, Gemma; Coloma, Ana; López-Cerero, Lorena; Pascual, Alvaro

    2010-05-01

    Extended-spectrum-beta-lactamase (ESBL)-producing Escherichia coli (ESBLEC) is an increasing cause of community and nosocomial infections worldwide. However, there is scarce clinical information about nosocomial bloodstream infections (BSIs) caused by these pathogens. We performed a study to investigate the risk factors for and prognosis of nosocomial BSIs due to ESBLEC in 13 Spanish hospitals. Risk factors were assessed by using a case-control-control study; 96 cases (2 to 16% of all nosocomial BSIs due to E. coli in the participating centers) were included; the most frequent ESBL was CTX-M-14 (48% of the isolates). We found CTX-M-15 in 10% of the isolates, which means that this enzyme is emerging as a cause of invasive infections in Spain. By repetitive extragenic palindromic sequence-PCR, most isolates were found to be clonally unrelated. By multivariate analysis, the risk factors for nosocomial BSIs due to ESBLEC were found to be organ transplant (odds ratio [OR]=4.8; 95% confidence interval [CI]=1.4 to 15.7), the previous use of oxyimino-beta-lactams (OR=6.0; 95% CI=3.0 to 11.8), and unknown BSI source (protective; OR=0.4; 95% CI=0.2 to 0.9), and duration of hospital stay (OR=1.02; 95% CI=1.00 to 1.03). The variables independently associated with mortality were a Pitt score of >1 (OR=3.9; 95% CI=1.2 to 12.9), a high-risk source (OR=5.5; 95% CI=1.4 to 21.9), and resistance to more than three antibiotics, apart from penicillins and cephalosporins (OR=6.5; 95% CI=1.4 to 30.0). Inappropriate empirical therapy was not associated with mortality. We conclude that ESBLEC is an important cause of nosocomial BSIs. The previous use of oxyimino-beta-lactams was the only modifiable risk factor found. Resistance to drugs other than penicillins and cephalosporins was associated with increased mortality.

  9. Low body weight in females is a risk factor for increased tenofovir exposure and drug-related adverse events.

    Directory of Open Access Journals (Sweden)

    Cristina Gervasoni

    Full Text Available Treatment with tenofovir sometimes leads to non-reversible kidney and/or bone diseases. Factors associated with these drug-related adverse events are poorly characterized. Our objective was to investigate such factors in patients treated long term with daily tenofovir. One-hundred Caucasian HIV-positive patients with basal creatinine clearance >80 mL/min treated with tenofovir for at least 6 months and with at least one assessment of tenofovir plasma trough concentrations were considered. Tenofovir-associated adverse events were defined as the appearance of pathological proteinuria, worsening of renal function or bone demineralization. By multivariate regression analysis, we found that serum creatinine (p = 0.003 and body weight (p = 0.002 were the factors independently associated with plasma tenofovir concentrations. In particular, women with body weight50 Kg (160±93 vs.71±52 ng/mL, p<0.001. High tenofovir plasma trough concentrations and the age of the patients were independently associated with the development of drug-related kidney and bone toxicity. In this retrospective study we have shown that HIV-infected women with low body weight are at risk to be exposed to high tenofovir plasma trough concentrations, ultimately resulting in a significant hazard to develop long-term tenofovir complications.

  10. The MyD88+ phenotype is an adverse prognostic factor in epithelial ovarian cancer.

    LENUS (Irish Health Repository)

    d'Adhemar, Charles J

    2014-01-01

    The prognosis of epithelial ovarian cancer is poor in part due to the high frequency of chemoresistance. Recent evidence points to the Toll-like receptor-4 (TLR4), and particularly its adaptor protein MyD88, as one potential mediator of this resistance. This study aims to provide further evidence that MyD88 positive cancer cells are clinically significant, stem-like and reproducibly detectable for the purposes of prognostic stratification. Expression of TLR4 and MyD88 was assessed immunohistochemically in 198 paraffin-embedded ovarian tissues and in an embryonal carcinoma model of cancer stemness. In parallel, expression of TLR4 and MyD88 mRNA and regulatory microRNAs (miR-21 and miR-146a) was assessed, as well as in a series of chemosensitive and resistant cancer cells lines. Functional analysis of the pathway was assessed in chemoresistant SKOV-3 ovarian cancer cells. TLR4 and MyD88 expression can be reproducibly assessed via immunohistochemistry using a semi-quantitative scoring system. TLR4 expression was present in all ovarian epithelium (normal and neoplastic), whereas MyD88 was restricted to neoplastic cells, independent of tumour grade and associated with reduced progression-free and overall survival, in an immunohistological specific subset of serous carcinomas, p<0.05. MiR-21 and miR-146a expression was significantly increased in MyD88 negative cancers (p<0.05), indicating their participation in regulation. Significant alterations in MyD88 mRNA expression were observed between chemosensitive and chemoresistant cells and tissue. Knockdown of TLR4 in SKOV-3 ovarian cells recovered chemosensitivity. Knockdown of MyD88 alone did not. MyD88 expression was down-regulated in differentiated embryonal carcinoma (NTera2) cells, supporting the MyD88+ cancer stem cell hypothesis. Our findings demonstrate that expression of MyD88 is associated with significantly reduced patient survival and altered microRNA levels and suggest an intact\\/functioning TLR4\\/MyD88

  11. The MyD88+ phenotype is an adverse prognostic factor in epithelial ovarian cancer.

    Directory of Open Access Journals (Sweden)

    Charles J d'Adhemar

    Full Text Available The prognosis of epithelial ovarian cancer is poor in part due to the high frequency of chemoresistance. Recent evidence points to the Toll-like receptor-4 (TLR4, and particularly its adaptor protein MyD88, as one potential mediator of this resistance. This study aims to provide further evidence that MyD88 positive cancer cells are clinically significant, stem-like and reproducibly detectable for the purposes of prognostic stratification. Expression of TLR4 and MyD88 was assessed immunohistochemically in 198 paraffin-embedded ovarian tissues and in an embryonal carcinoma model of cancer stemness. In parallel, expression of TLR4 and MyD88 mRNA and regulatory microRNAs (miR-21 and miR-146a was assessed, as well as in a series of chemosensitive and resistant cancer cells lines. Functional analysis of the pathway was assessed in chemoresistant SKOV-3 ovarian cancer cells. TLR4 and MyD88 expression can be reproducibly assessed via immunohistochemistry using a semi-quantitative scoring system. TLR4 expression was present in all ovarian epithelium (normal and neoplastic, whereas MyD88 was restricted to neoplastic cells, independent of tumour grade and associated with reduced progression-free and overall survival, in an immunohistological specific subset of serous carcinomas, p<0.05. MiR-21 and miR-146a expression was significantly increased in MyD88 negative cancers (p<0.05, indicating their participation in regulation. Significant alterations in MyD88 mRNA expression were observed between chemosensitive and chemoresistant cells and tissue. Knockdown of TLR4 in SKOV-3 ovarian cells recovered chemosensitivity. Knockdown of MyD88 alone did not. MyD88 expression was down-regulated in differentiated embryonal carcinoma (NTera2 cells, supporting the MyD88+ cancer stem cell hypothesis. Our findings demonstrate that expression of MyD88 is associated with significantly reduced patient survival and altered microRNA levels and suggest an intact/functioning TLR4

  12. Impact of early psychosocial factors (childhood socioeconomic factors and adversities on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review

    Directory of Open Access Journals (Sweden)

    Tamayo Teresa

    2010-09-01

    Full Text Available Abstract Background Psychological factors and socioeconomic status (SES have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of

  13. Incidence and risk factors of serious adverse events during antituberculous treatment in Rwanda: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Natalie Lorent

    Full Text Available BACKGROUND: Tuberculosis (TB and TB-human immunodeficiency virus infection (HIV coinfection is a major public health concern in resource-limited settings. Although TB treatment is challenging in HIV-infected patients because of treatment interactions, immunopathological reactions, and concurrent infections, few prospective studies have addressed this in sub-Saharan Africa. In this study we aimed to determine incidence, causes of, and risk factors for serious adverse events among patients on first-line antituberculous treatment, as well as its impact on antituberculous treatment outcome. METHODS AND FINDINGS: Prospective observational cohort study of adults treated for TB at the Internal Medicine department of the Kigali University Hospital from May 2008 through August 2009. Of 263 patients enrolled, 253 were retained for analysis: median age 35 (Interquartile range, IQR 28-40, 55% male, 66% HIV-positive with a median CD4 count 104 cells/mm(3 (IQR 44-248 cells/mm(3. Forty percent had pulmonary TB, 43% extrapulmonary TB and 17% a mixed form. Sixty-four (26% developed a serious adverse event; 58/167 (35% HIV-infected vs. 6/86 (7% HIV-uninfected individuals. Commonest events were concurrent infection (n = 32, drug-induced hepatitis (n = 24 and paradoxical reactions/TB-IRIS (n = 23. HIV-infection (adjusted Hazard Ratio, aHR 3.4, 95% Confidence Interval, CI 1.4-8.7 and extrapulmonary TB (aHR 2, 95%CI 1.1-3.7 were associated with an increased risk of serious adverse events. For TB/HIV co-infected patients, extrapulmonary TB (aHR 2.0, 95%CI 1.1-3.9 and CD4 count <100 cells/mm3 at TB diagnosis (aHR 1.7, 95%CI 1.0-2.9 were independent predictors. Adverse events were associated with an almost two-fold higher risk of unsuccessful treatment outcome at 6 months (HR 1.89, 95%CI 1.3-3.0. CONCLUSION: Adverse events frequently complicate the course of antituberculous treatment and worsen treatment outcome, particularly in patients with extrapulmonary

  14. Factors associated with crashes involving taxi owners and non-owners: A case of moral hazard and adverse selection?

    Science.gov (United States)

    Tay, Richard; Choi, Jaisung

    2016-02-01

    Taxis experience a higher risk of a motor vehicle crash partly because of their much higher levels of exposure on the roads. Although several studies have been conducted to examine the factors associated with the frequency and severity of taxi collisions, little research has been conducted to examine the differences in the factors associated with owner taxis and non-owner taxis. This study finds that collisions involving non-owners are more likely to be associated with poor or risky driving behaviors than collisions involving taxi vehicle owners. This result is consistent with the economic principles of moral hazard and adverse selection. Hence, policy makers responsible for traffic safety, taxi regulation or taxi operations should consider measures to reduce these market inefficiencies and improve the safety of not only taxi drivers but all road users.

  15. Analysis of the related factors of sudden deafness prognosis%突发性耳聋预后相关因素分析

    Institute of Scientific and Technical Information of China (English)

    毕永华

    2014-01-01

    Objective:To explore the related factors of sudden deafness prognosis,and to provide effective clinical basis for the diagnosis and treatment of the disease.Methods:103 cases with sudden deafness were selected from January 2011 to December 2013.Their clinical data were retrospectively analyzed.Selecting many maybe related factors of sudden deafness prognosis were given statistical analysis.The effects of related factors on the prognosis were evaluated.Results:Gender,age,sick ear had no significant correlation with prognosis(P>0.05).The start treatment time after the onset,the hearing loss degree when the onset, whether early using hormones had significant correlation with prognosis(P<0.05).Conclusion:Early treatment and early using hormone after the onset help hearing restored of patients.The hearing decreased degree of patients with is bigger,and the prognosis is worse.%目的:探讨突发性耳聋预后的相关因素,为诊断及治疗该病提供有效的临床依据。方法:2011年1月-2013年12月收治突发性耳聋患者103例,对其临床资料进行回顾性分析。选取多项与突发性耳聋预后可能相关的因素进行统计分析,评价各相关因素对预后的影响。结果:性别、年龄、患侧耳与预后无明显相关性(P>0.05);发病后开始治疗时间、发病时听力下降程度、是否早期使用激素等与预后有明显相关性(P<0.05)。结论:发病后早期治疗及早期使用激素有助于患者听力恢复;患者听力的下降程度越大,预后就越差。

  16. Hygienic assessment of habitat adverse social and sanitary factors in the Altai Krai

    Directory of Open Access Journals (Sweden)

    A.A. Ushakov

    2015-12-01

    Full Text Available The materials on health status, socio-economic, sanitary living conditions of the population of the Altai Krai have been analyzed. The comparative analysis of the conditions of life and health outcomes in urban and rural settlements’ population has been performed. The estimation of health indicators’ correlation has been carried out in children of age group 0-1 years, children of age group 0-14 years, teens of age group 15-17 years and adults of age group over 18 years, depending on the type (urban or rural of settlement with indicators of social and sanitary environmental factors. Regression equations for the health outcomes of different age groups on the level of hygiene and social environmental factors are set, regional critical (reference values are justified. The hygienic assessment of unfavorable social, health and sanitation of the environment on the health of the population in the Altai Krai is provided.

  17. Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda

    Directory of Open Access Journals (Sweden)

    Turyakira Eleanor

    2011-10-01

    Full Text Available Abstract Background Obstructed labour is still a major cause of maternal morbidity and mortality and of adverse outcome for newborns in low-income countries. The aim of this study was to investigate the role of individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda. Methods A review was performed on 12,463 obstetric records for the year 2006 from six hospitals located in south-western Uganda and 11,180 women records were analysed. Multivariate logistic regression analyses were applied to control for probable confounders. Results Prevalence of obstructed labour for the six hospitals was 10.5% and the main causes were cephalopelvic disproportion (63.3%, malpresentation or malposition (36.4% and hydrocephalus (0.3%. The risk of obstructed labour was statistically significantly associated with being resident of a particular district [Isingiro] (AOR 1.39, 95% CI: 1.04-1.86, with nulliparous status (AOR 1.47, 95% CI: 1.22-1.78, having delivered once before (AOR 1.57, 95% CI: 1.30-1.91 and age group 15-19 years (AOR 1.21, 95% CI: 1.02-1.45. The risk for perinatal death as an adverse outcome was statistically significantly associated with districts other than five comprising the study area (AOR 2.85, 95% CI: 1.60-5.08 and grand multiparous status (AOR 1.89, 95% CI: 1.11-3.22. Women who lacked paid employment were at increased risk of obstructed labour. Perinatal mortality rate was 142/1000 total births in women with obstructed labour compared to 65/1000 total births in women without the condition. The odds of having maternal complications in women with obstructed labour were 8 times those without the condition. The case fatality rate for obstructed labour was 1.2%. Conclusions Individual socio-demographic and health system factors are strongly associated with obstructed labour and its adverse outcome in south-western Uganda. Our study provides baseline information which may be used by

  18. Intellectual disability: definition, etiological factors, classification, diagnosis, treatment and prognosis Discapacidad intelectual: definición, factores etiológicos, clasificación, diagnóstico, tratamiento y prognosis

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    Gregorio Katz

    2008-01-01

    Full Text Available Etiology and classification: Causal factors related with cognitive disability are multiples and can be classified as follows: Genetic, acquired (congenital and developmental, environmental and sociocultural. Likewise, in relation to the classification, cognitive disability has as a common denominator a subnormal intellectual functioning level; nevertheless, the extent to which an individual is unable to face the demands established by society for the individual’s age group has brought about four degrees of severity: Mild, moderate, severe and profound. Diagnostic: The clinical history must put an emphasis on healthcare during the prenatal, perinatal and postnatal period and include the results of all previous studies, including a genealogical tree for at least three generations and an intentional search for family antecedents of mental delay, psychiatric illnesses and congenital abnormalities. The physical exam should focus on secondary abnormalities and congenital malformations, somatometric measurements and neurological and behavioral phenotype evaluations. If it is not feasible to establish a clinical diagnosis, it is necessary to conduct high-resolution cytogenetic studies in addition to metabolic clinical evaluations. In the next step, if no abnormal data are identified, submicroscopic chromosomal disorders are evaluated. Prognosis: Intellectual disability is not curable; and yet, the prognostic in general terms is good when using the emotional wellbeing of the individual as a parameter. Conclusions: Intellectual disability should be treated in a comprehensive manner. Nevertheless, currently, the fundamental task and perhaps the only one that applies is the detection of the limitation and abilities as a function of subjects’ age and expectations for the future, with the only goal being to provide the support necessary for each one of the dimensions or areas in which the person’s life is expressed and exposed.Etiología y clasificaci

  19. Risk factors of adverse drug reaction from non-steroidal anti-inflammatory drugs in Shanghai patients with arthropathy

    Institute of Scientific and Technical Information of China (English)

    Wen SHI; Yong-ming WANG; Shao-li LI; Min YAN; Duan Li; Bin-yah CHEN; Neng-neng CHENG

    2004-01-01

    AIM: The study was to screen the possible risk factors of adverse drug reaction (ADR) induced by non-steroidal anti-inflammatory drugs (NSAIDs) in Shanghai patients with arthropathy. METHODS: The subjects were randomly selected from a database of outpatients with arthropathy from 9 main hospitals in Shanghai. A door to door retrospective epidemiological survey was used to collect demographic information about the patients, both individual and familial. This included data on their medical histories, lifestyle and dietary habits, history of smoking and alcohol consumption, history of drug therapy, quality of life (QOL) prior to NSAIDs intake, history of NSAIDs therapy and its ADR events, etc. Descriptive statistical methods and univariate analysis were also used to identify possible risk factors for ADRs induced by NSAIDs. RESULTS: Of the 1002 patients surveyed, the average length of NSAIDs intake was 2 years. ADR incidence from different NSAIDs was high, in a range from 46.7 %-66.2 %.In general, the candidate risk factors for ADRs were different for each NSAID. Each of the candidate risk factors were defined and studied in order to evaluate its role in the determination of ADRs from NSAIDs. "Family history of ADRs caused by NSAIDs" was found to be a significant risk factor for the four commonly used NSAIDs:meloxicam, diclofenac, nimesulide, and nabumetone. CONCLUSION: A retrospective epidemiological survey was useful in detecting the risk factors for ADRs caused by NSAIDs. The study found that different NSAIDs might have different risk factors and that there is no single risk factor universally applicable to all NSAIDs.

  20. Adolescence as risk factor for adverse pregnancy outcome in Central Africa--a cross-sectional study.

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    Florian Kurth

    Full Text Available BACKGROUND: Sub-Saharan Africa has the highest rates of maternal and neonatal mortality worldwide. Young maternal age at delivery has been proposed as risk factor for adverse pregnancy outcome, yet there is insufficient data from Sub-Saharan Africa. The present study aimed to investigate the influence of maternal adolescence on pregnancy outcomes in the Central African country Gabon. METHODOLOGY AND PRINCIPAL FINDINGS: Data on maternal age, parity, birth weight, gestational age, maternal Plasmodium falciparum infection, use of bednets, and intake of intermittent preventive treatment of malaria in pregnancy were collected in a cross-sectional survey in 775 women giving birth in three mother-child health centers in Gabon. Adolescent women (≤16 years of age had a significantly increased risk to deliver a baby with low birth weight in univariable analysis (22.8%, 13/57, vs. 9.3%, 67/718, OR: 2.9, 95% CI: 1.5-5.6 and young maternal age showed a statistically significant association with the risk for low birth weight in multivariable regression analysis after correction for established risk factors (OR: 2.7; 95% CI: 1.1-6.5. In further analysis adolescent women were shown to attend significantly less antenatal care visits than adult mothers (3.3±1.9 versus 4.4±1.9 mean visits, p<0.01, n = 356 and this difference accounted at least for part of the excess risk for low birth weight in adolescents. CONCLUSION: Our data demonstrate the importance of adolescent age as risk factor for adverse pregnancy outcome. Antenatal care programs specifically tailored for the needs of adolescents may be necessary to improve the frequency of antenatal care visits and pregnancy outcomes in this risk group in Central Africa.

  1. Early Life Adversity as a Risk Factor for Fibromyalgia in Later Life

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    Lucie A. Low

    2012-01-01

    Full Text Available The impact of early life events is increasingly becoming apparent, as studies investigate how early childhood can shape long-term physiology and behaviour. Fibromyalgia (FM, which is characterised by increased pain sensitivity and a number of affective co-morbidities, has an unclear etiology. This paper discusses risk factors from early life that may increase the occurrence or severity of FM in later life: pain experience during neonatal life causes long-lasting changes in nociceptive circuitry and increases pain sensitivity in the older organism; premature birth and related stressor exposure cause lasting changes in stress responsivity; maternal deprivation affects anxiety-like behaviours that may be partially mediated by epigenetic modulation of the genome—all these adult phenotypes are strikingly similar to symptoms displayed by FM sufferers. In addition, childhood trauma and exposure to substances of abuse may cause lasting changes in developing neurotransmitter and endocrine circuits that are linked to anxiety and stress responses.

  2. Fibroblast Growth Factor-23 in Obese, Normotensive Adolescents is Associated with Adverse Cardiac Structure

    Science.gov (United States)

    Ali, Farah N.; Falkner, Bonita; Gidding, Samuel S.; Price, Heather E.; Keith, Scott W.; Langman, Craig B.

    2014-01-01

    Objectives Fibroblast growth factor-23 (FGF23) is a biomarker for cardiovascular (CV) disease. Obesity may promote FGF23 production in the absence of chronic kidney disease (CKD). We sought to determine among normotensive African American adolescents, whether FGF23 levels are higher in obese compared with normal weight African American adolescents; and to determine the relationship of FGF23 with markers of cardiac structure and insulin resistance. Study design Cross-sectional data were obtained from a cohort of 130 normotensive, African American adolescents aged 13-18 years old without CKD; 74 were obese; 56 were normal weight. Plasma C-terminal FGF23, fasting glucose and insulin, and hsCRP were measured; participants underwent M-mode echocardiography. Results FGF23 was skewed and approximately normally distributed after natural log transformation (logFGF23). FGF23 levels were higher in obese versus normal weight participants (geometric mean 43 vs. 23 RU/mL, p<0.01). FGF23 values were significantly higher in participants with eccentric or concentric cardiac hypertrophy compared with those without hypertrophy (p<0.01). LogFGF23 directly correlated with BMI, BMI z-score, waist circumference, fasting insulin levels, and HOMA scores. Regression models adjusted for age, sex, and hsCRP suggest that each 10% increase in FGF23 is associated with 1.31 unit increase in LVM (p<0.01), 0.29 unit increase in LVMI (p<0.01), and 0.01 unit increase in left atrial dimension indexed to height (p=0.02). Conclusions In this sample of obese African American adolescents, FGF23 blood levels were associated with abnormal cardiac structure. We postulate that FGF23 may be an early marker of cardiac injury in obese but otherwise healthy African American adolescents. PMID:25063724

  3. Prognosis of pediatric epilepsy

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    Girish C Nair

    2008-01-01

    Full Text Available Epilepsy is a significant and commonplace neurological disability in the pediatric population. Data from increasingly larger and more representative studies have brought about noteworthy changes in our understanding of the prognosis of epilepsy in the pediatric age-group. Prevalence rates for epilepsy in both the developing and the developed world are surprisingly similar despite distinct differences in incidence and large treatment gaps in the developing world; this strongly points towards the possibility of spontaneous remission, at least in some patients. Prognosis after an isolated first seizure is generally quite favorable, but worsens with recurring seizures, remote symptomatic etiology, and the presence of abnormalities on EEG. Presently available antiepileptic drugs (AEDs are at best seizure suppressant in their action and have not been shown to be antiepileptic in the sense that they alter the long-term prognosis of the epilepsy for the better. Epilepsy syndromes can be considered to belong to distinct groups on the basis of their prognosis. Some have an excellent outcome in terms of seizure freedom and neurological development; yet others have a grim prognosis with respect to these variables. Factors that impact on the prognosis of treated epilepsy are being understood and include the specific etiology, age of onset of epilepsy, and EEG findings. Epileptics, especially those with remote symptomatic seizures and refractory epilepsy, suffer higher mortality as compared to the general population. While the outcomes in terms of seizure freedom in patients with epilepsy appear favorable, disturbing data on psychosocial morbidity are coming to light and are reflected in the lower rates of higher education, employment, marriage, and fertility among epileptics.

  4. Percutaneous transluminal angioplasty of malfunctioning Brescia-Cimino arteriovenous fistula: analysis of factors adversely affecting long-term patency

    Energy Technology Data Exchange (ETDEWEB)

    Sugimoto, Koji; Hirota, Shozo; Sugimura, Kazuro [Department of Radiology, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-Ku, 650-0017, Kobe (Japan); Higashino, Takanori; Kuwata, Yoichiro; Imanaka, Kazufumi [Department of Radiology, Nishi-Kobe Medical Center, 5-7-1 Koji-dai, Nishi-ku, 651-2273, Kobe (Japan)

    2003-07-01

    Our objective was to identify the factors adversely affecting long-term patency after percutaneous transluminal angioplasty (PTA) for hemodialysis Brescia-Cimino arteriovenous fistulas. Between November 1995 and March 2000, 91 PTA procedures were performed on 50 patients with 57 Brescia-Cimino fistulas. A retrospective study based on the chart review was performed. The initial technical success rate for all procedures and the primary and secondary patency rates for all fistulas were calculated. Regarding fistulas successfully maintained by the primary PTA, the primary and secondary patency rates were compared using the Kaplan-Meier method between two patient groups. They were classified on the basis of several factors, including age (older, over 70 years, and younger group), age of the fistulas (older, over 6 months, and younger group), with or without diabetes mellitus (DM), solitary or multiple lesions, long or short segment lesion, stenosis or occlusion, and with or without arterial and/or anastomotic lesions. Initial technical success rates for all procedures and fistulas were 91.2 and 89.5%, respectively. Cumulative primary and secondary patency rates at 1 year were 47.3 and 67.3%, respectively. In the comparative study, the secondary patency rate for the older group was lower than that of the younger group with statistical significance (p =0.029). The higher age is the only factor that reduces the long-term patency rate after PTA. (orig.)

  5. Factors associated with poor prognosis among patients admitted with heart failure in a Nigerian tertiary medical centre: a cross-sectional study

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    Sani Mahmoud U

    2008-07-01

    Full Text Available Abstract Background Heart failure is a major and growing public health problem worldwide. The prognosis of Heart Failure (HF is uniformly poor despite advances in treatment. The aims of the present study were to determine the causes of HF among patients admitted to a Nigerian tertiary medical centre, to determine the prevalence of factors known to be associated with poor prognosis among these patients, and to compare the factors and causes between males and females. Methods The study was cross-sectional in design, carried out on eligible patients who were consecutively admitted with HF, in Aminu Kano Teaching Hospital, Kano, Nigeria. The following established factors associated with poor prognosis of HF were assessed: low Left Ventricular Ejection Fraction (LVEF of ≤ 40%, anaemia, renal impairment, cardiac rhythm disturbances on the electrocardiogram, prolonged corrected QT interval (QTc, complete Left Bundle Branch Block (LBBB and advanced age. Results A total of 79 patients were studied over a six-month period. Forty four (55.7% of these patients were males while the remaining 35 (44.3% were females. The most prevalent prognostic factor was low LVEF found in a total of 35 patients (44.3%, while the least prevalent was complete LBBB found in two male patients only (2.53%. The commonest cause of heart failure in all patients and males was hypertensive heart disease, found in a total of 45 patients (57.0%, comprising of 33 male (73.3% and 12 female patients (26.7% (p = 0.0003. Cardiomyopathies were the commonest causes in females, the predominant type being peripartum cardiomyopathy found in 11 (31.4% female patients. Acute myocardial infarction has emerged to be an important cause of HF in males (13.6% with a high in-hospital mortality of 66.7%. Conclusion The most prevalent factor associated with poor prognosis was low LVEF. Hypertensive heart disease and cardiomyopathies were the most common causes of HF in males and females respectively

  6. 1196例突发性聋预后影响因素分析%Factors Affecting Prognosis in Sudden Deafness:An Analysis of 1196 Cases

    Institute of Scientific and Technical Information of China (English)

    张燕霞; 张强伟; 任鸿杰; 张芩娜

    2015-01-01

    目的:探讨突发性聋预后的影响因素,为临床治疗及预后判断提供依据。方法对我科收治的1196例(1247耳)突发性聋患者的临床资料进行回顾性分析,将性别、年龄、耳侧、伴发症状、就诊时间、听力损失程度、伴有的基础疾病各因素进行分组,均与预后行χ2检验或Spearman秩相关,将对预后有影响的的因素引入有序Logistic回归分析,得出影响突发性聋预后的相关因素。结果性别、耳侧、耳鸣、耳闷、高血压病、糖尿病、脑梗,各组内预后差异无统计学意义(p>0.05),不同年龄、就诊时间、听力损失程度,是否伴有眩晕、颈椎病、血脂异常,其预后差异有统计学意义(p<0.05);而年龄、就诊时间、听力损失程度、眩晕与预后有相关性(p<0.05)结论就诊时间越短,听力损失程度越轻,不伴眩晕,突聋预后越好,年龄对预后的影响有明显的阶段性。%Objective To study factors influencing prognosis in sudden deafness and provide guidance for clinical treat⁃ment. Methods Clinical data from 1196 cases (1247 ears) of sudden deafness treated in our department were reviewed and an⁃alyzed. Factors including sex, age, ear side, concurrent symptoms, treatment time, degree of hearing loss and comorbidities were screened for possible correlation to prognosis usingχ2 test and Spearman's rank test. Logistic regression analysis was used to fur⁃ther analyzed promising factors for their correlation to the prognosis of sudden deafness. Results Sex, ear side, tinnitus, aural fullness, co-existing hypertension, diabetes and cerebral infarction were not correlated to sudden deafness prognosis (p>0.05). Age, treatment time, degree of hearing loss, presence of vertigo, cervical spondylosis and dyslipidemia showed correlation to prognosis (p<0.05). Conclusion The prognosis of sudden deafness appears to be better if treatment time is shorter and

  7. Human factors issues for resolving adverse effects of human work underload and workload transitions in complex human-machine systems

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, T.G.

    1995-10-01

    A workshop was conducted whose specific purpose was to build on earlier work of the United States National Research Council, United States Federal government agencies, and the larger human factors community to: (1) clarify human factors issues pertaining to degraded performance in advanced human-machine systems (e.g., nuclear production, transportation, aerospace) due to human work underload and workload transition, and (2) develop strategies for resolving these issues. Recent history demonstrates that: (1) humans often react adversely to their diminishing roles in advanced human-machine systems, and therefore (2) new allocation models and strategies are required if humans are to be willing and able to assume diminishing and shifting roles assigned to them in these systems, and are to accept new technologies making up these systems. Problems associated with theses diminishing and shifting human roles are characterized as work underload and workload transitions. The workshop affirmed that: (1) work underload and workload transition are issues that will have to be addressed by designers of advanced human-machine systems, especially those relying on automation, if cost, performance, safety, and operator acceptability are to be optimized, (2) human machine allocation models, standards, and guidelines which go beyond simple capability approaches will be needed to preclude or seriously diminish the work underload and workload transition problems, and (3) the 16 workload definition, measurement, situational awareness, and trust issues identified during the workshop, need resolution if these models, standards, and guidelines are to be achieved.

  8. Relationship between serum carcinoembryonic antigen level and epidermal growth factor receptor mutations with the influence on the prognosis of non-small-cell lung cancer patients

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    Cai ZX

    2016-06-01

    Full Text Available Zuxun Cai Department of Thoracic Surgery, Henan Provincial Chest Hospital, Zhengzhou City, People’s Republic of China Objective: To investigate the relationship between serum carcinoembryonic antigen (CEA level and epidermal growth factor receptor (EGFR gene mutations in non-small-cell lung cancer (NSCLC patients and to analyze the influence of CEA level on postoperative survival time in lung cancer patients. Methods: A total of 296 patients who were treated in Thoracic Surgery Department of Henan Provincial Chest Hospital from September 2011 to September 2013 were recruited. The level of tumor markers, such as CEA, was determined before the surgery, and EGFR gene mutations were detected after surgery. Thereby, the relationship between tumor makers, including CEA, and EGFR mutation and its influence on prognosis could be investigated. Results: Among 296 patients, the positive rate of EGFR gene mutation was 37.84% (112/296; the mutation occurred more frequently in nonsmokers, adenocarcinoma patients, women, and patients aged <60 years (P<0.05. Both tumor markers and chemosensitivity indicators were related to the profile of EGFR mutations. Elevated squamous cell carcinoma and Cyfra21-1 as well as positively expressed ERCC1 were more common in patients with wild-type EGFR (P<0.05, whereas increased CEA level was observed more frequently in patients with EGFR gene mutation (P=0.012. The positive rate of EGFR gene mutations was higher as the serum CEA level increased, that is, the positive rate in patients with serum CEA level <5, 5–20, and >20 µg/L was 39.81%, 45.32%, and 65.47%, respectively (P=0.004. Logistic regression analysis showed that CEA level was an independent factor in predicting EGFR gene mutations, and serum CEA level was also an independent factor in affecting the prognosis of NSCLC patients, as the overall 2-year survival rate was 73.86% in elevated CEA group and 86.43% in normal group (P<0.01. Conclusion: The prognosis of

  9. Expressions of CLDN1 and insulin-like growth factor 2 are associated with poor prognosis in stage N2 non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen-fa; PEI Bao-xiang; WANG An-lei; ZHANG Lian-min; SUN Bing-sheng; JIANG Ri-cheng; WANG Chang-li

    2013-01-01

    Background Patients with single station mediastinal lymph node (N2) non-small call lung ccancer (NSCLC) have a better prognosis than those with multilevel N2.The molecular factors which are involved in disease progression remain largely unknown.The purpose of this study was to investigate gene expression differences between single station and multilevel N2 NSCLC and to identify the crucial molecular factors which are associated with progress and prognosis of stage N2 NSCLC.Methods Gene expression analysis was performed using Agilent 4x44K Whole Human Genome Oligo Microarray on 10 freshfrozen lymph node tissue samples from single station N2 and paired multilevel N2 NSCLC patients.Real-time reverse transcription (RT)-PCR was used to validate the differential expression of 14 genes selected by cDNA microarray of which four were confirmed.Immunohistochemical staining for these validated genes was performed on formalin-fixed,paraffinembedded tissue samples from 130 cases of stage N2 NSCLC arranged in a high-density tissue microarray.Results We identified a 14 gene expression signature by comparative analysis of gene expression.Expression of these genes strongly differed between single station and multilevel N2 NSCLC.Four genes (ADAM28,MUC4,CLDN1,and IGF2) correlated with the results of microarray and real-time RT-PCR analysis for the gene-expression data in samples from 56 NSCLC patients.Immunohistochemical staining for these genes in samples from 130 cases of stage N2 NSCLC demonstrated the expression of IGF2 and CLDN1 was negatively correlated with overall survival of stage N2 NSCLC.Conclusions Our results suggest that the expression of CLDN1 and IGF2 indicate a poor prognosis in stage N2 NSCLC.Further,CLDN1 and IGF2 may provide potential targeting opportunities in future therapies.

  10. Amplification of chromosome 2:Lq22.3 harboring trefoil factor family genes in liver fluke related cholangiocarcinoma is associated with poor prognosis

    Institute of Scientific and Technical Information of China (English)

    Kanuengnuch Muenphon; Temduang Limpaiboon; Patcharee Jearanaikoon; Chawalit Pairojkul; Banchob Sripa; Vajarabhongsa Bhudhisawasdi

    2006-01-01

    AIM: To determine allelic imbalance on chromosomal region 21q22-qter including trefoil factor family genes (TFF) in cholangiocarcinoma (CCA) patients and analyze the correlation between allelic imbalances and clinicopathological parameters.METHODS: Quantitative PCR amplification was performed on four microsatellite markers and trefoil factor family genes (TFF1, TFF2, and TFF3) using a standard curve and SYBR Green Ⅰ dye method. The relative copy number was determined by DNA copy number of tested locus to reference locus. The relative copy number was interpreted as deletion or amplification by comparison with normal reference range. Associations between allelic imbalance and clinicopathological parameters of CCA patients were evaluated by x2-tests.Kaplan-Meier method was used to analyze survival.RESULTS: The frequencies of amplification at D21S1890,D21S1893, and TFF3 were 32.5%, 30.0%, and 28.7%,respectively. Patients who had amplification at regions covering D21S1893, D21S1890, and TFF showed poor prognosis, whereas patients who had deletion showed favorable prognosis (mean: 51.7 wk vs 124.82 wk,P = 0.012). Multivariate Cox regression analysis revealed that amplification of D21S1893, D21S1890 and TFF,blood vessel invasion, and staging were associated with poor prognosis.CONCLUSION: D21S1893-D21S1890 region may harbor candidate genes especially TFF and serine protease family, which might be involved in tumor invasion and metastasis contributing to poor survival. The amplification in this region may be used as a prognostic marker in the treatment of CCA patients.

  11. Are atherosclerotic risk factors associated with a poor prognosis in patients with hyperuricemic acute heart failure? The evaluation of the causal dependence of acute heart failure and hyperuricemia.

    Science.gov (United States)

    Okazaki, Hirotake; Shirakabe, Akihiro; Kobayashi, Nobuaki; Hata, Noritake; Shinada, Takuro; Matsushita, Masato; Yamamoto, Yoshiya; Shibata, Yusaku; Shibuya, Junsuke; Shiomura, Reiko; Nishigoori, Suguru; Asai, Kuniya; Shimizu, Wataru

    2017-04-01

    Atherosclerosis induces the elevation of uric acid (UA), and an elevated UA level is well known to lead to a poor prognosis in patients with acute heart failure (AHF). However, the prognostic value of atherosclerotic risk factors in hyperuricemic AHF patients remains to be elucidated. The data from 928 patients who were admitted to the intensive care unit (ICU) at Nippon Medical School Chiba Hokusoh Hospital between January 2001 and December 2014, and whose serum UA levels were measured were screened. A total of 394 AHF patients with hyperuricemia were enrolled in this study. The patients were assigned to a low-risk group (≤1 atherosclerosis risk factor) and a high-risk group (≥2 atherosclerosis risk factors) according to their number of risk factors. The patients in the low-risk group were more likely to have dilated cardiomyopathy, clinical scenario 3 than those in the high-risk group. The serum total bilirubin, blood urea nitrogen, C-reactive protein, and brain-type natriuretic peptide levels were significantly higher in the low-risk group than the high-risk group (p factors (number = 1, HR (hazard ratio) 0.243, 95 % CI 0.096-0.618, p = 0.003; number = 2, HR 0.253, 95 % CI 0.108-0.593, p = 0.002; number ≥3, HR 0.209, 95 % CI 0.093-0.472, p factors were not associated with a poor prognosis in patients with hyperuricemic AHF.

  12. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... disease will go for you is called prognosis. It can be hard to understand what prognosis means ... prognosis include: The type of cancer and where it is in your body The stage of the ...

  13. Logistic regression analysis of relevant factors on the prognosis of sudden deafness%突发性耳聋预后影响因素分析

    Institute of Scientific and Technical Information of China (English)

    余娇艳; 杨柏球

    2016-01-01

    目的:探讨影响突发性耳聋预后转归的相关因素。方法回顾性分析89例突聋患者的临床资料,对性别、年龄、初诊时间,是否合并高血压、糖尿病,有无眩晕,发病耳别,听力损伤类型及分级等可能与突发性耳聋预后相关的因素进行观察和分析。结果初诊时间越短、听力损伤程度越轻、不伴有眩晕和听力曲线分型为上升型者预后较好。结论应根据突发性耳聋患者的发病时间、耳聋程度、听力曲线类型及是否伴有眩晕分析患者的预后并做到早发现、早治疗。%Objective To investigate the relevant factors on the prognosis of sudden deafness.Methods The clinical data of 89 patients with sudden deafness were analyzed retrospectively.The factors may be associated with the prognosis of sudden deaf-ness such as gender,age,the time from onset to treatment,complicated by hypertension,diabetes,vertigo or not,the type and grade of hearing impairment were observed and analysed.Results The patients who got the better prognosis were those with shorter time from onset to treatment,lighter degree of hearing damage,the ascending curve hearing type and those who were not complicated by dizziness.Conclusion The prognosis of sudden deafness should be analysed according to the time from onset to treatment,complicated by vertigo or not,and the type and grade of hearing impairment,it is necessary to achieve early detection and early treatment.

  14. 突发性耳聋预后的相关因素探讨%Analysis of relevant factors on prognosis of idiopathic sudden sensorineural hearing loss

    Institute of Scientific and Technical Information of China (English)

    赵璟; 桂晓钟

    2015-01-01

    目的:探讨影响突发性耳聋预后的相关因素。方法286例突发性耳聋患者治疗前和治疗后进行纯音听阈测试对比,探讨影响预后的相关因素。结果突发性耳聋预后与患者的发病时间、年龄大小、听力损失情况、有无眩晕、高血压、糖尿病及焦虑情绪有关,而与性别无关。结论突发性耳聋患者发病时间越长、年龄越大、听力损失越重,治疗预后越差。听力图中,高频型和水平型比中频型和低频型预后差,全聋型最差。不伴眩晕、无高血压高血脂糖尿病、无焦虑情绪的突发性耳聋患者疗效明显好于伴眩晕、有高血压高血脂糖尿病、有焦虑情绪患者。%Objective To evaluate the factors that may affect the prognosis of hearing recovery in cases of idiopathic sudden sensori-neural hearing loss( ISSHL) . Methods Through retrospective analysis of the 286 cases of ISSHL that were diagnosed and treated in our de-partment, and comparison between changes in pure tone threshold audiometry before and after treatment, the correlation factors of prognosis of ISSHL were explored. Results The prognosis was correlated with patients' morbidity time, age, degree of hearing loss, hearing loss curve type, disease of high blood pressure, dizziness and diabetes, and anxiety, and no correlation with gender was found. Conclusion The youn-ger the patients with ISSHL were, and the shorter the time of onset was, the better the prognosis would be. The efficacy of ISSHL without ver-tigo, underlying diseases and anxiety was significantly better than that with vertigo, underlying diseases and anxiety. Among various types of hearing loss curve, the prognoses of intermediate-frequency type and low-frequency type were better than those of high-frequency type and horizontal type, and the deaf type came the worst.

  15. Factors Affecting Adverse Drug Reaction Reporting of Healthcare Professionals and Their Knowledge, Attitude, and Practice towards ADR Reporting in Nekemte Town, West Ethiopia

    Directory of Open Access Journals (Sweden)

    Lense Temesgen Gurmesa

    2016-01-01

    Full Text Available Background. Adverse drug reactions are global problems of major concern. Adverse drug reaction reporting helps the drug monitoring system to detect the unwanted effects of those drugs which are already in the market. Aims. To assess the knowledge, attitude, and practice of health care professionals working in Nekemte town towards adverse drug reaction reporting. Methods and Materials. A cross-sectional study design was conducted on a total of 133 health care professionals by interview to assess their knowledge, attitude, and practice using structured questionnaire. Results. Of the total respondents, only 64 (48.2%, 56 (42.1%, and 13 (9.8% health care professionals have correctly answered the knowledge, attitude, and practice assessment questions, respectively. Lack of awareness and knowledge on what, when, and to whom to report adverse drug reactions and lack of commitments of health care professionals were identified as the major discouraging factors against adverse drug reaction reporting. Conclusion. This study has revealed that the knowledge, attitude, and practice of the health care professionals working in Nekemte town towards spontaneous adverse drug reaction reporting were low that we would like to recommend the concerned bodies to strive on the improvement of the knowledge, attitude, and practice status of health care professionals.

  16. Up-regulation of a HOXA-PBX3 homeobox-gene signature following down-regulation of miR-181 is associated with adverse prognosis in patients with cytogenetically abnormal AML.

    Science.gov (United States)

    Li, Zejuan; Huang, Hao; Li, Yuanyuan; Jiang, Xi; Chen, Ping; Arnovitz, Stephen; Radmacher, Michael D; Maharry, Kati; Elkahloun, Abdel; Yang, Xinan; He, Chunjiang; He, Miao; Zhang, Zhiyu; Dohner, Konstanze; Neilly, Mary Beth; Price, Colles; Lussier, Yves A; Zhang, Yanming; Larson, Richard A; Le Beau, Michelle M; Caligiuri, Michael A; Bullinger, Lars; Valk, Peter J M; Delwel, Ruud; Lowenberg, Bob; Liu, Paul P; Marcucci, Guido; Bloomfield, Clara D; Rowley, Janet D; Chen, Jianjun

    2012-03-08

    Increased expression levels of miR-181 family members have been shown to be associated with favorable outcome in patients with cytogenetically normal acute myeloid leukemia. Here we show that increased expression of miR-181a and miR-181b is also significantly (P miR-181b significantly promoted apoptosis and inhibited viability/proliferation of leukemic cells and delayed leukemogenesis; such effects could be reversed by forced expression of PBX3. Thus, the up-regulation of the 4 homeobox genes resulting from the down-regulation of miR-181 family members probably contribute to the poor prognosis of patients with nonfavorable CA-AML. Restoring expression of miR-181b and/or targeting the HOXA/PBX3 pathways may provide new strategies to improve survival substantially.

  17. Growth hormone and insulin-like growth factor-1 in prognosis coronary artery disease in patients with obesity

    Directory of Open Access Journals (Sweden)

    Olga Viktorovna Shpagina

    2014-10-01

    Full Text Available Introduction. In patients with obesity coronary atherosclerosis and chronic heart failure (CHF progress rapidly and have a worse long-term prognosis than those with normal weight.Objective: To investigate the prognostic significance of GH and IGF-1 in the evaluation of cardiovascular risk in patients with obesity.Materials and Methods. The study included 75 men (mean age 55.31±6.32 years, which are overweight or have mild obesity (body mass index (BMI 28.69±3.6 kg/m2. Group 1 included 45 patients (age 56.4±6.29 years, BMI 28.69±3.69 kg/m2, blood pressure 124±10.18/80±4.59 mm Hg who underwent coronary angiography. Group 2 included 30 patients (mean age 53.6 ± 6.1 years, BMI 28.68±3.52 kg/m2, blood pressure 128±9/83±6.81 mm Hg, CAD who are excluded by treadmill test. The coronary artery calcium score was assessed in group 2. All participants were evaluated impaired glucose tolerance (IGT, triglycerides (TG, IGF-1 and GH, LPHD, LPLD, geometry of the heart chambers was assessed by echocardiography.Results. Patients in both groups did not differ in age, BMI, blood pressure. IGF-1 levels were not significantly different among the study groups. High circulating IGF-1 levels were frequently observed in group 1 (р=0.018. A statistically significant association of high IGF-1 observed with obesity (p=0.033, smoking (p=0.049, hypertension (p=0.002, end-diastolic dimension (p=0.045. GH was lower in group 1 compared with group 2 (p=0.046. Serum levels of GH are positively associated with EF (p=0.023 and E/A (p=0.043 and negatively associated with left atrial wall thickness (p=0.025 and coronary artery calcium score (p=0.005.Conclusion: 1. IGF-1 may be a useful indicator to assess the prognosis of CAD and CHF in patients with obesity. 2. Relative GH deficiency was more often associated with severe CAD in patients with obesity.

  18. 肠伤寒穿孔手术治疗预后的影响因素分析%Factors Influencing Prognosis of Surgical Treatment in Typhoid Perforation

    Institute of Scientific and Technical Information of China (English)

    杨洪范

    2012-01-01

    Objective To study the factors affecting prognosis in patients with typhoid ileal perforation and to offer strategies for improvement. Methods The clinical records of 295 patients who underwent surgery because of typhoid enteric perforation in the Department of Surgery, Regional Hospital of Maradi, Niger, from January 2010 to December 2011 , were reviewed retrospectively. Seven of potential prognostic factors were examined by the x2 test and the multiple Logistic regression analysis. Results The mortality rate was 20.7% ( 61/295 ). Lnivariate analysis revealed that age, number of perforation, perforation-operation interval( PO1 ) and postoperative faecal fistula were significantly associated with prognosis of typhoid ileal perforation( P < 0. 05 ). Multiple Logistic regression analysis showed that perforation-operation interval( OR -4. 723 ,95% CI -1.403 - 15. 897,P< 0.05 )and postoperative faecal fistula( OR -3. 334 ,95% CI = 1. 102-10. 087 , P < 0. 05 )were closely associated with the prognosis. Conclusion Perforation-ope ration interval and postoperative faecal fistula are significant independent factors influencing prognosis of surgical treatment in typhoid perforation. Early diagnosis and timely surgical intervention could improve the prognosis.%目的 探讨影响肠伤寒穿孔手术治疗预后的因素,为改善预后提供帮助.方法 回顾性分析2010年1月至2011年12月中国援尼日尔医疗队工作点玛拉迪地方医院外科295例肠伤寒穿孔患者的临床资料.应用χ2检验和多因素Logistic回归分析影响预后的因素.结果 295例均手术治疗,病死率为20.7%(61/295).单因素分析结果显示年龄、穿孔-手术间隔、穿孔数量和术后肠瘘与肠伤寒穿孔手术治疗的预后相关(P<0.05).多因素Logistic 回归分析显示:穿孔-手术间隔(OR=4.723,95% CI=1.403 ~15.897,P<0.05)、术后肠瘘(OR=3.334,95% CI=1.102 ~10.087,P<0.05)与肠伤寒穿孔手术治疗的预后密切相关.结论 穿孔-手

  19. BDNF Val 66 Met and 5-HTTLPR genotype moderate the impact of early psychosocial adversity on plasma brain-derived neurotrophic factor and depressive symptoms: a prospective study.

    Science.gov (United States)

    Buchmann, Arlette F; Hellweg, Rainer; Rietschel, Marcella; Treutlein, Jens; Witt, Stephanie H; Zimmermann, Ulrich S; Schmidt, Martin H; Esser, Günter; Banaschewski, Tobias; Laucht, Manfred; Deuschle, Michael

    2013-08-01

    Recent studies have emphasized an important role for neurotrophins, such as brain-derived neurotrophic factor (BDNF), in regulating the plasticity of neural circuits involved in the pathophysiology of stress-related diseases. The aim of the present study was to examine the interplay of the BDNF Val⁶⁶Met and the serotonin transporter promoter (5-HTTLPR) polymorphisms in moderating the impact of early-life adversity on BDNF plasma concentration and depressive symptoms. Participants were taken from an epidemiological cohort study following the long-term outcome of early risk factors from birth into young adulthood. In 259 individuals (119 males, 140 females), genotyped for the BDNF Val⁶⁶Met and the 5-HTTLPR polymorphisms, plasma BDNF was assessed at the age of 19 years. In addition, participants completed the Beck Depression Inventory (BDI). Early adversity was determined according to a family adversity index assessed at 3 months of age. Results indicated that individuals homozygous for both the BDNF Val and the 5-HTTLPR L allele showed significantly reduced BDNF levels following exposure to high adversity. In contrast, BDNF levels appeared to be unaffected by early psychosocial adversity in carriers of the BDNF Met or the 5-HTTLPR S allele. While the former group appeared to be most susceptible to depressive symptoms, the impact of early adversity was less pronounced in the latter group. This is the first preliminary evidence indicating that early-life adverse experiences may have lasting sequelae for plasma BDNF levels in humans, highlighting that the susceptibility to this effect is moderated by BDNF Val⁶⁶Met and 5-HTTLPR genotype.

  20. Profile of Patients with Acute Poisoning and Factors Effecting Prognosis: A Retrospective Analysis in the Intensive Care

    Directory of Open Access Journals (Sweden)

    Mehmet Toptaş

    2014-03-01

    Full Text Available Aim: The aim of this study was to retrospectively analyse demographic and epidemiologic characteristics, clinical course, laboratory results and prognosis of patients who were admitted to Haseki Training and Research Hospital Intensive Care Unit due to intoxication between 24.11 2007 and 21.02.2013. Methods: We evaluated age, gender, types of intoxication (accident, suicide, etiology, length of stay, mortality rate, duration of mechanical ventilation, and blood pressure, heart rate and symptoms at the time of admission. Patients who took multiple drugs were recorded. Liver and kidney function tests, blood glucose, complete blood count parameters, electrolytes and arterial blood gas values at the time of admission were evaluated. Results: A total of 59 cases of intoxication were studied. 59.7% of patients were male, 42.4% were female. The mean age was 32±13 years. 86.4% of cases occurred due to suicide attempts and 13.6%, accidentally. In our study, it was found that the most common intoxication agents were paracetamol and amitriptyline, and the most common cause of death was methyl alcohol intoxication. Conclusion: Our results showed that a significant portion of the intoxication cases admitted to the intensive care unit were young adults who attempted suicide by overdosing on drugs. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 29-33

  1. PEA3/ETV4-related transcription factors coupled with active ERK signalling are associated with poor prognosis in gastric adenocarcinoma

    LENUS (Irish Health Repository)

    Keld, R

    2011-06-28

    Background: Transcription factors often play important roles in tumourigenesis. Members of the PEA3 subfamily of ETS-domain transcription factors fulfil such a role and have been associated with tumour metastasis in several different cancers. Moreover, the activity of the PEA3 subfamily transcription factors is potentiated by Ras-ERK pathway signalling, which is itself often deregulated in tumour cells.\\r\

  2. Adverse-Drug-Reaction-Related Hospitalisations in Developed and Developing Countries: A Review of Prevalence and Contributing Factors.

    Science.gov (United States)

    Angamo, Mulugeta Tarekegn; Chalmers, Leanne; Curtain, Colin M; Bereznicki, Luke R E

    2016-09-01

    Adverse drug reactions (ADRs) are one of the leading causes of hospital admissions and morbidity in developed countries and represent a substantial burden on healthcare delivery systems. However, there is little data available from low- and middle-income countries. This review compares the prevalence and characteristics of ADR-related hospitalisations in adults in developed and developing countries, including the mortality, severity and preventability associated with these events, commonly implicated drugs and contributing factors. A literature search was conducted via PubMed, Scopus, Web of Science, Embase, ProQuest and Google Scholar to find articles published in English from 2000 to 2015. Relevant observational studies were included. The median (with interquartile range [IQR]) prevalence of ADR-related hospitalisation in developed and developing countries was 6.3 % (3.3-11.0) and 5.5 % (1.1-16.9), respectively. The median proportions of preventable ADRs in developed and developing countries were 71.7 % (62.3-80.0) and 59.6 % (51.5-79.6), respectively. Similarly, the median proportions of ADRs resulting in mortality in developed and developing countries were 1.7 % (0.7-4.8) and 1.8 % (0.8-8.0), respectively. Commonly implicated drugs in both settings were antithrombotic, non-steroidal anti-inflammatory and cardiovascular drugs. Older age, female gender, number of medications, renal impairment and heart failure were reported to be associated with an increased risk for ADR-related hospitalisation in both settings while HIV/AIDS was implicated in developing countries only. The majority of ADRs were preventable in both settings, highlighting the importance of improving medication use, particularly in vulnerable patient groups such as the elderly, patients with multiple comorbidities and, in developing countries, patients with HIV/AIDS.

  3. Frequent Mental Distress, Chronic Conditions, and Adverse Health Behaviors in the Behavioral Risk Factor Surveillance Survey, Jordan, 2007

    Directory of Open Access Journals (Sweden)

    Mohannad Al-Nsour, MD, MSc

    2013-08-01

    Full Text Available Introduction Recent evidence indicates that chronic diseases and mental illness are associated. In the Middle Eastern country of Jordan, chronic diseases and frequent mental distress (FMD are increasing; however, the capacity for mental health care is limited. The objective of this study was to determine the association between FMD, chronic conditions, and adverse health behaviors in Jordan. Methods The third cycle of the Jordan Behavioral Risk Factor Surveillance Survey (2007 served as the data source for this study. The sample consisted of 3,612 noninstitutionalized Jordanian adults aged 18 years or older. Logistic regression was used to obtain odds ratios for the association between chronic conditions, health behaviors, and FMD adjusted for age, sex, marital status, education, income, and employment. Results In the adjusted models, people with hypertension (adjusted odds ratio [AOR], 2.0; 95% confidence interval [CI], 1.6–2.7, high cholesterol (AOR, 2.3; 95% CI, 1.6–3.2, diabetes (AOR, 1.6; 95% CI, 1.1–2.4, and asthma (AOR, 2.2; 95% CI, 1.5–3.1 and smokers (AOR, 1.5; 95% CI, 1.1–2.0 were more likely to have FMD than people without each of these conditions. Adults who reported vigorous physical activity were less likely to have FMD (AOR, 0.6; 95% CI, 0.4–0.9 than their less active counterparts. Conclusions In Jordan, FMD was associated with several chronic conditions. As a result, we suggest additional research to examine the complex relationship between FMD and chronic conditions. More doctors in the primary health care system should be trained in mental health.

  4. Obesity and prognosis in chronic diseases--impact of cardiorespiratory fitness in the obesity paradox.

    Science.gov (United States)

    Lavie, Carl J; Schutter, Alban De; Archer, Edward; McAuley, Paul A; Blair, Steven N

    2014-01-01

    The effects of overweight and obesity on chronic diseases, particularly on cardiovascular disease (CVD), and its impact on increasing CVD risk factors and total CVD are reviewed. However despite the adverse effects of obesity on CVD risk factors and CVD, obesity has a surprising association with prognosis in patients with established diseases, often showing an "obesity paradox," [corrected] where overweight (body mass index (BMI), 25 to 29.9 kg·m(-2)) and obese patients (BMI, ≥30 kg·m(-2)) with established CVD frequently have a better prognosis than that of their leaner counterparts (BMI, <25 kg·m(-2)) with the same diseases. Fitness-versus-fatness debate is summarized also, including the critical role that fitness plays to alter the relationship between adiposity and subsequent prognosis.

  5. Risk Factors and Early Unfavourable Prognosis Factors of Cerebral Venous Sinus Thrombosis%颅内静脉窦血栓形成的危险因素及早期不良预后相关因素分析

    Institute of Scientific and Technical Information of China (English)

    赵惠卿; 王安心; 赵性泉

    2013-01-01

    Objective To analyze the risk factors and early prognosis factors of cerebral venous sinus thrombosis (CVST). Methods 68 patients with CVST were analyzed retrospectively. The patients were divided into early favorable prognosis group and early unfavorable prognosis group according to modified Rankin Scale (mRS). The clinical data and prognosis were analyzed by univariate analysis and multi-variate logistic regression analysis. Results and Conclusion On discharge, there were 37(54.4%) cases and 31(45.6%) cases in the early fa-vorable prognosis group and the early unfavorable prognosis group respectively. Univariate analysis showed that 8 factors, including preg-nancy-associated factors, central nervous system infection, hyperhomocysteinemia, ocular symptoms, disturbance of consciousness, limb pa-ralysis, secondary cerebral infarction and ventricular compression/midline shift/encephaledema were associated with the early prognosis. Multivariate logistic regression analysis showed that pregnancy-associated factors, central nervous system infection, hyperhomocysteinemia, disturbance of consciousness and ventricular compression/midline shift/encephaledema were the independent factors.%目的:分析颅内静脉窦血栓形成(CVST)的危险因素及影响早期预后的相关因素。方法对68例CVST患者的临床资料进行回顾性分析。按改良Rankin量表(mRS)评分分为早期预后良好组与早期预后不良组。临床资料及其早期预后采用单因素和多因素Logistic回归分析。结果与结论68例CVST患者出院时早期预后良好37例(54.4%),早期预后不良31例(45.6%)。单因素Logistic回归分析结果显示,妊娠相关、中枢神经系统感染、高同型半胱氨酸血症、眼部症状、意识障碍、肢体瘫痪、伴继发性脑梗死、伴脑室受压/中线移位/全脑水肿8项因素是早期预后不良的影响因素。多因素Logistic回归分析显示,妊娠相关、中枢神经系统感染、高同型

  6. Adverse life events as risk factors for behavioural and emotional problems in a 7-year follow-up of a population-based child cohort

    DEFF Research Database (Denmark)

    Rasmussen, Cathrine Skovmand; Nielsen, Louise Gramstrup; Petersen, Dorthe Janne

    2014-01-01

    Background and aim: The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9-16 years, the risk factors being seven parental and two child-related adverse life events. Methods: Data...... on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8-9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change. Results: Parental divorce...... significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers...

  7. 影响酒精性肝病预后的危险因素分析%Analysis of risk factors for alcoholic liver disease prognosis

    Institute of Scientific and Technical Information of China (English)

    郑长春; 陈瑜君; 何瑶

    2013-01-01

    Objective To investigate the risk factors for alcoholic liver disease prognosis. Methods 141 patients with alcoholic liver disease (ALD) were recruited in the study. Patients were classified into 4 groups according to their liver function, included namely alcoholic hepatitis group, alcoholic liver cirrhosis Child-Pugh A group, B group, and C group. Possible risk factors which could affect the prognosis of ALD in these patients were investigated respectively. Possible risk factors studied here included age, total amount of alcohol intake, body mass index (BMI) , AST/ALT ratio, GGT and LDH levels. The relationship between above factors and liver function were analyzed to determine risk factors in ALD. Results ①Both the average age and total amount of alcohol intake in hepatitis patients were significantly lower than those in patients with alcoholic liver cirrhosis (P0.05).② 酒精性肝炎与肝硬化Child-Pugh A级患者间(P>0.05)、酒精性肝硬化Child-Pugh B级与C级患者间的BMI无显著差异(P>0.05),但酒精性肝炎与酒精性肝硬化Child-Pugh A级患者BMI显著高于酒精性肝硬化Child-Pugh B级及C级患者(P<0.05).③ AST/ALT比值与肝功能受损程度呈正相关(r=0.9752,P<0.01).④ LDH水平与肝功能受损程度呈正相关(r=0.9797,P<0.01).⑤ GGT水平在各组间均无显著性差异.结论 患者年龄、BMI、酒精总摄入量、AST/ALT比值及LDH均与酒精性肝病的严重程度有一定关系,其中AST/ALT比值及LDH水平可较好地用于评估酒精性肝病患者的预后.

  8. Clinicopathological Features and Prognosis of Papillary Thyroid Microcarcinoma for Surgery and Relationships with the BRAFV600E Mutational Status and Expression of Angiogenic Factors

    Science.gov (United States)

    Shi, Chenlei; Guo, Yong; Lv, Yichen; Nanding, Abiyasi; Shi, Tiefeng; Qin, Huadong; He, Jianjun

    2016-01-01

    Objective To investigate the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) for surgery by comparing the difference between PTMC and larger papillary thyroid carcinoma (LPTC). Methods We analyzed the differences in the clinicopathological characteristics, prognosis, B-type RAF kinase (BRAF)V600E mutational status and expression of angiogenic factors, including pigment epithelium-derived factor (PEDF), Vascular Endothelial Growth Factor (VEGF), and hypoxia-inducible factor alpha subunit (HIF-1α), between PTMC and LPTC by retrospectively reviewing the records of 251 patients with papillary thyroid carcinoma, 169 with PTMC, and 82 with LPTC (diameter >1 cm). Results There were no significant differences in the gender, age, multifocality, Hashimoto’s thyroiditis, TNM stage, PEDF protein expression, rate of recurrence, or mean follow-up duration between patients with PTMC or LPTC. The prevalence of extrathyroidal invasion (EI), lymph node metastasis (LNM), and BRAF mutation in patients with PTMC was significantly lower than in patients with LPTC. In addition, in PTMC patients with EI and/or LNM and/or positive BRAF (high-risk PTMC patients), the prevalence of extrathyroidal invasion, Hashimoto's disease, lymph node metastasis, tumor TNM stage, PEDF positive protein expression, the rate of recurrent disease, and the mRNA expression of anti-angiogenic factors was almost as high as in patients with larger PTC, but with no significant difference. Conclusions Extrathyroid invasion, lymph node metastases, and BRAFV600E mutation were the high risk factors of PTMC. PTMC should be considered for the same treatment strategy as LPTC when any of these factors is found. Particularly, PTMC with BRAFV600E gene mutations needed earlier surgical treatment. In addition, the high cell subtype of PTMC with BRAFV600E gene mutation is recommended for total thyroidectomy in primary surgery to reduce the risk of recurrence. PMID:27936049

  9. Low Concentration of BDNF in the Acute Phase of Ischemic Stroke as a Factor in Poor Prognosis in Terms of Functional Status of Patients.

    Science.gov (United States)

    Lasek-Bal, Anetta; Jędrzejowska-Szypułka, Halina; Różycka, Jagoda; Bal, Wiesław; Holecki, Michał; Duława, Jan; Lewin-Kowalik, Joanna

    2015-12-14

    BACKGROUND According to recent studies, brain-derived neurotrophic factor (BDNF) probably plays a role in development of cerebral ischemia and can be significant for the prognosis of improved mobility after stroke. The aim of this prospective study was to evaluate the blood concentration of BDNF during the 1st day of first-ever ischemic stroke and find a potential association between BDNF concentration and the neurological status in the acute period, as well as between BDNF and the functional status in the sub-acute phase of stroke. MATERIAL AND METHODS The prospective study involved 87 patients aged 39-99 years (42 women, 45 men) with first-in-life complete ischemic stroke. All study subjects underwent analysis as follows: BDNF blood concentration and neurological status according to NIHSS on the 1st day of stroke, comorbidities, etiological type of ischemic stroke by ASCOD, and functional status on the 14th and 90th day after the onset according to mRankin scale. RESULTS Mean concentration of BDNF in the study group was 9.96 ng/mL±5.21, median 10.39 ng/mL. Patients aged ≤65 years (25 individuals) had a significantly higher mean concentration of BDNF (11.94 ng/mL±4.46; median 12.34 ng/mL) than the older subjects (62 individuals) with a mean concentration of 9.17 ng/mL±5.32 (median 8.66 ng/mL). The mean score by mRankin scale on the 90th day was significantly higher among patients with lower concentrations of BDNF on the 1st day of stroke, which reflects their poorer functional status. The functional status on the 90th day was significantly worse (3-6 points by Rankin scale) in patients who had BDNF below the mean value in the acute phase of stroke. The independent factors for poor functional status of patients on the 90th day after stroke were a score >4 points by NIHSS (RR 1.14; 95% CI: 1.00-1.31; p=0.027) and the concentration of BDNF below the mean value (assessed on the 1st day of stroke) (RR 14.49; CI 4.60-45.45; p=0.000). CONCLUSIONS The neurological

  10. Neuropilin-1 promotes epithelial-to-mesenchymal transition by stimulating nuclear factor-kappa B and is associated with poor prognosis in human oral squamous cell carcinoma.

    Directory of Open Access Journals (Sweden)

    Weiming Chu

    Full Text Available The epithelial-to-mesenchymal transition (EMT is a key process in carcinogenesis, invasion, and metastasis of oral squamous cell carcinoma (OSCC. In our previous studies, we found that neuropilin-1 (NRP1 is overexpressed in tongue squamous cell carcinoma and that this overexpression is associated with cell migration and invasion. Nuclear factor-kappa B (NF-κB plays an essential role both in the induction and the maintenance of EMT and tumor metastasis. Therefore, we hypothesized that NRP1 induces EMT, and that NRP1-induced migration and invasion may be an important mechanism for promoting invasion and metastasis of OSCC through NF-κB activation.The variations in gene and protein expression and the changes in the biological behavior of OSCC cell lines transfected with a vector encoding NRP1, or the corresponding vector control, were evaluated. NRP1 overexpression promoted EMT and was associated with enhanced invasive and metastatic properties. Furthermore, the induction of EMT promoted the acquisition of some cancer stem cell (CSC-like characteristics in OSCC cells. We addressed whether selective inhibition of NF-κB suppresses the NRP1-mediated EMT by treating cells with pyrrolidinedithiocarbamate ammonium (PDTC, an inhibitor of NF-κB. Immunohistochemical analysis of NRP1 in OSCC tissue samples further supported a key mediator role for NRP1 in tumor progression, lymph node metastasis, and indicated that NRP1 is a predictor for poor prognosis in OSCC patients.Our results indicate that NRP1 may regulate the EMT process in OSCC cell lines through NF-κB activation, and that higher NRP1 expression levels are associated with lymph node metastasis and poor prognosis in OSCC patients. Further investigation of the role of NRP1 in tumorigenesis may help identify novel targets for the prevention and therapy of oral cancers.

  11. Related Factors of Latent Prognosis of Viral Encephalitis%病毒性脑炎近期预后的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    吴哲; 裴晓蕊; 罗晓光; 戚其学

    2011-01-01

    Objective To exolore the risk factors of latent prognosis of viral encephalitis. Methods Clinical data of 98 cases of viral encephalitis(these patients were in hospital of the Department of Neurology in the First Affilited Hospital of China Medical University from February 2005 to September 2009) were rctrospective analyzed,according to the Glasgow Outcome Scale(GOS).The patients were divided into good(GOS was grade 5) and poor(GOS were grade 1,2,3,4) prognosis groups,and made multi-factor Logistic regressive analysis.Results Single-factor analysis showed the lasting time of seizures,conscious disorder, deficiency of cranial nerves,servere abnormal electroencephalogram,abnormity of cranial MRI having significant statistics(P<0.05)between two groups,but the sex,the age,fever, abnormity of psycho-behavior, meningeal irratation sign,Babinski sign,cerebrospinal fluid pressure,cerebrospinal fluid leukocyte count,cerebrospinal fluid red blood cell count,abnormity of cranial CT,pulmonitis,peripheral blood leukocyte count,serum potassium,serum sodium having no significant statistics(P>0.05).When making them into the multi-factor Logistic regressive analysis,it showed that the abnormity of cranial MRI was the first related risk factor(P=0.009),the lasting time of seizures were second only to it. Conclusion Latent poor prognosis of viral encephalitis were related to abnormity of cranial MRI and lasting time of seizures.%目的 了解影响病毒性脑炎近期预后的相关因素.方法回顾性分析2005 年 2月~2009 年 9月中国医科大学附属第一医院神经内科收治的98例病毒性脑炎住院患者的临床资料.应用格拉斯哥预后评分(Glasgow Outcome Scale,GOS)对患者出院时的情况进行评估,将患者分为两组:预后不良组(GOS1~4级)和预后良好组(GOS5级),并选取20个因素进行Logistic 回归分析.结果 在两组之间,性别、年龄、发热、精神行为异常、脑膜刺激征、巴宾斯基征、脑脊液压

  12. 889例早产儿的预后及其影响因素分析%Prognosis of 889 premature infants and its influence factors

    Institute of Scientific and Technical Information of China (English)

    麦凤鸣; 钟为平; 王晓萍; 钟柳英

    2013-01-01

    Objective To investigate the prognosis of premature infants and its influence factors. Methods A retrospective study was designed, and a total of 724 pregnant women with premature delivery in the Third Affiliated Hospital of Guangzhou Medical College, Guangzhou Severe Maternal Treatment Center from Jun. 2008 to Dec. 2009 were included in our study, with 889 premature infant. The prognosis of premature infants and its influence factors were analyzed. Results (1) The main complications of premature infant were asphyxia (11.40%), RDS (5.29%), pneumonia (6.64%), anemia (12.37%), acid-base imbalance (27.00%), retinopathy (6.97%). (2) The mortality rate, incidence of asphyxia, NRDS and pulmonary hemorrhage of premature infant were negatively correlated with gestational age and neonatal weight. (3) Plmonary hemorrhage, RDS and MSOF were the main causes of death for premature infant. (4) Factors of unfavourable prognosis for premature infant were gestational age, neonatal weight, asphyxia, RDS, pneumonia, alimentary tract hemorrhage, acid-base imbalance, and PROM, prccclampsia, fetal distress, polyhy-dramnios or oligohydramnios of pregnant woman (P<0.05). Conclusion The control of the risk factors of premature delivery can avoid or delay the occurrence of premature birth, improved maternal and neonatal outcomes.%目的 观察早产儿的预后并探讨其影响因素.方法 选取广州医学院第三附属医院、广州市重症孕产妇救治中心2008年1月至2009年12月间分娩的889例早产儿,分析早产儿的结局及影响早产儿预后的因素.结果 (1)早产儿的主要并发症有窒息(11.4%)、NRDS (5.29%)、肺炎(6.64%)、贫血(12.37%)、酸碱失衡(27%)、视网膜病变(6.97%)等.(2)早产儿胎龄、出生体重与窒息、NRDS、肺出血等并发症发生率和死亡率与呈负相关(P<0.05).(3)早产儿死亡原因前三位分别为肺出血、NRDS及多器官衰竭.(4)早产儿预后不良的相关因素是:早产儿低胎龄、低出生

  13. Codeine Ultra-rapid Metabolizers: Age Appears to be a Key Factor in Adverse Effects of Codeine.

    Science.gov (United States)

    Heintze, K; Fuchs, W

    2015-12-01

    Codeine is widely used as an analgesic drug. Taking into account the high consumption of codeine, only few fatal adverse events have been published. A number of reports, where neonates and children showed serious or fatal adverse reactions, led to a restriction of the use of codeine in this patient group. Therefore, we reviewed the safety of codeine in adults. PubMed was systematically searched for clinical studies and case reports, with a special focus on CYP2D6, the enzyme that converts codeine to morphine and exhibits genetic polymorphism.181 cases were identified in adults in conjunction with serious or lethal effects of codeine. In the vast majority of cases, codeine was used in combination with other drugs by drug-dependent individuals or with a suicidal intent. Only 2 cases were found where ultra-rapid metabolizers experienced severe non-lethal adverse events. This is far less than would be predicted from the number of cases reported in children. The discrepancy may be explained by developmental changes in the disposition of codeine.The strategy of regulatory authorities to restrict access to codeine for infants and young children, the apparent highest risk group, has a factual and pharmacological rationale. By the same standards, there is no need for restrictions for adult use of codeine.

  14. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... doctor to give you an accurate prognosis. Understanding the Difference Between Cure and Remission Cure means that ... about her colorectal cancer prognosis. Diving Out of the Dark View this video on YouTube. Andrew wants ...

  15. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Overview Research Cancer Screening Cancer Screening Overview Screening Tests Research Diagnosis and Staging Symptoms Diagnosis Staging Prognosis ... Cancer Prevention Overview Screening Cancer Screening Overview Screening Tests Diagnosis & Staging Symptoms Diagnosis Staging Prognosis Treatment Types ...

  16. 急性会厌炎不良预后的危险因素分析%An analysis of prognosis risk factors in sever acute epiglottitis

    Institute of Scientific and Technical Information of China (English)

    王春燕; 王烁

    2016-01-01

    目的:对比不同预后急性会厌炎患者的特异性症状及检查结果,以确定可能影响其预后的危险因素。方法回顾性分析本院门急诊系统中1995年至2014年的698例经间接喉镜或纤维喉镜确诊的急性会厌炎患者,将患者按预后分为两组:最终进行急诊气道干预者为重症组(n =115),未进行气道干预为轻症组(n =583)。采用χ2检验及成组 t 检验对比两组患者既往史、一般情况、实验室检查结果;运用 Spearman 相关系数分析呼吸困难分级与会厌水肿程度的关系;并用 Logistic 回归确定可能影响预后的危险因素。结果男女比例为1.366∶1,重症患者易发生于冬春季节及夜间。重症组中有吸烟史者较轻症组多(χ2=41.957,P <0.01)。患者呼吸困难严重程度与不良预后呈正相关(r =0.573,P <0.01),但入院时会厌水肿程度分级与不良预后无关(r =-0.024,P =0.525)。Logistic 回归分析发现男性(OR =1.84,95%CI:1.41~3.22,P =0.001)、夜间发病(OR =2.61,95%CI:1.98~3.16,P =0.07)、有吸烟史(OR =1.63,95%CI:1.05~3.39,P =0.04)及 PaO2降低(OR =2.97,95%CI:1.58~4.49,P =0.02)为急性会厌炎不良预后的危险因素。结论男性、夜间发病、吸烟史及 PaO2降低是急性会厌炎预后不良的独立危险因素。对于入院时会厌水肿不重,而有以上危险因素的患者,亦应密切监测病情变化。%Objective To confirm the risk factors of poor prognosis in patients with severe acute epiglottitis by comparing symptoms and results of laboratory tests.Methods A total of 698 patients with acute epiglottitis from outpatient and emergency room from 1995 to 2014 were retrospectively studied.These patients were divided into severe or mild group as per the means of treatment of airway including invasive (n =115)and non-invasive (n =583).The past history

  17. The impact of obesity on risk factors and prevalence and prognosis of coronary heart disease-the obesity paradox.

    Science.gov (United States)

    De Schutter, Alban; Lavie, Carl J; Milani, Richard V

    2014-01-01

    Obesity is associated with a host of cardiovascular risk factors and its prevalence is rising rapidly. Despite strong evidence that obesity predisposes to the development and progression of coronary heart disease (CHD), numerous studies have shown an inverse relationship between various measures of obesity (most commonly body mass index) and outcomes in established CHD. In this article we review the evidence surrounding the ≪obesity paradox≫ in the secondary care of CHD patients and the CHD presentations where a paradox has been found. Finally we discuss the impact of cardiorespiratory fitness and a number of mechanisms which may offer potential explanations for this puzzling phenomenon.

  18. Vascular endothelial growth factor, matrix metalloproteinases, and cyclooxygenase-2 influence prognosis of uterine cervical cancer in young women.

    Science.gov (United States)

    Noriyuki, Maiko; Sumi, Toshiyuki; Zhi, Xu; Misugi, Fumiko; Nobeyama, Hiroyuki; Yoshida, Hiroyuki; Matsumoto, Yoshinari; Yasui, Tomoyo; Honda, Ken-Ichi; Ishiko, Osamu

    2007-09-01

    Recent changes in the lifestyle of young women have led to an increase in the rate of uterine cervical cancer. We investigated the clinicopathological characteristics of uterine cervical cancer in young women, and examined the expression of vascular endothelial growth factor (VEGF), matrix metalloproteinases (MMPs) and cyclooxygenase-2 (COX-2). Tumor samples from 439 patients with uterine cervical cancer, who were initially treated at Osaka City University Medical School Hospital, Japan between 1995 and 2004, were stained immunohistochemically. The patients were classified into two groups according to age at onset: group Y included women aged or =36 years. Group Y had more cases of squamous cell carcinoma, while group O had more advanced cases (Pcervical cancer in young women.

  19. High fibroblast growth factor 19 (FGF19) expression predicts worse prognosis in invasive ductal carcinoma of breast.

    Science.gov (United States)

    Buhmeida, Abdelbaset; Dallol, Ashraf; Merdad, Adnan; Al-Maghrabi, Jaudah; Gari, Mamdooh A; Abu-Elmagd, Muhammad M; Chaudhary, Adeel G; Abuzenadah, Adel M; Nedjadi, Taoufik; Ermiah, Eramah; Al-Thubaity, Fatima; Al-Qahtani, Mohammed H

    2014-03-01

    Metabolic diseases like diabetes and obesity are major risk factors for breast cancer. Aberrant expression of metabolic effectors such as fibroblast growth factor 19 (FGF19) could be therefore associated with the disease. The expression of FGF19 was examined in 193 archival breast tumor samples by immunohistochemistry and evaluated semi-quantitatively by determining the staining index and correlating it with clinicopathological parameters using Fisher's exact test. The correlation between FGF19 expression and 5-year disease-specific survival rate was determined using the univariate Kaplan-Meier analysis. The prognostic value of FGF19 expression was evaluated using the multivariate Cox regression analysis. Of the 193 tumors analyzed, 40% were classified with low FGF19 expression, whereas 60% were categorized as tumors with high FGF19 expression. There was a highly significant correlation between high FGF19 expression and patients' age (p = 0.008) as well as 5-year disease-specific survival (p = 0.001). However, FGF19 expression did not show any significant correlations with other clinicopathological parameters, including hormonal status, tumor grade, tumor size, or lymph node status. Univariate Kaplan-Meier log rank analysis showed that patients with high FGF19 expression exhibited a significantly shorter disease-specific 5-year survival (p = 0.007). This effect was exacerbated by lymph node metastasis (p = 0.001), negative estrogen receptor (ER) status (p = 0.002), or old age (p = 0.013). Multivariate analysis showed that high FGF19 expression could be an independent prognostic marker of disease-specific survival in breast cancer patients (p = 0.030). Quantification of FGF19 expression appears to provide valuable prognostic information in breast cancer, particularly in older patients with lymph node metastasis and negative ER status.

  20. Prevalence, Adverse Events, and Factors Associated with Dietary Supplement and Nutritional Supplement Use by US Navy and Marine Corps Personnel

    Science.gov (United States)

    2016-04-12

    questionnaire included “palpitations, racing heart,” “ abdominal pain,” “nausea/vomiting,” “diarrhea,” “muscle cramps/pain/weakness,” “sleep disturbances...in our study used proteins/AAs to a greater extent than women. This may be related to the fact that active men are more interested in the development ...Individuals reporting 1 or more adverse eventsPalpitations Abdominal pain Nausea, vomiting Diarrhea Muscle cramps pain or weakness Sleep problems, insomnia

  1. Correlation of IDH1 mutation with clinicopathologic factors and prognosis in primary glioblastoma: a report of 118 patients from China.

    Directory of Open Access Journals (Sweden)

    Wei Yan

    Full Text Available It has been reported that IDH1 (IDH1R132 mutation was a frequent genomic alteration in grade II and grade III glial tumors but rare in primary glioblastoma (pGBM. To elucidate the frequency of IDH1 mutation and its clinical significance in Chinese patients with pGBM, one hundred eighteen pGBMs were assessed by pyro-sequencing for IDH1 mutation status, and the results were correlated with clinical characteristics and molecular pathological factors. IDH1 mutations were detected in 19/118 pGBM cases (16.1%. Younger age, methylated MGMT promoter, high expression of mutant P53 protein, low expression of Ki-67 or EGFR protein were significantly correlated with IDH1 mutation status. Most notably, we identified pGBM cases with IDH1 mutation were mainly involved in the frontal lobe when compared with those with wild-type IDH1. In addition, Kaplan-Meier survival analysis revealed a highly significant association between IDH1 mutation and a better clinical outcome (p = 0.026 for progression-free survival; p = 0.029 for overall survival. However, in our further multivariable regression analysis, the independent prognostic effect of IDH1 mutation is limited when considering age, preoperative KPS score, extent of resection, TMZ chemotherapy, and Ki-67 protein expression levels, which might narrow its prognostic power in Chinese population in the future.

  2. Cell surgery and growth factors in dry age-related macular degeneration: visual prognosis and morphological study

    Science.gov (United States)

    Limoli, Paolo Giuseppe; Limoli, Celeste; Vingolo, Enzo Maria; Scalinci, Sergio Zaccaria; Nebbioso, Marcella

    2016-01-01

    Background The aim of this research was to study the overall restoration effect on residual retinal cells through surgically grafted autologous cells onto the surrounding tissue, choroid and retina in order to produce a constant secretion of growth factors (GFs) in dry age-related macular degeneration (AMD) patients. Results 6 months after surgery, several values were statistically significant in the group with higher RTA. Also patient compliance analysis (PCA) in relation to functional change perception appeared to be very good. Methods Thirty-six eyes of 25 patients (range 64-84 years of age) affected by dry AMD were included in study, and divided in two groups by spectral domain-optical coherence tomography (SD-OCT): group A with retinal thickness average (RTA) less than 250 microns (μm) and group B with RTA equal to or more than 250 μm. Adipocytes, adipose-derived stem cells from the stromal-vascular fraction, and platelets from platelet-rich plasma were implanted in the suprachoroidal space. Particularly, the following parameters were evaluated: best corrected visual acuity (BCVA) for far and near distance, retinal thickness maps, scotopic and photopic electroretinogram (ERG), and microperimetry (MY). All statistical analyses were performed with STATA 14.0 (Collage Station, Texas, USA). Conclusions The available set of GFs allowed biological retinal neuroenhancement. After 6 months it improved visual performance (VP), but the increase was better if RTA recorded by OCT was higher, probably in relation to the presence of areas with greater cellularity. PMID:27391437

  3. Vascular endothelial growth factor A and vascular endothelial growth factor receptor 2 expression in non-small cell lung cancer patients: relation to prognosis

    DEFF Research Database (Denmark)

    Bonnesen, Barbara; Pappot, Helle; Holmstav, Julie;

    2009-01-01

    elements in neoplastic cells and their microenvironment have recently been and are continuously developed including drugs inhibiting the angiogenic system. Angiogenic factor vascular endothelial growth factor (VEGF) and its receptor vascular endothelial growth factor receptor 2 (VEGFR2) seem to play key...

  4. 影响护理不良事件发生因素的质性研究%A qualitative study of influencing factors on nursing adverse event

    Institute of Scientific and Technical Information of China (English)

    韩金红; 韩金香; 马新翠

    2012-01-01

    Objective To explore the influencing factors on nursing adverse event. Methods Using a qualitative study, an in - depth interview was conducted on 8 nurses and 8 head nurses . Data were collected by a living recording and shorthand, and were analyzed by Colaizzi's analysis. Results Six influencing factors were identified, including nurse, management, article, environment, patient. Conclusion To decrease the accident rate of nursing adverse event, administrator should adopt multivariate analyses on nursing adverse event and take various measures.%目的 探讨护理不良事件发生的相关因素.方法 采用深度访谈法,收集15例个案资料.进行现场录音和速记,并运用Golaizzi分析程序进行分析.结果 提炼出6个主题,分别为护理人员因素、管理因素、物晶因素、环境因素、患者因素、多种因素相互作用.结论 对护理不良事件应进行多因素分析,并采取多种措施,以降低护理不良事件的发生率.

  5. Effect of Factor XIII-A G185T Polymorphism on Visual Prognosis after Photodynamic Therapy for Neovascular Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Francesco Parmeggiani

    2015-08-01

    Full Text Available Macular degenerations represent leading causes of central blindness or low vision in developed countries. Most of these severe visual disabilities are due to age-related macular degeneration (AMD and pathologic myopia (PM, both of which are frequently complicated by subfoveal choroidal neovascularization (CNV. Photodynamic therapy with verteporfin (PDT-V is still employed for CNV treatment in selected cases or in combined regimen. In Caucasian patients, the common polymorphism G185T of factor XIII-A gene (FXIII-A-G185T; rs5985 has been described as predictor of poor angiographic CNV responsiveness to PDT-V. Nevertheless, the prognostic implications of this pharmacogenetic determinant on long-term visual outcome after a PDT-V regimen have not been evaluated. We retrospectively selected Caucasian patients presenting with treatment-naive CNV and receiving standardized PDT-V protocol for two years. The study population included patients affected by subfoveal CNV secondary to AMD or PM. We assessed the correlations between the polymorphic allele T of FXIII-A-G185T and: (1 total number of photodynamic treatments; and (2 change in visual acuity from baseline to the end of the follow-up period. Considering a total study population of 412 patients with neovascular AMD or PM, the carriers of 185 T-allele of FXIII-A (GT or TT genotype received a higher number of photodynamic treatments than patients without it (GG wild-type genotype (p < 0.01; mean number of PDT-V: 5.51 vs. 3.76, respectively. Moreover, patients with 185 T-allele of FXIII-A had a more marked worsening of visual acuity at 24 months than those with the GG-185 wild genotype (p < 0.01; mean difference in logMAR visual acuity: 0.22 vs. 0.08, respectively. The present findings show that the G185T polymorphism of the FXIII-A gene is associated with significant differences in the long-term therapeutic outcomes of patients treated with standardized PDT-V protocol. The comprehensive appraisal of

  6. Factors affecting the development of adverse drug reactions to β-blockers in hospitalized cardiac patient population

    Directory of Open Access Journals (Sweden)

    Mugoša S

    2016-08-01

    Full Text Available Snežana Mugoša,1,2 Nataša Djordjević,3 Nina Djukanović,4 Dragana Protić,5 Zoran Bukumirić,6 Ivan Radosavljević,7 Aneta Bošković,8 Zoran Todorović5,9 1Department of Pharmacotherapy, Faculty of Pharmacy, University of Montenegro, 2Clinical Trial Department, Agency for Medicines and Medical Devices of Montenegro, Podgorica, Montenegro; 3Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, 4High Medical School “Milutin Milanković”, Belgrade, 5Department of Pharmacology, Clinical Pharmacology and Toxicology, 6Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, 7Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; 8Clinic for Heart Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro; 9Department of Clinical Immunology and Allergy, Medical Center “Bežanijska kosa”, Belgrade, Serbia Abstract: The aim of the present study was to undertake a study on the prevalence of cytochrome P450 2D6 (CYP2D6 poor metabolizer alleles (*3, *4, *5, and *6 on a Montenegrin population and its impact on developing adverse drug reactions (ADRs of β-blockers in a hospitalized cardiac patient population. A prospective study was conducted in the Cardiology Center of the Clinical Center of Montenegro and included 138 patients who had received any β-blocker in their therapy. ADRs were collected using a specially designed questionnaire, based on the symptom list and any signs that could point to eventual ADRs. Data from patients’ medical charts, laboratory tests, and other available parameters were observed and combined with the data from the questionnaire. ADRs to β-blockers were observed in 15 (10.9% patients. There was a statistically significant difference in the frequency of ADRs in relation to genetically determined enzymatic activity (P<0.001, with ADRs’ occurrence significantly

  7. The road to success. Long-term prognosis for persons living with HIV in Denmark - time trends and risk factors.

    Science.gov (United States)

    Lohse, Nicolai

    2016-02-01

    The work on this thesis began in 2003 when the global HIV epidemic was out of control. A minority of persons with HIV were benefitting fully from the recently introduced highly efficacious antiretroviral therapy (ART) combinations. Among the global challenges were lack of access to good healthcare, drug toxicity, and emergence of drug-resistant virus. It was unknown how long the drugs could maintain their efficacy in the individual even if administered as intended, and there was a fear that the increased drug pressure would increase the prevalence of drug resistance, subsequently leading to transmission of resistant virus from one individual to another, and thereby waning the treatment options available. Hence, we were far from the ideal conditions where an HIV-infected individual gets to know immediately that he/she is infected, has access to specialized medical and social support, receives a drug combination which effectively suppresses the virus and has no side effects, and is free of co-morbid conditions both before and after he/she gets infected. The nine papers on which this thesis is based each aimed to provide new knowledge to aspects of the above. Late diagnosis and late presentation to clinical care continue to be major barriers to improved HIV management. We used nation-wide hospital registries to explore the potential for an indicator disease-based HIV testing strategy. A range of conditions that were manifestations of the HIV infection itself were found to be associated with highly increased risk of HIV diagnosis during the coming year, but less so three to five years later. Other conditions were associated with an almost constant five-year long increased risk of being diagnosed with HIV because they share behavioural risk factors with HIV, making them indicators of not only current HIV but also of future HIV acquisition. Hence, indicator condition-based testing should be adapted to the local epidemic and could be a valuable addition to the existing

  8. Relationship analysis between clinical factor and prognosis of prostate cancer%前列腺癌临床各因素与预后的关系分析

    Institute of Scientific and Technical Information of China (English)

    窦建国; 王德林

    2011-01-01

    were 86% ,64% ,54 % ,33% in PCa patients, respectively. The median survival time was 43. 36 months. Conclusion Prognosis of PCa patients are certainly correlated with bone metastasis,clinical stage,PSAD, Gleason score; Bone metastases, PSAD and clinical stage are risk factors for prognosis of PCa patients. The cumulative survival rate of PSAD level >3 ng · mL-1 · (cm3 )-1 group is significantly lower than that of ≤3 ng · mL-1 . ( cm3 ) -1 group(P<0. 05) , thus PSAD may play a key role in determining the prog nosis of PCa patients.

  9. Analysis of the tumor length and other prognosis factors in pT1-2 node-negative esophageal squamous cell carcinoma in a Chinese population

    Directory of Open Access Journals (Sweden)

    Song Zhengbo

    2012-12-01

    Full Text Available Abstract Background Tumor length is an important prognostic factor for many carcinomas, but its role in esophageal cancer remained undetermined. The aim of this study was to investigate the effect of tumor length on survival for patients with confined tumors (grade pT1-2 without lymph-node metastases in esophageal squamous cell carcinoma. Methods We enrolled 201 patients with esophageal squamous cell carcinoma (SCC who had undergone surgical resection and been confirmed as pT1-2N0M0. The relationship of tumor length with overall survival was assessed and compared with other factors detailed in the American Joint Committee on Cancer (AJCC tumor, node, metastasis (TNM staging system published in 2009. Results The overall survival (OS rates at 1, 3, and 5 years were 93.0%, 83.7%, and 69.2%, respectively. The tumor length adversely affected OS, with the 5-year rate being 93.5%, 82.0%, 68.6%, 67.9%, 55.3% and 41.1%, respectively for tumor lengths of less than 10 mm, 10 to 20 mm, 20 to 30 mm, 30 to 40 mm, 40 to 50 mm, and greater than 50 mm (PP = 0.04, as did the other current TNM factors. Conclusion Tumor length appears to affect the OS of patients with early-stage esophageal squamous cell carcinoma. It may provide additional prognostic information for the current TNM staging system.

  10. Incidence and risk factors of bleeding-related adverse events in patients with chronic lymphocytic leukemia treated with ibrutinib

    DEFF Research Database (Denmark)

    Lipsky, Andrew H; Farooqui, Mohammed Z H; Tian, Xin

    2015-01-01

    , suggesting that the risk of bleeding decreases with continued therapy. At baseline, von Willebrand factor and factor VIII levels were often high and normalized on treatment. Platelet function measured via the platelet function analyzer (PFA-100™) was impaired in 22 patients at baseline and in an additional...

  11. Stromal Cell-Derived Factor 1 Gene Polymorphism Is Associated with Susceptibility to Adverse Long-Term Allograft Outcomes in Non-Diabetic Kidney Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Chung-Jieh Wang

    2014-07-01

    Full Text Available Although the genetic polymorphism of Stromal Cell-Derived Factor 1 (SDF-1 is associated with higher mortality of liver allograft recipients, the role of SDF-1 in the modulation of renal allograft outcomes is unclear. Between March 2000 and January 2008, we recruited 252 non-diabetic renal transplant recipients (RTRs. Baseline characteristics and blood chemistry were recorded. Genomic DNA extraction with polymerase chain reaction-restriction fragment length polymorphism was utilized to analyze the genetic polymorphisms of SDF-1 (rs1801157. The influence of SDF-1 on an adverse renal allograft outcome, defined as either a doubling of serum creatinine, graft failure, or patient death was evaluated. Sixteen patients with the SDF-1 AA/AG genotype and nine with the SDF-1 GG genotype reached an adverse outcome. According to Kaplan-Meier analysis, patients carrying the SDF-1 AA/AG genotype or A allele showed a significantly higher risk of reaching an adverse outcome than those carrying the SDF-1 GG genotype or G allele (p = 0.041; p = 0.0051, respectively; log rank test. Stepwise multivariate Cox proportional regression analysis revealed that patients carrying the SDF-1 AA/AG genotype and A allele had a 2.742-fold (95% CI. 1.106–6.799, p = 0.03 and 2.306-fold (95% CI. 1.254–4.24, p = 0.008 risk of experiencing an adverse outcome. The SDF-1 AA/AG genotype and A allele have a detrimental impact on the long-term outcome of RTRs.

  12. Negative Effects of Psychological Treatments: An Exploratory Factor Analysis of the Negative Effects Questionnaire for Monitoring and Reporting Adverse and Unwanted Events.

    Science.gov (United States)

    Rozental, Alexander; Kottorp, Anders; Boettcher, Johanna; Andersson, Gerhard; Carlbring, Per

    2016-01-01

    Research conducted during the last decades has provided increasing evidence for the use of psychological treatments for a number of psychiatric disorders and somatic complaints. However, by focusing only on the positive outcomes, less attention has been given to the potential of negative effects. Despite indications of deterioration and other adverse and unwanted events during treatment, little is known about their occurrence and characteristics. Hence, in order to facilitate research of negative effects, a new instrument for monitoring and reporting their incidence and impact was developed using a consensus among researchers, self-reports by patients, and a literature review: the Negative Effects Questionnaire. Participants were recruited via a smartphone-delivered self-help treatment for social anxiety disorder and through the media (N = 653). An exploratory factor analysis was performed, resulting in a six-factor solution with 32 items, accounting for 57.64% of the variance. The derived factors were: symptoms, quality, dependency, stigma, hopelessness, and failure. Items related to unpleasant memories, stress, and anxiety were experienced by more than one-third of the participants. Further, increased or novel symptoms, as well as lack of quality in the treatment and therapeutic relationship rendered the highest self-reported negative impact. In addition, the findings were discussed in relation to prior research and other similar instruments of adverse and unwanted events, giving credence to the items that are included. The instrument is presently available in eleven different languages and can be freely downloaded and used from www.neqscale.com.

  13. Over-expression of eukaryotic translation initiation factor 4 gamma 1 correlates with tumor progression and poor prognosis in nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Li Xin

    2010-04-01

    Full Text Available Abstract Background The aim of the present study was to analyze the expression of eukaryotic translation initiation factor 4 gamma 1 (EIF4G1 in nasopharyngeal carcinoma (NPC and its correlation with clinicopathologic features, including patients' survival time. Methods Using real-time PCR, we detected the expression of EIF4G1 in normal nasopharyngeal tissues, immortalized nasopharyngeal epithelial cell lines NP69, NPC tissues and cell lines. EIF4G1 protein expression in NPC tissues was examined using immunohistochemistry. Survival analysis was performed using Kaplan-Meier method. The effect of EIF4G1 on cell invasion and tumorigenesis were investigated. Results The expression levels of EIF4G1 mRNA were significantly greater in NPC tissues and cell lines than those in the normal nasopharyngeal tissues and NP69 cells (P EIF4G1 protein was higher in NPC tissues than that in the nasopharyngeal tissues (P EIF4G1 protein in tumors were positively correlated with tumor T classification (P = 0.039, lymph node involvement (N classification, P = 0.008, and the clinical stages (P = 0.003 of NPC patients. Patients with higher EIF4G1 expression had shorter overall survival time (P = 0.019. Multivariate analysis showed that EIF4G1 expression was an independent prognostic indicator for the overall survival of NPC patients. Using shRNA to knock down the expression of EIF4G1 not only markedly inhibited cell cycle progression, proliferation, migration, invasion, and colony formation, but also dramatically suppressed in vivo xenograft tumor growth. Conclusion Our data suggest that EIF4G1 can serve as a biomarker for the prognosis of NPC patients.

  14. Impact of operative and peri-operative factors on the long-term prognosis of primary liver cancer patients undergoing hepatectomy.

    Science.gov (United States)

    Xu, Li-Ning; Xu, Ying-Ying; Gao, De-Wei

    2016-08-01

    This study examined the impact of the operative and peri-operative factors on the long-term prognosis of patients with primary liver cancer undergoing hepatectomy. A total of 222 patients with primary liver cancer who underwent hepatectomy were followed up from January 1986 to December 2010 at Chinese PLA General Hospital. The post-operative complication rate was 14.0% for all cases, 13.7% for hepatocellular carcinoma (HCC), 10.0% for cholangiocarcinoma. The 1-, 3-, 5- and 10-year overall survival rates in patients with primary liver cancer after resection were 76.6%, 57.6%, 41.4%, and 21.0%. The survival rates were significantly higher in the HCC group than in the cholangiocarcinoma group (P=0.000), in the non-anatomical resection group than in the anatomical resection group (P=0.005), in the female group than in the male group (P=0.002), in patients receiving no blood transfusion than in those who were given intra-operative blood transfusion (P=0.000), in patients whose intra-operative blood loss was less than 400 mL than in those who intra-operatively lost more than 400 mL (P=0.000). No significant difference was found in the survival rate between the HBsAg-positive group and the HBsAg-negative group (P=0.532). Our study showed that anatomical resection, blood loss and blood transfusion were predictors of poor survival after hepatectomy for primary liver cancer patients, and concomitant hepatitis B virus infection bore no relation with the post-resection survival.

  15. Family-based risk factors for non-suicidal self-injury: Considering influences of maltreatment, adverse family-life experiences, and parent-child relational risk.

    Science.gov (United States)

    Martin, Jodi; Bureau, Jean-François; Yurkowski, Kim; Fournier, Tania Renaud; Lafontaine, Marie-France; Cloutier, Paula

    2016-06-01

    The current investigation addressed the potential for unique influences of perceived childhood maltreatment, adverse family-life events, and parent-child relational trauma on the lifetime occurrence and addictive features of non-suicidal self-injury (NSSI). Participants included 957 undergraduate students (747 females; M = 20.14 years, SD = 3.88) who completed online questionnaires regarding the key variables under study. Although self-injuring youth reported more experiences with each family-based risk factor, different patterns of association were found when lifetime engagement in NSSI or its addictive features were under study. Perceived parent-child relational trauma was uniquely linked with NSSI behavior after accounting for perceived childhood maltreatment; adverse family-life events had an additional unique association. In contrast, perceived paternal maltreatment was uniquely related with NSSI's addictive features. Findings underline the importance of studying inter-related family-based risk factors of NSSI simultaneously for a comprehensive understanding of familial correlates of NSSI behavior and its underlying features.

  16. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Questions to Ask about Your Diagnosis Research Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a ... for provider care teams (PDF-210KB). Understanding Your Cancer Prognosis Video View this video on YouTube. Three ...

  17. 影响劳力性热射病预后的危险因素分析%Analysis of risk factors affecting prognosis of exertional heat stroke

    Institute of Scientific and Technical Information of China (English)

    赵佳佳; 周京江; 胡婕; 周飞虎; 康红军; 刘辉; 潘亮; 宋青

    2013-01-01

    目的 探讨影响劳力性热射病(EHS)预后的危险因素.方法 收集2002年6月至2012年8月期间10家部队医院资料完整的69例EHS患者的主要临床参数及预后情况,包括是否合并横纹肌溶解(RM)、弥散性血管内凝血(DIC)、急性肾损伤(AKI)、肝功能障碍、继发性癫痫、休克、心律失常、多器官功能障碍综合征(MODS)及意识状态等9个主要临床参数.进行logistic多因素回归分析,筛选出与EHS预后有关的主要危险因素,并验证其准确性和可靠性.结果 EHS患者69例,以出院为观察终点,死亡18例,病死率26.09%;DIC、AKI为影响预后的独立危险因素[DIC优势比(OR) =94.994,95%可信区间(95%CI)为3.837~2352.031,P=0.005; AKI OR=90.871,95%CI为2.079~3971.995,P=0.019];其中DIC和AKI任何一个因素单独存在的病死率为16.67% (3/18);DIC和AKI同时存在的病死率为93.75%(15/16),其敏感度为83.33%,特异度为98.03%,阳性预测值为93.75%,阴性预测值为94.34%,准确性为94.20%.结论 EHS患者合并DIC、AKI为影响预后的主要危险因素;如同时存在DIC、AKI 2个因素的EHS患者,死亡风险极高.%Objective To determine prognostic risk factors of exertional heat stroke (EHS).Methods Sixty-nine patients who met the case definition of EHS at ten military hospitals from June 2002 to August 2012 were enrolled in this retrospective study.The clinical data and prognosis was observed,including rhabdomyolysis (RM),disseminated intravascular coagulation (DIC),acute kidney injury (AKI),hepatosis,epilepsy,shock,arrhythmia,multiple organ dysfunction syndrome (MODS) and consciousness disorder.A logistic regression analysis was made to look for the significant risk factors,and its accuracy and reliability were tested and verified by statistical equation.Results There were 69 patients with EHS in the study,and 18 (26.09%) were dead.The independent prognostic factors were identified as DIC and AKI [DIC odds

  18. 肥厚型心肌病患者的生存分析%Iong-term prognosis and probably impact factors of hypertrophic cardiomyopathy patients

    Institute of Scientific and Technical Information of China (English)

    汪烨; 姜腾勇; 韩智红; 任学军; 吴学思

    2011-01-01

    Objective: The purpose of this study was to acquire the present situation about long-term prognosis and probably impact factors of hypertrophic cardiomyopathy( HCM) patients who encountered in tertiary hospitals in China. Methods : We retrospectively analysed 457 patients [ age ( 47. 9 ± 16. 0) years;54. 9% men] encountered in our hospital from Jan. 2000 to Sep. 2008. All cases were documented by 12-lead ECG and percutaneous UCG. We carried factors,which were know n and connected with bad prognosis, on the COX analysis, such as LVOT obstr-uction, maximal left ventricular wall thickness, left ventricular end-diastolic diamensi-on,LVEF, NYHA functional class. family history, coexisting disease, complication, clinlcal symptom etc. Results : Altogether have 368 patients who completed the revisit [ revisit rate 80. 5% , follow-up (41. 9 ±28. 4) months ] . Death occurred in 25 patients ( 5. 5% ) , HCM-related death occurred in 14 patients( SCD 7 patients). Accumulative 5-and 10-year survival estimates were 91.6% and 80. 9% . The first annual mortality is 2. 8% , the second is 1. 7% , the third is 1. 4% ,the forth 2. 7% , the fifth is 0%. Independent predictors of allcause mortality were heart function( RR = 2. 90 ,P = 0. 017) , EF ( RR = 0. 96 ,P = 0. 009 ) , and AF( RR = 2. 40 ,P = 0. 009) . Conclusion : The prognosis of HCM patients is related with poor heart function and AF occurrence.%目的:获得在我院就诊的肥厚型心肌病(HCM)患者的长期预后情况及可能的影响因素.方法:回顾性分析2000年1月至2008年9月在我院就诊的HCM患者457例,男性251例(54.9%),女性206例(45.1%),年龄2~84岁,平均年龄(47.9±16.0)岁.所有患者均有12导联心电图,超声心动图检测结果.对已知的与预后不佳相关的因素如左心室流出道(LVOT)梗阻、最大左心室室壁厚度、左心室内径、左心室射血分数(LVEF)、心功能NYHA分级、家族史、并存疾病、并发症、临床症状等

  19. SPOCK1 Is a Novel Transforming Growth Factor-β-Induced Myoepithelial Marker That Enhances Invasion and Correlates with Poor Prognosis in Breast Cancer.

    Science.gov (United States)

    Fan, Li-Ching; Jeng, Yung-Ming; Lu, Yueh-Tong; Lien, Huang-Chun

    2016-01-01

    In addition to contraction, myoepithelia have diverse paracrine effects, including a tumor suppression effect. However, certain myoepithelial markers have been shown to contribute to tumor progression. Transforming growth factor-β (TGF-β) is involved in the transdifferentiation of fibroblasts to contractile myofibroblasts. We investigated whether TGF-β can upregulate potential myoepithelial markers, which may have functional and clinicopathological significance in breast cancer. We found that TGF-β induced SPOCK1 expression in MCF10A, MCF12A, and M10 breast cells and demonstrated SPOCK1 as a novel myoepithelial marker that was immunolocalized within or beneath myoepithelia lining ductolobular units. A functional study showed that overexpression of SPOCK1 enhanced invasiveness in mammary immortalized and cancer cells. To further determine the biological significance of SPOCK1 in breast cancer, we investigated the expression of SPOCK1 in 478 invasive ductal carcinoma (IDC) cases through immunohistochemistry and correlated the expression with clinicopathological characteristics. SPOCK1 expression was significantly correlated with high pathological tumor size (P = 0.012), high histological grade (P = 0.013), the triple-negative phenotype (P = 0.022), and the basal-like phenotype (P = 0.026) and was correlated with a significantly poorer overall survival on univariate analysis (P = 0.001, log-rank test). Multivariate Cox regression analysis demonstrated that SPOCK1 expression maintained an independent poor prognostic factor of overall survival. Analysis of SPOCK1 expression on various non-IDC carcinoma subtypes showed an enrichment of SPOCK1 expression in metaplastic carcinoma, which is pathogenetically closely related to epithelial-mesenchymal transition (EMT). In conclusion, we identified SPOCK1 as a novel TGF-β-induced myoepithelial marker and further demonstrated that SPOCK1 enhanced invasion in breast cancer cells and correlated with poor prognosis in breast

  20. 妊娠合并肺动脉高压患者预后的危险因素分析%Risk factors analysis of prognosis of pregnancy with pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    刘燕

    2016-01-01

    events. Results The maternal deaths occurred in seven cases(15. 2%)of pulmonary hypertension and only one case of normal pregnant women. Three independent risk factors of adverse cardiac events in pulmonary hypertension were severe pulmonary hypertension( sPAP≥50 mmHg,1 mmHg =0. 133 kPa )[ OR =38. 64,95% CI (8. 93-86. 39),P﹤0. 01],NYHA( New York Heart Association)functional greater than class Ⅲ[ OR=15. 37 ,95%CI( 6. 79 -62. 18 ),P ﹤0. 01 ] and hypotension during anesthetic stage[ OR=29. 97,95%CI(4. 60-77. 08),P﹤0. 01]. Conclusions The prognosis of pregnant women with pul-monary hypertension is related to the factors of the severity of pulmonary hypertension,heart function and hypotension during anesthetic stage.

  1. 鲍曼不动杆菌血流感染预后的危险因素分析%Analysis of risk factors on prognosis of Acinetobacter baumannii bloodstream infection

    Institute of Scientific and Technical Information of China (English)

    乔莉; 张劲松; 梅亚宁; 张华忠; 苏成磊

    2013-01-01

    Objective To explore the risk factors on prognosis of Acinetobacter baumannii bloodstream infection.Methods Clinical data from 78 patients with Acinetobacter baumannii bloodstream infection hospitalized in First Affiliated Hospital of Nanjing Medical University from January 2010 to November 2012 were analyzed retrospectively.According to the 28-day prognosis after admission,the patients were divided into non-survivors (n=40) and survivors (n=38).Data on demographic and clinical characteristics,wards,underlying diseases,treatments,invasive medical procedures,bacterial resistance to antibiotics,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in the beginning were collected.The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis.The predictor value was concluded by comparing area under the receiver operating characteristic curve (ROC curve) of each index.Results Risk factors of mortality of Acinetobacter baumannii bloodstream infection goes as following,including intensive care unit admission [ICU,odds ratio (OR)=12.9,95% confidence interval (95% CI) 2.4-63.5,P=0.001],trachea intubationor tracheostomy (OR =6.2,95% CI 1.5-30.4,P=0.023),invasive mechanical ventilation (OR =5.1,95% CI 1.4-22.6,P=0.042),invasive medical procedure besides central venous catheter (including thoracentesis,bone marrow puncture,lumbar puncture,catheterization,bronchoalveolar lavage with bronchofibroscope,arteriovenous fistula plastic operation,OR =8.4,95%CI 1.7-37.8,P=0.011),APACHE Ⅱ score ≥ 19 in the beginning (OR=35.4,95%CI 3.8-318.6,P=0.001).With respect to APACHE Ⅱ score ≥ 19 as mortality cut-off point,an area under the receiver operating curve of 0.938 was statistically significant (P<0.05),with sensitivity 76.2% and specificity 94.1%.The relationship between prognosis and antibiotic resistance did not have statistically significance.Conclusion Invasive medical procedures and

  2. Risk factors in the development of adverse reactions to N-acetylcysteine in patients with paracetamol poisoning

    DEFF Research Database (Denmark)

    Schmidt, L E; Dalhoff, K

    2001-01-01

    AIMS: To identify risk factors in the development of side-effects to N-acetylcysteine (NAC) in patients with paracetamol poisoning. METHODS: A retrospective study was carried out based upon the hospital charts of 529 consecutive patients admitted with paracetamol poisoning, all treated with NAC......, at the Department of Hepatology, Copenhagen University Hospital (the tertiary care centre of liver disease in Denmark). RESULTS: Forty-five patients (8.5%; 95% confidence intervals (CI) 6.4, 11%) developed side-effects to NAC and 18 patients (3.4%; 95% CI 2.1, 5.4%) developed systemic side-effects. Asthmatics were...... 2.9 times (95% CI 2.1, 4.7) more likely to develop side-effects (Chi-square: P = 0.004). Side-effects were of similar severity in asthmatics and nonasthmatics. A history of medical allergy was not a risk factor. Serum paracetamol was lower in patients with side-effects than in those without (Mann...

  3. Study on prognosis status and its influential factors in children with febrile convulsion%高热惊厥小儿预后现状和影响因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋建军; 杨毅

    2012-01-01

    目的 探讨高热惊厥小儿预后现状和影响因素.方法 采用自编问卷收集2010年8月~2011年8月在湖南省永州市祁阳县人民医院儿科住院治疗的43例高热惊厥患儿临床资料.结果 在本研究入选的43例患儿中,35例患儿预后良好,预后良好率为81.40%,而预后不良率为18.60%,多因素Logistic回归分析发现初次发作年龄<1岁,高热惊厥持续时间≥15 min、高热惊厥次数≥2次和脑电图异常是高热惊厥患儿预后差危险因素.结论 高热惊厥患儿总体预后欠佳,预后影响因素较多,在对高热惊厥进行治疗的过程中,积极治疗高热惊厥,发作时尽可能在最短时间内止痉,改善患儿的预后.%Objective To investigate the prognosis status and its influential factors in children with febrile convulsion. Methods Clinical data of 43 children with febrile convulsion who were treated in the Department of Pediatric in the People's Hospital of Qiyang County in Yongzhou City, Hu'nan Province, from August 2010 to August 2011 were collected by self-made questionnaire. Results 43 children with febrile convulsion were favorable prognosis, the good prognosis rate was 81.40%, the bad prognosis rate was 18.60%, binary classification logistic regression analysis showed that first onset age <1 year old, febrile convulsion duration ≥15 min, febrile convulsion number ≥2 and electroencephalography abnormality were risk factors. Conclusion The prognosis status of children with febrile convulsion was bad. It is affected by various factors. We should give positive treatment and control attack as soon as possible to improve the prognosis of children with febrile convulsion.

  4. The colorectal carcinoma prognosis factors: Significance of diagnosis delay Factores pronósticos en carcinoma colorrectal: Importancia de la demora diagnóstica

    Directory of Open Access Journals (Sweden)

    E. Gómez-Domínguez

    2006-05-01

    Full Text Available Introduction: detection of early-stage colorectal carcinoma (CRC -( Dukes' A or B- provides better survival rates in these patients. Thus, the effectiveness of screening programs in asymptomatic patients or of early diagnosis in symptomatic individuals has been postulated. The aim of this study was to establish whether a delay in diagnosis or other factors are related to CRC stage. Patients and methods: a retrospective study was performed on 96 patients with CRC. Age at diagnosis, gender distribution, intestinal disorders, diagnosis delay, primary sign and -regarding CRC- localization, stage (Dukes' and grade of differentiation (well differentiated; non-well differentiated; poorly differentiated were recorded. Results: diagnosis delay was 185 ± 190 days. Patients delay in obtaining a diagnosis was 119 ± 158 days. In 40% of patients CRC was diagnosed at an early stage (Dukes' A or B, and in 13% CRC was poorly differentiated. The only factor with an independent effect on Dukes' stage was tumor differentiation (p: 0.0012. Distal location was associated with less advanced tumors without statistical significance (p: 0.156. Conclusion: based on the presented data, a greater effort regarding screening programs for healthy people seems warranted, as improved survival has been demonstrated when diagnosis delay is reduced, particularly in patients with the highest mean delay.Introducción: el diagnóstico precoz del cáncer colorrectal (estadios A y B de Dukes consigue mejorar las tasas de supervivencia de estos pacientes. Con este objetivo se ha propuesto como estrategia acelerar el diagnóstico de enfermos sintomáticos o realizar cribados en enfermos asintomáticos. El objetivo de este trabajo es identificar los factores que influyen en la extensión tumoral del carcinoma colorrectal, especialmente la demora en el diagnóstico. Material y métodos: estudio prospectivo de una serie de 99 pacientes diagnosticados de carcinoma colorrectal en los que se

  5. Negative Effects of Psychological Treatments: An Exploratory Factor Analysis of the Negative Effects Questionnaire for Monitoring and Reporting Adverse and Unwanted Events.

    Directory of Open Access Journals (Sweden)

    Alexander Rozental

    Full Text Available Research conducted during the last decades has provided increasing evidence for the use of psychological treatments for a number of psychiatric disorders and somatic complaints. However, by focusing only on the positive outcomes, less attention has been given to the potential of negative effects. Despite indications of deterioration and other adverse and unwanted events during treatment, little is known about their occurrence and characteristics. Hence, in order to facilitate research of negative effects, a new instrument for monitoring and reporting their incidence and impact was developed using a consensus among researchers, self-reports by patients, and a literature review: the Negative Effects Questionnaire. Participants were recruited via a smartphone-delivered self-help treatment for social anxiety disorder and through the media (N = 653. An exploratory factor analysis was performed, resulting in a six-factor solution with 32 items, accounting for 57.64% of the variance. The derived factors were: symptoms, quality, dependency, stigma, hopelessness, and failure. Items related to unpleasant memories, stress, and anxiety were experienced by more than one-third of the participants. Further, increased or novel symptoms, as well as lack of quality in the treatment and therapeutic relationship rendered the highest self-reported negative impact. In addition, the findings were discussed in relation to prior research and other similar instruments of adverse and unwanted events, giving credence to the items that are included. The instrument is presently available in eleven different languages and can be freely downloaded and used from www.neqscale.com.

  6. Is chronic kidney disease an adverse factor in lung cancer clinical outcome? A propensity score matching study

    Science.gov (United States)

    Lu, Ming‐Shian; Chen, Miao‐Fen; Lin, Chien‐Chao; Tseng, Yuan‐Hsi; Huang, Yao‐Kuang; Liu, Hui‐Ping

    2017-01-01

    Background Comorbidity has a great impact on lung cancer survival. Renal function status may affect treatment decisions and drug toxicity. The survival outcome in lung cancer patients with coexisting chronic kidney disease (CKD) has not been fully evaluated. We hypothesized that CKD is an independent risk factor for mortality in patients with lung cancer. Methods A retrospective, propensity‐matched study of 434 patients diagnosed between June 2004 and May 2012 was conducted. CKD was defined as estimated glomerular filtration rate cancer and coexisting CKD patients were matched 1:1 to patients with lung cancer without CKD. Results Age, gender, smoking status, histology, and lung cancer stage were not statistically significantly different between the CKD and non‐CKD groups. Kaplan–Meier survival analysis demonstrated a median survival of 7.26 months (95% confidence interval [CI] 6.06–8.46) in the CKD group compared with 7.82 months (95% CI 6.33–9.30) in the non‐CKD group (P = 0.41). Lung cancer stage‐specific survival is not affected by CKD. Although lung cancer patients with CKD presented with an increased risk of death of 6%, this result was not statistically significant (hazard ratio 1.06, 95% CI 0.93–1.22; P = 0.41). Conclusion According to our limited experience, CKD is not an independent risk factor for survival in lung cancer patients. Clinicians should not be discouraged to treat lung cancer patients with CKD. PMID:28207203

  7. Clinical analysis of high risk factors for premature and prognosis of premature infants%早产高危因素及早产儿预后的临床分析

    Institute of Scientific and Technical Information of China (English)

    晏金荣

    2016-01-01

    目的:分析早产高危因素及早产儿预后的影响因素。方法:回顾性分析55例早产儿的临床资料,分析早产原因及影响预后的因素。结果:导致早产的高危因素主要包括胎膜早破、前置胎盘、重度子痫前期、高龄、妊娠期贫血、多胎妊娠和瘢痕子宫等。影响早产儿预后的因素主要包括胎龄、体重、分娩方式。结论:早产的高危因素复杂。重视围生期保健、防治妊娠并发症可降低早产的发生率。%Objective:To analyze the high risk factors for premature and the influence factors for prognosis of premature infants. Methods:The clinical data of 55 cases of premature infants were analyzed retrospectively.The high risk factors for premature and the influence factors for prognosis of premature infants were analyzed.Results:The high risk factors causing premature included premature rupture of membrane,placenta previa,severe preeclampsia,age,gestational anemia,multiple pregnancy and scarred uterus.The factors affecting the prognosis of premature infants included gestational age,body weight and delivery mode.Conclusion:The high risk factors of preterm were complex.Paying attention to the perinatal health care and taking measures to prevent and control the pregnancy complications actively could reduce the incidence of premature infants.

  8. Elevated serum levels of vascular endothelial growth factor predict a poor prognosis of platinum-based chemotherapy in non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Zang JL

    2017-01-01

    Full Text Available Jialan Zang,1–3,* Yong Hu,1,2,* Xiaoyue Xu,1,2 Jie Ni,1,2 Dali Yan,1,2 Siwen Liu,4 Jieyu He,5 Jing Xue,4 Jianzhong Wu,4 Jifeng Feng2 1The Fourth Clinical School of Nanjing Medical University, 2Department of Chemotherapy, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, 3Department of Oncology, The First Hospital of Harbin City, Harbin, 4Center of Clinical Laboratory, Nanjing Medical University Affiliated Cancer Hospital, 5Department of Public Health, Southeast University, Nanjing, People’s Republic of China *These authors contributed equally to this work Aim: This study was designed to investigate the predictive and prognostic values of serum vascular endothelial growth factor (VEGF level in non-small cell lung cancer (NSCLC patients treated with platinum-based chemotherapy. Methods: Patients’ peripheral blood samples were collected prior to chemotherapy and after 1 week of the third cycle of combination chemotherapy. Serum VEGF levels were evaluated through Luminex multiplex technique. Between September 2011 and August 2015, a total of 135 consecutive advanced or recurrent histologically verified NSCLC patients were enrolled in the study. Moreover, all the patients received platinum-based combination chemotherapy as a first-line treatment. Results: No significant associations were found between pretreatment serum VEGF levels and clinical characteristics, such as sex (P=0.0975, age (P=0.2522, stage (P=0.1407, lymph node metastasis (P=0.6409, tumor location (P=0.3520, differentiated degree (P=0.5608, pathological (histological type (P=0.4885, and response to treatment (P=0.9859. The VEGF load per platelet (VEGFPLT levels were not correlated with sex, age, primary tumor site, and pathological type in NSCLC patients (all P>0.05. The median survival time of progression-free survival (PFS was 6.407 and 5.29 months in the low and high groups, respectively, when using 280 pg/mL VEGF level as the cutoff point (P=0.024. Conclusion

  9. Factors Relevant to the Prognosis of Patients with Sudden Deafness after Hyperbaric Oxygen Therapy%高压氧综合治疗突发性耳聋预后相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李琴; 吴嗣洪; 唐守英; 张惠华; 曹晓燕; 葛秀英

    2014-01-01

    Objective To establish a scoring model that predicts the prognosis of patients with sudden deafness after hyperbaric oxygen therapy based on clinical data and to evaluate the efficacy of the model. Methods 188 patients with sudden deafness(221 ears)who received hyperbaric oxygen therapy were divided into two groups: 168 patients(201 ears) in training group and 20 patients(20 ears)in testing group. With a self-controlled experimental design, the training group were divided into the effective group and ineffective group. Chi-square test was applied to choose statistically significant risk factors which were used to establish a scoring model. Receiver operator characteristic (ROC) curve was then used to analyze the scoring model. Results The factors that had adverse effects on the prognosis of patients with sudden deafness after hyperbaric oxygen therapy included sudden deafness with vertigo, descending/completely deaf audiogram, prehospital delay time≥15 d, hyperbaric oxygen therapy<2 courses, beginning time of treatment≥fifteen days after onset, average hearing loss at the first visit≥60 dB HL, sudden deafness with HBP(high blood pressure)/DM(diabetes mellitus)or both. The ROC curve analysis revealed that the area under the curve (AUC) for the scoring model was 0.967, which was significantly different from the AUC(0.5) under the completely random circumstances(P<0.05). The appraisal of prospective misjudge possibility was applied to the scoring model in testing samples and the results showed the misjudgement rate was about 10%. Conclusion This scoring model based on clinical data can be used to predict the prognosis of patients with sudden deafness after hyperbaric oxygen therapy.%目的:根据临床资料建立预测高压氧(hyperbaric oxygen,HBO)综合治疗突发性耳聋(sudden deafness,SD)预后的评分模型,并评价科学性。方法连续选择188例(221耳)接受高压氧综合治疗的SD患者,随

  10. ICP围产儿不良结局的高危因素分析%High risk factors for adverse outcomes of perinatal infants of intrahepatic cholestasis pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘翠; 王勇; 楼方

    2015-01-01

    Objective To discuss the high risk factors for adverse outcomes of perinatal infants in intrahepatic cholestasis of pregnancy ( ICP) . Methods The ICP cases were collected from Affiliated Hospital of Chengdu University. The relationship between obstetric factors and adverse outcomes of perinatal infants was retrospectively analyzed with the data of 522 cases of ICP. Results Univariate analysis showed that the time of onset earlier than 34 gestational week, high TBA, high ALT, high TBIL, high DBIL, and complicated hypertension were statistically significant (χ2 value was 35. 079, 15. 140, 12. 155, 6. 142, 9. 988 and 12. 604, respectively, all P <0. 05). Logistic regression analysis indicated that time of onset earlier than 34 gestational week, high TBA and complicated hypertension were high risk factors for adverse outcomes of ICP perinatal infants (OR value was 2. 922, 1. 770 and 1. 861, respectively, all P<0. 05). Conclusion TBA≥40μmol/L, time of onset earlier than 34 gestational week and complicated high hypertension are risk factors for adverse outcomes of ICP perinatal infants.%目的:探讨妊娠期肝内胆汁淤积症( ICP)围产儿不良结局的高危因素。方法收集在成都大学附属医院住院分娩的ICP病例。回顾性分析522例ICP病例的产科因素与围产儿不良结局之间的关系。结果单因素分析发现发病时间≤孕34周、高总胆汁酸( TBA)、高谷丙转氨酶( ALT)、高总胆红素( TBIL)、高直接胆红素( DBIL)、合并高血压对围产儿不良结局均有统计学差异(χ2值分别为35.079、15.140、12.155、6.142、9.988、12.604,均P<0.05);经Logistic回归分析发现ICP的发病时间≤孕34周、高TBA、合并高血压系ICP围产儿不良结局的高危因素,其OR值分别为2.922、1.770、1.861,均P<0.05。结论 TBA≥40μmol/L、发病时间≤孕34周、合并高血压系ICP围产儿不良结局的高危因素。

  11. Prognosis factors of the metastatic thyroid differentiated cancer: value of the iodo-fixation on the secondary sites; Facteurs pronostiques du cancer differencie thyroidien metastatique: valeur de la iodo-fixation sur les sites secondaires

    Energy Technology Data Exchange (ETDEWEB)

    Benisvy, D.; Benoliel, J.; Fontana, X.; Bussiere, F.; Darcourt, J. [Service de medecine nucleaire, centre Antoine-Lacassagne, Nice, (France); Chamorey, E. [unite de biostatistique, centre Antoine-Lacassagne, Nice, (France)

    2009-05-15

    The survival of patients with a differentiated thyroid cancer of follicle strain with distant metastases is very variable, going from 14 to 95% at ten year. The study of factors influencing the prognosis stays essential in order to adapt the therapy. Conclusions: According to the results published in other series, the prognosis variables were age, histology, metastases extension and the number of ira therapies. On the other hand, the existence of iodine fixation at the metastases level was not significantly correlated to a better survival. This study enlightens the importance to quantify objectively the character iodo fixing of metastases, that cannot be evaluated after resection of the remainder on a whole body scintigraphy with a strong dose. (N.C.)

  12. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... to treatment Seeking Information About Your Prognosis Is a Personal Decision When you have cancer, you and ... how long she has to live. For Doctors, a Patient-Centered Approach View this video on YouTube. ...

  13. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... treatment Seeking Information About Your Prognosis Is a Personal Decision When you have cancer, you and your ... think they are too impersonal to be of value to you. It is up to you to ...

  14. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... to know more, the doctor who knows the most about your situation is in the best position ... statistics may be used to estimate prognosis. The most commonly used statistics include: Cancer-specific survival This ...

  15. Risk factors of pre-eclampsia/eclampsia and its adverse outcomes in low- and middle-income countries: a WHO secondary analysis.

    Directory of Open Access Journals (Sweden)

    Ver Luanni Bilano

    Full Text Available BACKGROUND: Pre-eclampsia has an immense adverse impact on maternal and perinatal health especially in low- and middle-income settings. We aimed to estimate the associations between pre-eclampsia/eclampsia and its risk factors, and adverse maternal and perinatal outcomes. METHODS: We performed a secondary analysis of the WHO Global Survey on Maternal and Perinatal Health. The survey was a multi-country, facility-based cross-sectional study. A global sample consisting of 24 countries from three regions and 373 health facilities was obtained via a stratified multi-stage cluster sampling design. Maternal and offspring data were extracted from records using standardized questionnaires. Multi-level logistic regression modelling was conducted with random effects at the individual, facility and country levels. RESULTS: Data for 276,388 mothers and their infants was analysed. The prevalence of pre-eclampsia/eclampsia in the study population was 10,754 (4%. At the individual level, sociodemographic characteristics of maternal age ≥30 years and low educational attainment were significantly associated with higher risk of pre-eclampsia/eclampsia. As for clinical and obstetric variables, high body mass index (BMI, nulliparity (AOR: 2.04; 95%CI 1.92-2.16, absence of antenatal care (AOR: 1.41; 95%CI 1.26-1.57, chronic hypertension (AOR: 7.75; 95%CI 6.77-8.87, gestational diabetes (AOR: 2.00; 95%CI 1.63-2.45, cardiac or renal disease (AOR: 2.38; 95%CI 1.86-3.05, pyelonephritis or urinary tract infection (AOR: 1.13; 95%CI 1.03-1.24 and severe anemia (AOR: 2.98; 95%CI 2.47-3.61 were found to be significant risk factors, while having >8 visits of antenatal care was protective (AOR: 0.90; 95%CI 0.83-0.98. Pre-eclampsia/eclampsia was found to be a significant risk factor for maternal death, perinatal death, preterm birth and low birthweight. CONCLUSION: Chronic hypertension, obesity and severe anemia were the highest risk factors of preeclampsia

  16. Extent of poly-pharmacy, occurrence and associated factors of drug-drug interaction and potential adverse drug reactions in Gondar Teaching Referral Hospital, North West Ethiopia

    Directory of Open Access Journals (Sweden)

    Endalkachew Admassie

    2013-01-01

    Full Text Available The aim of this study was to assess the extent of poly-pharmacy, occurrence, and associated factors for the occurrence of drug-drug interaction (DDI and potential adverse drug reaction (ADR in Gondar University Teaching Referral Hospital. Institutional-based retrospective cross-sectional study. This study was conducted on prescriptions of both in and out-patients for a period of 3 months at Gondar University Hospital. Both bivariate analysis and multivariate logistic regression were used to identify risk factors for the occurrence of DDI and possible ADRs. All the statistical calculations were performed using SPSS; software. A total of 12,334 prescriptions were dispensed during the study period of which, 2,180 prescriptions were containing two or more drugs per prescription. A total of 21,210 drugs were prescribed and the average number of drugs per prescription was 1.72. Occurrences of DDI of all categories (Major, Moderate, and Minor were analyzed and DDI were detected in 711 (32.6% prescriptions. Sex was not found to be a risk factor for the occurrence of DDI and ADR, while age and number of medications per prescription were found to be significant risk factors for the occurrence of DDI and ADR. The mean number of drugs per prescription was 1.72 and hence with regard to the WHO limit of drugs per prescription, Gondar hospital was able to maintain the limit and prescriptions containing multiple drugs supposed to be taken systemically. Numbers of drugs per prescription as well as older age were found to be predisposing factors for the occurrence of DDI and potential ADRs while sex was not a risk factor.

  17. Analysis of Prognosis of Insomnia and Its Influence Factors%失眠的预后及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    蒋尚融; 王传刘; 林子江; 敖文玲; 何金彩

    2012-01-01

    Objective To investigate the general conditions and prognosis factors for patients with insomnia. Methods The questionnaire self-made in accordance with the Consensus on definition and treatment in insomnia (draft) was used in the Sleep Center of First Affiliated Hospital of Wenzhou Medical College for the investgation on patients newly diagnosed with insomnia from Aug to Sept, 2007. All the patients were subjected to the individualized drug therapy which was supplemented with dormancy hygiene education, and then a telephone follow - up after 6 months. The process was targeted at observing the relationship of the disease outcome with drug compliance and dormancy hygiene education. Results A total of 123 patients completed the investigation. It was found that these insomnia patients mainly included female patients,chronic insomnia patients,patients aged 31 -40 years,mental workers,and patients with insomnia combined with mild or anxiety - free depression. Most had inducing factors that maily were stress events in the life. Patients adhering to dormancy hygiene advice and having good drug compliance produced a better outcome and the results were significant difference (P < 0.05 ). Conclusion Chronic insomnia patients,female patients,31 -40 years old patients,mental working patients and so on account for the majority, and the better outcome may be attributable to the dormancy health education and drug compliance improvement.%目的 调查失眠患者一般情况以及预后影响因素.方法 自制问卷,按照《中国失眠定义、诊断及药物治疗专家共识(草案)》,对2007年8~9月温州医学院附属第一医院睡眠中心初诊失眠患者进行调查,所有患者采用个体化药物治疗辅以睡眠卫生宣教,6个月后进行电话随访,观察患者病情转归与药物依从性以及睡眠卫生宣教的关系.结果 共有123例患者完成调查,发现其中以女性患者、慢性失眠、31~40岁患者、脑力劳动者、合并轻度

  18. High Expression of Stromal Cell-Derived Factor 1 (SDF-1) and NF-κB Predicts Poor Prognosis in Cervical Cancer.

    Science.gov (United States)

    Song, Zhiwang; Zhang, Xia; Ye, Xiaojuan; Feng, Chan; Yang, Guang; Lu, Yonglin; Lin, Yun; Dong, Chunyan

    2017-01-11

    BACKGROUND SDF-1 and NF-κB are associated with the prognosis of a wide range of cancers, but their value in cervical cancer remains controversial. The aim of this study was to investigate the expression of SDF-1and NF-κB in cervical cancer and their significance in clinical prognosis. MATERIAL AND METHODS The expression of SDF-1and NF-κB in 105 formalin-fixed, paraffin-embedded cervical cancer tissues and the adjacent tissues was examined by immunohistochemistry (IHC). The results were semi-quantitatively scored and analyzed by chi-square test. The overall survival times (OS) were collected by follow-up and analyzed by Kaplan-Meier analysis. RESULTS The expression level of both SDF-1and NF-κB in cervical cancer are higher than that in the adjacent tissues (PSDF-1 expression are correlated with tumor size and FIGO histology grade (PSDF-1or NF-κB tended to have much shorter survival time than patients with negative expression. In addition, multivariate Cox regression analysis demonstrated that SDF-1 expression and lymph node metastasis are independent predictors of the OS in cervical cancer patients. CONCLUSIONS The expression of SDF-1 is significantly associated with tumor size and FIGO histology grade. The expression of NF-κB is significantly associated with tumor size, FIGO histology grade, and lymph node metastasis. The positive SDF-1or NF-κB expression is significantly correlated with poor prognosis. These may be valuable biomarkers for the prognosis and the potential therapeutic targets of cervical cancer.

  19. Study on Influential Factors of Prognosis Status in Intracranial Aneurysm Surgery Patients in the Department of Cerebral Surgery%神经外科颅内动脉瘤手术患者预后影响因素研究

    Institute of Scientific and Technical Information of China (English)

    毛华

    2013-01-01

    Objective:To investigate the influential factors of prognosis in the intracranial aneurysm surgery patients. Methods:The clinical data of sixty-five intracranial aneurysm surgery patients who were treated in the department of cerebral surgery in our hospital from June 2010 to June 2011 were collected by self-made questionnaire according to literature summary. Then the collected clinical data of patients with intracranial aneurysm surgery patients were analysed by the SPSS16.0 for descriptive statistics and binary classification logistic regression analysis to find out prognosis status and its influential factors of intracranial aneurysm surgery patients. Results:Thirty-eight intracranial aneurysm surgery patients were favorable prognosis,the good prognosis rate was 58.46%,the bad prognosis rate was 41.54%,binary classification logistic regression analysis showed that age, hypertension, Fisher ‘s classification and Hunt - Hess classification had risk factors,but treatment in time is a protective factor,but fully resection was a protective effect on intracranial aneurysm surgery patients. Conclusion:The prognosis status of intracranial aneurysm surgery patients was bad.it is affected by various factors.We take the targeted intervention measures to improve the prognosis of intracranial aneurysm surgery patients.%  目的:探讨神经外科颅内动脉瘤手术患者预后影响因素。方法:采用根据查阅颅内动脉瘤手术患者相关文献制定自编问卷收集2010年6月~2011年6月在我院神经外科住院治疗的65例颅内动脉瘤手术患者对临床资料,采用二分类Logistic回归分析对颅内动脉瘤手术患者预后影响因素。结果:在本研究入选的65例患者中,38例患者预后良好,预后良好率为58.46%,而预后不良率为41.54%,多因素Logistic回归分析发现年龄、高血压、Fisher’s分级和Hunt-Hess分级是影响颅内动脉瘤手术患者预后的危险因素。结论:颅内动脉瘤手

  20. Urinary Tissue Inhibitor of Metalloproteinase-2 (TIMP-2 • Insulin-Like Growth Factor-Binding Protein 7 (IGFBP7 Predicts Adverse Outcome in Pediatric Acute Kidney Injury.

    Directory of Open Access Journals (Sweden)

    Jens H Westhoff

    Full Text Available The G1 cell cycle inhibitors tissue inhibitor of metalloproteinase-2 (TIMP-2 and insulin-like growth factor-binding protein 7 (IGFBP7 have been identified as promising biomarkers for the prediction of adverse outcomes including renal replacement therapy (RRT and mortality in critically ill adult patients who develop acute kidney injury (AKI. However, the prognostic value of urinary TIMP-2 and IGFBP7 in neonatal and pediatric AKI for adverse outcome has not been investigated yet.The product of the urinary concentration of TIMP-2 and IGFBP7 ([TIMP-2]•[IGFBP7] was assessed by a commercially available immunoassay (NephroCheck™ in a prospective cohort study in 133 subjects aged 0-18 years including 46 patients with established AKI according to pRIFLE criteria, 27 patients without AKI (non-AKI group I and 60 apparently healthy neonates and children (non-AKI group II. AKI etiologies were: dehydration/hypovolemia (n = 7, hemodynamic instability (n = 7, perinatal asphyxia (n = 9, septic shock (n = 7, typical hemolytic-uremic syndrome (HUS; n = 5, interstitial nephritis (n = 5, vasculitis (n = 4, nephrotoxic injury (n = 1 and renal vein thrombosis (n = 1.When AKI patients were classified into pRIFLE criteria, 6/46 (13% patients fulfilled the criteria for the category "Risk", 13/46 (28% for "Injury", 26/46 (57% for "Failure" and 1/46 (2% for "Loss". Patients in the "Failure" stage had a median 3.7-fold higher urinary [TIMP-2]•[IGFBP7] compared to non-AKI subjects (P<0.001. When analyzed for AKI etiology, highest [TIMP-2]•[IGFBP7] values were found in patients with septic shock (P<0.001 vs. non-AKI I+II. Receiver operating characteristic (ROC curve analyses in the AKI group revealed good performance of [TIMP-2]•[IGFBP7] in predicting 30-day (area under the curve (AUC 0.79; 95% CI, 0.61-0.97 and 3-month mortality (AUC 0.84; 95% CI, 0.67-0.99 and moderate performance in predicting RRT (AUC 0.67; 95% CI, 0.50-0.84.This study shows that urinary [TIMP

  1. Post-marketing surveillance of the safety profile of iodixanol in the outpatient CT setting. A prospective, multicenter, observational study of patient risk factors, adverse reactions and preventive measures in 9953 patients

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Frank Hugo Heinz [Radiology and Nuclear Medicine Center, Ludwigshafen (Germany)

    2014-11-15

    Non-interventional study in outpatient, contrast-enhanced CT: 1. to determine the extent of preventive measures for risk reduction of adverse drug reactions after contrast-enhanced CT examinations. 2. to prospectively determine the incidence and severity of adverse drug reactions occurring after administration of the iso-osmolar contrast medium iodixanol. 3. to determine a possible influence of preventive measures on the incidence/severity of adverse drug reactions. Evaluable documentation was provided for 9953 patients from 66 radiology centers across Germany. Patient characteristics, aspects of iodixanol administration, and adverse events with an at least 'possible' relationship were documented on a standardized case report form (CRF) and were evaluated up to seven days after contrast medium administration. About 55.5% of patients showed one or more risk factors (e.g. impaired renal function 4.4%, diabetes mellitus 8.5%, hypertension 20.6%). One third of the sites did not implement any preventive measures. Patients with a known risk for an allergy-like reaction were more likely to receive pharmacologic preventive treatment (0.5-50.5%). Oral hydration was the main preventive measure in patients with renal risk factors (<8%) followed by intravenous hydration (1%). Adverse drug reactions, mainly hypersensitivity reactions, occurred in 77 patients (0.74%), but were classified as serious in only 3 patients (0.03%). No statistically significant correlation between risk factors, preventive measures, and adverse reactions could be found. The use of preventive measures for CT examinations in this outpatient setting was generally low with risk patients being pre-medicated more often, depending on their history. In the routine outpatient setting, iso-osmolar iodixanol was very well tolerated in almost 10 000 patients undergoing diagnostic CT. The rate of acute and delayed adverse reactions was low. No correlation could be found between risk factors, preventive

  2. Correlation of integrin β3 mRNA and vascular endothelial growth factor protein expression profiles with the clinicopathological features and prognosis of gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    Shu-Guang Li; Zai-Yuan Ye; Zhong-Sheng Zhao; Hou-Quan Tao; Yuan-Yu Wang; Chun-Yu Niu

    2008-01-01

    AIM: To investigate integrin 133 mRNA and vascular endothelial growth factor (VEGF) protein expression in gastric carcinoma, and its correlation with microvascular density, growth-pattern, invasion, metastasis and prognosis. METHODS: In situ hybridization(ISH) of integrin β3 mRNA and immunohistochemistry of VEGF and CD34 protein were performed on samples from 118 patients with gastric cancer. RESULTS: The positive rate of integrin 133 mRNA in non- tumor gastric mucosa (20%) was significantly lower than that of the gastric cancer tissue (52.5%, x2 = 10.20, P < 0.01). In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the positive expression rates of integrin β3 mRNA were significantly higher than those in patients of expanding type (P < 0.01), stage T1-T2 (P < 0.01), non-vessel invasion (P < 0.01), without lymphatic metastasis (P < 0.01), without hepatic and peritoneal metastasis (P < 0.01), respectively. In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the positive expression rates of VEGF protein were significantly higher than those in patients of expanding type (P < 0.01), stage T1-T2 (P < 0.01), non-vessel invasion (P < 0.01), without lymphatic metastasis (P < 0.01), without hepatic and peritoneal metastasis (P < 0.01), respectively. In patients of infiltrating type, stage T3-T4, vessel invasion, lymphatic metastasis, hepatic or peritoneal metastasis, the mean MVD were significantly higher than those in patients of expanding type (P < 0.01), stage T1-T2 (P < 0.01), non-vessel invasion (P < 0.01), without lymphatic metastasis (P < 0.01), without hepatic and peritoneal metastasis (P < 0.01), respectively. It was found that the positive expression rate of integrin β3 mRNA was positively related to that of VEGF protein (P < 0.01) and MVD (P < 0.05), meanwhile the positive expression rate of

  3. Adverse trends of cardiovascular risk factors among low risk populations (1983-1994 - a cohort study of workers and farmers in Guangzhou, China

    Directory of Open Access Journals (Sweden)

    Liu Xiaoqing

    2011-12-01

    Full Text Available Abstract Background The levels and trends of cardiovascular risk factors vary greatly throughout China. We examine 10-year trends of cardiovascular risk factors (1983-1994 and the factors related to these trends among low-risk cohorts of workers and farmers in Guangzhou, China. Methods This is a cohort study of 3,131 workers and 3,493 farmers aged 25-64 years at baseline with 10 years of follow-up. We performed a longitudinal analysis to account for the aging of the cohorts and the repeated measures of the same individual. Results At baseline the prevalence of overweight (including obese ranged from 1.0% to 11.8%, hypertension ranged from 3.8% to 10.5%, and mean serum total cholesterol (TC ranged from 155.4 mg/dl to 187.2 mg/dl. Although prevalence of smoking declined, blood pressure levels and body mass index (BMI increased significantly, and lipid profiles changed unfavorably during the 10-year follow-ups. The prevalence of hypertension increased from 5.0 percentage points (female farmers to 12.3 percentage points (male farmers. Mean TC increased significantly (e.g., +22.8 mg/dl and +17.0 mg/dl in male and female farmers, respectively. In the longitudinal data analyses, increase in BMI was associated with increase in blood pressure levels and TC. Significant adverse trends of risk factors persisted after adjustment for aging, education, BMI, smoking, and alcohol intake. Conclusion Urgent action is needed to prevent and reverse the unhealthy trends occurring among these low risk Chinese workers and farmers.

  4. Clinical Features and Influencing Factors of Prognosis in Patients with Viral Encephalitis%病毒性脑炎的临床特点及预后影响因素研究

    Institute of Scientific and Technical Information of China (English)

    周晶; 秦新月

    2012-01-01

    Objective To explore the clinical and imaging features of viral encephalitis and to understand its short time prognosis. Methods Clinical data of 160 viral encephalitis inpatients diagnosed during January 2006 - May 2010, in the First Affiliated Hospital of Chongqing Medical University, were analyzed retrospectively. All patients were divided into good and poor prognosis groups according to the Glasgow Outcome Scale, and several factors were analyzed by Logistic regressive analysis. Results The univariate analysis showed that anomaly of cranial MRI, moderate or serious anomaly of EEG, abnormal consciousness, abnormal mental behaviors, abnormal muscular power, epilepsy, and headache may correlated with the prognosis. However, the multifactor analysis showed that only anomaly of cranial MRI and abnormal consciousness had a definite relation with the prognosis []P = 0.03, OR = 13.0, 95% CI (2.40, 70.46)]. Conclusion The prognosis of viral encephalitis is related to several factors. But anomaly of cranial MRI and abnormal consciousness are the most important factors to its short time prognosis of viral encephalitis, and the more the cranial lesions are, the worse the prognosis is.%目的 了解病毒性脑炎(VE)的临床特征和影像学特征,探讨VE近期预后的相关影响因素.方法 回顾性分析2006年1月-2010年5月重庆医科大学附属第一医院住院治疗的临床诊断为VE的160例患者的临床资料,应用格拉斯哥评分(GOS)将其分为预后良好组和预后不良组,对多个因素与预后的关系进行Logistic回归分析.结果 单因素分析显示颅脑MRI异常、脑电图中重度异常、意识状态异常、精神行为异常、肌力异常、癫痫、头痛与VE预后可能有关系.多因素分析显示仅颅脑MRI异常和意识状态异常与VE预后有明确关系,MRI多个病灶较单个病灶预后更差[P=0.03,OR =13.0,95%CI (2.40,70.46)].结论 VE的预后是多因素共同作用的结果,意识状态异常、

  5. 不良妊娠结局现状及其影响因素分析%Current status of adverse pregnancy outcomes and their influencing factors

    Institute of Scientific and Technical Information of China (English)

    李媛媛; 张海鲲; 李忠良; 张成元

    2014-01-01

    Objective To investigate the current status of adverse pregnancy outcomes and their major influencing factors .Methods Totally 698 pregnant women visiting hospital were randomly selected from 2 hospitals in Shandong Weifang from May 2012 to May 2013.The general situation of newborns ’ mother and father , pregnancy and delivery data were obtained through maternal clinical records , birth records, on-the-spot inquiry and follow-up.Multiple logistic regression analysis was conducted to screen the major influencing factors of pregnancy outcomes .Results The incidence of adverse pregnancy outcomes was 15.09%.Good maternal nutritional status was protective factor of pregnancy outcomes (OR=2.28, 95%CI:1.47-3.54, P<0.05).Risk factors included advanced maternal age , long-term medication history , maternal history of abnormal pregnancy , pregnancy complications , bacterial or viral infection , history of exposure to harmful factors, abnormal amniotic fluid and placenta (all P<0.05).Conclusion Childbearing women are advocated to deliver at best childbearing age .Maternal nutrition should be balanced , and exposure to harmful factors such as pesticide should be reduced .Health care during pregnancy and childbirth needs to be emphasized , and special attention should be paid to the prevention of infection , pregnancy complications , abnormal placenta and amniotic fluid abnormality .%目的:了解不良妊娠结局的现状并探讨其主要影响因素。方法随机抽取山东省潍坊市2家医院2012年5月至2013年5月期间就诊的孕产妇共计698人,通过查阅产妇病例、新生儿出生记录、现场询问和随访获得产妇和新生儿父亲的一般情况、孕期及分娩情况等资料,应用多因素Logistic回归分析筛选妊娠结局的主要影响因素。结果不良妊娠结局的发生率为15.09%;产妇营养状况好为妊娠结局的保护性因素(OR=2.28,95%CI:1.47~3.54,P<0.05);而高龄产妇、

  6. Divergent effects of various diabetes drugs on cardiovascular prognosis.

    Science.gov (United States)

    Bell, David S H; Patil, Harshal R; O'Keefe, James H

    2013-01-01

    This review discusses the current data on various antidiabetic medications and their effects on major adverse cardiovascular events (MACE). Diabetes mellitus is a potent independent risk factor for MACE, and this risk increases in proportion to the elevation of hemoglobin A1c. Available data suggest that tight glycemic control in patients with diabetes reduces microvascular complications, but has limited effect or may even increase the risk of MACE and other macrovascular complications. For individuals with type 2 diabetes mellitus (T2DM) drugs that reduce postprandial glucose (α-glucosidase inhibitors, incretin mimetics, quick-acting bromocriptine, dipeptidyl peptidase-4 inhibitors, and colesevelam) are associated with a decrease in MACE. Drugs that directly reduce insulin resistance (pioglitazone and metformin) are also associated with lesser but still significant decreases in MACE. Insulin, rosiglitazone (but not pioglitazone), and sulfonylureas (especially with glyburide and particularly the glyburide + metformin combination) are associated with increases in MACE. In summary, drugs that reduce postprandial glucose and improve insulin resistance without predisposing patients to hypoglycemia appear to both control hyperglycemia and improve cardiovascular prognosis. However, many of the traditional agents used for treating T2DM, such as insulin and sulfonylureas, do not improve cardiovascular prognosis despite improving hyperglycemia.

  7. The relationship between nuclear factor (NF)-κB family gene expression and prognosis in triple-negative breast cancer (TNBC) patients receiving adjuvant doxorubicin treatment.

    Science.gov (United States)

    Kim, Ji-Yeon; Jung, Hae Hyun; Ahn, Soomin; Bae, SooYoun; Lee, Se Kyung; Kim, Seok Won; Lee, Jeong Eon; Nam, Seok Jin; Ahn, Jin Seok; Im, Young-Hyuck; Park, Yeon Hee

    2016-08-22

    We investigated gene expression profiles of the NF-κB pathway in patients with triple-negative breast cancer (TNBC) receiving adjuvant chemotherapy to determine the prognostic value of NF-κB pathway genes according to chemotherapeutic regimen. We used the nCounter expression assay to measure expression of 11 genes (NFKB1, NFKB2, RELA, RELB, REL, TP53, FOXC1, TBP, SP1, STAT3 and IRF1 genes) belonging to the NF-κB pathway using mRNA extracted from paraffin-embedded tumor tissues from 203 patients diagnosed with TNBC. Of the 203 patients, 116 were treated with a chemotherapeutic regimen containing doxorubicin. As revealed by the expression profiles of the 11 genes, increased expression of SP1 was associated with poor prognosis in TNBC patients treated with adjuvant doxorubicin chemotherapy (5-year distant recurrence-free survival [5Y DRFS], low vs. high expression [cut-off: median]: 92.3% vs. 71.6%, P = 0.001). In a multivariate Cox regression model, SP1 expression was a useful marker for predicting long-term prognosis in TNBC patients receiving doxorubicin treatment, and we thus suggest that SP1 expression could serve as a prognostic marker in these patients.

  8. 玻璃体手术治疗外伤性黄斑裂孔的预后及影响因素%An analysis of the prognosis and factors of vitrectomy for a traumatic macular hole

    Institute of Scientific and Technical Information of China (English)

    侯婧; 姜燕荣

    2013-01-01

    Objective To evaluate the prognosis and factors of vitrectomy for a traumatic macular hole.Methods A retrospective case study was performed on a consecutive series of 54 patients (54 eyes) who underwent vitrectomy for macular hole surgery.The postoperative anatomic closure status of the hole,visual acuity prognosis,and multiple factors related to prognosis,including preoperative visual acuity,duration of disease,size of the macular hole,and preoperative anterior or posterior segment complications,were analyzed.Data were analyzed with a paired t test and chi-square test.Results After surgery,48 (89%) traumatic macular hole eyes had closure; 6 eyes with traumatic macular holes eyes had joint results.The closure time was 20.6±10.1 days.Visual acuity (VA) increased in 28 eyes (52%).There was a significant difference between preoperative VA and postoperative VA (t=4.496,P<0.01).There were no significant differences in preoperative VA,duration of disease,or preoperative anterior segment complications between the two different VA prognosis groups.There were significant differences in macular hole size and preoperative posterior segment complications between the two different VA prognosis groups (x2=6.006,10.650,P<0.05).Conclusion Using vitrectomy is helpful for the prognosis of anatomy and function in traumatic macular hole patients,but the patients with preoperative posterior segment complications had a poor VA prognosis.%目的 评价玻璃体手术治疗外伤性黄斑裂孔的预后及其影响因素分析.方法 回顾性病例研究.行玻璃体切割术的外伤性黄斑裂孔患者54例(54眼),分析这些裂孔愈合情况、视力预后及术前视力、病程,黄斑孔径、有无术前眼前段或眼后段合并症与视力预后的关系.采用配对t检验和卡方检验.结果 外伤性黄斑裂孔手术后裂孔闭合48眼(89%),裂孔贴附6眼.闭合时间为(20.6±10.1)d.视力提高28眼(52%),术后视力明显提高(t=4.496,P<0.01).术

  9. Brief depression screening with the PHQ-2 associated with prognosis following percutaneous coronary intervention with paclitaxel-eluting stenting

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Denollet, Johan; de Jonge, Peter;

    2009-01-01

    Depression is associated with adverse prognosis in cardiac patients, warranting the availability of brief and valid instruments to identify depressed patients in clinical practice.......Depression is associated with adverse prognosis in cardiac patients, warranting the availability of brief and valid instruments to identify depressed patients in clinical practice....

  10. Sustained myocardial production of stromal cell-derived factor-1α was associated with left ventricular adverse remodeling in patients with myocardial infarction.

    Science.gov (United States)

    Uematsu, Manabu; Yoshizaki, Toru; Shimizu, Takuya; Obata, Jun-ei; Nakamura, Takamitsu; Fujioka, Daisuke; Watanabe, Kazuhiro; Watanabe, Yosuke; Kugiyama, Kiyotaka

    2015-11-15

    The role of stromal cell-derived factor-1α (SDF-1α) expressed in infarcted myocardium is unknown in humans. We examined whether SDF-1α produced in an infarcted myocardial lesion may play a role in left ventricle (LV) remodeling and dysfunction in patients with acute myocardial infarction (AMI). We measured SDF-1α levels in plasma obtained from aortic root (AO) and anterior interventricular vein (AIV) in the early phase (2 wk after MI) and the chronic phase (6 mo after MI) in 80 patients with anterior MI. An increment in SDF-1α level from AO to AIV, reflecting SDF-1α release from infarcted myocardium, was more frequent in patients with MI in the early phase of MI [n = 52 (65%), P = 0.03] but not in the chronic phase of MI [n = 46 (58%), P = 0.11] compared with that in control patients [n = 6/17 (35%)]. On linear regression analysis, the transmyocardial gradient in SDF-1α level in the chronic phase of MI was correlated with percentage changes in LV end-diastolic volume index (r = 0.39, P infarcted myocardium in the chronic phase of MI was associated with LV adverse remodeling and progressive dysfunction in AMI survivors.

  11. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... has to live. For Doctors, a Patient-Centered Approach View this video on YouTube. Anthony L. Back, M.D., coaches other oncologists about how to discuss prognosis with their patients. Good communication, he says, is part of providing good care. ...

  12. Analysis on the related factors of prognosis in patients with prehospital hypoglycemia%院前低血糖患者的预后相关因素分析

    Institute of Scientific and Technical Information of China (English)

    徐平; 徐勇

    2013-01-01

    Objective To analyze the related factors of prognosis in patients with prehospital hypoglycemia. Methods The clinical data of 204 patients with prehospital hypoglycemia in Zigong City from 2005 to 2010 was retrospectively analyzed. The correlation between the prognosis of hypoglycemia and the factors chosen by chi-square test, Fisher probabilities and Mann-whitney u test was assessed by logistic regression analysis. Results Pathological syndrome, symptom, age, duration of hypoglycemia, Glasgow Coma Scale score and blood glucose concentration showed statistically significant difference between the groups with and without neurological recovery (P<0.05). A significant positive correlation between the prognosis of prehospital hypoglycemia and the factors (age, blood glucose concentration, duration of hypoglycemia and symptom) was found (P<0.05). Conclusion Older age, lower blood glucose concentration, longer duration of hypoglycemia, and hypoglycemia unawareness might indicate unfavourable prognosis of hypoglycemia.%目的 研究院前低血糖患者的预后相关因素.方法 回顾性分析自贡市区2005-2010 年度204 例院前低血糖患者的临床资料,采用χ2检验或Fisher 精确概率法以及Mann-whitney u 检验比较低血糖意识恢复组与未恢复组临床指标差异,将初筛有意义的变量引入二分类多元Logistic 回归方程确定最优回归模型.结果 院前低血糖意识恢复组与意识未恢复组资料比较,病理征、症状、年龄、持续时间、GCS评分、血糖值比较差异有统计学意义(P<0.05).多元Logistic 回归结果显示,院前低血糖预后与患者年龄、血糖值、低血糖持续时间及症状有关(P<0.05).结论 高龄、血糖值低、持续时间长及无症状低血糖是低血糖预后不良的高危因素

  13. Analysis of risk factors for the prognosis of ICU patients with stroke-associated pneumonia%重症卒中相关性肺炎预后危险因素分析

    Institute of Scientific and Technical Information of China (English)

    吴玉娟; 朱明; 杨贺英; 李秋宇

    2012-01-01

    Objective To study the risk factors for the prognosis of patients with stroke-associated pneumonia (SAP). Methods Clinical data of 78 critically ill patients with SAP were studied retrospectively. Results Glasgow coma scales less than 8 (OR = 7.899), age above 65 years (OR = 0.222), and tracheotomy (OR = 0.206) were associated with the prognosis of SAP patients. Conclusion Glasgow coma scales less than 8, age above 65 years were the risk factors for SAP, and tracheotomy would help to improve the prognosis of patients with coma and respiratory failure.%目的:探讨影响卒中相关性肺炎(SAP)患者预后的相关危险因素.方法:回顾性分析本院2010年1月至2012年1月78例SAP患者的临床资料.结果:SAP患者预后不良组和预后良好组比较年龄、有无糖尿病史、格拉斯哥昏迷评分(GCS)、是否气管切开及呼吸机治疗时间存在统计学差异(P<0.05).进行单因素分析和多因素Logistic回归分析提示,SAP预后不良与GCS评分<8分、年龄≥65岁及气管切开有关.结论:GCS评分<8分、年龄≥65岁是SAP患者预后不良的危险因素,气管切开对意识障碍伴呼吸功能不全的SAP患者有益.

  14. 青少年突发性耳聋预后相关因素分析%Investigation on the related factors in prognosis of sudden deafness in juveniles

    Institute of Scientific and Technical Information of China (English)

    努尔比亚·米尔扎木; 刘志连; 亚力坤·亚生; 王淑霞

    2011-01-01

    Objective To study the causes , clinical characteristics , treatment efficacy , and main affecting factors in the prognosis of sudden deafness in juveniles. Methods 65 patients with sudden deafness were chosen and divided into different groups according to sex , nationality ill ear , season , audiogram , degree of hearing loss , beginning time of therapy , accompanying vertigo or not , tinnitus , smoking and drinking history , and so on. The rank sum test and logistic regression analysis were then used for analyzing the data. Results Of all the 6 5 patients , the therapeutic effective rate was 5 8. 5 % . Single factor analysis showed that the beginning time of therapy , degree of hearing loss , accompanying vertigo were correlated with the prognosis ( P < 0. 05 ) . The logistics regression analysis showed that the beginning time of therapy and accompanying vertigo were correlated with patients ' prognosis ( P < 0. 0 5 ) . Conclusion The prognosis of sudden deafness in juveniles is related with the beginning time of therapy , accompanying vertigo and degree of hearing loss , which is similar to those of adults but also with some special characteristics.%目的 探讨青少年突发性耳聋的临床特点、疗效及预后.方法 选取65例青少年突发性耳聋病例作为研究对象,根据患者性别、患侧耳、发病季节、听力图形、听力下降程度、就诊时间、有无伴眩晕、耳鸣、吸烟饮酒史等进行分组,所得数据采用单因素秩和检验,分别比较各组治疗有效率的差异,并用logistic多元回归分析法评价各相关因素对预后的影响.结果 治疗后总有效率为58.5%;单因素分析显示就诊时间、听力下降程度、有无伴眩晕等因素与预后有关(P<0.05);多因素logistic回归分析中发病至就诊时间、有无伴眩晕与预后有相关性(P<0.05).结论 在影响青少年突发性耳聋预后的因素中,眩晕、听力损失程度及就诊时间与预后有关.

  15. Understanding Your Cancer Prognosis Video

    Science.gov (United States)

    Understanding Your Cancer Prognosis is the main video in the NCI Prognosis Video Series, which offers the perspectives of three cancer patients and their doctor, an oncologist who is also a national expert in doctor-patient communication.

  16. Hand eczema - prognosis and consequences

    DEFF Research Database (Denmark)

    Petersen, A. H.; Johansen, J D; Hald, M

    2014-01-01

    BACKGROUND: Hand eczema is recognized as a long-lasting disease with personal and societal repercussions. Long-term studies are required to generate information on factors contributing to a poor outcome. OBJECTIVES: The aims of this 7-year follow-up study were to evaluate the clinical course...... of patients with hand eczema, the occupational consequences and to identify risk factors associated with a poor prognosis. MATERIALS AND METHODS: In all, 536 patients with hand eczema participated and were examined by a dermatologist. The clinical severity was assessed at baseline and 7 years later using...... a self-administrated photographic guide. Additional information was obtained from a questionnaire. RESULTS: Based on the photographic guide, 73% experienced a clinical improvement. Notably, 20% had moderate to very severe hand eczema at follow-up. Severe hand eczema or frequent eruptions at baseline...

  17. Fertility prognosis for infertile couples

    DEFF Research Database (Denmark)

    Bostofte, E; Bagger, P; Michael, A

    1993-01-01

    OBJECTIVE: To develop a fertility prognosis model for infertile couples. DESIGN: Prospective follow-up study. PARTICIPANTS: In the period November 30, 1977 to June 1, 1985, 321 consecutive couples were investigated for infertility at Hvidovre University Hospital. Investigation of the female...... MEASURE: The Cox regression model was used to predict the time required to conceive based on informations provided by fertility investigations. RESULTS: Three of 16 prognostic variables (the period of infertility, the female infertility factor, and the P-test) possess significant prognostic information....... The period of infertility and the P-test are best scored as continuous variables, whereas the female infertility factor are best categorized in four classes, i.e., normal, ovulation or cervical disorder, anatomic disorder, or a combination of disorders. CONCLUSIONS: The three prognostic variables...

  18. Reproductive prognosis in endometriosis

    DEFF Research Database (Denmark)

    Hjordt Hansen, Maj V; Dalsgaard, Torur; Hartwell, Dorthe

    2014-01-01

    OBJECTIVE: To assess the reproductive long-term prognosis of women with and without endometriosis, to explore changes over time, and to quantify the contribution of artificial reproductive techniques. DESIGN: Cohort study. SETTING: Denmark 1977-2009. SAMPLE: Data retrieved from four national...... registries. Among 15-49-year-old women during the period 1977-82, 24 667 were diagnosed with endometriosis and 98 668 (1:4) women without endometriosis were age-matched. METHODS: To assess long-term reproductive prognosis, all pregnancy outcomes were identified among the women with and without endometriosis......, but this was restricted to pregnancies from assisted reproduction. CONCLUSION: Women with endometriosis have slightly fewer children, but this lessened over time due to artificially conceived pregnancies. The risk for miscarriages and ectopic pregnancies was increased compared with women without the disease....

  19. 间接视神经损伤患者视力预后的影响因素%Research of influence factors of visual prognosis for patients with indirect injury of optic nerve

    Institute of Scientific and Technical Information of China (English)

    张丹娜; 胡卫群

    2015-01-01

    Objective To analyze the influence factors of visual prognosis for patients with indirect injury of optic nerve (ON) and provide the scientific basis of improvements of curative effects and visual prognosis.Methods 127 patients with indi‐rect injury of optic nerve treated from January 2011 to January 2014 were selected.According to the clinical data ,the multiple influence factors of visual prognosis were analyzed and the independent risk factors were observed.Results According to the e‐valuation standards of visual improvements ,the total effective rate of visual improvements was 37.9% ;based on the single fac‐tor analysis ,the eyesight ,fractures of ON ,swelling of ON and the stressful locations had a significant impact on the visual im‐provements (P0.05);based on the multiple‐factor analysis and Logistic regression analysis ,the eyesight and fracture of ON had the signifi‐cant impact on the visual prognosis(P<0.05).Conclusion The research indicates that the visual prognosis for patients with in‐direct injury of optic nerve has a close correlation with the injury scales of optic nerve and fracture of ON.%目的:分析间接视神经损伤患者视力预后的影响因素。方法入选2011‐01—2014‐01于我院就诊的间接视神经损伤患者127例,回顾性分析患者的临床资料,对影响视力预后的多项因素进行分析,探讨其独立危险因素。结果根据视力改善评价标准,本组患者视力改善总有效率为37.9%;经单因素分析显示,视力分级、视神经管骨折、视神经肿胀和受力部位对患者视力改善有显著影响(P<0.05);而性别、年龄、手术情况和视力改变时间均与视力预后无显著关系(P>0.05);选取单因素分析中有统计学意义的因素,经 Logistic回归分析显示,视力分级和视神经管骨折与视力预后有显著相关性( P<0.05)。结论间接性视神经损伤患者视力预后与视神经损伤分级

  20. Study on Causes and Prognosis Influence Factors of Coma Patients in the Department of Emergency Internal Medicine%急诊内科昏迷患者的病因及预后影响因素探讨

    Institute of Scientific and Technical Information of China (English)

    杜林

    2016-01-01

    Objective To study the causes and prognosis influence factors of coma patients in the department of emergency internal medicine. Methods The clinical data of 156 cases of coma patients admitted and treated in the department of emer-gency internal medicine in our hospital from January 2013 to January 2015 were researched and analyzed, and the coma causes and prognosis influence factors were summarized. Results The main causes of coma patients in the department of e-mergency internal medicine included the cerebrovascular disorder (38.6%), poisoning (34.6%), serious trauma (14.7%), dia-betes disease (7.0%), and the ratio of cerebrovascular disorder was the highest, and the prognosis influence factors of coma patients in the department of emergency internal medicine is closely correlated to the admission time and coma degree after onset of patients, and the prognosis situation in 1h after onset was obviously better than that of patients after 1h of onset, and there was an obvious difference with statistical significance (P<0.05), and the prognosis situation of mild coma patients was obviously better than that of the severe coma patients with obvious difference and statistical significance(P<0.05). Con-clusion The main cause of coma of patients in the department of emergency internal medicine is the cerebrovascular disor-der, and the main influence factors of patients are the coma degree and admission time after onset.%目的:探讨急诊内科昏迷患者的病因及预后的影响因素。方法选取该院2013年1月—2015年1月收治的急诊内科昏迷的156例患者,对其临床资料进行研究分析,总结其昏迷的病因以及预后的影响因素。结果急诊内科患者昏迷的主要病因包括脑血管疾病(38.6%)、中毒(34.6%)、严重创伤(14.7%)、糖尿病疾病(7.0%)。脑血管疾病占比最高。急诊内科昏迷患者预后的影响因素和患者发病后的入院时间以及昏迷程度有密切的联系,发病后1h内入

  1. Influencing Factors of the Prognosis in 412 Elderly Patients with Acute Renal Failure%老年急性肾衰竭412例预后影响因素分析

    Institute of Scientific and Technical Information of China (English)

    李庆华; 陈静; 谭清武; 唐静怡

    2014-01-01

    目的:探讨影响老年急性肾衰竭( ARF)患者预后的因素。方法对解放军白求恩国际和平医院干部病房2005年1月—2013年1月住院的412例老年ARF的临床资料进行回顾性分析。结果412例ARF中,感染、心力衰竭、肾毒性药物、肿瘤、手术为导致老年ARF的常见原因(分别占38.4%、21.6%、18.0%、9.0%、6.1%)。单因素分析提示,感染、应用肾毒性药物、心力衰竭、高龄(≥80岁)、合并多器官功能不全综合征( MODS)、有慢性肾脏病史与老年ARF患者的预后密切相关(P<0.01,P<0.05)。 logistic回归分析显示,感染、应用肾毒性药物、心力衰竭、高龄(≥80岁)、合并多器官功能障碍综合征(MODS)是影响老年ARF患者预后的独立危险因素(P<0.05)。结论应充分重视影响老年ARF预后的相关因素,及时给予针对性治疗,以降低病死率、改善预后。%Objective To investigate the influencing factors of the prognosis in elderly patients with acute renal failure ( ARF) . Methods Clinical data of 412 elderly patients with ARF during January 2005 and January 2013 was ret-rospectively analyzed. Results The common causes of induced ARF in the 412 elderly patients were infection, heart failure, application of renal toxicity drugs, tumor and surgery, and the corresponding rates were 38. 4%, 21. 6%, 18. 0%, 9. 0% and 6. 1% respectively. The single factor analysis showed that infection, application of renal toxicity drugs, heart failure, aged (≥80 years old) , complication of MODS ( multiple organ dysfunction syndrome) and history of chronic renal disease were closely related with prognosis (P <0. 01, P <0. 05). The Logistic Regression Analysis showed that infection, application of renal toxicity drugs, heart failure, aged (≥80 years old) and complication of MODS were independent risk factors of the prognosis in elderly patients with ARF (P<0. 05). Conclusion Influencing factors of prognosis should be given more

  2. Incidence and risk factors for new-onset diabetes in HIV-infected patients: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study

    DEFF Research Database (Denmark)

    De Wit, Stephane; Sabin, Caroline A; Weber, Rainer;

    2008-01-01

    OBJECTIVE: The aims of this study were to determine the incidence of diabetes among HIV-infected patients in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort, to identify demographic, HIV-related, and combination antiretroviral therapy (cART)-related factors associated...

  3. The Prognosis of Patients with Chronic Kidney Disease and Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Vladu Mihaela

    2014-09-01

    Full Text Available Background and Aims: Diabetes mellitus (DM is a chronic disease which can evolve towards devastating micro and macro-vascular complications. Chronic kidney disease (CKD is a worldwide public health problem, with adverse outcomes of kidney failure, cardiovascular disease (CVD and premature death. The aim of our study was to evaluate the prognosis in patients with DM and CKD, depending on estimated glomerular filtration rate (eGFR and albuminuria, according to the classification of Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (KDIGO from 2013 Materials and Methods: The study was epidemiological, transversal, non interventional type, with 600 subjects unselected patients divided into three subgroups: 200 patients with T1DM, 200 patients with T2DM and 200 age matched subjects without DM. The recorded data have been analyzed using the Statistic Package for Social Sciences (SPSS, the 17.00 software (IBM Corporation, Armonk, NY, United States of America. Results:. We found a statistically significant difference among the three study groups (p < 0.0001 regarding the prognosis of CKD. Conclusions: DM represents an important risk factor for the appearance of CKD but also a negative prognosis factor for the patients with CKD.

  4. Analysis of CT Features and Prognosis Related Factors of Hypertensive Cerebral Hemorrhage%高血压脑出血CT特征与预后的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李娟

    2015-01-01

    significantly lower than that of 30- 30ml and more than 60ml (P<0.05). Univariate and multiple Logistic analysis indicated that age, cerebral hemorrhage volume and hemorrhage breaking into ventricle were the independent risk factors for poor prognosis of patients with hypertensive cerebral hemorrhage.Conclusion CT imaging features can be used as an important basis for evaluating the prognosis of hypertensive cerebral hemorrhage.

  5. Reacções cutâneas adversas aos inibidores do receptor do factor de crescimento epidérmico: estudo de 14 doentes Adverse cutaneous reactions to epidermal growth factor receptor inhibitors: a study of 14 patients

    Directory of Open Access Journals (Sweden)

    Felicidade Santiago

    2011-06-01

    Full Text Available FUNDAMENTOS: O cetuximab e o erlotinib, inibidores do receptor do factor de crescimento epidérmico, provocam frequentemente reacções cutâneas adversas peculiares. OBJETIVOS: Caracterizar do ponto de vista clínico-evolutivo as reacções cutâneas adversas e avaliar a sua abordagem terapêutica. METODOLOGIA: Entre março/2005 e setembro/2009 foram seguidos 14 doentes com idade média de 59,6 anos, em tratamento com cetuximab (7 ou erlotinib (7, por neoplasia pulmonar (10 ou colorrectal (4. Retrospectivamente foi avaliado o padrão clínico evolutivo de reacção cutânea, o intervalo entre a introdução do fármaco e o início dos sintomas e a resposta ao tratamento. RESULTADOS: Doze doentes apresentaram erupção papulopustulosa predominantemente na face, decote e dorso, em média 13,5 dias após o início do fármaco. Efectuaram tratamento oral com minociclina ou doxiciclina e tópico com metronidazol, peróxido de benzoílo e/ou corticoide. Ocorreu melhoria das lesões em todos os doentes. Cinco doentes, em média oito semanas após o início da terapia, apresentaram granulomas piogénicos periungueais, em quatro casos associados a paroníquia, melhorados com tratamento tópico (antibióticos, corticoides e antissépticos. Observou-se xerose em alguns doentes e, de forma isolada, outros efeitos adversos, como telangiectasias e angiomas, alterações dos cabelos e cílios e nevos melanocíticos eruptivos. Na maioria dos doentes, a terapêutica com o inibidor do receptor do factor de crescimento epidérmico foi mantida. CONCLUSÃO: Com o crescente uso destas terapêuticas-alvo, torna-se obrigatório reconhecer e tratar os seus efeitos cutâneos adversos, assegurando uma intervenção atempada de forma a permitir a manutenção desta terapêuticaBACKGROUND: Cetuximab and erlotinib, epidermal growth factor receptor inhibitors, often cause peculiar adverse cutaneous reactions. OBJECTIVES: Our aim was to evaluate adverse cutaneous reactions

  6. 老年期全面惊厥性癫持续状态预后不良的影响因素%To Explore the Influence Factors of senile Comprehensive Convulsive status Epilepticus of poor Prognosis

    Institute of Scientific and Technical Information of China (English)

    单玉民

    2015-01-01

    目的:探讨老年期全面惊厥性癫持续状态预后不良的影响因素。方法对2013年6月至2014年6月我院收治的60例全面惊厥性癫患者资料进行回顾性分析。结果60例患者中病死7例,占11.7%,均死于多器官功能障碍综合征(MODS);53例生存患者中,32例出现不同程度的复发,21例得到完全控制,复发率为53.3%,治愈率为35.0%。结论老年期全面惊厥性癫持续状态预后不良的影响因素有MODS、原发病未根除以及机体的自身因素等。%Objective To explore the influence factors of senile comprehensive convulsive status epilepticus of poor prognosis.Methods In 2013 June to 2014 June in our hospital 60 cases of epilepsy patients comprehensive retrospective analysis..Results 7 patients died,60 death patients accounted for 11.7%,al died of multiple organ failure comprehensive disorder syndrome multiple organ(MODS);53 cases of survivors,32 cases occurred different degrees of recurrence,21 cases got complete control,the cure rate was 35.0%,the recurrence rate was 53.3%. Conclusion The influence factors of senile comprehensive convulsive status epilepticus of poor prognosis of MODS,the primary disease was not eradicated and the body's own factors etc.

  7. Serious adverse events associated with yellow fever vaccine.

    Science.gov (United States)

    de Menezes Martins, Reinaldo; Fernandes Leal, Maria da Luz; Homma, Akira

    2015-01-01

    Yellow fever vaccine was considered one of the safest vaccines, but in recent years it was found that it could rarely cause invasive and disseminated disease in some otherwise healthy individuals, with high lethality. After extensive studies, although some risk factors have been identified, the real cause of causes of this serious adverse event are largely unknown, but findings point to individual host factors. Meningoencephalitis, once considered to happen only in children less than 6 months of age, has also been identified in older children and adults, but with good prognosis. Efforts are being made to develop a safer yellow fever vaccine, and an inactivated vaccine or a vaccine prepared with the vaccine virus envelope produced in plants are being tested. Even with serious and rare adverse events, yellow fever vaccine is the best way to avoid yellow fever, a disease of high lethality and should be used routinely in endemic areas, and on people from non-endemic areas that could be exposed, according to a careful risk-benefit analysis.

  8. Investigation and analysis of influencing factors of adverse events report intent among clinical nurses%临床护士不良事件报告习惯调查分析

    Institute of Scientific and Technical Information of China (English)

    毛秋云; 翟荣慧; 仲丽霞; 张伟

    2016-01-01

    Objective To investigate adverse events report intent and its influencing factors in clinical nurses. Methods Questionnaire investigation was conducted among 917 clinical nurses from ten hospitals in Tai'an city using the Intent to Report Questionnaire. Results The score of clinical nurses adverse events report intent was 36.80 ± 19.71. The score of each dimension in descending order were:nurses operation adverse events, system process adverse events, and patient care adverse events. Hospital levels were significant influencing factors of clinical nurses adverse events report intent. Pressure sores were the most frequently reported, and report of patient injury caused by unreasonable nurse manpower allocation was the lowest frequency. Conclusions The level of clinical nurses adverse events report intent need to be improved. Nursing managers should pay attention to improve nurse reporting adverse event in order to better promote the safety of patients and reduce occurrence of adverse event.%目的:调查临床护士不良事件报告习惯现况及其影响因素。方法采用护理不良事件报告习惯量表,对泰安市10所医院的917名临床护士进行问卷调查。结果临床护士不良事件报告习惯得分为(36.80±19.71)分;各类事件平均得分由高到低依次为:护士操作类不良事件、系统流程类不良事件和患者照护类不良事件;临床护士不良事件报告习惯的影响因素只有医院级别;压疮的报告频率最高,而护士人力配置不合理导致患者伤害的报告频率最低。结论临床护士不良事件报告习惯水平有待提高,护理管理者要注重提高护士不良事件报告习惯,主动上报不良事件,以更好地提高患者安全管理水平,降低不良事件的发生率。

  9. Influencing factors for prognosis of congenital heart disease complicated with infective endocarditis%影响先天性心脏病合并感染性心内膜炎的预后分析

    Institute of Scientific and Technical Information of China (English)

    刘海红; 赵铁英; 田甜

    2014-01-01

    OBJECTIVE To explore the influencing factors for prognosis of the shunt congenital heart disease com-plicated with infective endocarditis so as to provide guidance for clinical treatment .METHODS The shunt congenital heart disease patients complicated with infective endocarditis who were treated in the hospital from Apr 2002 to Oct 2012 were recruited in the study ,then the clinical data of the subjects were retrospectively analyzed ,the sur-vival rates of the patients were calculated by using Kaplan-Merier method ,and the influencing factors for the prog-nosis were observed .RESULTS The six-month survival rate of the patients was 84 .00% .The univariate analysis indicated that the congenital heart disease surgery ,complication of anemia ,complication of arrhythmia ,and com-plication of severe heart failure were the related influencing factors for the prognosis (P<0 .05);the multivariate analysis of the COX model showed that the congenital heart disease surgery ,severe heart failure ,and anemia were the independent influencing factors for the prognosis of the shunt congenital heart disease patients complicated with infective endocarditis .The relative risk of death of the patients with severe heart failure increased by 2 .267 times , the patients with anemia by 1 .473 times .CONCLUSION The complication of anemia and complication of severe heart failure are the important factors to increase the relative risk of death .It is an effective way to focus on the prevention of complications during the treatment process so as to raise the survival rates of the patients .%目的:探讨影响分流型先天性心脏病合并感染性心内膜炎的预后因素,为临床治疗提供参考依据。方法回顾性分析医院2002年4月-2012年10月收治的分流型先天性心脏病合并感染性心内膜炎患者临床资料,采用Kaplan-M erier法计算患者的生存率,研究影响患者预后的相关因素。结果患者治疗6个月后的生存率为84.00%

  10. A case-control study on influence factors of adverse pregnancy outcome%不良妊娠结局影响因素的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    王欣; 张亚玮; 冯永亮; 岳福娟; 赵楠; 杨海澜; 王素萍

    2013-01-01

    目的:探讨不良妊娠结局发生的影响因素,为不良妊娠结局综合防治提供参考依据.方法:采用1:2匹配病例对照研究方法,分析不良妊娠结局发生的影响因素.结果:单因素条件Logistic回归分析结果显示:不良妊娠结局组与无不良妊娠结局组的孕妇文化程度、全家人均月收入、孕前健康教育、月经是否规则、此次妊娠患有妊娠期高血压疾病等差异有统计学意义(P<0.05);多因素条件Logistic回归分析结果表明:孕妇文化程度、此次妊娠患有妊娠期高血压疾病、参加体育活动、妊娠次数被引入回归方程.结论:孕妇文化程度高、参加体育活动、妊娠次数少为不良妊娠结局发生的保护因素,而患有妊娠期高血压疾病为不良妊娠结局发生的危险因素.%Objective:To explore the influence factors of adverse pregnancy outcome,and provide the scientific evidence for comprehensive prevention of adverse pregnancy outcome.Methods:A 1∶ 2 matched case-control study was conducted to explore the influence factors of adverse pregnancy outcome.Results:Univariate conditional logistic regression analysis showed that the significant factors included maternal education level,family per capita monthly income,pre-pregnancy health education,menstrual history,hypertensive disorder complicating pregnancy between adverse pregnancy outcome group and no adverse pregnancy outcome group.Multivariate conditional logistic regression analysis showed:maternal educational level (OR =0.541),hypertensive disorder complicating pregnancy (OR =10.966),sports activities (OR =0.322) and numbers of pregnancy (OR =0.565) went into regression equation.Conclusion:The protective factors of adverse pregnancy outcome include high education level,participating in sports activities,and reduction of numbers of pregnancy.Hypertensive disorder complicating pregnancy is the risk factor of adverse pregnancy outcome.

  11. Clinical analysis of precipitating factors and prognosis in 68 patients with hepatic encephalopathy%68例肝硬化合并肝性脑病诱因与预后临床分析

    Institute of Scientific and Technical Information of China (English)

    李仲军; 何学钰

    2012-01-01

    OBJECTIVE To analysis the precipitating factors of hepatic encephalopathy and investigate the relation between its precipitating factors and prognosis. METHODS The clinical data of 68 patients with hepatic encephalopathy were analyzed retrospectively. RESULTS The mortality rate was 52.9%. The factors that can precipitate hepatic encephalopathy of cirrhosis included gastrointestinal bleeding (36.8%), infection (29.4%), iatrogenic factor (26.4%), electrolyte disturbances (25%), renal failure (17.6%), dietary protein overload (5.8%), and others (4.4%). The major causes of death were gastrointestinal bleeding, infection and iatrogenic factor. The patients with more precipitating factors had worse outcomes, and the patients with degree C (Child classification) or with Ⅲ-Ⅳ Phases (EH Phases) had the worst prognosis. CONCLUSION Prevention and removal of precipitating factors is the key to treatment of hepatic encephalopathy.%目的 探讨肝性脑病的常见诱因及其与预后的关系.方法 回顾性分析某院收治的68例肝性脑病患者的临床资料.结果 肝性脑病总的死亡率为52.9%,其常见诱因依次为消化道出血(36.8%),感染(29.4%),医源性因素(26.4%),电解质紊乱(25%),肾功能不全(17.6%),高蛋白饮食(5.8%)及其他(4.4%).诱因的多少、Child分级程度和肝性脑病分期程度与肝性脑病的发生发展及预后密切相关.结论 积极去除诱因是治疗肝性脑病的关键.

  12. 慢性鼻-鼻窦炎鼻内镜手术预后的影响因素分析%Analysis of the factors affecting the prognosis of functional endoscopic sinus surgery for chronic rhinosinusitis

    Institute of Scientific and Technical Information of China (English)

    徐艳红; 何刚; 黄定强; 朱玉博; 石向阳

    2013-01-01

    目的 分析影响慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)功能性鼻内镜手术(functional endoscopic sinus surgery,FESS)预后的因素,为术前评价和术后治疗提供依据.方法 对有手术指征的59例CRS患者行术前检查,记录视觉类比法评分(visual analog scale,VAS)、鼻内镜评分、性别、年龄、血嗜酸性粒细胞数目以及是否合并哮喘、息肉资料.患者术后随访1年以上,共5次,每次随诊记录患者VAS及鼻内镜评分,根据结果判断手术预后,并进行影响预后的因素分析.结果 血嗜酸性粒细胞数目增高,伴有哮喘的患者FESS预后差,其他因素不是影响FESS术后预后情况的主要因素.结论 在所记录的指标中,血嗜酸性粒细胞数目增高,伴有哮喘评估手术效果意义重大,伴有息肉的CRS并不引起更差的手术效果,提示传统意义上的CRS的分型可能并不合理.%Objective To analyze the factors affecting the prognosis of functional endoscopic sinus surgery(FESS)for chronic rhinosinusitis( CRS)in order to provide the basis for preoperative evaluation and postoperative treatment. Methods The preoperative examinations were performed for fifty-nine patients with CRS including scores of visual analog scale (VAS) ,and nasal endoscopy, and gender,age,number of eosnophils,and whether or not combinated with asthma or nasal polyp. After the operation,the patients were fol-lowed-up for five times during the period of one year. The scores of VAS and nasal endoscopy were recorded. Factors affecting the prognosis were statistically analyzed. Results The increased number of blood esonophils and the combination with asthma had a negative effect on the prognosis of the operation while the other factors did not. Conclusions The number of blood esonophils and CRS combined with asthma are the major factors that affect the prognosis of FESS while CRS combined with nasal polyp had no significant effect. Therefore, the traditional classification of

  13. Analysis of relevant factors on the prognosis of sudden deafness%影响突发性耳聋治疗效果的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    孙涛

    2011-01-01

    Objective To investigate the relevant factors on the prognosis of sudden deafness. Method The clinical data of 133 patients (148 ears) with sudden deafness were analyzed retrospectively. Results Through systemic treatment, 25 cases got recovery, 18 cases were excellence and 39 cases were effective, the total effective rate was 61.7%(82/133). Univariate analysis showed that the factors related to the prognosis of sudden deafness were age, the time from onset to treatment, deafness classification,accompanied by vertigo or not and the duration of treatment. Patients with the age lower than 60, the earlier the time from onset to treatment, the lighter the deafness classification, not accompanied by vertigo and the longer duration of treatment got a better efficacy. Logistic regression analysis showed that the independent factors related to the prognosis of sudden deafness were the time from onset to treatment and deafness classification. Conclusion The etiology of sudden deafness is still unclear, the time from onset to treatment interval and the degree of hearing loss are the main factors affecting the prognosis of it, in clinic, it should be paid attention and took a early diagnosis and early treated so as to get good efficacy.%目的 探讨影响突发性耳聋治疗效果的相关因素.方法 回顾性分析133例(148耳)突发性耳聋患者的临床资料.结果 133例患者经系统治疗后,痊愈25例,显效18例,有效39例,总有效率为61.7%(82/133).单因素分析显示,与突发性耳聋预后相关的因素有年龄、发病至治疗时间、耳聋分级、是否伴有眩晕和治疗时间.年龄<60岁、发病至治疗时间越早、耳聋分级越轻、不伴有眩晕以及治疗时间较长的患者疗效明显占优.Logistic逐步回归分析显示,与突发性耳聋预后相关的独立因素是发病至治疗时间和耳聋分级.结论 突发性耳聋病因不明,从发病到治疗时间间隔和发病后听力损失的程度是影响其预后

  14. 突发性聋的病因、治疗及预后相关因素的探讨%The Etiology,Treatment and Prognosis of Sudden Deafness Related Factors

    Institute of Scientific and Technical Information of China (English)

    朱霞; 张兆峰; 王兴峰

    2013-01-01

      突发性聋成为严重危害健康人群听力的耳科常见病,虽然治疗突发性聋的研究由来已久,但仍有多数病例遗留永久性听力损失。我们应深入了解突发性聋的特点及预后相关因素,帮助患者复聪。%Sudden deafness is otology diseases,which cause serious damage to healthy people listening. Sudden deafness research time has been for a long time,but there are still most cases left permanent hearing loss. In order to help patients after hearing,we study the characteristics and prognosis of sudden deafness related factors.

  15. Acute histologic chorioamnionitis is a risk factor for adverse neonatal outcome in late preterm birth after preterm premature rupture of membranes.

    Directory of Open Access Journals (Sweden)

    Seung Mi Lee

    Full Text Available BACKGROUND: The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. METHODOLOGY/PRINCIPAL FINDINGS: The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005 than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. CONCLUSIONS/SIGNIFICANCE: The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM.

  16. Acute Histologic Chorioamnionitis Is a Risk Factor for Adverse Neonatal Outcome in Late Preterm Birth after Preterm Premature Rupture of Membranes

    Science.gov (United States)

    Lee, Seung Mi; Park, Jeong Woo; Kim, Byoung Jae; Park, Chan-Wook; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun

    2013-01-01

    Background The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. Methodology/Principal Findings The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005) than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. Conclusions/Significance The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM. PMID:24324586

  17. [Prognosis in tumor diagnosis].

    Science.gov (United States)

    Bruns, G

    1983-01-01

    This essay on prognosis in tumor diagnosis pathology resp. tumor etiology, cancerogenesis and molecular oncology is the authors personal opinion. Generally tumor diagnosis improves with progress in histo- and cytological methods for example in tumors of the APUD-system and precancerous lesions especially of the breast. Fundamental principle of developed tumor diagnosis is the knowledge of malignant transformation. Its profits favours the etiology in cancerogenesis and e.g. non Hodgkin lymphomas (Burkitt lymphoma, adult T-cell lymphoma) and to result from new methods in molecular biology and viral genetics (DNS-hybridizing, -recombination and gene technology). With the beginning century a stepwise fitted diagnosis of malignant lymphomas is evident up to monoclonal dedifferentiated lymphoid cells and their multifarious phenotypical markers. This concept may be of general significance in tumor diagnosis already indicated in prelymphomas. Finally the present prognosis of tumor diagnosis is evaluated by contents, tasks and strategies of its corresponding research lines in clinical and experimental tumor pathology resp. its organization.

  18. Factors influencing short-term prognosis of tuberculous meningitis in children%儿童结核性脑膜炎近期预后的影响因素

    Institute of Scientific and Technical Information of China (English)

    廖琼; 邓建军; 邓思燕; 万朝敏

    2012-01-01

    Objective To study the factors influencing shprt-term prognosis of tuberculous meningitis (TBM) in children Methods TV clinical data of 137 hospitalized children with TBM between January 2007 and February 2011 were retrospectively reviewed A (owl of 30 potential factors influcncing short-term prognosis of TBM were evaluated by univariate analysis and multivariate logistic regression analysis. Results Clinical staging showed that of the 137 children 21 cases (15. 3% )were in the early stage, 67 cases (48. 9% ) in the medium stage and 49 cases (35. 8% ) in the late stage of TBM. The univariate analysis revealed 8 factors associated with a poor short-term prognosis; clinical stage of TBM (late), coma, positive Rabinski signs, ciania) nerve involvements, paralysis, seizures, nhvious abnormalities in brain computed tomography (CT) or magnetic, resonance imaging ( MRI) and eleuated protein concenirations in cerebrospinal fluid (CSF). Factors associated with a favourable short-term prognosis for TBM included glucocorticoid steroids therapy, positive reaction of PPD skin test and an increased length of stay in hospital. Multivariute logistic analysis revealed two independent risk factors for a poor short-term prognosis: clinical stage of TBM (late) (OK: 11. 168, 95%CI: 3.521-35. 426) and positive signs of meningeal irritation ( OR: 4. 275, 9S% CI: 1. 043-17. 521). An increased length of stay in hospital was shown as a favorable factor (OR: 0. 893, 95% CI: 0.825-0. 968). Conclusions Late-stage TBM and positive signs of meningeai irritation suggest a poor proenosis, while an appmpriately longer length of stay in hospital may contribute to a favorable short-term prognosis for children with TBM.%目的 探讨影响儿童结核性脑膜炎(TBM)近期预后的因素.方法 采用回顾性病例分析的方法,收集2007年1月至2011年2月137例住院治疗的TBM患儿的临床资料,对30个可能影响近期预后的因素进行了单因素

  19. 小儿心肺复苏的临床特点及预后的影响因素%Clinical characteristics and the influence factors of prognosis of pediatric cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    王昕

    2015-01-01

    Objective:To analyze the clinical characteristics and the influence factors of prognosis of pediatric cardiopulmonary resuscitation.Methods:46 patients with pediatric cardiopulmonary resuscitation treatment were selected from May 2010 to May 2014.18 cases used cardiopulmonary resuscitation because of cardiac arrest;28 cases used cardiopulmonary resuscitation because of respiratory arrest.The clinical characteristics and prognosis of pediatric cardiopulmonary resuscitation were detailedly analyzed. Results:The cardiopulmonary resuscitation rate 42.9% of respiratory arrest children was higher than the cardiopulmonary resuscitation rate 16.7% of cardiac arrest children,and the difference was statistically significant(P<0.05).The children common diseases caused pediatric cardiopulmonary resuscitation were accidental injuries,infectious diseases and cardiovascular diseases and so on.Conclusion:More attention should be paid to the causes and clinical characteristics of pediatric cardiopulmonary resuscitation.Popularization of pediatric first-aid knowledge and doing a good job in the publicity and education work can effectively improve the rescue success rate of pediatric cardiopulmonary resuscitation and improve prognosis.%目的:分析小儿心肺复苏的临床特点及预后的影响因素。方法:2010年5月-2014年5月收治小儿心肺复苏治疗患者46例,其中因心跳停止采用心肺复苏18例,因呼吸停止采用心肺复苏28例,详细分析小儿心肺复苏的临床特点和预后。结果:呼吸停止患儿的心肺复苏率42.9%高于心跳停止患儿的心肺复苏率16.7%,差异具有统计学意义(P<0.05);引起小儿心肺复苏的患儿常见疾病有意外伤害、感染性疾病以及心血管疾病等。结论:应更加重视引起小儿心肺复苏的原因和临床特点,普及儿科急救的相关知识,做好宣传教育工作,有效提高小儿心肺复苏抢救成功率,改善预后。

  20. Characterization and prognosis factors of cerebro-vascular disease in Cienfuegos province. Caracterización y factores pronósticos de la enfermedad cerebrovascular en la Provincia de Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Eduardo Concepción Morales

    2004-08-01

    Full Text Available Fundaments: Cerebrovascular disease constitutes the third cause of death and the first cause of severe discapacity in adults in those countries that have a developed health system like ours. Objective: To characterise the patients with cerebrovascular disease and to determine the variables that influence upon their prognosis once it is established. Method: Prospective, descriptive, longitudinal study of a series of cases developed at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨. Questionnaires were applied to the patients that fitted the inclusion criteria (n 1318 Results: The mean age was 66,08 years with a predominance of white patients ( 75,26 %, mainly males ( 56,67%. The risk factor of highest frequency was hypertension ( 43,24 % The evolution for alive patients without discapacities was 14,71%, alive with discapacities ( 57,96% and death 27,31%. There was a predominance of ischemic cerebrovascular disease (46,13 % of aterothrombotic infarcts and 14,94 % cardioembolic disease. In regards to hemorrhagic disease 13,42 % were intracerebral hemorrhage and 4,55% subarachnoid hemorrhage. There was a prognostic correlation between the clinical variables: consciousness, sight, sensibility, language, tone, Babinski , osteotendious reflexes and muscular force. For the general variables cerebral edema, bacterial bronchopneumonia , displacement of the medial line, diagnosis is some values, CT scan diagnoses in some values for diabetes mellitus and convulsions.

    Fundamento: Las enfermedades cerebrovasculares constituyen la tercera causa de muerte y la primera de discapacidad grave del adulto en los países con sistemas de salud desarrollados similares al nuestro. Objetivo : Caracterizar a los pacientes con enfermedades cerebrovasculares y determinar las variables que influyen en su pron

  1. 青岛地区小细胞肺癌围化/放疗期预后因素分析%Analysis the prognosis factors of small cell lung cancer during peri-chemotherapy/radiotherapy in ;Qingdao city

    Institute of Scientific and Technical Information of China (English)

    陈霞; 徐德祥; 刘凤娟; 张春玲

    2014-01-01

    overall survival.Elevated or unchanged serum tumor markers and depression reduced 2 years progression-free survival rate.Conclusions For the patients who are unable to surgery, ZPS score less than 2 and serum albumin >35.0 g/L are protective factors of prognosis, elevated serum tumor markers and depression were risk factors of prognosis.

  2. 急诊科呼吸困难患儿预后影响因素的临床研究%Clinical study of prognosis factors for children with dyspnea in emergency department

    Institute of Scientific and Technical Information of China (English)

    杨蕾; 李德渊; 肖东琼; 李熙鸿

    2016-01-01

    困难患儿预后影响因素的非条件多因素logistic 回归分析结果显示,是否进行有创通气、是否入住 PICU、是否合并先天性疾病、血 Ca2+水平及 Sp O 2,为影响急诊科呼吸困难患儿预后的独立危险因素(OR =2.521、2.260、3.867、1.992、2.225,95% CI :1.244~5.109、1.112~4.594、2.122~7.045、1.068~3.719、1.059~4.677,P =0.010、0.024、0.000、0.030、0.035)。结论对于急诊科呼吸困难患儿,急诊科医师应高度重视患儿是否合并先天性疾病、是否进行有创通气、是否入住 PICU、血 Ca2+水平及 Sp O2等危险因素,这对呼吸困难患儿在急诊科的临床诊治具有指导意义。%Objective To identify the prognosis factors for children with dyspnea in emergency department.Methods From October 2013 to October 201 5,a total of 364 cases of children with dyspnea whose medical records were complete in Department of Emergency,West China Second University Hospital, Sichuan University were selected as research subjects. Among them, 230 (63.2%)cases were boys and 134 (36.8%)cases were girls.The age was 1 month to 13 years old and the median age was 7 months old.According to pediatric risk of mortality (PRISM)Ⅲ score, relevant references and biochemical indicators detected in emergency department, age, gender, received mechanical ventilation or not,combined with congenital disease or not,admitted to pediatric intensive care unit (PICU ) or not, heart rate, level of hemoglobin, hematocrit, serum Ca2+concentration,level of plasma albumin,arterial pH value,hemoglobin oxygen saturation by pulse oximetry (Sp O2 ),arterial oxygen saturation (Sa O2 ),partial pressure of carbon dioxide (Pa CO2 ), partial pressure of oxygen (Pa O2 ),level of blood lactate and base excess were selected as possible prognosis factors for children with dyspnea in emergency department.Retrospective method was used to analyze the clinical data,those 1 7 possible prognosis factors and the main diagnosis and

  3. 不良妊娠结局环境危险因素的病例对照研究%A case-control study on environmental risk factors of adverse pregnancy outcomes

    Institute of Scientific and Technical Information of China (English)

    宋烨; 张恒艳; 岳喜同

    2014-01-01

    Ob j ective To study the environmental risk factors of adverse pregnancy outcome and provide scien-tific evidence for further study on the causes and preventive measures .Methods 1∶1 matched case-control study was conducted in 803 cases of adverse pregnancy with diagnosis according to the national unified diagnostic criteria and 803 matched controls ,using univariate and multivariate conditional logistic regression analysis .Results Univa-riate conditional logistic regression analysis showed that 14 variables were risk factors for the occurrence of adverse pregnancy outcomes .Multivariate conditional logistic regression analysis showed mobile phone number ,interior dec-oration ,video display terminal work ,passive smoking ,the housing environmental electromagnetic radiation ,exposur-ing to vibration or doing strenuous exercise and cooking were risk factors for adverse pregnancy outcome .Conclusion There are a lot of environmental risk factors on adverse pregnancy outcomes .We should strengthen the pregnancy health care to reduce the occurrence of adverse pregnancy outcomes .%目的:研究不良妊娠结局的环境危险因素,为进一步探讨其病因及预防措施提供科学依据。方法采用1∶1配比的病例对照研究,对按全国统一诊断标准明确诊断的803例不良妊娠结局的孕产妇匹配对照后进行单因素和多因素条件logistic回归分析。结果单因素分析共筛选出14个变量是发生不良妊娠结局的危险因素;然后经过条件logistic回归分析,发现接通移动电话次数、室内装修、视频显示终端作业、被动吸烟、住房环境电磁辐射、接触振动或做剧烈运动及烹调油烟是不良妊娠结局的危险因素。结论不良妊娠结局的环境危险因素很多,应加强优生保健,减少不良妊娠结局的发生。

  4. Homeobox transcription factor muscle segment homeobox 2 (Msx2) correlates with good prognosis in breast cancer patients and induces apoptosis in vitro.

    LENUS (Irish Health Repository)

    Lanigan, Fiona

    2010-01-01

    The homeobox-containing transcription factor muscle segment homeobox 2 (Msx2) plays an important role in mammary gland development. However, the clinical implications of Msx2 expression in breast cancer are unclear. The aims of this study were to investigate the potential clinical value of Msx2 as a breast cancer biomarker and to clarify its functional role in vitro.

  5. Factors on prognosis in patients of stage pT3N0M0 thoracic esophageal squamous cell carcinoma after two-field esophagectomy

    Directory of Open Access Journals (Sweden)

    Yuxiang Wang

    2015-01-01

    Conclusion: For patients of pT3N0M0 thoracic ESCC, the independent factors were the site of a lesion for OS and PFS, Hb levels, small LN in CT, and number of removed LN for OS. The value of postoperative adjuvant therapy need be further proved.

  6. An evaluation of factors predicting breast recurrence and prognosis after recurrence, on distinguishing intramammary and extramammary recurrence, in breast-conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Reiki; Nagao, Kazuharu; Miyayama, Haruhiko [Kumamoto City Hospital (Japan)] (and others)

    2001-06-01

    Recurrence of cancer in the breast is an important problem in breast-conserving therapy. We evaluated risk factors for recurrence from the viewpoint of recurrence type and outcome after recurrence. Of 533 cases of breast cancer treated with breast-conserving surgery from April 1989 through July 2000, disease in 66 recurred (12.4%) and were classified as 23 cases of breast recurrence only, 16 cases of both breast recurrence and distant metastasis, and 27 cases of distant metastasis only. The clinical factors examined included age, lymphatic invasion, nodal status, extensive intraductal component (EIC), proliferative activity, and estrogen receptor (ER) status. Of the 39 cases of breast recurrence, 19 had intramammary tumors and 20 had extramammary tumors of the skin, subcutaneous tissue, or muscle, including 8 cases with inflammatory breast recurrence. Multivariate analysis showed that factors correlated with breast recurrence were age, ER status, proliferative activity, and surgical margin. EIC-comedo was related to intramammary recurrence, whereas lymphatic invasion and nodal status were related to extramammary recurrence. Postoperative irradiation was an effective treatment for tumors in young women and tumors with positive margins or a comedo component. Outcome after breast recurrence depended on nodal status at primary operation, and survival rates were worst in patients with inflammatory breast recurrence. In conclusion, age, EIC-comedo status, the surgical margin, and negative ER status were correlated with breast recurrence. Countermeasures against these factors should be investigated. (author)

  7. Study of Prognosis Factors of Liver Cirrhosis Patients with Upper Gastrointestinal Hemorrhage%肝硬化并上消化道出血患者预后的相关因素研究

    Institute of Scientific and Technical Information of China (English)

    陈炀森

    2015-01-01

    目的:探讨肝硬化并上消化道出血( UGH )患者预后的相关因素。方法:回顾性分析2010年3月至2014年2月收治的149例肝硬化并UGH患者的临床资料,其中死亡27例(死亡组),经治疗后存活122例(生存组),比较两组年龄、既往出血史、并发症、呕血量、24h内再出血、Hb水平、出血病因以及肝功能Child-Pugh分级等因素的差异,分析肝硬化并UGH预后的相关因素。结果:多因素Logistic回归显示出血病因、年龄、呕血量、Hb水平、24h内再出血、Child-Pugh 分级、并发症是影响肝硬化并UGH患者预后的独立危险。结论:UGH仍是肝硬化并UGH患者临床死亡的一项重要原因,病人年龄大、呕血量>500mL、Hb水平<90g/L、恶性肿瘤、Child-Pugh分级为C级、食管胃底静脉曲张( EGV)、24h内再出血、合并症等均影响患者转归,是其独立危险因素。%Objective:To study the prognosis related factors of liver cirrhosis patients with upper gastro-intestinal hemorrhage ( UGH) .Method:A retrospective analysis of patients with cirrhosis and UGH in Mar . 2010 to Feb.2014 were performed, including 27 patients died (death group), 122 cases survived (survival group), Differences between the two groups in age , previous history of bleeding, complication, hemateme-sis, 24 hours rebleeding, Hb level, the cause of hemorrhage and the Child-Pugh classification of liver func-tion and other factors were compared .Related factors and prognosis of UGH in liver cirrhosis were analyzed . Result:Multivariate Logistic regression showed that age , amount of bleeding , hematemesis, the level of Hb, 24h, Child-Pugh grading of rebleeding , complications were independent risk factors of the prognosis of pa-tients with liver cirrhosis and UGH .Conclusion:UGH is an important reason of death of patients with liver cirrhosis and clinical UGH, patient age, hematemesis, Hb <90g/L and malignant tumor, Child

  8. Analysis on the high risk factors of neonatal clinical prognosis after septic shock%影响新生儿感染性休克临床预后的高危因素分析

    Institute of Scientific and Technical Information of China (English)

    陈小倩; 朱雪萍; 缪珀; 肖志辉

    2015-01-01

    目的:探讨影响新生儿感染性休克临床预后的高危因素,以期及早诊治、提高抢救的成功率、改善预后。方法对2010年10月~2015年10月我院NICU 收住的79例感染性休克患儿的临床资料、实验室检查结果及转归进行回顾性分析,并根据存活与否分为存活组和死亡组。结果我院NICU 近6年共收治新生儿败血症500例,并发感染性休克79例,发生率为15.8%。男50例,女29例;平均胎龄(35.57±5.57)周;平均出生体重(2.55±0.88)kg;存活组46例,死亡组33例,死亡率为41.77%;轻度休克15例,中度休克47例,重度休克17例,其中并发代谢性酸中毒53例、电解质紊乱47例、血糖异常(低血糖或高血糖)47例、多器官功能障碍37例,其中累及2个器官14例、3个器官10例、4个器官7例、5个器官5例、6个器官1例。器官功能障碍中肺衰竭49例,心力衰竭15例,肾衰竭16例,脑损伤24例,胃肠衰竭18例,肝损伤9例,DIC 17例。血培养阳性26例,外周血白细胞>10×109/L 31例、外周血白细胞10×109/L was found in 31 cas-es. WBC<4×109/L was found in 24 cases. There were 50 cases with positive serum CRP. Single factor analysis of logistic infor-mation between the two groups showed that PH, BE, blood pressure, urine output, mechanical ventilation, shock score, multi-ple organ failure were risk factors affecting the prognosis. Multiple factors regression analysis showed BE , shock score and mul-tiple organ failure were independent risk factors for poor prognosis. Conclusion The mortality of neonatal septic shock re-mains at a high level, and the shock tends to occur before the blood pressure step-down. Severe acidosis, high shock score, and multiple organ failure should be regarded as the independent risk factors for poor prognosis. The more organs involved , the higher the death rate occurred.

  9. Survey on Risk Factors for Adverse Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus%妊娠糖尿病患者相关不良妊娠结局危险因素调查

    Institute of Scientific and Technical Information of China (English)

    王霞

    2015-01-01

    Objective To diagnoses the risk factors for adverse pregnancy outcomes in patients with gestational diabetes melitus.Methods 200 patients with gestational diabetes melitus in our hospital from May 2014 to May 2015 were selected , 100 cases were adverse pregnancy among them and another 100 cases were normal labor. Adverse pregnancy outcome risk factors were analysised. Results Adverse pregnancy risk factors including pregnant women over 35 years of age, low education, medication, unexpected pregnancy, etc. after analysis and discovery, among the factors, the greatest risk factor was the history of accidental pregnancy and the history of polution of the environment. Conclusion Influence factors of adverse pregnancy outcome of patients with gestational diabetes melitus were more, it should pay attention to the history of accidents and polution of the environment and the history of the contact population particularly,in order to ensure delivery safety.%目的 对妊娠糖尿病患者相关不良妊娠结局的危险因素进行调查分析.方法 选取我院在2014年5月~2015年5月接收的200例妊娠糖尿病患者,其中100例不良妊娠,另外100例正常分娩.对不良妊娠结局危险因素分析.结果 经过分析发现,不良妊娠危险因素包括:孕妇35岁以上、学历低、用药、意外妊娠等等,其中在多因素分析中,意外妊娠史和污染环境接触史为最大危险因素.结论 妊娠糖尿病患者不良妊娠结局影响因素比较多,尤其要注重意外妊娠史和有污染环境接触史的人群,确保分娩安全.

  10. Hospital deaths and adverse events in Brazil

    Directory of Open Access Journals (Sweden)

    Pavão Ana Luiza B

    2011-09-01

    Full Text Available Abstract Background Adverse events are considered a major international problem related to the performance of health systems. Evaluating the occurrence of adverse events involves, as any other outcome measure, determining the extent to which the observed differences can be attributed to the patient's risk factors or to variations in the treatment process, and this in turn highlights the importance of measuring differences in the severity of the cases. The current study aims to evaluate the association between deaths and adverse events, adjusted according to patient risk factors. Methods The study is based on a random sample of 1103 patient charts from hospitalizations in the year 2003 in 3 teaching hospitals in the state of Rio de Janeiro, Brazil. The methodology involved a retrospective review of patient charts in two stages - screening phase and evaluation phase. Logistic regression was used to evaluate the relationship between hospital deaths and adverse events. Results The overall mortality rate was 8.5%, while the rate related to the occurrence of an adverse event was 2.9% (32/1103 and that related to preventable adverse events was 2.3% (25/1103. Among the 94 deaths analyzed, 34% were related to cases involving adverse events, and 26.6% of deaths occurred in cases whose adverse events were considered preventable. The models tested showed good discriminatory capacity. The unadjusted odds ratio (OR 11.43 and the odds ratio adjusted for patient risk factors (OR 8.23 between death and preventable adverse event were high. Conclusions Despite discussions in the literature regarding the limitations of evaluating preventable adverse events based on peer review, the results presented here emphasize that adverse events are not only prevalent, but are associated with serious harm and even death. These results also highlight the importance of risk adjustment and multivariate models in the study of adverse events.

  11. Absence of transforming growth factor-beta type II receptor is associated with poorer prognosis in HER2-negative breast tumours

    DEFF Research Database (Denmark)

    Paiva, C E; Drigo, S A; Rosa, F E;

    2010-01-01

    BACKGROUND: The clinical relevance of transforming growth factor-beta (TGF-beta)-signalling pathway in breast carcinomas (BCs) remained elusive. This study aimed to evaluate the prognostic value of TGF-beta1 and transforming growth factor-beta type II receptor (TGF-betaRII) expression levels...... in tumour cells and their association with the established biomarkers in BC. PATIENTS AND METHODS: In 324 BC from patients with long-term follow-up, the TGF-beta1 and TGF-betaRII transcript and protein expression levels were assessed. RESULTS: TGF-beta1 and TGF-betaRII down-expression was significantly...... associated with BC. Negative TGF-beta1 and TGF-betaRII protein status was associated with the development of distant metastasis (P = 0.003 and P = 0.029, respectively). In multivariate analysis, TGF-beta1-positive tumours were associated with increased disease-free survival (DFS) [hazard ratio (HR) = 0...

  12. 脑积水分流术后感染因素与预后相关性分析%The correlation analysis of hydrocephalus shunt postoperative infection factors and prognosis

    Institute of Scientific and Technical Information of China (English)

    宋志伟

    2014-01-01

    Objective To analyze the hydrocephalus shunt postoperative infection factors and prognosis.Methods The clinical data of 403 patients with hydrocephalus shunts,including 64 cases of postoperative infection,were retrospectively analyzed.And the sex ratio,age level,differences in etiology and infection,and their relationship with prognosis were analyzed by logistic regression.Results There were 64 infection cases (15.9%),including 47 cases of meningitis (73.5%),10 cases of peritonitis (15.6 %),and 7 cases of postoperative infection (10.9%).The results of single factor Logistic regression analysis showed that gender,idio-hydrocephaly,apoplexy were not significantly correlated with hydrocephalus shunt postoperative infection(P >0.05),while age,congenital hydrocephalus,intracranial neoplasms,infection time were correlated with hydrocephalus shunt postoperative infection (P < 0.05).Age was negatively correlated with GOS (r =-0.478,P < 0.05).Conclusion Age,hydrocephalus etiology and infection time were the risk factors for infection.Age is a factor affect the prognosis.%目的 分析脑积水分流术后感染的相关因素及预后.方法 回顾性分析403例脑积水分流术后患者的临床资料,其中术后感染64例,并对性别比例、年龄层次、病因学及感染时期的差异与预后的关系进行Logistic回归分析.结果 403例接受脑积水分流术患者中有64例发生感染(15.9%),其中脑膜炎47例(73.5%)、腹膜炎10例(15.6%)、切口感染7例(10.9%).单因素Logistic回归分析结果显示,性别、特发性脑积水、脑出血等与脑积水分流术后感染无明显关联(均P>0.05);而年龄、先天性脑积水、颅内肿瘤、感染时间等则为脑积水分流术后感染发生的相关因素(均P <0.05).相关分析表明年龄与GOS呈负相关(r=-0.478,P<0.05).结论 年龄、脑积水病因及术后感染时间等是感染的危险因素;患者年龄越小,预后越好.

  13. High risk factors of occurrence and prognosis of infantile persistent diarrhea disease%婴幼儿迁延性腹泻病发病及预后的高危因素

    Institute of Scientific and Technical Information of China (English)

    石永生; 王永军; 蒋成鹏; 周丽

    2011-01-01

    Objective: To explore the high risk effect factors of occurrence and prognosis of infantile persistent diarrhea disease. Methods: 76 infants according with diagnostic criteria who were in the hospital from January 2007 to December 2009 were selected,60 infants with acute diarrhea at the same period were selected as control group; conditional lngistic regression analysis was used to screen the high risk effect factors of occurrence of infantile persistent diarrhea disease. Results: The high risk effect factors of occurrence of infantile persistent diarrhea disease included malnutrition ( OR = 6. 073 ), anemia ( OR = 2. 505 ), infants less than one year ( OR = 2. 125 ), antibiotic consumption ( OR = 1. 091 ), non - breast feeding ( OR =0. 329); the high risk effect factors of prognosis of infantile persistent diarrhea disease included malnutrition ( 0R = 7. 286), abnormal humoral immunity ( OR = 6. 873), extraintestinal infection ( OR = O. 276), course of the disease ( OR = 0. 062 ) . Conclusion: For the infants less than one year, preventing and correcting malnutrition, using antibiotics reasonably, advocating breast feeding actively may reduce the incidence of infantile persistent diarrhea disease; for the infants with acute diarrhea, enhancing nursing, preventing secondary infection during the course of the disease, correcting abnormal humoral immunity may improve the prognosis obviously.%目的:探讨影响婴幼儿迁延性腹泻病发病及预后的高危因素.方法:选取2007年1月~2009年12月收住儿内科符合诊断标准的病例76例,以同期急性腹泻病患儿60例作对照,经条件Logistic回归分析筛选影响其发病的危险因素.结果:影响其发病的危险因素有5个,即营养不良(OR=6.073)、贫血(OR=2.505)、1岁以下婴儿(OR=2.125)、使用抗生素(OR=1.091)、非母乳喂养(OR=0.329).影响其预后的危险因素有4个,即营养不良(OR=7.286)、体液免疫异常(OR=6.873)、肠外感染(OR=0.276)、病程(OR=0

  14. Early adversity, neural development, and inflammation.

    Science.gov (United States)

    Chiang, Jessica J; Taylor, Shelley E; Bower, Julienne E

    2015-12-01

    Early adversity is a risk factor for poor mental and physical health. Although altered neural development is believed to be one pathway linking early adversity to psychopathology, it has rarely been considered a pathway linking early adversity to poor physical health. However, this is a viable pathway because the central nervous system is known to interact with the immune system via the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). In support of this pathway, early adversity has been linked to changes in neural development (particularly of the amygdala, hippocampus, and prefrontal cortex), HPA axis and ANS dysregulation, and higher levels of inflammation. Inflammation, in turn, can be detrimental to physical health when prolonged. In this review, we present these studies and consider how altered neural development may be a pathway by which early adversity increases inflammation and thus risk for adverse physical health outcomes.

  15. A reappraisal of ICU and long-term outcome of allogeneic hematopoietic stem cell transplantation patients and reassessment of prognosis factors: results of a 5-year cohort study (2009-2013).

    Science.gov (United States)

    Platon, L; Amigues, L; Ceballos, P; Fegueux, N; Daubin, D; Besnard, N; Larcher, R; Landreau, L; Agostini, C; Machado, S; Jonquet, O; Klouche, K

    2016-02-01

    Epidemiology and prognosis of complications related to allogeneic hematopoietic stem cell transplant (HSCT) recipients requiring admission to intensive care unit (ICU) have not been reassessed precisely in the past few years. We performed a retrospective single-center study on 318 consecutive HSCT patients (2009-2013), analyzing outcome and factors prognostic of ICU admission. Among these patients, 73 were admitted to the ICU. In all, 32 patients (40.3%) died in ICU, 46 at hospital discharge (63%) and 61 (83.6%) 1 year later. Survivors had a significantly lower sequential organ failure assessment (SOFA) score, serum lactate and bilirubin upon ICU admission. Catecholamine support, mechanical ventilation (MV) and/or renal replacement therapy during ICU stay, a delayed organ support and an active graft versus host disease (GvHD) significantly worsen the outcome. By multivariate analysis, the worsening of SOFA score from days 1 to 3, the need for MV and the occurrence of an active GvHD were predictive of mortality. In conclusion, the incidence of HSCT-related complications requiring an admission to an ICU was at 22%, with an ICU mortality rate of 44%, and 84% 1 year later. A degradation of SOFA score at day 3 of ICU, need of MV and occurrence of an active GvHD are main predictive factors of mortality.

  16. The predictability for the prognosis of breast cancer using the apparent diffusion coefficient value of diffusion weighted 3T MRI and the standardized uptake value of positron emission tomography/CT: Assessment of prognostic factor

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seong Joo; Kim, Keum Won; Jang, Hye Young; Hwang, Cheol Mog; Kim, Dae Ho; Sohn, Jang Sihn; Kim, Jin Suk; Lee, Jin Yong [Konyang Univ. College of Medicine, Daejeon (Korea, Republic of)

    2012-09-15

    To correlate the apparent diffusion coefficient (ADC) value and peak standardized uptake value (pSUV) with histologic grade and clinical prognostic factors of breast ductal carcinoma. Fifty breast cancers of 49 patients (age range: 37-83 years, mean: 53 years) were studied retrospectively. The breast cancers included 4 ductal carcinoma in situ (DCIS) and 46 invasive ductal carcinomas (IDC). The relationships for both pSUV and ADC values with clinicopathological prognostic factors (age, tumor size, histologic grade, nodal metastasis, hormone receptor and HER-2 neu status) were statistically evaluated. The histologic type of ductal carcinoma include DCIS (n = 4) and IDC (n = 46, grade 1 = 10, grade 2 = 13, and grade 3 = 23). pSUV was associated with histologic grade and tumor size and the ADC value was associated with histologic grade (p < 0.05). As the histologic grade becomes higher, the ADC values decrease, while pSUV and pSUV/ADC increase (p < 0.05). The characterization accuracy of pSUV/ADC (90.2%) was higher than pSUV (86.7%) and ADC values (25.4%) alone for the diagnosis of breast cancer (p < 0.05). pSUV and ADC values correlated with histologic grade, and tumor size. The pSUV/ADC value had a high accuracy for the diagnosis of breast cancer. Therefore, pSUV and ADC values provided additional information for predicting histologic grade and prognosis of breast cancer.

  17. Expression of connective tissue growth factor in tumor tissues is an independent predictor of poor prognosis in patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Lu-Ying Liu; Yan-Chun Han; Shu-Hua Wu; Zeng-Hua Lv

    2008-01-01

    AIM: To examine the expression of connective tissue growth factor (CTGF), also known as CCN2, in gastric carcinoma (GC), and the correlation between the expression of CTGF, dinicopathologic features and clinical outcomes of patients with GC.METHODS: One hundred and twenty-two GC patients were included in the present study. All patients were followed up for at least 5 years. Proteins of CTGF were detected using the Powervision two-step immunostaining method.RESULTS: Of the specimens from 122 GC patients analyzed for CTGF expression, 58 (58/122, 47.5%) had a high CTGF expression in cytoplasm of gastric carcinoma cells and 64 (64/122, 52.5%) had a low CTGF expression. Patients with a high CTGF expression showed a higher incidence of lymph node metastasis than those with a low CTGF expression {P = 0.032). Patients with a high CTGF expression had significantly lower 5-year survival rate than those with a low CTGF expression (27.6% vs 46.9%, P = 0.0178), especially those staging I + H + m (35.7% vs 65.2%, P = 0.0027).CONCLUSION: GC patients with an elevated CTGF expression have more lymph node metastases and a shorter survival time. CTGF seems to be an independent prognostic factor for the successful differentiation of high-risk GC patients staging I + n + m. Over-expression of CTGF in human GC cells results in an increased aggressive ability.

  18. Etiology of hospital-acquired pneumonia in elderly patients and risk factors for prognosis%老年医院获得性肺炎病原学及预后危险因素分析

    Institute of Scientific and Technical Information of China (English)

    田甜; 刘长庭; 方向群; 张晓军

    2012-01-01

    目的 了解并探讨老年医院获得性肺炎(HAP)的临床特点、病原学分布、影响预后因素等.方法 回顾性分析2002年1月-2011年12月老年病房中669例,年龄≥65岁老年HAP患者的临床资料;通过单因素与多因素分析方法研究影响老年HAP的多种预后因素.结果 总共培养出的1130株病原菌,其中革兰阴性菌1000株,占88.5%,革兰阳性菌130株,占11.5%,居前3位的病原菌为铜绿假单胞菌、鲍氏不动杆菌及嗜麦芽寡养单胞菌,占61.9%、9.4%及6.1%;机械通气、受累肺叶数、胸腔积液情况及APACHEⅡ评分是影响老年患者HAP预后的因素.结论 老年医院获得性肺炎病原菌分布广、患者病情重、机械通气比例较高,加之需要多种侵入性操作和治疗导致其死亡率较高.%OBJECTIVE To investigate the clinical characteristics, etiologic distribution, and impact factors for prognosis of the hospital-acquired pneumonia( HAP) in the senile patients. METHODS A cohort of 669 elderly patients from geriatric wards which were diagnosed as HAP from Jan 2002 to Dec 2011 were retrospectively studied. All the enrolled patients were with the age above 65 years. By means of the univariate analysis and multivariate logistic regression analysis, the multiple factors for the prognosis of the elderly patients with HAP were observed. RESULTS A total of 1130 strains of pathogens were isolated, including 1000 (88. 5%) strains of gram-negative bacteria and 130 (11. 5%) strains of gram-negative bacteria. The top three species of pathogens were Pseudomonas aeruginosa (61.9%), Acinetobacter baumannii (9.4%), and Stenotrophomonas maltophilia (6. 1%). The mechanical ventilation, number of affected lung lobes, pleural effusion and APACHE Ⅱ score are the impact factors for the prognosis of the patients with HAP. CONCLUSION The pathogens causing HAP in the elderly patients distribute widely, the condition is severe, with high proportion of mechanical

  19. 早发型重度子痫前期患者的围产儿预后及影响因素分析%Analysis of perinatal prognosis and influencing factors in patients with early onset severe preeclampsia

    Institute of Scientific and Technical Information of China (English)

    李卫文

    2015-01-01

    目的:探讨早发型重度子痫前期患者围产儿预后及影响因素。方法选取2005年4月至2008年4月盐城市妇幼保健院收治的妊娠28~33周分娩的早发型重度子痫前期患者90例,分析其围产儿预后及影响因素。结果90例患者围产儿胎死宫内16例(17.8%),引产中出现死产6例(6.7%),新生儿出现重度窒息死亡10例(11.1%),出生后因急性呼吸窘迫综合症(acute respiratory distress syndrome ,ARDS)死亡2例(2.2%),总死亡率为37.8%(34/90)。随访6年,13例失访,41例存活的新生儿发育过程中无明显异常,2例出现脑瘫。 Logistic多元回归显示规律产检(OR=0.192)、分娩孕周(OR=2.217)、新生儿出生体质量(OR=1.003)、胎盘早剥(OR=6.512)、期待治疗天数(OR=6.512),均是影响围产儿死亡的因素(P<0.05)。结论早发型重度子痫前期对产妇和围产儿均有较大的伤害,应根据产妇及胎儿的具体情况选择适时终止妊娠,改善母儿预后。%Objective To explore the perinatal prognosis and influencing factors in patients with early onset severe preeclampsia .Methods 90 patients of 28 ~33 weeks of gestation with early onset of severe preeclampsia in Yancheng Material and Child Health Care Hospital from April 2005 to April 2008 were selected .The perinatal prognosis and influencing factors were analyzed . Results 16 cases (17.8%) were intrauterine fetal death , 6 cases(6.7%) were death during treatment of labor induction , 10 cases (11.1 %) were severe neonatal asphyxia death , 2 cases(2.2%) were ARDS death after birth, the total mortality was 37.8%(34/90).After follow -up for 6 years, 13 patients were withdraw , 2 cases got cerebral palsy , 41 survived newborns had no obvious abnormity.Logistic multiple regression showed that the regular prenatal examination ( OR=0.192 ) , gestational age ( OR=6.512 ) , neonatal weight ( OR=1

  20. 鲍氏不动杆菌医院获得性肺炎预后危险因素分析%Risk factors for prognosis of hospital-acquired pneumonia due to Acinetobacter baumannii

    Institute of Scientific and Technical Information of China (English)

    汪群智; 郭安

    2015-01-01

    目的:探讨影响鲍氏不动杆菌医院获得性肺炎(ABA‐HAP)预后的危险因素,为临床早期干预高危患者提供参考依据。方法回顾性分析2011年1月-2013年12月199例ABA‐HAP住院患者的临床资料,根据患者发病后30 d预后情况分为存活组119例和死亡组80例,两组间采取单因素及多因素 logistic回归分析,确定ABA‐HAP预后的危险因素。结果单因素分析发现,入住 ICU、昏迷、气管插管/切开、机械通气、发生 ABA‐HAP后糖皮质激素使用≥1周、低白蛋白血症、APACHEⅡ≥20分、耐碳青霉烯类鲍氏不动杆菌(CRAB)、多药耐药鲍氏不动杆菌(MDRAB)与ABA‐HAP死亡有关(P<0.05);多因素 logistic回归分析发现,ABA‐HAP发病时APACHEⅡ≥20分、昏迷、ABA‐HAP发病后糖皮质激素使用≥1周、CRAB是ABA‐HAP患者死亡的独立危险因素(P<0.05)。结论患者发生ABA‐HAP时APACHEⅡ高分值、昏迷,提示其预后差,糖皮质激素长期使用以及CRAB感染明显增加ABA‐HAP患者死亡风险。%OBJECTIVE To explore the risk factors for prognosis of the Acinetobacter baumannii hospital‐acquired pneumonia (ABA‐HAP) so as to provide guidance for the clinical interventions to high‐risk patients in early stage . METHODS The clinical data of 199 patients with ABA‐HAP who were hospitalized from Jan 2011 to Dec 2013 were retrospectively analyzed ,and the enrolled patients were divided into the survival group with 119 cases and the death group with 80 cases according to the clinical outcomes 30 days after the onset .The univariate analysis and multivariate logistic regression analysis were performed to define the risk factors for the prognosis of ABA‐HAP . RESULTS The univariate analysis indicated that the ABA‐HAP‐induced death was associated with the ICU stay , coma ,endotracheal intubation or tracheotomy ,mechanical ventilation ,use of glucocorticoids no less

  1. Treatment of Serious Hypertensive Intracerebral Hemorrhage with CT-location Drill-crandum Smashing-draw and Analysis of Prognosis Factors

    Institute of Scientific and Technical Information of China (English)

    Huang Panbing

    2000-01-01

    Objective: To study curative effect of CT-location drill-cranium smashing-draw and affective pregniosis factors for serious hypertensive intracerebral hemorrhage (HIH). Methods :15 cases of serious HIH(group A)were treated with CT-location drill-cranium smashing-draw ,other 15 patients treated (group B)were treated with medicine only as controls. Results: The curative rate (20%) anis improvable rate (33.3%)in group A were higher than that of (6.7% and 26.7%)in group B (P<0. 001). The mortality rate (46.7%)in group A was lower than that of (66.6%)in group B significantly (P<0.001). Conclusions: The efffect of the therapy was satisfactory The higher or lower of the mortality rate was closely related to operative time 、 m-hemorrhage 、 location and range of the hemotoma

  2. Correlation between the findings of magnetic resonance imaging and prognosis of patients with predisposing factors of aseptic necrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Takatori, Yoshio; Nakamura, Shigeru; Nakamura, Toshitaka; Ninomiya, Setsuo; Kokubo, Takashi (Tokyo Univ. (Japan). Faculty of Medicine); Sugimoto, Hisayuki

    1991-08-01

    Eighteen patients with the predisposing factors for aseptic necrosis of the femoral head were followed up for more than two years after the initial magnetic resonance (MR) imaging. At the time of the initial examination, 24 femoral heads showed abnormal low-intensity areas on MR images without abnormal findings on plain radiographs. Among them, six femoral heads collapsed in the follow-up period. The initial mid-coronal T{sub 1}-weighted MR images of these femoral heads had shown characteristic findings, that is, band-shaped low-intensity areas with the lateral end not covered by the acetabulum. Subchondral fracture of the femoral head occurred in the vicinity of the lateral end of the band. The findings of initial MR imaging seem to predict subsequent collapse of the femoral head. (author).

  3. 青年脑出血128例的病因、危险因素及预后分析%Analysis of the etiology,risk factors and prognosis of youth cerebral hemorrhage in 128 cases

    Institute of Scientific and Technical Information of China (English)

    徐新良

    2015-01-01

    Objective:To explore the etiology,risk factors and prognosis of youth cerebral hemorrhage.Methods:The clinical data of 128 patients with youth cerebral hemorrhage were retrospectively analyzed.Results:99 cases(77.34% ) had definite etiology, including 43 cases(33.59% ) of hypertension,36 cases(28.13% ) of arteriovenous malformation,12 cases(9.38% ) of internal medicine diseases,6 cases(4.69%) of hematological system diseases,2 cases(1.56%) of pregnancy status.29 cases(22.67%) were unknown cause.The main risk factors were smoking,drinking.32 cases(25% ) were cured,50 cases(39.06% ) were improved,22 cases(17.19%) were unrecovered,24 cases(18.75%) were death.Conclusion:Hypertension,cerebral vascular malformation are the main causes of youth cerebral hemorrhage,its clinical symptoms are heavier,most patients have good prognosis.%目的:探讨青年脑出血的病因、危险因素及预后。方法:对128例青年脑出血患者的临床资料进行回顾性分析。结果:有明确病因99例(77.34%),其中高血压43例(33.59%),动静脉畸形36例(28.13%),内科疾病12例(9.38%),血液系统疾病6例(4.69%),妊娠状态2例(1.56%);原因不明29例(22.67%)。主要危险因素有吸烟、饮酒。痊愈32例(25%),好转50例(39.06%),未愈22例(17.19%),死亡24例(18.75%)。结论:高血压病、脑血管畸形是青年脑出血的主要病因,临床症状表现较重,大多数患者预后良好。

  4. 生活方式对胃癌根治术患者预后的多因素研究%Multivariate analysis of lifestyle factors on the prognosis of gastric cancer after radical resection

    Institute of Scientific and Technical Information of China (English)

    李文琦; 黄水平

    2012-01-01

    目的 探讨胃癌根治术后患者的饮食、生活行为方式及心理等多方面因素对患者预后的影响.方法 用回顾性随访方法,调查某市各大医院行胃癌根治性切除术的患者术后的饮食、生活行为方式及心理因素等.采用Kaplan-Meier法计算生存率,Log-Rank时序检验进行单因素分析,比例风险模型(Cox模型)进行多因素分析比较.结果 胃癌根治术患者1、3、5年生存率分别为80.6%、49.5%、35.5%;吸烟习惯、睡眠状况、体育锻炼、爱人对患者病情的了解程度4项因素成为根治术后胃癌患者独立的预后因素.结论 胃癌患者术后戒烟、良好的睡眠状况、规律的体育锻炼习惯及良好的社会支持状况可改善患者的预后,延长其生存时间.%OBJECTIVE To explore the factors that includes dietary, lifestyle and psychological habits related to the prognosis of gastric cancer after radical resection. METHODS 156 patients underwent radical excision were recruited from three large hospitals in a city. The patients' diet, lifestyle and psychological habits were followed from May 2010 to May 2010. Survival rate was calculated by using Kaplan-Meier method. Log-rank test and proportional-hazards regression model (Cox model) were used for univariate and multivariate analysis. RESULTS One-year, three-year and five-year survival rates were 80.6%, 49.5% and 35.5%, respectively. Smoking habits, sleep, psychological habits and support from the patients' spouse were the independent prognostic factors. CONCLUSION Quit smoking, good sleep, regular physical exercise, and social support of gastric cancer after radical resection can improve the prognosis and prolong survival time.

  5. 中国颅脑创伤数据库:短期预后因素分析%Chinese Head Trauma Data Bank: factors of short-term prognosis

    Institute of Scientific and Technical Information of China (English)

    惠纪元; 龚如; 梁玉敏; 高国一; 包映晖; 江基尧

    2014-01-01

    Objective To set up Chinese Head Trauma Data Bank and analyze the factors which may be related to the prognosis of patient with acute head trauma.Methods 11 937 cases with acute head trauma were enrolled Chinese Head Trauma Data Bank from 47 hospitals from December 2008 to December 2012,and all causes including gender,age,causes of trauma,GCS,ICP and cerebral herniation were analyzed to prognosis of patients.Results All factors were significantly related to the mortality and morbidity of patients except the gender.Conclusions Chinese Head Trauma Data Bank is established and offers the evidence of current status of head trauma in China,which provides the evidence for improving the outcome of patients with head trauma.%目的 建立我国颅脑创伤资料库,并分析影响急性颅脑创伤患者预后的相关因素.方法 2008年12月至2012年12月47家医院11 937例急性颅脑创伤患者资料,分析患者的性别、年龄、致伤原因、GCS评分、ICP和脑疝对患者病死率及不良预后率(死亡、植物生存、重残)的影响.结果 除男性与女性病死率无明显统计学差异外,患者年龄、致伤原因、GCS评分和颅内压值与病死率和预后不良率均有明显统计学差异.结论 我国颅脑创伤资料库的建立为客观了解我国颅脑创伤治疗现状、提高我国颅脑创伤救治水平提供了客观依据.

  6. Analysis on the influential factors for prognosis of 81 patients with infective endocarditis%感染性心内膜炎81例预后影响因素分析

    Institute of Scientific and Technical Information of China (English)

    虞燕波; 邢云利; 梁金锐

    2016-01-01

    Objective To analyze the influential factors for prognosi of patients with infective endocarditis. Methods The clinical data of 81 patients with infective endocarditis in Beijing Friendship Hospital during January 1992 to October 2013 were retrospectively reviewed and ana-lyzed. Results Among these 81 patients with infective endocarditis,the male gender was predominated with a sex ratio of 2. 1:1,48 patients (59. 3% )had basic heart diseases,70 patients(87. 4% )had fever and 60. 5% patients had anemia. The bacterial cultures were positive in 38. 3% of patients,and 22. 2% patients accepted surgical treatment. Conclusion The data in this study showed that the clinical manifestations of infective endocarditis are complex with high mortality rate. Rheumatic heart disease is the basic disease for this infection and renal impairment is the risk factor for the poor prognosis of these patients.%目的:分析感染性心内膜炎(IE)的预后影响因素。方法调查1992年1月至2013年10月北京友谊医院确诊的81例 IE 患者病例资料,对其临床特点进行回顾性分析,并对可能的相关因素进行单因素统计学分析。结果81例患者中单因素分析显示,风湿性心脏病对于感染性心内膜炎患者的 OR =5.387(95% CI 1.626-8.425),肾脏损伤对于感染性心内膜炎患者的 OR =4.233(95% CI 1.607~10.494),外科治疗对于感染性心内膜炎患者的 OR =1.153(95% CI 1.121~1.440),具有统计学意义。结论 IE 临床表现复杂,是一种危害大、病死率较高的心脏疾病;风湿性心脏基础疾病以及肾脏损伤是患者预后不良的危险因素。

  7. The Rutter Scale for Completion by Teachers: Factor Structure and Relationships with Cognitive Abilities and Family Adversity for a Sample of New Zealand Children.

    Science.gov (United States)

    McGee, Rob; And Others

    1985-01-01

    Factor analysis revealed three main factors: aggressiveness, hyperactivity and anxiety-fearfulness. Measures based upon these factors had a reasonably high level of reliability and were moderately stable over a 2-year interval. Hyperactivity was negatively associated with cognition ability. Both hyperactivity and aggressiveness were related to…

  8. Endometrial Cancer Insulin-Like Growth Factor 1 Receptor (IGF1R) Expression Increases with Body Mass Index and Is Associated with Pathologic Extent and Prognosis

    Science.gov (United States)

    Joehlin-Price, Amy S.; Stephens, Julie A.; Zhang, Jianying; Backes, Floor J.; Cohn, David E.; Suarez, Adrian A.

    2016-01-01

    Background Obesity is a main risk factor for endometrial carcinoma (EC). Insulin-like growth factor 1 receptor (IGF1R) expression may influence this association. Methods IGF1R IHC was performed on a tissue microarray with 894 EC and scored according to the percentage and intensity of staining to create immunoreactivity scores, which were dichotomized into low and high IGF1R expression groups. Logistic regression modeling assessed associations with body mass index (BMI), age, histology, pathologic extent of disease (pT), and lymph node metastasis (pN). Overall survival (OS) and disease-free survival (DFS) were compared between IGF1R expression groups using Kaplan–Meier curves and log-rank tests. Results The proportion of patients with high IGF1R expression increased as BMI (<30, 30–39, and 40+ kg/m2) increased (P = 0.002). The adjusted odds of having high IGF1R expression was 1.49 [95% confidence interval (CI), 1.05–2.10, P = 0.024] for patients with BMI 30 to 39 kg/m2 compared with <30 kg/m2 and 1.62 (95% CI, 1.13–2.33, P = 0.009) for patients with BMI 40+ kg/m2 compared with <30 kg/m2. High IGF1R expression was associated with pT and pN univariately and with pT after adjusting for BMI, pN, age, and histologic subtype. DFS and OS were better with high IGF1R expression, P = 0.020 and P = 0.002, respectively, but DFS was not significant after adjusting for pT, pN, and histologic subtype of the tumor. Conclusions There is an association between BMI and EC IGF1R expression. Higher IGF1R expression is associated with lower pT and better DFS and OS. Impact These findings suggest a link between IGF1R EC expression and obesity, as well as IGF1R expression and survival. PMID:26682991

  9. Non-specific neck pain in schoolchildren: prognosis and risk factors for occurrence and persistence. A 4-year follow-up study.

    Science.gov (United States)

    Ståhl, Minna; Kautiainen, Hannu; El-Metwally, Ashraf; Häkkinen, Arja; Ylinen, Jari; Salminen, Jouko J; Mikkelsson, Marja

    2008-07-15

    This study investigated the natural course of neck pain (NP) in 9-12-year-olds during a 4-year follow-up. Risk factors for the occurrence and persistence of weekly NP were explored separately for boys and girls. At baseline, 1756 schoolchildren completed a questionnaire eliciting musculoskeletal pain symptoms, other physical, and psychological symptoms and frequency of physical activity, and were tested for joint hypermobility. Symptoms during the preceding three months were asked using a five-level frequency classification. Re-evaluation was performed after one and four years using identical questionnaires. During follow-up, 24% reported none, 71% fluctuating, and 5% persistent weekly NP. The frequency of NP at baseline was linearly related to weekly NP during follow-up in both genders (Pneck pain-free pre-/early adolescents, weekly other musculoskeletal pain symptoms (only in girls) and other physical and psychological symptoms (in both genders) predicted the occurrence of weekly NP during follow-up. In conclusion, neck pain in schoolchildren tends to fluctuate, but there also seems to exist a subgroup (5%) with persistent NP already in pre-/early adolescents, or even earlier. Co-occurrence of frequent other musculoskeletal symptoms and/or markers of psychological stress with frequent NP are risk indicators for a more persistent course, at least within next few years. Since adult chronic NP problems might originate in childhood, further studies are needed, including preventive interventions.

  10. Association of macrophage migration inhibitory factor gene -173 G/C polymorphism with prognosis in Turkish children with juvenile rheumatoid arthritis.

    Science.gov (United States)

    Berdeli, Afig; Ozyürek, Arif Ruhi; Ulger, Zülal; Gürses, Dolunay; Levent, Ertürk; Salar, Koray; Gürpinar, Ali Rahmi

    2006-06-01

    The objectives of this study were to determine genotypic and allelic frequencies of macrophage migration inhibitory factor (MIF) gene -173 G/C polymorphism in patients with juvenile rheumatoid arthritis (JRA) and to evaluate the association of the MIF -173 C allele with the outcome of JRA. Genomic DNA was collected from 67 JRA patients and 153 healthy individuals. To evaluate the association of the MIF -173 polymorphism with the outcome, we analyzed the data concerning the treatment regimen, duration of glucocorticoid treatment, score on the childhood health assessment questionnaire (C-HAQ) and the number of joints with active arthritis. Nonsignificant differences were observed between the study and control groups in the distribution of genotype and allele frequencies of the MIF gene -173 G/C polymorphism. In JRA patients, carrying a MIF -173 C allele, the number of disease modifying antirheumatic drugs required for the treatment was more, the duration of glucocorticoid treatment was significantly longer, and at the last visits the C-HAQ scores and the number of joints with active arthritis were significantly higher. MIF gene -173 C allele frequency did not differ between the controls and JRA patients. MIF -173 C allele did not confer increased susceptibility to JRA in our study group. Carriage of the MIF -173 C allele was found to be a strong predictor of poor outcome in all types of JRA.

  11. Onset, prognosis and effect factors of postpartum depression%产后抑郁发生、转归及其影响因素

    Institute of Scientific and Technical Information of China (English)

    张小松; 赵更力; 陈丽君; 狄江丽

    2009-01-01

    目的:了解产后42天、6个月产后抑郁发生及42天产后抑郁在6个月时的恢复情况与其影响因素.方法:应用爱丁堡产后抑郁量表(EPDS)和产妇一般情况调查表在产后42天对551例无孕期并发症/合并症和精神疾患的产妇进行测评,并于产后6个月随访时再次测评,用SPSS 10.0统计软件对相关资料进行统计分析.结果:产后42天产后抑郁发病率为6.5%,6个月产后抑郁患病率为5.7%.42天产后抑郁患者有25.0%在6个月仍为产后抑郁,占6个月产后抑郁的25.9%;42天正常产妇有4.5%在6个月发生产后抑郁.家庭、工作及孩子因素是影响产后抑郁发生与恢复的重要因素.结论:产后较长时间内仍有可能发生产后抑郁,产后一定时期内产妇的精神状况仍应得到重视.%To explore the incidence of postpartum depression at 42 days and 6 months postpartum and the recovery process of postpartum depression, as well as effect factors. Methods: 551 healthy mothers without complications and mental diseases were investigated by EPDS and general status questionnaires respectively at 42 days and 6 months postpartum, the analysis was performed on SPSS 10. 0. Results: The incidences of postpartum depression at 42 days and 6 months were 6. 5% and 5.6%. About 25.0% women with post-partum depression at 42 days were still depressed at 6 months postpartum. Approximately 25. 9% women with postpartum depression at 6 months were depressed at 42 days. About 4. 5% healthy women at 42 days suffered postpartum depression at 6 months. The important effect factors of incidence and recovery of postpartum depression were family, employment and children. Conclusion: Postpartum depression maybe occur during longtime postpartum. Mental health status of childbirth women should be enhanced after delivery.

  12. Tumor necrosis factor receptor-associated periodic syndrome (TRAPS): definition, semiology, prognosis, pathogenesis, treatment, and place relative to other periodic joint diseases.

    Science.gov (United States)

    Masson, Charles; Simon, Virginie; Hoppé, Emmanuel; Insalaco, Paolo; Cissé, Idrissa; Audran, Maurice

    2004-07-01

    Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant inherited condition of periodic fever and pain. Most patients are of northern European descent. The attacks manifest as fever and pain in the joints, abdomen, muscles, skin, or eyes, with variations across patients. An acute-phase response occurs during the attacks. Patients with TRAPS are at risk for AA amyloidosis, the most common targets being the kidneys and liver. Soluble TNFRSF1A is usually low between the attacks and may be normal during the attacks, when TNF levels are high. TNFRSF1A is found in abnormally high numbers on leukocyte cell membranes. TRAPS is the first condition for which naturally occurring mutations in a TNF receptor were found; the mutations affect the soluble TNFRSF1A gene in the 12p13 region. In some patients, the pathogenesis involves defective TNFRSF1A shedding from cell membranes in response to a given stimulus. Thus, TRAPS is a model for a novel pathogenic concept characterized by failure to shed a cytokine receptor. This review compares TRAPS to other inherited periodic febrile conditions, namely, familial Mediterranean fever, Muckle-Wells syndrome, cold urticaria, and hyper-IgD syndrome. The place of TRAPS relative to other intermittent systemic joint diseases is discussed. Colchicine neither relieves nor prevents the attacks, whereas oral glucocorticoid therapy is effective when used in dosages greater than 20 mg/day. The pathogenic hypothesis involving defective TNFRSF1A shedding suggests that medications targeting TNF may be effective in TRAPS.

  13. Prognosis and Risk Factors for Congenital Airway Anomalies in Children with Congenital Heart Disease: A Nationwide Population-Based Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Yu-Sheng Lee

    Full Text Available The mortality risk associated with congenital airway anomalies (CAA in children with congenital heart disease (CHD is unclear. This study aimed to investigate the factors associated with CAA, and the associated mortality risk, among children with CHD.This nationwide, population-based study evaluated 39,652 children with CHD aged 0-5 years between 2000 and 2011, using the Taiwan National Health Insurance Research Database (NHIRD. We performed descriptive, logistic regression, Kaplan-Meier, and Cox regression analyses of the data.Among the children with CHD, 1,591 (4.0% had concomitant CAA. Children with CHD had an increased likelihood of CAA if they were boys (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.33-1.64, infants (OR, 5.42; 95%CI, 4.06-7.24, or had a congenital musculoskeletal anomaly (OR, 3.19; 95%CI, 2.67-3.81, and were typically identified 0-3 years after CHD diagnosis (OR, 1.33; 95%CI 1.17-1.51. The mortality risk was increased in children with CHD and CAA (crude hazard ratio [HR], 2.05; 95%CI, 1.77-2.37, even after adjusting for confounders (adjusted HR, 1.76; 95%CI, 1.51-2.04. Mortality risk also changed by age and sex (adjusted HR and 95%CI are quoted: neonates, infants, and toddlers and preschool children, 1.67 (1.40-2.00, 1.93 (1.47-2.55, and 4.77 (1.39-16.44, respectively; and boys and girls, 1.62 (1.32-1.98 and 2.01 (1.61-2.50, respectively.The mortality risk is significantly increased among children with CHD and comorbid CAA. Clinicians should actively seek CAA during the follow-up of children with CHD.

  14. Family skills for overcoming adversity

    Directory of Open Access Journals (Sweden)

    Mónica Patricia Ardila Hernández

    2013-12-01

    Full Text Available This section draws on research four families in displacement in Tunja Boyacá step of this research is to present the problem of displacement from another different look that has embargoed regarding this topic. Critical reflection was raised from resilient approach Parsons theory in order to understand families immersed in this conflict as change agents capable of adapting to a new system and overcome adversity. Within this scheme is used to obtain qualitative research of the following categories : adaptation to the new social context risk factors present in families and protective factors.

  15. Influencing factors of prognosis of open reduction and internal fixation for Pilon frecture%切开复位内固定治疗Pilon骨折预后影响因素分析

    Institute of Scientific and Technical Information of China (English)

    郑吉高

    2014-01-01

    目的:探讨切开复位内固定治疗 Pilon 骨折临床疗效影响因素。方法对60例切开复位内固定治疗Pilon 骨折患者的临床资料进行回顾性分析,并对影响手术疗效的相关因素进行分析。结果合并深部感染和创伤性关节炎的患者骨折分型越高、骨折复位情况越差,预后越差(P <0.01)。结论影响切开复位内固定治疗 Pilon 骨折预后的影响因素包括骨折分型、骨折复位、合并深部感染和创伤性关节炎。%Objective To discuss influencing factors of prognosis clinical efficacy of open reduction and internal fixation for Pilon frecture. Methods Clinical data of 60 cases with open reduction and internal fixation for Pilon frecture were retrospectively analyzed. Influencing factors of clinical efficacy were analyzed. Results Cases with higher frecture classification, worse reduction of fracture, complicated with deep fungal infection and traumatic arthritis showed worse clinical efficacy(P < 0.01). Conclusion Frecture classification,reduction of fracture, complicated with deep fungal infection and traumatic arthritis are influencing factors of clinical efficacy of open reduction and internal fixation for Pilon frecture.

  16. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Menu Contact Dictionary Search About Cancer Causes and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer Screening Cancer Screening Overview Screening ...

  17. Adverse Effects of Hormonal Contraception

    Directory of Open Access Journals (Sweden)

    Sabatini R

    2011-01-01

    Full Text Available contraception acceptability, compliance and continuation. Despite the safety profile of current COCs, fears of adverse metabolic and vascular effects caused by estrogen component, and possible neoplastic effects of these formulations remain. Misperceptions and concerns about side-effects, especially those affecting the menstrual cycle and increased body weight, are often given as reason for discontinuation. Besides, severe adverse effects exist; perhaps they are very rare, but it might be that other cases were underestimated or ignored. It is important to take into account that COCs, as all medications, have some contraindications, which is mandatory to consider. The „pill“ could be not for everyone. In any case, also mild or moderate adverse effects of COCs may impair the woman’s quality of life. It is well known that even small increases in frequency of adverse effects, in COCs-users, could have a general critical health impact because of their widespread use, which is currently expanding to potential risk groups. To avoid adverse events by COC use the exclusion of patients with known risk factors including patient history and family history is necessary. Furthermore the patient should be informed about possible side effects and side effects during OC use should be carefully monitored. Finally the risk benefit analysis for oral contraceptive pills which are worldwide used since more than 50 years for healthy patients is positive. Most women will benefit from additional noncontraceptive benefits such as improvement of acne vulgaris, dysmenorrhoea, stabilization of menstrual bleeding pattern, less ovarian cysts and finally a lower risk for ovarian and breast cancer, which persists even after withdrawl of COC for several years.

  18. 48例血管免疫母性T细胞淋巴瘤治疗及预后因素分析%Treatment response and prognosis factors in 48 patients with angioimmunoblastic T cell lymphoma

    Institute of Scientific and Technical Information of China (English)

    李佳; 刘卓刚

    2016-01-01

    Objective To explore the influencing factors of therapeutic effect and prognosis in patients with angioimmunoblastic T cell lymphoma (AITL). Methods The clinical data of 48 patients with AITL were collected in order to evaluate its therapeutic effect and the influencing factors of prognosis. Results In the 48 patients with AITL, complete remission (CR) was in 15 cases, partial remission (PR) was in 16 cases, and the total effective rate was 64.58%(31/48). The recent total effective rate in patients of international prognostic index (IPI) score ≤2 scores was significantly higher than that in patients of IPI score >2 scores: 84.00% (21/25) vs. 43.48% (10/23), and there was statistical difference (P2 scores, Ki-67 ≥ 50% and using CHOP regimen: 8/13 vs. 25.71%(9/35), 52.00% (13/25) vs. 17.39% (4/23), 55.00% (11/20) vs. 21.43% (6/28) and 48.28% (14/29) vs. 3/19, and there were statistical differences (P<0.05). Conclusions AITL is a kind of disease with poor prognosis. IPI score is the important influencing factor of recent therapeutic effect. The Ann Arbor stage, IPI score, Ki-67 levels and using contained ASP chemotherapy are the important factors of prognosis in patients with AITL.%目的:探讨影响血管免疫母性T细胞淋巴瘤(AITL)疗效和预后的因素。方法收集48例AITL患者的临床资料,评价其疗效,探讨影响其预后的因素。结果48例AITL患者,完全缓解(CR)15例,部分缓解(PR)16例,总有效率为64.58%(31/48)。国际预后指数(IPI)评分≤2分患者的近期总有效率明显优于IPI评分>2分患者[84.00%(21/25)比43.48%(10/23)],差异有统计学意义(P<0.05)。1、2、3年总生存率分别为75.00%(36/48)、52.08%(25/48)及35.42%(17/48),中位生存时间24.5个月。Ann Arbor分期Ⅰ~Ⅱ期、IPI评分≤2分、Ki-67<50%及应用CHOP联合门冬酰胺酶方案化疗患者较Ann Arbor分期Ⅲ~Ⅳ期、IPI评分>2分、Ki-67≥50%

  19. Analysis of related factors influencing the prognosis of women with severe pre-eclampsia and their perinatal fetuses%影响重度子痫前期孕妇及围产儿预后的相关因素

    Institute of Scientific and Technical Information of China (English)

    张红卫; 王琪; 吴静

    2010-01-01

    Objective To investigate related factors influencing the prognosis of women with severe preeclampsia and their perinatal fetuses. Methods Data of 157 women with severe pre-eclampsia from Beijing Obstetrics and Gynecology Hospital were retrospectively collected. Risk factors affecting the outcomes of the subjects and their perinatal fetuses were analyzed by logistic stepwise regression model. Results Hypertension while admission was found related to complications at pregnancy termination. The risk of occurrence of complications in pregnant women with severe hypertension was 3. 147 ( 95% CI: 1.483~6. 679) times higher than those with mild hypertension. Pregnancy termination at 32 - 36 weeks of gestation was a protective factor of neonatal asphyxia. Incidence of neonatal asphyxia in subjects of 32~36 weeks of gestation was significantly lower than in those of less than 27 weeks ( OR =0. 026, 95% CI:0. 004~0. 169). Conclusions For women with severe pre-eclampsia, hypertension while admission was a risk factor for their prognosis, and pregnancy termination at 32~36 weeks of gestation was a protective factor of neonatal asphyxia.%目的 了解影响重度子痫前期孕妇及围产儿预后的相关因素.方法 采用以医院为基础的方法 收集回顾性资料,共纳入157例研究样本.采用SAS8.2对孕产儿结局的危险因素进行单因素分析和多因素Logistic回归分析.结果经单因素和多因素分析,入院时血压与妊娠终止时孕妇的并发症有关,重度高血压孕妇发生并发症的危险是轻度高血压孕妇的3.147倍(95%CI:1.483~6.679).32~36孕周终止妊娠是新生儿窒息发生的保护因素,期间所产新生儿窒息发生的危险是≤27孕周的0.026倍(95%CI:0.004~0.169).结论 重度子痫前期孕妇的入院时血压情况(重度高血压)是孕妇预后的危险因素,32~36孕周终止妊娠是围产儿并发症发生的保护因素.

  20. The relationship between plasma levels of pigment epithelial derived factor and vascular endothelial growth factor in the patients with hepatocellular carcinoma and prognosis%肝癌患者血浆 PEDF 和 VEGF 表达水平及其与预后关系的探讨

    Institute of Scientific and Technical Information of China (English)

    朱莉丽; 杨凯; 刘亚

    2014-01-01

    目的:观察肝癌患者血浆色素上皮衍生因子(PEDF)及血管内皮生长因子(VEGF)表达水平并探讨其与预后的关系。方法采用ELISA法检测肝癌患者43例(肝癌组)、肝脏良性疾病患者20例(良性肝病组)及健康对照者20例(健康对照组)血浆PEDF和VEGF水平;肝癌患者平均随访(12 W.02±0.23)个月,记录短期主要不良终点事件(SMAE)发生情况。结果血浆PEDF水平肝癌组较良性肝病组及健康对照组明显降低( P <0.01),VEGF水平明显升高( P <0.01),而良性肝病组与健康对照组比较差异无统计学意义( P >0.05)。肝癌患者随访结束后,高PEDF/VEGF比值(≥3)亚组22例发生SMAE 3例(13.64%),低PEDF/VEGF比值(<3)亚组21例发生SMAE 7例(33.33%),Kaplan-Meier生存曲线显示2组差异有统计学意义( P =0.039)。另外,与未发生SMAE的肝癌患者(33例)比较,发生SMAE者(10例)有更低的PEDF/VEGF比值(2.14±0.76 vs.3.49±1.12, P <0.01)。结论 PEDF和VEGF参与肝癌的病理生理过程,低表达的PEDF及高表达的VEGF反映肝癌发生、发展及转移情况,两者比值可能成为预测肝癌转移及预后的有效指标。%Objective To observe the expression of pigment epithelium derived factor ( PEDF) and vascular endothe-lial growth factor ( VEGF) in liver cancer patients , and to explore its relationship with the prognosis .Methods ELISA was used to detect 43 cases of patients with hepatocellular carcinoma (HCC group), 20 patients with benign liver disease (benign liver disease group ) and 20 cases of healthy controls'( healthy control group ) levels of plasma PEDF and VEGF levels , pa-tients with hepatocellular carcinoma with average follow-up (12.02 ±0.23) months, the main short recording adverse events ( SMAE) occurrence were recorded .Results The levels of plasma PEDF of liver cancer group

  1. Research on related factors of post-stroke depression and their relationship with prognosis%脑卒中后抑郁相关因素与患者预后分析研究

    Institute of Scientific and Technical Information of China (English)

    张国利; 曾湘良; 刘芳; 朱勇

    2012-01-01

    目的 探讨脑卒中后抑郁的相关因素及患者预后分析.方法选择2008年2月~2011年2月本院住院治疗的280例脑卒中患者,采用抑郁自评量表、汉密尔顿抑郁量表对患者进行评估.280例患者中确诊为卒中后抑郁者62例,将32例接受早期干预治疗的卒中后抑郁者为观察组,30例未接受早期干预者为对照组.对可能引起脑中后抑郁的相关因素进行分析,并采用改良Barthel指数评估患者日常生活能力(ADL),采用FMA运动功能评定肢体运动功能.结果统计学分析显示文化程度、家庭关系、病变部位、偏瘫严重程度与患者脑卒中后抑郁显著相关(P 0.05);治疗后1、3及6个月进行评估,结果显示观察组MBI评分及FMA评分显著优于对照组(P 0.05); MBI scores and FMA scores in experience group were much better than that in control group on 1, 3 and 6 months of post-treatment (P < 0.05). Conclusion Culture degree, family relationship, lesion site, the hemiplegic degree are the risk factors for post-stroke depression. The patients who receive early treatment have better prognosis. Early treatment should be performed in order to promote the recovery and improve the prognosis of patients.

  2. Risk Factors of Umbilical Cord Prolapse and Effects on Neonatal Prognosis%脐带脱垂的风险因素及对新生儿预后的影响

    Institute of Scientific and Technical Information of China (English)

    彭金; 洪朝辉

    2015-01-01

    目的 探讨脐带脱垂的相关风险因素及脐带脱垂对新生儿预后的影响.方法 脐带脱垂22例,从同期10 542例足月阴道顺娩的产妇中随机抽取300例为对照组.所获数据采用X2检验.结果 脐带脱垂发生率0.12%,早产、胎儿出生体重小于2 500 g、胎儿心电监护出现晚期减速或变异减速,两组比较,P0.05,无显著性差异;两组均无新生儿死亡.结论 规范产前检查、密切产时监护、迅速结束分娩是解决脐带脱垂的风险及改善新生儿预后的有效办法.%Objective To study the related risk factors of umbilical cord prolapse and influence on the prognosis of neonatal umbilical cord prolapse. Methods 22 patients with umbilical cord prolapse;we randomly select 300 cases as control group from the same period in 10542 cases of full-term vaginal shun deliser maternal . the data obtained by X 2 test. Results The incidence rate of umbilical cord prolapse 0.12%, premature delivery, fetal birth weight less than 2500 g, fetal ecg monitoring mutation in late to slow down or slow, comparing the two groups have significant difference (P0.05);Two groups had no neona?tal death. Conclusion umbilical cord prolapse, see more at premature birth, low birth weight, breech presentation, most?ly occurs in the"active"before. Specification antenatal examination, closely intrapartum guardianship, quick end delivery will effectively improve neonatal prognosis.

  3. 重组人粒细胞刺激因子在乳癌治疗中不良反应的分析%Adverse reactions of recombinant human granulocyte colony-stimulating factor in breast cancer treatment

    Institute of Scientific and Technical Information of China (English)

    叶青青; 蔡君; 聂铮; 张立军; 王茁

    2011-01-01

    Objective : To analyze the adverse drug reaction in the clinical application of recombinant human granulocyte colony - stimulating factor ( rhG - CSF) .Methods : cases suffered from adverse drug reaction of rhG - CSF from January 2006 to November 2009 were collected and analyzed.Results : Most of adverse drug reactions induced by rhG - CSF manifested as allergic reactions and are not serious.Condusion; More attention should be paid on safety of rhG - CSF.%目的:分析在乳腺癌治疗中重组人粒细胞刺激因子注射液致药物不良反应(ADR) 发生的特点.方法:收集并分析2006年1月至2009年11月我科重组人粒细胞刺激因子注射液致不良反应病例.结果 :重组人粒细胞刺激因子注射液致不良反应,临床表现多数为过敏反应,反应较轻,尚有罕见严重的不良反应.结论:临床应重视重组人粒细胞刺激因子注射液使用的安全性问题.

  4. Prognosis of Cyclic Vomiting Syndrome

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2016-03-01

    Full Text Available Investigators from Teikyo University School of Medicine, Tokyo, Japan, evaluated the clinical features, prognosis, and prophylaxis of cyclic vomiting syndrome and the relationship between the syndrome and levels of adrenocorticotropic/antidiuretic hormones (ACTH/ADH.

  5. Tumour biological prognosis factors in advanced-stage uterus cervical carcinoma treated primarily by radiation therapy. A study on the significance of tumour oxygenation, tumour vascularisatio, anaemia and tumour proteins for the clinical treatment outcome; Tumorbiologische Prognosefaktoren beim fortgeschrittenen, primaer strahlentherapeutisch behandelten Uteruszervixkarzinom. Eine Untersuchung zur Bedeutung von Tumoroxygenierung, Tumorvaskularisation, Anaemie und Tumorproteinen fuer das klinische Behandlungsergebnis

    Energy Technology Data Exchange (ETDEWEB)

    Haensgen, G.

    2002-07-01

    The goal of the present study was to evaluate tumour biological prognosis factors that might give an indication of a patient's probable radiation sensitivity and hence of the probable clinical outcome. The ultimate goal was to reveal relationships between special tumour biological circumstances and clinical results that would permit a definition of risk factors, thus facilitating an individualised, i.e. optimised treatment.

  6. 白内障超声乳化术中后囊膜破裂危险因素及预后研究%Analysis on risk factors and prognosis of posterior capsular rupture in phacoemulsification cataract surgery

    Institute of Scientific and Technical Information of China (English)

    廖友生

    2016-01-01

    Abstract?AIM: To investigate the risk factors and prognosis of posterior capsular rupture in phacoemulsification cataract surgery through analyzing the cataract patients in our hospital.?METHODS:Totally 1825 patients (1912 eyes) treated in our hospital were selected from November 2012 to November 2015. The patients with posterior capsular rupture were as observation group.Control group was randomly selected with a 1: 4 ratio in patients without posterior capsular rupture.All the patient's age, gender, type of cataract, ocular disease history, other medical history, surgical history, preoperative intraocular pressure, the eyes affected, the health situation, visual acuity at 1d before and after surgery and other factors were recorded and analyzed for risk factors and prognosis.?RESULTS: Statistical results showed gender, type of cataract, preoperative intraocular pressure, history of tobacco and alcohol, eyes affected and other factors did not impact on the rupture rate ( P>0.05 ); and type of nucleus, preoperative visual acuity, some eye diseases were the risk factors for posterior capsule rupture ( P<0.05).Postoperative visual acuity of the two groups was all improved, but visual acuity of patients with posterior capsule rupture significantly decreased.?CONCLUSION: With eye disease history ( a history of vitreous hemorrhage, retinal detachment before surgery and preoperative visual acuity <20/200) are more likely to result in intraoperative posterior capsular rupture.Nuclear hardness over grade Ⅳ is also an important risk factor. Before one surgery, it is needed to learn more about the medical history of cataract patients, to conduct a reasonable comprehensive assessment for risk factors, to decrease the risk in the surgery, which are to increase the success rate and to improve the prognosis.%目的:通过调查本院内超声乳化吸除术治疗的白内障患者,分析术中造成后囊膜破裂相关危险性因素,并对手术预后相关情况

  7. Analysis of the risk factor of adverse events associated with neonatal exchange transfusion%新生儿换血治疗后不良反应及其危险因素分析

    Institute of Scientific and Technical Information of China (English)

    吴玫; 陈大鹏; 熊英

    2011-01-01

    Objective To investigate the adverse events associated with neonatal exchange transfusion and its risk factors. Methods 71 newhorn received exchange transfusion who were hospitalized in our NICU during October 2009 to Octoher 2010 were investigated. Adverse events was defined as serious complications occurring within one week of exchange transfusion , including hyperkalemia , hypocalcemia , hypoglycemia , thrombocytopenia et al. Correlative factors include sex , gestational age , weight.Results The most common adverse events in the exchange transfusion was thrombocytopenia, others including hyperkalemia, hypocalcemia,hypoglycemia et al. Age less than 7 days when exchange transfusion was independent risk factor. Conclusion Most common adverse event of exchange transfusion in newborn was thrombocytopenia, age less than 7 days when exchange transfusion was the only independent risk factor we found.%目的 探讨新生儿换血后的不良反应及其危险因素.方法 选择于2009年10月~2010年10月在我院新生儿科行换血治疗的71例患儿为研究对象,全部71例惠儿均采用外周动静脉同步换血术.换血后的不良反应定义为换血7d内发生的任何一种并发症.采用回顾性分析方法,记录患儿性别、胎龄、换血时体重、换血日龄、换血前、中、后各种血液和基本生命指标.结果 ①不良反应发生率最高的为血小板减少,为63.38%.本研究纳入样本中未发生DIC及NEC;②不良反应与原发疾病没有确切的相关性;③换血时间在7d以内是换血不良结局的危险因素(P<0.05),而性别、孕周、体重差异则无统计学意义.结论 新生儿换血治疗存在不良反应的危险,最常见的是血小板减少,不良反应的发生与原发疾病没有确切的相关性,在生后7d内换血是其危险因素.

  8. The factors influencing the prognosis of herpes simplex virus encephalitis%儿童单纯疱疹病毒性脑炎的预后影响因素

    Institute of Scientific and Technical Information of China (English)

    彭炳蔚; 朱海霞; 李小晶; 高媛媛; 麦坚凝

    2014-01-01

    目的 评价影响儿童单纯疱疹病毒性脑炎(HSE)的预后因素,探讨儿童HSE预后差的病理生理机制.方法 纳入广州市妇女儿童医疗中心2012年1月至2013年10月确诊的儿童HSE 21例,除2例自动出院外,余19例纳入本研究,所有病例脑脊液单纯疱疹病毒(HSV) DNA-PCR检测均阳性.所有病例发病48 h内均未予阿昔洛韦抗病毒治疗,对所有病例进行临床和影像学分析随访,随访时间6个月以上,临床及检查数据包括脑电图(EEG)、改良Glasgow Coma Scale(GCS)评分、脑磁共振成像(MRI)的结果,所有患儿均在住院时和起病1个月后进行至少2次MRI的平扫和增强扫描,然后对分析结果进行合理分组,进行多因素和单因素预后分析,以Logistic回归和Fisher's精确概率法统计分析,计算OR值.结果 本组病例年龄(2.03 ±2.23)岁,GCS评分(9.68±2.65)分,18例患儿存活,5例(27.8%)没有后遗症,3例(16.7%)轻度损害,这8例属于预后好.6例(33.3%)有中度神经系统损害,4例(22.2%)有严重的神经系统后遗症.8例预后好,11例预后差.多因素分析显示EEG、影像学病灶性质分布、年龄、GCS评分与预后相关(P<0.05).单因素分析显示年龄1~4岁(OR=30,95% CI 2.066~366.510,P=0.002),GCS评分≤10分(OR=27.518,95% CI2.066~306.510,P=0.004),MRI显示广泛坏死性异常(OR=12,95% CI1.294 ~ 111.323,P=0.017)是预后差的高危因素.结论 年龄、GCS评分、MRI的病变性质和损害程度是儿童HSE预后的重要影响因素.儿童HSE容易累及广泛甚至深部核团或白质,坏死性损害为主,是儿童HSE预后差的重要病理基础.%Objective To evaluate the factors influencing prognosis and to explore the pathological mechanism in which herpes simplex virus encephalitis(HSE) was one of the severe types of acute viral encephalitis in children and had poor prognosis.Methods Twenty-one children with HSE were diagnosed by the clinical syndrome of focal encephalitis

  9. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure.

    Science.gov (United States)

    Lavie, Carl J; Alpert, Martin A; Arena, Ross; Mehra, Mandeep R; Milani, Richard V; Ventura, Hector O

    2013-04-01

    Obesity has reached epidemic proportions in the United States and worldwide. Considering the adverse effects of obesity on left ventricular (LV) structure, diastolic and systolic function, and other risk factors for heart failure (HF), including hypertension and coronary heart disease, HF incidence and prevalence, not surprisingly, is markedly increased in obese patients. Nevertheless, as with most other cardiovascular diseases, numerous studies have documented an obesity paradox, in which overweight and obese patients, defined by body mass index, percent body fat, or central obesity, demonstrate a better prognosis compared with lean or underweight HF patients. This review will describe the data on obesity in the context of cardiopulmonary exercise testing in HF. Additionally, the implications of obesity on LV assist devices and heart transplantation are reviewed. Finally, despite the obesity paradox, we address the current state of weight reduction in HF.

  10. Multiple adverse experiences and child cognitive development.

    Science.gov (United States)

    Guinosso, Stephanie A; Johnson, Sara B; Riley, Anne W

    2016-01-01

    During childhood and adolescence, children's social environments shape their cognitive development. Children exposed to multiple adversities in their social environment are more likely to have poorer cognitive outcomes. These findings have prompted interest among pediatric and public health communities to screen and connect youth to appropriate interventions that ameliorate the detrimental effects of adverse exposures. Such intervention efforts can be improved with a stronger conceptual understanding of the relationship between multiple adverse exposures and child cognitive development. This includes disentangling adverse exposures from other risk factors or underlying mechanisms, specifying mechanisms of action, and determining when adverse exposures are most detrimental. This review summarizes findings from the literature on each of these areas and proposes a conceptual model to guide further research and intervention.

  11. Risk factors of major adverse cardiac events in patients with severe sepsis%严重脓毒症患者主要不良心脏事件的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    赵秀娟; 朱凤雪; 杜安琪; 李纾; 王晓旋; 赵慧颖; 刘方; 安友仲

    2016-01-01

    Objective To investigate the risk factors of major adverse cardiac events in patients with severe sepsis.Methods Totally 148 patients with severe sepsis in intensive care unit (ICU) from January 2013 to July 2015 was retrospectively analyzed.The medical history,infection indicators,biochemical indexes,life indication and myocardial injury within 24 h after admission in ICU were recorded;the risk factors of major adverse cardiac events were analyzed by Logistic regression.Results The incidence of major adverse cardiac events in hospital was 34.5% (51/148),the mortality in hospital was 33.1% (49/148).Logistic regression analysis showed that the risk factors of major adverse cardiac events in patients with severe sepsis included rise of cardiac troponin Ⅰ immediately after admission in ICU (OR=3.90,95% CI:1.75-8.66,P=0.001) and higher acute physiology and chronic health evaluation (APACHE) Ⅱ score within 24 h after admission in ICU (OR =1.07,95% CI:1.01-1.14,P =0.035).Conclusions The incidence of major adverse cardiac events in patients with severe sepsis is high;rise of cardiac troponin Ⅰ immediately after admission in ICU and higher APACHE Ⅱ score with in 24 h after admission in ICU are independent risk factors of major adverse cardiac events in patients with severe sepsis.%目的 探讨严重脓毒症患者主要不良心脏事件的危险因素.方法 回顾性分析2013年1月至2015年7月北京大学人民医院重症监护病房收治的严重脓毒症患者148例.记录病史、感染指标、生化指标、入室24 h内生命指征及心肌损伤情况;采用Logistic回归分析评估严重脓毒症患者主要不良心脏事件危险因素.结果 严重脓毒症患者院内主要不良心脏事件发生率为34.5%(51/148),院内死亡率为33.1% (49/148).Logistic回归分析表明入室即刻心脏肌钙蛋白Ⅰ升高[比值比(OR)=3.90,95%置信区间(CI):1.75 ~8.66,P=0.001)和入室24 h内高急性生理和慢性

  12. Against the odds: a case study of recovery from coma after devastating prognosis

    OpenAIRE

    2015-01-01

    Abstract To demonstrate the possibility for hidden rehabilitation potential even following most severe brain injury and the uncertainty of current prognosis factors for coma and unresponsive wakefulness syndrome, we detail the rehabilitation of J. W., after coma from traumatic brain injury. Originally, with many negative prognosis factors and several medical complications, prognosis was devastating. But, with continuing treatment, J. W. improved to a high level of independence in everyday lif...

  13. Clarifying associations between childhood adversity, social support, behavioral factors, and mental health, health, and well-being in adulthood: A population-based study

    Directory of Open Access Journals (Sweden)

    Mashhood Ahmed Sheikh

    2016-05-01

    Full Text Available Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES, childhood traumatic experiences (CTEs, social support and behavioural factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n=12,981 of the adult population in Tromsø, Norway, this study examines (i the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress to social support and behavioural factors in adulthood ; (ii the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioural factors to three multi-item instruments of mental health (SCL-10, health (EQ-5D, and subjective well-being (SWLS in adulthood; (iii the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv the mediating role of adult social support and behavioural factors in these associations. Instrumental support (24.16%, p<0.001 explained most of the variation in mental health, while gender (21.32%, p<0.001 explained most of the variation in health, and emotional support (23.34%, p<0.001 explained most of the variation in well-being. Psychological abuse was relatively more important for mental health (12.13%, health (7.01%, and well-being (9.09%, as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%, health (10.60%, and well-being (20.60%, as compared to mother’s and father’s education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs

  14. Age-related trends in injection site reaction incidence induced by the tumor necrosis factor-α (TNF-α) inhibitors etanercept and adalimumab: the Food and Drug Administration adverse event reporting system, 2004-2015

    Science.gov (United States)

    Matsui, Toshinobu; Umetsu, Ryogo; Kato, Yamato; Hane, Yuuki; Sasaoka, Sayaka; Motooka, Yumi; Hatahira, Haruna; Abe, Junko; Fukuda, Akiho; Naganuma, Misa; Kinosada, Yasutomi; Nakamura, Mitsuhiro

    2017-01-01

    Tumor necrosis factor-α (TNF-α) inhibitors are increasingly being used as treatment for rheumatoid arthritis (RA). However, the administration of these drugs carries the risk of inducing injection site reaction (ISR). ISR gives rise to patient stress, nervousness, and a decrease in quality of life (QoL). In order to alleviate pain and other symptoms, early countermeasures must be taken against this adverse event. In order to improve understanding of the risk factors contributing to the induction of ISR, we evaluated the association between TNF-α inhibitors and ISR by applying a logistic regression model to age-stratified data obtained from the Food and Drug Administration Adverse Event Reporting System (FAERS) database. The FAERS database contains 7,561,254 reports from January 2004 to December 2015. Adjusted reporting odds ratios (RORs) (95% Confidence Intervals) were obtained for interaction terms for age-stratified groups treated with etanercept (ETN) and adalimumab (ADA). The adjusted RORs for ETN* ≥ 70 and ADA* ≥ 70 groups were the lowest among the age-stratified groups undergoing the respective monotherapies. Furthermore, we found that crude RORs for ETN + methotrexate (MTX) combination therapy and ADA + MTX combination therapy were lower than those for the respective monotherapies. This study was the first to evaluate the relationship between aging and ISR using the FAERS database. PMID:28260984

  15. 百草枯中毒的急救与影响预后的因素分析%Analysis of the Emergency Treatment and Factors Affecting the Prognosis of Paraquat Poisoning

    Institute of Scientific and Technical Information of China (English)

    孟成金

    2015-01-01

    Objective To analyze and study the emergency treatment and factors affecting the prognosis of paraquat poison-ing patients. Methods 72 cases with paraquat poisoning admitted in our hospital from October 2013 to December 2014 were selected. All the patients were given timely effective emergency treatment. And the results of emergency treatment and fac-tors affecting the prognosis were analyzed and studied. Results After blood perfusion, the plasma paraquat concentration was much lower than that before blood perfusion(P<0.05);the activity of SOD was significantly higher than that before blood per-fusion (P<0.05). The first blood perfusion time of the death group was later than that of the survival group (P<0.05). Patients in the death group took much more paraquat dose than those in the survival group (P<0.05). The survival group visited hospital much earlier than the death group (P<0.05). The death group had much lower incidence of complications than the survival group (P<0.05). The earlier visiting time and first blood perfusion time, and smaller paraquat dose, the longer survival time would be. Conclusion Many factors can affect the prognosis of paraquat poisoning, and the main factors are first blood per-fusion time, dose of paraquat and visiting time. Paraquat poisoning needs to be treated early, which can significantly reduce the mortality, improve the quality of life with the value of clinical promotion.%目的:分析研究百草枯中毒患者预后相关因素以及急救措施。方法整群选取2013年10月-2014年12月在该院接收的患有百草枯中毒的患者一共有72例,对72例患者采取及时、有效的急救措施,对其急救效果以及影像预后因素给予分析研究。结果72例患者采取血液灌流以后的血浆百草枯浓度明显低于血液灌流之前(P<0.05);血液灌流以后的SOD活力明显高于血液灌流之前(P<0.05);病死组的首次血液灌流时间要比存活组晚(P<0.05);病死组患者服

  16. Relation of Serum Adiponectin Levels to Number of Traditional Atherosclerotic Risk Factors and All-Cause Mortality and Major Adverse Cardiovascular Events (from the Copenhagen City Heart Study)

    DEFF Research Database (Denmark)

    Lindberg, Soren; Mogelvang, Rasmus; Pedersen, Sune H;

    2013-01-01

    Adiponectin exerts anti-inflammatory and antiatherogenic effects and appears to protect against arteriosclerosis. Accordingly, an association between low concentrations of plasma adiponectin and cardiovascular (CV) disease has been demonstrated in several studies. In contrast, elevated plasma...... or nonfatal myocardial infarction or ischemic stroke (n = 502). High adiponectin was inversely associated with an increasing number of traditional CV risk factors (p...

  17. The Relative Influence of Childhood Sexual Abuse and Other Family Background Risk Factors on Adult Adversities in Female Outpatients Treated for Anxiety Disorders and Depression

    Science.gov (United States)

    Peleikis, Dawn E.; Mykletun, Arnstein; Dahl, Alv A.

    2004-01-01

    Objective: This study from Norway examines the relative influence of child sexual abuse (CSA) and family background risk factors (FBRF) on the risk for current mental disorders and the quality of current intimate relationships in women with CSA treated for anxiety disorders and/or depression. Women with these disorders frequently seek treatment,…

  18. Newly diagnosed glucose intolerance and prognosis after acute myocardial infarction: comparison of post-challenge versus fasting glucose concentrations

    Science.gov (United States)

    Katayama, Minako; Takagi, Tsutomu; Yamamuro, Atsushi; Kaji, Shuichiro; Yoshikawa, Junichi; Furukawa, Yutaka

    2012-01-01

    Background Recent studies have demonstrated that newly diagnosed glucose intolerance is common among patients with acute myocardial infarction (AMI). The purpose of this study was to assess the long-term clinical cardiovascular outcomes in participants with AMI with abnormal fasting glucose compared with normal fasting glucose and an abnormal oral glucose tolerance test (OGTT) compared with a normal OGTT. Methods A prospective study was performed in 275 consecutive patients with AMI, 85 of whom had pre-diagnosed diabetes mellitus (DM). Those without DM were divided into two groups based on the 75 g OGTT at the time of discharge. Abnormal glucose tolerance (AGT) was defined as 2 h glucose ≥140 mg/dl; 78 patients had normal glucose tolerance (NGT) and 112 had AGT. The same patients were also reclassified into the normal fasting glucose group (NFG; n=168) or the impaired fasting glucose group (IFG; n=22). The association between the glucometabolic status and long-term major adverse cardiovascular event rates was evaluated. Results Kaplan–Meier survival curves showed that the AGT group had a worse prognosis than the NGT group and an equivalent prognosis to the DM group (p<0.0005). Cox proportional hazard model analysis showed that the HR of AGT to NGT for major adverse cardiovascular event rates was 2.65 (95% CI 1.37 to 5.15, p=0.004) while the HR of DM to NGT was 3.27 (1.68 to 6.38, p=0.0005). However, Cox HR of IFG to NFG for major adverse cardiovascular event rates was 1.83 (0.86 to 3.87), which was not significant. Conclusion In patients with AMI, an abnormal OGTT is a better risk factor for future adverse cardiovascular events than impaired fasting blood glucose. PMID:22581733

  19. [Muscle-related adverse effects of statins].

    Science.gov (United States)

    Pohjola-Sintonen, Sinikka; Julkunen, Heikki

    2014-01-01

    Adverse effects on muscles occur in approximately 5 to 10% of patients taking statins. Drug interactions, associated diseases, agedness, low body weight, high statin dose and hereditary factors increase the risk of adverse effects. In most cases the muscle effects are mild and disappear upon discontinuation of the medication. Rhabdomyolysis is a severe though rare complication that can possibly result in renal damage. A totally different muscle-related adverse effect, necrotizing myopathy, has recently been linked to the use of statins. Its characteristic feature is progression of the symptoms in spite of discontinuation of the statin.

  20. Peritonite bacteriana espontânea na cirrose hepática: prevalência, fatores preditivos e prognóstico Spontaneous bacterial peritonitis in hepatic cirrhosis: prevalence, predictive factors and prognosis

    Directory of Open Access Journals (Sweden)

    F.A.F. Figueiredo

    1999-04-01

    investigate prospectively prevalence, predictive factors and prognosis of the episode of SBP, we studied 143 in and outpatients with cirrhosis admitted to HUCFF and HUPE between January, 1995 and January, 1996. All patients were submitted to a questionaire, physical examination, blood analysis and abdominal paracentesis with ascitic fluid analysis. They were followed for a mean follow-up period of 4 months and survival was determined. RESULTS: The prevalence of SBP was 20%. Culture-positive SBP, Culture-negative Neutrocytic Ascites and Bacterascites were identified in 24%, 66% and 10%, respectively. After uni - and multivariate analysis, only anterior gastrointestinal hemorrhage, serum albumin and ascitic fluid C4 reached statistical significance (p=0.05 as predictive factors for the development of the SBP. The in-hospital and follow-up mortality rates were 33.3% and 53.8% for the SBP patients and 8.5% and 31.9% for the non-SBP patients, respectively (p=0.01 and p=0.04. The cumulative probability of survival in the SBP group was significantly lower than the probability of the non-SBP group (p=0.05. CONCLUSIONS: We conclude that SBP is a frequent complication, depends of the severity of liver failure and is a marker for poor prognosis in patients with liver cirrhosis.

  1. 乳腺癌组织中巨噬细胞移动抑制因子表达与预后的关系%The relationship between expression of macrophage migration inhibitory factor and prognosis of breast cancer

    Institute of Scientific and Technical Information of China (English)

    徐向东; 姚陈; 林颖; 王丽萍; 马兰兰; 王深明

    2008-01-01

    目的 观察巨噬细胞移动抑制因子(MIF)在乳腺癌中的表达,探讨其表达水平与乳腺癌临床病理特征、微血管密度(MVD)及预后的关系.方法 应用组织芯片技术,通过免疫组化染色检测MIF在121例乳腺癌和20例乳腺良性肿瘤和20例正常乳腺组织中表达,采用抗CD34免疫组织化学技术评价乳腺癌MVD;通过SPSS对所有结果进行统计学分析.结果 MIF在121例乳腺癌组织中表达阳性为36例(29.8%),高于乳腺良性肿瘤和正常乳腺组织,MIF表达和IL-8、MVD、HER-2呈正相关,且同无瘤生存率相关.结论 MIF阳性表达提示乳腺癌预后不良,可作为评价乳腺癌预后的一项指标;MIF有可能通过促进IL-8分泌途径参与促进乳腺癌血管形成.%Objective To investigate the expression of macrophage migration inhibitory factor (MIF) in breast cancer and to analyze the relationship between MIF expression and clinicopathological features,tumor microvessel density(MVD),and prognosis.Method The expression of MIF in 121 samples of breast cancer,20 samples of breast benign tumors,and 20 samples of normal breast tissues were examined by tissue microarray using immunohistoehemistry.The values of MVD in the breast cancer samples were examined by immunohistochemistry using anti-CD34.The association of MIF expression with the clinicopathological characteristics and prognosis was further analyzed using the computer software Statistical Package for the Social Sciences 13.0.Results The MIF positive expression rate of the breast cancer tissues Was 29.8%,significantly higher than those of the benign tumors and normal breast tissue (P=0.031).MIF expression rate was positively correlated with the expression of interleukin-8(IL-8)(P=0.014),MVD (P=0.043),and HER-2 (P=0.030).The survival rate of the patients with positive MIF expression in breast tissues was 80.6%.not significantly different from that of the negative MIF expression group (87.1%,P=0.171),however

  2. Adverse outcomes after colposcopy

    Directory of Open Access Journals (Sweden)

    Damery Sarah L

    2011-01-01

    Full Text Available Abstract Background Colposcopy is an essential part of the National Health Service Cervical Screening Programme (NHSCSP. It is used for both diagnosis and treatment of pre-cancerous cells of the cervix. Despite colposcopy being a commonly performed and relatively invasive procedure, very little research has explored the potential long-term impacts of colposcopic examination upon patient quality of life. The aim of this study is to investigate and quantify any potential reduction in women's quality of life following a colposcopy procedure. More specifically, the degree of female sexual dysfunction and the excess risk of adverse events in those undergoing colposcopy will be explored. If such risks are identified, these can be communicated to women before undergoing colposcopy. It will also assist in identifying whether there are particular sub-groups at greater risk and if so, this may lead to a re-evaluation of current recommendations concerning colposcopically directed treatments. Methods/design Cohort study using postal surveys to assess sexual function and quality of life in women who have attended for colposcopy (cases, compared with those who have not attended colposcopy (controls. The prevalence and excess risk of female sexual dysfunction will be determined. Logistic regression will identify the predictors of adverse outcomes. Discussion There are more than 400,000 colposcopy appointments each year in England, of which 134,000 are new referrals. There is some evidence that there may be long-term implications for women treated under colposcopy with respect to adverse obstetric outcomes, persisting anxiety, increased rates of sexual dysfunction and reduced quality of life. Reliably establishing whether such adverse outcomes exist and the excess risk of adverse events will facilitate informed decision-making and patient choice.

  3. 雌激素受体阳性乳腺癌预后的相关因素分析∗%Analysis of prognosis-related factors for breast cancer with positive estrogen receptors

    Institute of Scientific and Technical Information of China (English)

    陈慧; 莫淋; 徐晓帆; 顾军

    2015-01-01

    目的:探讨影响雌激素受体( ER)阳性乳腺癌患者预后的因素。方法收集2006年1月至2009年11月诊治的229例ER阳性乳腺癌患者的临床和随访资料,分析其临床病理参数中与预后相关的因素。将发病年龄、月经状况、肿瘤大小、淋巴结转移率( LNR)、PR表达、Her⁃2表达、组织学分级、新辅助化疗及放疗等因素进行Kaplan⁃Meier单因素和Cox回归多因素生存分析。结果获随访的223例患者的复发率为15�70%。 Cox模型多因素生存分析显示:肿瘤大小、LNR、Her⁃2表达及PR表达均为影响ER阳性患者接受内分泌治疗后无复发生存的独立因素( P<0�05)。结论肿瘤越大、Her⁃2过表达、PR阴性及LNR较高是ER阳性乳腺癌复发转移的独立危险因素。%Objective To investigate the related factors for prognosis of estrogen receptor( ER)⁃positive breast cancer. Meth⁃ods The clinical and pathological data of 229 patients with ER⁃positive breast cancer from Jan 2006 to Nov 2009 were collected. The onset of age, menstrual status, tumor size, tumor grade, lymph node ratio( LNR) , expression patterns of PR and Her⁃2, neoadjuvant chemotherapy and radiotherapy were analyzed by Kaplan⁃Meier survival plots and multivariable Cox hazard regression analysis to identify prognostic factors for survival. Results In this retrospective analysis,15�70% of 223 patients who had completed the follow⁃up suffered from local recurrence or metastasis. The Cox regression revealed that the tumor size, LNR, expression patterns of PR and Her⁃2 affected the recurrence⁃free survival after the endocrine therapy of breast cancer. Conclusion Large size of tumor, high LNR, over⁃expression of Her⁃2 and loss of PR are risk factors for recurrence/metastasis of ER⁃positive breast cancer.

  4. A complex background in children and adolescents with psychiatric disorders: developmental delay, dyslexia, heredity, slow cognitive processing and adverse social factors in a multifactorial entirety.

    Science.gov (United States)

    Frisk, M

    1999-09-01

    A consecutive cohort of 112 children, 42 girls and 70 boys, aged 5-17 years, receiving child psychiatric inpatient care, was investigated regarding the probability of a complex background of concomitant biological and social factors. Most of the subjects showed maladjustment and depressive states, school problems, problems with peers, psychosomatic complaints and anxiety. A very high rate of factors indicating neurodevelopmental dysfunctions was found particularly in boys, who exhibited developmental delay, dyslexia, heredity for dyslexia, and a slow complex reaction time (CRT) - suggesting slow cognitive processing - considered an impairment in itself. Further, many children obtained errors on the CRT task, indicating attention deficit and deterioration during the test, pointing toward exhaustion. The social background displayed frequent problems such as broken homes, care outside the biological home, and disordered and/or abusing parents. The biological and social factors created a complex web, predisposing the child to primary, secondary and/or comorbidity problems, and leading to an interactive process reducing the child's psychosocial capacity and competence. A pattern was developed of an impaired child, living in an inadequate/insufficient family milieu in a modern society, with increasing demands on children.

  5. Risk factors and adverse perinatal outcomes among term and preterm infants born small-for-gestational-age: secondary analyses of the WHO Multi-Country Survey on Maternal and Newborn Health.

    Directory of Open Access Journals (Sweden)

    Erika Ota

    Full Text Available Small for gestational age (SGA is not only a major indicator of perinatal mortality and morbidity, but also the morbidity risks in later in life. We aim to estimate the association between the birth of SGA infants and the risk factors and adverse perinatal outcomes among twenty-nine countries in Africa, Latin America, the Middle East and Asia in 359 health facilities in 2010-11.We analysed facility-based, cross-sectional data from the WHO Multi-country Survey on Maternal and Newborn Health. We constructed multilevel logistic regression models with random effects for facilities and countries to estimate the risk factors for SGA infants using country-specific birthweight reference standards in preterm and term delivery, and SGA's association with adverse perinatal outcomes. We compared the risks and adverse perinatal outcomes with appropriate for gestational age (AGA infants categorized by preterm and term delivery.A total of 295,829 singleton infants delivered were analysed. The overall prevalence of SGA was highest in Cambodia (18.8%, Nepal (17.9%, the Occupied Palestinian Territory (16.1%, and Japan (16.0%, while the lowest was observed in Afghanistan (4.8%, Uganda (6.6% and Thailand (9.7%. The risk of preterm SGA infants was significantly higher among nulliparous mothers and mothers with chronic hypertension and preeclampsia/eclampsia (aOR: 2.89; 95% CI: 2.55-3.28 compared with AGA infants. Higher risks of term SGA were observed among sociodemographic factors and women with preeclampsia/eclampsia, anaemia and other medical conditions. Multiparity (> = 3 (AOR: 0.88; 95% CI: 0.83-0.92 was a protective factor for term SGA. The risk of perinatal mortality was significantly higher in preterm SGA deliveries in low to high HDI countries.Preterm SGA is associated with medical conditions related to preeclampsia, but not with sociodemographic status. Term SGA is associated with sociodemographic status and various medical conditions.

  6. [Obesity and the prognosis of heart failure: the obesity paradox, myth or reality?].

    Science.gov (United States)

    Bounhoure, Jean-Paul; Galinier, Michel; Roncalli, Jerôme; Massabuau, Pierre

    2014-01-01

    Obesity has now reached epidemic proportions worldwide. Obesity is associated with numerous comorbidities, including hypertension, lipid disorders and type II diabetes, and is also a major cause of cardiovascular disease, coronary disease, heart failure, atrial fibrillation, and sudden death. Obesity is the main cause of heart failure in respectively 11% and 14% of cases in men and women. The Framingham study showed that, after correction for other risk factors, each point increase in the body mass index raises the risk of heart failure by 5% in men and 7% in women. Obesity increases the heart workload, causes left ventricular hypertrophy, and impairs both diastolic and systolic function. The most common form of heart failure is diastolic dysfunction, and heart failure in obese individuals is associated with preserved systolic function. Despite these comorbidities and the severity of heart failure, numerous studies have revealed an "obesity paradox" in which overweight and obese individuals with heart failure appear to have a better prognosis than non overweight subjects. This review summarizes the adverse cardiac effects of this nutritional disease, the results of some studies supporting the obesity paradox, the better survival rate of obese patients with heart failure. Potential explanations for these surprising data include the possibility that a number of obese patients may simply not have heart failure, as well as methodological bias, and protective effects of adipose tissue. Further studies of large populations are needed to determine how obesity may improve the prognosis of heart failure.

  7. Adverse reactions to cosmetics

    Directory of Open Access Journals (Sweden)

    Dogra A

    2003-03-01

    Full Text Available Adverse reaction to cosmetics constitute a small but significant number of cases of contact dermatitis with varied appearances. These can present as contact allergic dermatitis, photodermatitis, contact irritant dermatitis, contact urticaria, hypopigmentation, hyperpigmentotion or depigmentation, hair and nail breakage. Fifty patients were included for the study to assess the role of commonly used cosmetics in causing adverse reactions. It was found that hair dyes, lipsticks and surprisingly shaving creams caused more reaction as compared to other cosmetics. Overall incidence of contact allergic dermatitis seen was 3.3% with patients own cosmetics. Patch testing was also done with the basic ingredients and showed positive results in few cases where casual link could be established. It is recommended that labeling of the cosmetics should be done to help the dermatologists and the patients to identify the causative allergen in cosmetic preparation.

  8. Analysis of Prognosis and Influencing Factors of 60 Patients with Idiopathic Inflammatory Myopathies%60例炎症性肌病患者的预后及影响因素的分析

    Institute of Scientific and Technical Information of China (English)

    李悦; 陈博; 林婧; 罗璇; 桂梦翠; 卜碧涛

    2012-01-01

    目的:总结特发性炎症性肌病(IIM)的临床特征并分析影响IIM预后的因素.方法:分析60例IIM患者的临床资料,对临床症状、肌酶水平、生活质量等进行跟踪随访.结果:60例患者男女性别比约为1∶2;100%表现出不同程度的四肢无力,38.3%(23/60)存在吞咽困难等球麻痹症状,31.7%(19/60)出现胸闷;随访期内临床缓解率为68.0%,缓解后复发率18.0%,死亡率为10.0%;多元Logistic回归分析显示,胸闷(OR=13.20)、吞咽困难(OR=3.36)、四肢肌力(OR=2.12~3.78)、ADL评分高(OR值=1.06)是IIM预后不良的危险因素.结论:随访期间,IIM患者在临床症状及血清学指标上逐步好转;心脏疾病、肺部疾病、肿瘤等合并症发生率相对较高;伴随胸闷、吞咽困难、起病症状较重的患者预后不良.%Objective: To assess the long-time outcomes of idiopathic inflammatory myopa-thies patients and to evaluate the prognostic factors. Methods: The clinical data of 60 patients with idiopathic inflammatory myopathies were documented and followed up. Results: In this study, 39 patients were female and 21 were male. The patients showed the symptoms of muscle weakness (60/60), dysphagia (23/60), and chest tightness (19/60). The clinic improvement rate was 68% , the relapse rate was 18% , and mortality rate wasl0%. The Logistic regression a-nalysis showed that chest tightness (OR =13. 20), dysphagia (OR value=3. 36), limb muscle strength (OR=2. 12~3. 78) , and the ADL score (OR value = l. 06) were significantly related to prognosis. Conclusion: The majority of patients undergo good prognosis. Complications occur most commonly in patients with cancer, heart disease or lung disease. More attention should be paid to acute onset of severe symptoms, the complications such as chest tightness and dysphagia, which are associated with poor outcomes.

  9. Treatment of LipoprostaglandinE1 and Multiple Factors of Prognosis on Sudden Hearing Loss%凯时治疗突聋的预后多因素分析

    Institute of Scientific and Technical Information of China (English)

    黄孟捷; 张林

    2015-01-01

    Objective To investigate prognostic factors and review therapeutic ef ect of lipoprostaglandinE1,on sudden sensorineural hearing loss. Methods One hundred and fourteen patients have pure tone test before and after the therapy, the standard treatment is:intravenous injection kaishi 2ml per day、dexamethasone 1.5mg ,Tanakan 40mg three times a day and Mecobalamin Tablets 0.5mg three times a day oral y for seven days. Results Initial visit after onset of the hearing loss、tinnitus,age,the severity of hearing loss are the prognostic factors. The overal recovery of lipoprostaglandinE1 is 60.5%. Conclusion Initial visit after onset of the hearing loss and tinnitus are in positive cor elation, while age and the severity of hearing loss are in negative correlation. Hearing loss of 40dB HL or less has a bet er prognosis.%目的探讨突发性耳聋(以下称突聋)预后相关因素对患者听力恢复的影响及回顾凯时(前列腺素E1)治疗突聋的疗效。方法对114例突聋患者治疗前后进行纯音听力测试,治疗药物标准为:静脉推注凯时2ml,1次/d,口服醋酸地塞米松1.5mg,3次/d,达纳康(银杏叶片)40mg,3次/d,怡神保(甲钴胺片):0.5mg,3次/d,共7d;分析年龄、性别、听力损失程度、就诊时间、伴随症状对预后的影响及治疗的总有效率和平均听阈改善情况。结果就诊时间、耳鸣、年龄、听力损失程度是突聋预后的相关因素,凯时治疗突聋的总有效率60.5豫。结论就诊时间和耳鸣与突聋预后呈正相关,年龄和听力损失程度与突聋预后呈负相关,平均听力损失≤40dB HL者,预后更好。

  10. 老年上消化道出血患者近期预后多因素分析%Risk factors for short-term prognosis in elderly patients with upper gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    陈宁

    2008-01-01

    Eighty-five elderly patients treated for the upper gastrointestinal bleeding(UGB)in our hospital between January 2000 and December 2002 were divided into death or survival group.Their clinical characteristics,risk factors,treatment and complications were retrospectively analyzed.Eighteen patients died of UGB within 30 days.Univariate analysis indicated that documented diabetes,cardiovascular disease,cerebrovascular disease,gastric ulcer,hemoglobin,arrhythmia,stomach cancer,multiple organ dysfunction syndrome(MODS),and shock were significantly associated with inhospital mortality within 30 days(P<0.05 or P<0.01).Stomach cancer,MODS,and shock entered into the Logistic regression model.These findings demonstrate that stomach cancer,MODS,and shock might be independent risk factors for short-term prognosis in elderly UGB patients.%将2000年1月至2007年12月期间收住我院≥60岁的上消化道出血患者85例分为病死组(18例,出血30 d内死亡)与存活组(67例),对比分析患者的病史、临床表现、并发症等特点,探讨近期死亡的影响因素.结果 显示病死组心脑血管病、糖尿病、胃溃疡、血红蛋白、心律失常、胃癌、多器官功能障碍综合征(MODS)、休克者比例较多(P<0.05或P<0.01),最终进入logistic回归模型的因素有胃癌、MODS、休克.提示胃癌、MODS、休克并存是≥60岁老年上消化道出血患者近期预后的独立危险因素.

  11. Fructose Containing Sugars at Normal Levels of Consumption Do Not Effect Adversely Components of the Metabolic Syndrome and Risk Factors for Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Theodore J. Angelopoulos

    2016-03-01

    Full Text Available The objective of the current study was to explore our hypothesis that average consumption of fructose and fructose containing sugars would not increase risk factors for cardiovascular disease (CVD and the metabolic syndrome (MetS. A randomized, double blind, parallel group study was conducted where 267 individuals with BMI between 23 and 35 kg/m2 consumed low fat sugar sweetened milk, daily for ten weeks as part of usual weight-maintenance diet. One group consumed 18% of calories from high fructose corn syrup (HFCS, another group consumed 18% of calories from sucrose, a third group consumed 9% of calories from fructose, and the fourth group consumed 9% of calories from glucose. There was a small change in waist circumference (80.9 ± 9.5 vs. 81.5 ± 9.5 cm in the entire cohort, as well as in total cholesterol (4.6 ± 1.0 vs. 4.7 ± 1.0 mmol/L, p < 0.01, triglycerides (TGs (11.5 ± 6.4 vs. 12.6 ± 8.9 mmol/L, p < 0.01, and systolic (109.2 ± 10.2 vs. 106.1 ± 10.4 mmHg, p < 0.01 and diastolic blood pressure (69.8 ± 8.7 vs. 68.1 ± 9.7 mmHg, p < 0.01. The effects of commonly consumed sugars on components of the MetS and CVD risk factors are minimal, mixed and not clinically significant.

  12. Fructose Containing Sugars at Normal Levels of Consumption Do Not Effect Adversely Components of the Metabolic Syndrome and Risk Factors for Cardiovascular Disease

    Science.gov (United States)

    Angelopoulos, Theodore J.; Lowndes, Joshua; Sinnett, Stephanie; Rippe, James M.

    2016-01-01

    The objective of the current study was to explore our hypothesis that average consumption of fructose and fructose containing sugars would not increase risk factors for cardiovascular disease (CVD) and the metabolic syndrome (MetS). A randomized, double blind, parallel group study was conducted where 267 individuals with BMI between 23 and 35 kg/m2 consumed low fat sugar sweetened milk, daily for ten weeks as part of usual weight-maintenance diet. One group consumed 18% of calories from high fructose corn syrup (HFCS), another group consumed 18% of calories from sucrose, a third group consumed 9% of calories from fructose, and the fourth group consumed 9% of calories from glucose. There was a small change in waist circumference (80.9 ± 9.5 vs. 81.5 ± 9.5 cm) in the entire cohort, as well as in total cholesterol (4.6 ± 1.0 vs. 4.7 ± 1.0 mmol/L, p < 0.01), triglycerides (TGs) (11.5 ± 6.4 vs. 12.6 ± 8.9 mmol/L, p < 0.01), and systolic (109.2 ± 10.2 vs. 106.1 ± 10.4 mmHg, p < 0.01) and diastolic blood pressure (69.8 ± 8.7 vs. 68.1 ± 9.7 mmHg, p < 0.01). The effects of commonly consumed sugars on components of the MetS and CVD risk factors are minimal, mixed and not clinically significant. PMID:27023594

  13. An update on predictive biomarkers for major adverse cardiovascular events in patients undergoing vascular surgery.

    Science.gov (United States)

    Patelis, Nikolaos; Kouvelos, George N; Koutsoumpelis, Andreas; Moris, Demetrios; Matsagkas, Miltiadis I; Arnaoutoglou, Eleni

    2016-09-01

    Cardiovascular complications signify a major cause of morbidity and mortality in patients undergoing vascular surgery adversely affecting both short- and long-term prognosis. During the last decade, unmet needs for a distinct cardiovascular risk assessment have led to an intensive research for establishment of biomarkers with sufficient predictive value. This literature review aims in examining the value of several biomarkers in predicting the incidence of major adverse cardiac events in vascular surgery patients. We reviewed the English language literature and analyzed the biomarkers as independent predictors or in correlation with other factors. We found several biomarkers showing a significant predictive value for a major adverse cardiovascular event in patients undergoing vascular surgery. These biomarkers can be used in clinical practice as outcome predictors, although sensitivity and specificity varies. Detection of subclinical cardiovascular damage may improve total risk estimation and facilitate clinical assessment of patients at risk for future cardiovascular events. The wide variety of sensitivity and specificity in predicting a MACE of these biomarkers exert the need for future trials in which these markers will be tested as adjunctive tools of cardiovascular risk estimation scoring systems.

  14. Prognosis Relevance of Serum Cytokines in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Carolina Torres

    2015-01-01

    Full Text Available The overall survival of patients with pancreatic ductal adenocarcinoma is extremely low. Although gemcitabine is the standard used chemotherapy for this disease, clinical outcomes do not reflect significant improvements, not even when combined with adjuvant treatments. There is an urgent need for prognosis markers to be found. The aim of this study was to analyze the potential value of serum cytokines to find a profile that can predict the clinical outcome in patients with pancreatic cancer and to establish a practical prognosis index that significantly predicts patients’ outcomes. We have conducted an extensive analysis of serum prognosis biomarkers using an antibody array comprising 507 human cytokines. Overall survival was estimated using the Kaplan-Meier method. Univariate and multivariate Cox’s proportional hazard models were used to analyze prognosis factors. To determine the extent that survival could be predicted based on this index, we used the leave-one-out cross-validation model. The multivariate model showed a better performance and it could represent a novel panel of serum cytokines that correlates to poor prognosis in pancreatic cancer. B7-1/CD80, EG-VEGF/PK1, IL-29, NRG1-beta1/HRG1-beta1, and PD-ECGF expressions portend a poor prognosis for patients with pancreatic cancer and these cytokines could represent novel therapeutic targets for this disease.

  15. Risk factors and prognosis of delirium in patients with mechanical ventilation%机械通气患者谵妄高危因素及预后分析

    Institute of Scientific and Technical Information of China (English)

    陈鹏; 吴慧娟; 余慧; 徐颖鹤; 张胜; 章华萍; 陈文泽; 郑贞苍; 张超; 王锦栋

    2014-01-01

    Objective To investigate the risk factors and prognosis of delirium in patients with mechanical ventilation. Methods Consecutive patients with mechanical ventilation were divided into the delirium group and the non-delirium group. Multivariate logistic regression analysis was used to analyze risk factors of delirium. 90-day survival rate between the two groups was compared by Log-rank test. Results Total 306 cases in 472 cases suffered from delirium, the incidence of delirium was 64.83%. Higher APACHE II score, prolonged mechanical ventilation, older age and midazolam sedation were independent high risk factors of delirium while programmed sedation was the protective factor. 90-day survival rate were 62.75%in the delirium group and 86.75%in the non-delirium group, the difference was statistically significant(χ2=15.27, P<0.05). 90-day survival rate were 77.50% in hyperergy delirium group and 57.52% in hypoergia and hybrid delirium groups, the difference was statistically significant (χ2=8.70,P<0.05). Conclusion The incidence rate of delirium is rela-tively higher in patients with mechanical ventilation. Higher APACHE Ⅱ score, prolonged mechanical ventilation, older age and midazolam sedation were independent high risk factors of delirium. 90-day survival rate would be decreased by delirium.%目的:分析机械通气患者谵妄的发生率、高危因素及预后情况。方法472例机械通气患者根据是否谵妄分为谵妄组和非谵妄组,采用多因素回归分析谵妄发生的高危因素,采用log-rank检验比较两组患者90 d生存率。结果472例入选患者中有306例发生谵妄,谵妄发生率为64.83%。高APACHEⅡ评分、机械通气时间延长、高龄及咪达唑仑针镇静是谵妄的危险因素,程序性镇静是谵妄的保护因素。谵妄组90 d生存率为62.75%,非谵妄组为86.75%,两组比较差异具有统计学差异(χ2=15.27,P<0.05)。高反应性谵妄组90 d生存率为77.50%,低反应

  16. Risk factors affecting the prognosis of adult cardiogenic shock patients treated with extracnrporeal membrane oxygenation%影响体外膜肺氧合救治成人心源性休克预后的因素分析

    Institute of Scientific and Technical Information of China (English)

    侯六生; 谢钢; 蒋崇慧; 袁勇; 李斌飞; 郑伟华; 宁晔; 赵双彪

    2012-01-01

    Objective To find out risk factors affecting the prognosis of adult cardiogenic shock patients treated with extracorporeal membrane oxygenation.Methods From January 2003 to December 2010,patients with cardiogenic shock required veno-arterial ECMO after failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury,advanced malignancies and multiple organ failure were excluded.All patients were divided into survival group and death group.The risk factors were found out using one-way ANOVA and a multivariate logistic regression analysis was used to determine independent factors associated with survival.Results Thirty-one patients successfully weaned from ECMO. Twenty-two patients were successfully discharged.The average duration of ECMO was 41.56 ± 43.07 hours.Factors associated with failure of hospital discharge were age,pre-ECMO levels of ejection fraction,pre-ECMO levels of lactate,disseminated intravascular coagulation,renal failure and multiorgan failure (P < 0.05). Conclusions Irreversible heart failure and the complications are significantly correlated with survival,and the early use of ECMO for cardiogenic shock and recognize the factors are key to the success of ECMO treatment.%目的 总结中山大学附属中山医院体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)在成人心源性休克(cardiogenic shock,CS)中的临床救治经验,分析影响患者预后的危险因素.方法 回顾性分析中山大学附属中山医院2003年1月至2010年12月因药物和(或)主动脉内球囊反搏无效而行ECMO辅助的CS患者的临床资料,将合并严重颅脑损伤、晚期恶性肿瘤及多脏器功能衰竭的患者排除在外,据出院时的预后将其分为康复出院组与院内死亡组,先通过组间单因素分析筛选出影响预后的可能危险因素,再通过多因素Logistic回归分析确定影响预

  17. 感染性心内膜炎患者临床特征与预后影响因素分析%Clinical characteristics and influencing factors of prognosis of infective endocarditis

    Institute of Scientific and Technical Information of China (English)

    张苑; 任鹏涛; 杨婧; 刘婷婷; 闫庆辉; 张国建

    2016-01-01

    OBJECTIVE To investigate the clinical characteristics and prognostic factors of infective endocarditis ,so as to provide basis for improving the prognosis of patients with endocarditis .METHODS A total of 900 patients with infective endocarditis in the hospital from Jan .2010 to Dec .2014 were selected ,and their clinical data were retrospectively analyzed .Clinical characteristics of the patients and their performance were analyzed .The prognos‐tic factors were analyzed by univariate and multivariate logistic regression analyses ,the results were statistically analyzed by using SPSS 20 .0 software .RESULTS Totally 869 patients had underlying heart diseases among the 900 patients with infective endocarditis ,accounting for 96 .56% .The univariate analysis showed artificial valve , fever ≥39 ℃ ,hypersensitive C‐reactive protein ≥60 mg/L ,hemoglobin <90 g/L ,serum albumin <30 g/L and surgical treatment were the related prognostic factors (P< 0 .05) .The multivariate logistic regression analysis showed that hemoglobin <90 g/L ,serum albumin <30g/L and surgical treatment were the independent prognos‐tic factors (P<0 .05) .CONCLUSION The results show that most patients with infective endocarditis have under‐lying heart diseases ,the majority of patients have normal ECG .Levels of hemoglobin and serum albumin as well as surgical treatment are prognostic risk factors in infective endocarditis .%目的:探讨感染性心内膜炎患者的临床特征及预后影响因素,为提高心内膜炎患者预后提供参考依据。方法回顾性分析2010年1月-2014年12月医院收治的900例感染性心内膜炎患者临床资料,分析患者的临床特征及表现,预后影响因素进行单因素及多因素logistic回归分析,结果采用SPSS 20.0软件进行统计分析。结果900例感染性心内膜炎患者中有基础心脏疾病患者869例占96.56%;单因素分析显示,人工瓣膜、发热≥39

  18. 父源因素对胎儿生长发育的不良影响研究进展%Advances of the Adverse Effects of Paternal Factors on Fetal Development

    Institute of Scientific and Technical Information of China (English)

    周梦林; 应俊; 陈丹青

    2015-01-01

    The fetal development is closely related with the adverse pregnancy outcomes such as miscarriage, dystocia, congenital malformation, premature baby, low weight baby and so on. It is also a potential predictor of the fetal origin of some adult diseases. Most of the researches on the risk factors affecting fetal development were focused on the mother origin in recent years. The risk factors of father origin can be classified into two groups: the heredity-related factors such as age, diseases, somatotype, lifestyle and environmental exposure which could disturb the integrity of genomics of father origin or the genomic expression; the social and environmental factors such as psychological state, occupation and income which could mainly affect maternal pregnancy environment and life quality. Two kinds of factors can result in abnormal fetal development in uterus, which is related to adverse outcomes of pregnancy. It is benefit for the fetal development and the infant and adult health to offer genetic counseling to those couples with high-risk factors.%胎儿在宫内的生长发育不仅与流产、难产、畸形、早产、低体质量儿等不良妊娠结局密切相关,而且能用于评估成年期罹患某些疾病的风险。近年国内外关于胎儿生长发育的研究大多关注的是母源因素,对父源因素的研究相对较少。父亲影响胎儿发育的主要因素可以分为两类,即包括年龄、疾病、体型、生活方式、暴露环境在内的遗传因素和以心理状态、职业、经济收入为代表的社会环境因素,前者直接影响父源基因的完整性和表达情况,而后者主要影响母体的生活环境和生活质量,这两类因素的不良发展均可能导致胎儿在宫内的生长发育发生异常,从而出现各种不良妊娠结局。

  19. Adverse event and related factors analysis of modiifed electro-convulsive therapy in the treatment of mental disorder%MECT治疗精神障碍的不良反应及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    陈翔春; 王雅萍; 江文庆; 吴彦

    2016-01-01

    目的:探讨无抽搐电休克治疗(modiifed electroconvulsive therapy,MECT)术后不良反应及其相关因素。方法:对2014年到2015年期间,在上海市嘉定区精神卫生中心住院期间接受MECT治疗的964例精神障碍患者进行MECT术后不良事件的记录和比较。结果:共报告不良事件119例(12.34%);女性报告不良事件的发生率显著高于男性(χ2=13.964,P=0.000)。不同精神疾病的不良事件报告率存在显著差异(χ2=9.736,P=0.004),其中情感性障碍的不良事件报告率最高。丙泊酚麻醉后导致近记忆减退的发生率显著高于依托咪酯(χ2=8.111,P=0.005);而依托咪酯麻醉后导致急性谵妄的发生率显著高于丙泊酚(χ2=9.201,P=0.003)。结论:MECT在治疗上总体安全,但也应注意其不良反应并及时处理,特别是发生意识不清(急性谵妄)时,应密切观察。%Objective:To explore the adverse event and related factors of modiifed electroconvulsive therapy (MECT) on patients with mental disorder.Methods:The data of post-operative adverse events in the patients who received MECT during hospitalization from 2014 to 2015 in Jiading Mental Health Center, Shanghai were retrospectively analyzed.Results:The adverse events were seen in 119 cases of patients(12.34%) and the incidence of adverse events was signiifcant higher in female than male (χ2=13.964,P=0.000). There existed some obvious differences in the reported incidence of adverse events in different kinds of mental disorders (χ2=9.736,P=0.004), in which the highest occurred in the patients with affective disorder. The incidence of recency memory decline caused by propofol anesthesia was obviously higher than that by etomidate(χ2=8.111,P=0.005)while the incidence of acute delirium caused by etomidate was higher than that by propofol(χ2=9.201,P=0.003).Conclusion: MECT is a safe and effective treatment method in clinic, but the adverse

  20. Prognosis analysis and risk factors related to persistent unconscious patients after severe traumatic brain injury%重型颅脑损伤患者持续意识障碍的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    傅圆伟; 杨晓明; 冯杰; 秦兴国

    2015-01-01

    目的 分析影响重型颅脑损伤患者持续意识障碍的危险因素,建立风险预测模型,并评价其预测能力.方法 回顾性研究山西医科大学第一附属医院急诊科2011年7月至2013年11月收治的重型颅脑损伤患者,符合纳入/排除标准165例.按照收治顺序分组,推导组(115例),验证组(50例).纳入标准:(1)年龄>15岁;(2)有明确颅脑外伤史;(3)行头颅CT或MRI检查确诊颅脑损伤;(4)格拉斯哥评分(glasgow coma scale,GCS)≤8分;(5)入院当日呈昏迷或意识障碍逐渐加重至昏迷状态.排除标准:(1)外伤后仅有短暂意识丧失或昏迷的患者(昏迷时间<6h);(2)外伤后癔病或精神抑郁状态致昏迷样表现;(3)外伤后情绪诱发癫痫持续状态而呈意识障碍.对28个可能影响因素进行单因素筛选及logistic多重回归分析并建立风险模型.运用Hosmer-Lemeshow检验和受试者工作特征曲线(receiver operating characteristic,ROC)对模型进行拟合优度检验及判别.结果 入院时GCS、神经系统并发症、弥漫性轴索损伤(diffuse axonal injury,DAI)、电解质紊乱是影响颅脑损伤患者持续昏迷的独立风险因素.推导组Hosmer-Lemeshow检验显示x2 =4.380,P=0.496,预测昏迷率与实际昏迷率差异无统计学意义,风险模型的辨识度在推导组(AUC=0.87; 95%CI:0.798~0.942)及验证组(AUC=0.90;95% CI:0.803 ~0.997)中均较好.结论 预测模型虽有一定局限性,但仍能对颅脑损伤患者持续意识障碍进行较准确的估计.%Objective To investigate the risk factors related to persistent unconsciousness in patients with severe traumatic brain injury (sTBI) by way of building a prognosis model.Methods The clinical data of 165 sTBI patients admitted from July 2011 to November 2013 were retrospectively analyzed.The eligible patients were randomly assigned to derivation cohort (n =115) and verification cohort (n =50) by treatment order.Inclusion criteria:(1) age > 15 years; (2

  1. Severe preeclampsia women a risk factor for adverse pregnancy outcomes%重度子痫前期孕妇不良妊娠结局的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李元成; 沈伶; 黄菊

    2014-01-01

    目的:探讨重度子痫前期孕妇发生不良妊娠结局的相关危险因素。方法回顾性分析2012年6月至2013年6月在汕头大学医学院第一附属医院住院分娩的重度子痫前期孕妇122例临床资料,按妊娠结局分为不良妊娠结局组27例和良好妊娠结局95例。结果①一般资料:两组孕妇妊娠终止孕周及入院时舒张压比较,差异有统计学意义(P<0.05)。②相关实验室检查结果比较:不良妊娠结局组尿蛋白定量明显高于良好妊娠结局组,差异有统计学意义(P<0.05)。不良妊娠结局组的血小板计数明显低于良好妊娠结局组,而红细胞压积却明显低于良好妊娠结局组,差异均有统计学意义(P<0.05)。不良妊娠结局组的丙氨酸氨基转移酶(ALT),血尿素氮(BUN)的水平均明显高于良好妊娠结局组,差异有统计学意义(P<0.05)。③出现不良妊娠结局的危险因素分析:孕妇入院时舒张压越高(OR值2.13),终止妊娠时孕周越早(OR值0.42),血小板计数越低(OR值0.78),与不良妊娠结局的相关。结论重度子痫前期孕妇入院时舒张压,终止妊娠时孕周,血小板计数是判定出现不良妊娠结局的高危因素,可以指导临床医生适时终止妊娠。%Objective To study the severe preeclampsia women the related risk factors for adverse pregnancy out-comes.Methods A retrospective analysis in June 2012 to June 2013 in the first affiliated hospital of shantou university medical college hospital childbirth of severe preeclampsia in pregnant women,122 cases of clinical data,according to the pregnancy outcome in adverse pregnancy outcome groups 27 cases and 95 cases of good pregnancy outcome.Results ①General information:two groups of pregnant women to terminate pregnancy gestational age and diastolic blood pressure on admission to compare,the difference was significant (P<0.05).

  2. [Cardiovascular pharmacotherapy. Risks and adverse effects].

    Science.gov (United States)

    Voigt, N; Heijman, J; Dobrev, D

    2014-03-01

    Adverse side effects of drugs are a significantly underestimated problem in modern medicine. In this review article, we summarize common adverse side effects of cardiovascular drugs. In particular, we highlight the factors promoting these adverse side effects in patients, including reduced hepatic or renal clearance in elderly patients that often requires dosage adjustment. Pharmacodynamic and pharmacokinetic interactions between drugs (e.g. through the cytochrome P450 system or P-glycoproteins) can modify the plasma concentration of many compounds, thereby also increasing the likelihood of unwanted side effects. The most prominent cardiac side effects include arrhythmias, e.g. atrioventricular (AV) block, drug-induced long-QT syndrome and torsade de pointes and altered inotropy. Non-cardiac side effects are subsequently discussed grouped by drug class. A better understanding of the risks and side effects of cardiovascular drugs is expected to reduce the mortality and morbidity associated with adverse side effects.

  3. Cardiac adverse effects of naloxone-precipitated morphine withdrawal on right ventricle: Role of corticotropin-releasing factor (CRF) 1 receptor

    Energy Technology Data Exchange (ETDEWEB)

    Navarro-Zaragoza, J.; Martínez-Laorden, E.; Mora, L.; Hidalgo, J.; Milanés, M.V.; Laorden, M.L., E-mail: laorden@um.es

    2014-02-15

    Opioid addiction is associated with cardiovascular disease. However, mechanisms linking opioid addiction and cardiovascular disease remain unclear. This study investigated the role of corticotropin-releasing factor (CRF) 1 receptor in mediating somatic signs and the behavioural states produced during withdrawal from morphine dependence. Furthermore, it studied the efficacy of CRF1 receptor antagonist, CP-154,526 to prevent the cardiac sympathetic activity induced by morphine withdrawal. In addition, tyrosine hydroxylase (TH) phosphorylation pathways were evaluated. Like stress, morphine withdrawal induced an increase in the hypothalamic–pituitary–adrenal (HPA) axis activity and an enhancement of noradrenaline (NA) turnover. Pre-treatment with CRF1 receptor antagonist significantly reduced morphine withdrawal-induced increases in plasma adrenocorticotropic hormone (ACTH) levels, NA turnover and TH phosphorylation at Ser31 in the right ventricle. In addition, CP-154,526 reduced the phosphorylation of extracellular signal-regulated kinase (ERK) after naloxone-precipitated morphine withdrawal. In addition, CP-154,526 attenuated the increases in body weight loss during morphine treatment and suppressed some of morphine withdrawal signs. Altogether, these results support the idea that cardiac sympathetic pathways are activated in response to naloxone-precipitated morphine withdrawal suggesting that treatment with a CRF1 receptor antagonist before morphine withdrawal would prevent the development of stress-induced behavioural and autonomic dysfunction in opioid addicts. - Highlights: • Morphine withdrawal caused an increase in myocardial sympathetic activity. • ERK regulates TH phosphorylation after naloxone-induced morphine withdrawal. • CRF1R is involved in cardiac adaptive changes during morphine dependence.

  4. 非ST段抬高心肌梗死预后的影响因素分析%Investigation of factors influencing prognosis of patients with non-ST-segment elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    刘广彬; 彭永平; 江时森

    2011-01-01

    important baseline determinants of short-term outcome were age,heart failure,renal insufficiency and aspirin;the most important baseline determinants of long-term outcomes were age,heart failure,renal insufficiency,aspirin and early PCI. Determinants of mortality were also predictors of death or myocardial infarction. Conclusion Patients with NSTEMI have poor outcomes. Age,heart failure and renal insufficiency are most important risk factors;while aspirin is an important protective factor,early PCI can significantly improve long-term prognosis of patients.

  5. 脑外伤合并颅内感染预后不良相关因素分析%Risk factors of prognosis in patients with intracranial infection secondary to brain injury

    Institute of Scientific and Technical Information of China (English)

    曾上飞; 娄晓辉; 杨晓清; 陈宁

    2015-01-01

    Objective To analyze the risk factors for short- term prognosis in brain injury patients complicated by in-tracranial infection. Methods The clinical data of 82 brain injury patients with intracranial infection confirmed by cerebrospinal fluid (CSF) culture in Huashan Hospital Trauma Center during January 2008 and December 2012 were retrospectively reviewed. Influencing factors related to Glasgow Coma Scale (GCS) at discharge, multiple microbial infection and G-/+infection were ana-lyzed. Results Total 97 bacterial strains from 82 patients were identified by CSF culture, and A. baumanni was the most com-mon pathogenic bacteria (28.9%). GCS at admission (OR=7.44, 95%CI 2.80~19.76, P<0.001), extra- ventricular drainage (EVD) (OR=9.594, 95%CI 3.338~12.575, P=0.001), G- infection (OR=3.745, 95%CI 1.008~12.560, P=0.034) and pneumonia (OR=3.225, 95%CI 1.128~9.219, P=0.029) were the main risk factors for poor GCS at discharge. There was significant difference in hospital fatality(OR=10.95, 95%CI 0.6234~192.2, P=0.0327) between patients with G- and G+bacterial infection. Conclusion GCS at ad-mission, EVD, G- infection and pneumonia are risk factors associated with the poor GCS at discharge and G- bacterial infection is related to higher in- hospital mortality.%目的研究、分析脑外伤伴发颅内感染预后不良的相关因素。方法选择2008年1月至2012年12月经脑脊液培养证实颅内感染的脑外伤患者82例,分析与出院时格拉斯哥昏迷评分(glasgow coma scale,GCS评分)高低、单/多菌种感染以及G-/+菌感染的相关因素。结果检出细菌97株,最主要的致病菌是鲍曼不动杆菌,占所有病原菌的28.9%。入院时GCS评分(OR=7.44,95%CI 2.80~19.76,P<0.01)、脑室外引流术(OR=9.594,95%CI 3.338~12.575,P<0.01)、G-菌感染(OR=3.745,95%CI 1.008~12.560,P<0.05)以及肺炎(OR=3.225,95%CI 1.128~9.219,P<0.05)与出院时GCS评分高低相关;院内病死率在G-菌和G

  6. Vaccine adverse events.

    Science.gov (United States)

    Follows, Jill

    2012-01-01

    Millions of adults are vaccinated annually against the seasonal influenza virus. An undetermined number of individuals will develop adverse events to the influenza vaccination. Those who suffer substantiated vaccine injuries, disabilities, and aggravated conditions may file a timely, no-fault and no-cost petition for financial compensation under the National Vaccine Act in the Vaccine Court. The elements of a successful vaccine injury claim are described in the context of a claim showing the seasonal influenza vaccination was the cause of Guillain-Barré syndrome.

  7. Correlation between related factors and prognosis of the hypertensive cerebral hemorrhagepatients with cerebro-car-diac syndrome%高血压性脑出血并发脑-心综合征与预后的关系

    Institute of Scientific and Technical Information of China (English)

    唐兵; 邓发斌; 陈淳; 周宇; 郭川; 史阳; 孙杰; 张晓东

    2012-01-01

    目的 探讨高血压性脑出血并发脑-心综合征影响因素及与预后的关系.方法 纳入2007年6月~2011年6月来我院就诊的脑出血并发脑-心综合征患者,共纳入脑出血并发脑.心综合征患者87例,以同期就诊的脑出血未并发脑-心综合征患者为对照,对照组141例.比较两组患者之间临床指标的差异;并分析脑出血并发脑-心综合征患者的预后相关因素.结果 与脑出血未并发脑-心综合征患者相比,脑出血并发脑-心综合征病患者年龄较大(P<0.05).GCS评分较低(Pprognosis of the hypertensive cerebral hemorrhage patients with ce re bro-cardiac syndrome. Methods Clinical data of 228 hypertensive cerebral hemorrhage patients were divided into 2 groups; hypertensive cerebral hemorrhage group and hypertensive cerebral hemorrhage with cere bro-cardiac syndrome group. Results In cerebro-cardiac syndrome group, patients were higher complication and higher death rates. Conclusion Cerebro-cardiac syndrome is the risk factors of hypertension cerebral hemorrhage patients progonsis

  8. Combined and individual tumor-specific expression of insulin-like growth factor-I receptor, insulin receptor and phospho-insulin-like growth factor-I receptor/insulin receptor in primary breast cancer: Implications for prognosis in different treatment groups.

    Science.gov (United States)

    Björner, Sofie; Rosendahl, Ann H; Simonsson, Maria; Markkula, Andrea; Jirström, Karin; Borgquist, Signe; Rose, Carsten; Ingvar, Christian; Jernström, Helena

    2017-02-07

    Clinical trials examining insulin-like growth factor-I receptor (IGF1R)-targeting strategies have emphasized that better predictive biomarkers are required to improve patient selection.Immunohistochemical tumor-specific protein expression of IGF1R, insulin receptor (InsR), and phosphorylated IGF1R/InsR (pIGF1R/InsR) individually and combined in relation to breast cancer prognosis was evaluated in a population-based cohort of 1,026 primary invasive breast cancer patients without preoperative treatment diagnosed in Sweden. IGF1R (n = 923), InsR (n = 900), and pIGF1R/InsR (n = 904) combined cytoplasmic and membrane staining was dichotomized. IGF1Rstrong/InsRmod/strong/pIGF1R/InsRpos tumors were borderline associated with 2-fold risk for events, HRadj (2.00; 95%CI 0.96-4.18). Combined IGF1R and pIGF1R/InsR status only impacted prognosis in patients with InsRmod/strong expressing tumors (Pinteraction = 0.041). IGF1Rstrong expression impacted endocrine treatment response differently depending on patients' age and type of endocrine therapy. Phospho-IGF1R/InsRpos was associated with lower risk for events among non-endocrine-treated patients irrespective of ER status, HRadj (0.32; 95%CI 0.16-0.63), but not among endocrine-treated patients (Pinteraction = 0.024). In non-endocrine-treated patients, pIGF1R/InsRpos was associated with lower risk for events after radiotherapy, HRadj (0.31; 95%CI 0.12-0.80), and chemotherapy, HRadj (0.29; 95%CI 0.09-0.99). This study highlights the complexity of IGF hetero-and homodimer signaling network and its interplay with endocrine treatment, suggesting that combinations of involved factors may improve patient selection for IGF1R-targeted therapy.

  9. 肝硬化并上消化道出血患者预后的影响因素%Influencing Factors of Prognosis on Patients with Upper Gastrointestinal Hemorrhage Induced by Cirrhosis

    Institute of Scientific and Technical Information of China (English)

    占国清; 郑三菊; 李儒贵; 张薇薇; 谭华炳

    2011-01-01

    目的 探讨肝硬化并上消化道出血(UGH)患者预后的影响因素.方法 回顾性分析2003年6月至2009年6月我科196例肝硬化并UGH患者的临床资料.根据患者预后分为生存组与死亡组,比较两组病例的出血病因、既往出血史、24 h内再出血、肝功能Child-Pugh分级、并发症(腹水、肝性脑病、肝肾综合征)、血常规(PLT、Hb)、重要生化指标(TBIL、ALB、Cr)及凝血相关指标(PT、TT、aPTT)等因素.结果 死亡组出血原因中食管胃静脉曲张出血发生率高于生存组,门脉高压性胃病出血发生率低于生存组(P<0.01);两组在上述其他观察指标间差异均有统计学意义(P<0.05,P<0.01).结论 出血病因、既往出血史、24 h内再出血、肝功能分级、并发症、重要生化指标(PLT、Hb、TBIL、ALB、Cr)及凝血因子水平均影响肝硬化并上消化道出血患者的转归,可作为评价此病预后的重要指标.%Objective To explore the influencing factors of prognsis on patients with upper gastrointestinal hemorrhage (UGH) induced by cirrhosis. Methods The clinical date of 196 cases with UGH induced by cirrhosis from June 2003 to June 2009 were retrospectively analyzed. Cases were divided into survival group and dead group according to their prognosis, and the predisposing factors of the two groups which included the hemorrhage causes, UGH history, rebleeding within 24 hours, ChildPugh grade, complications ( ascites, hepatic encephalopathy, hepatorenal syndrome), blood routine ( PLT, Hb), important biochemical parameters (TBIL, ALB, Cr) and coagulation-related indicators (PT, TT, aPTT) were compared. Results Of bleeding causes, the dead group was higher in esophageal variceal bleeding and less in portal hypertensive gastropathy bleeding than the survival group ( P < 0. 01 ). There were signficant differces in above other observing parameters between the two groups ( P .< 0. 05, P <0.01 ). Conclusion The hemorrhage causes, UGH

  10. Meta analysis on risk factors of adverse pregnancy outcome in China%影响中国妇女不良妊娠结局相关危险因素的Meta 分析

    Institute of Scientific and Technical Information of China (English)

    郭晓燕; 郝培培

    2015-01-01

    目的:通过 Meta 分析探讨影响中国妇女不良妊娠结局的危险因素。方法采用 Meta 分析的方法,对2010年1月至2015年1月国内有关不良妊娠结局的影响因素文献进行综合分析,根据纳入与排除标准,共检索到124篇文献,通过阅读题目及摘要,初筛得到文献38篇,通过仔细阅读全文,排除24篇,最终纳入14篇文献,研究这14篇文献的6项影响因素对妊娠结局的影响程度进行 Meta 分析,并进行综合定量评价,以期提高对不良妊娠结局危险因素的认识,为制定预防措施提供依据。结果胎位异常与不良妊娠结局存在强关联,为危险因素。而产妇有流产史与不良妊娠结局的发生无关联。多胎妊娠、梅毒感染与不良妊娠结局存在强关联,妊娠期高血压疾病与不良妊娠结局存在中等关联。胎位异常的 OR 值为3.48(2.70~4.43),流产史的 OR 值为1.14(0.90~91.44),妊娠期高血压疾病的 OR 值为2.88(1.69~4.92),多胎的OR 值为6.40(2.05~20.01),梅毒感染的 OR 值为5.54(1.64~18.64)。结论不良妊娠结局的危险因素由强到弱依次为:多胎妊娠、梅毒感染、胎位异常和妊娠期高血压疾病。%Objective To investigate the risk factors of adverse pregnancy outcome of women in China by Meta analysis.Methods Meta analysis was used to analyze the influencing factors of adverse pregnancy outcomes from January 2010 to January 2015.According to the inclusion and exclusion criteria,124 articles were retrieved,and 38 articles were excluded.14 papers were included in this study.Results There was strong correlation between fetal abnormalities and adverse pregnancy outcomes.And the maternal history of abortion and adverse pregnancy outcomes were not related.There was strong association between multiple pregnancy,syphilis infection and adverse pregnancy outcome,and there was moderate

  11. Clinical severity and prognosis of hand eczema

    DEFF Research Database (Denmark)

    Hald, M; Agner, T; Blands, J

    2009-01-01

    BACKGROUND: Hand eczema (HE) is a frequent, long-lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms. OBJECTIVES: In this study, patients with HE were followed for 6 months from the first visit to a dermatologist...... to identify factors associated with severe disease and a poor prognosis. METHODS: Study participants were 799 patients with HE from nine dermatological clinics in Denmark. Severity assessment of the HE was done at baseline and at the 6-month follow-up using the Hand Eczema Severity Index (HECSI......) and by patients using a self-administered photographic guide. Additional information was obtained from a baseline questionnaire. RESULTS: At baseline, 60.3% assessed their HE as moderate to very severe using the self-administered photographic guide compared with 36.1% at follow-up. The mean HECSI value decreased...

  12. Social inhibition modulates the effect of negative emotions on cardiac prognosis following percutaneous coronary intervention in the drug-eluting stent era

    DEFF Research Database (Denmark)

    Denollet, Johan; Pedersen, Susanne S.; Ong, Andrew T L

    2006-01-01

    Negative emotions have an adverse effect on cardiac prognosis. We investigated whether social inhibition (inhibited self-expression in social interaction) modulates the effect of negative emotions on clinical outcome following percutaneous coronary intervention (PCI)....

  13. Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope

    DEFF Research Database (Denmark)

    Ruwald, Martin Huth; Hansen, Morten Lock; Lamberts, Morten;

    2012-01-01

    OBJECTIVE: This study sought to examine the risk of major cardiac adverse events and death in a nationwide cohort of patients without previous comorbidity admitted for syncope. BACKGROUND: Syncope is a common clinical event, but knowledge of prognosis is not fully elucidated in healthy individual...

  14. 妊娠合并脑出血的临床特征和影响预后的相关因素分析%Clinical characteristics and influencing factors on prognosis of pregnancy complicated with intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    梁竹巍; 蔺莉; 冯力民; 高婉丽

    2016-01-01

    Objective To analyze the clinical features and factors affecting prognosis for intracerebral hemorrhage (ICH) during pregnancy and postpartum.Methods A study of ICH was performed on 61 women in Beijing Tiantan Hospital,Capital Medical University between January 1997 and December 2014,and all cases were diagnosed with cerebral hemorrhage or subarachnoid hemorrhage during pregnancy or six weeks after delivery with CT or MRI after exclusion of ICH due to craniocerebral trauma.The subjects were divided into surgery (n=26) and conservative treatment (n=35) groups according to different ways of treatment;pregnancy associated problems (n=11) and cerebrovascular diseases groups according to the aetiology of ICH;low (n=13) and high score group (n=48) according their Glasgow score at the first visit;and short clinical onset to diagnosis time (O-D time) group (≤ 24 h,n=33) and long O-D time (>24 h) group (n=28).We compared the maternal clinical features and prognosis between different groups with t,Mann-Whitney U or Chi-square tests.A stratified logistic regression was used to assess the effect of factors affecting the prognosis.Results The average gestational age at the onset of ICH of the 61 cases was (28.8±8.3) weeks (6-40 weeks),the Glasgow score was (11.3±4.8),the median O-D time was 24.0 h,the modified Rankin scale (mRS) was 2.7,and 14 maternal deaths were reported (23.0%).Among the 61 women,three were terminated in early trimester,12 terminated in second trimester,and the rest 46 delivered in late term among which two fetal deaths,44 live births,and four neonatal deaths.Thus the perinatal infant death rate was 13.0% (6/46).The difference of maternal clinical features and prognosis between the surgery and conservative treatment group was not significant (all P>0.05).However,comparison between the cerebrovascular disease and pregnancy associated diseases group showed the latter had a lower Glasgow score and Apgar score [12.2(3.0) vs 7.5(12.0),(8.9±1.9) vs (7

  15. A Survey of Nursing Adverse Events and Influencing Factors in the Family Ward%家庭病床患者护理不良事件现况调查及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    凡芸; 马海萍; 彭幼清; 吴金贵; 任燕芳

    2014-01-01

    目的:调查家庭病床患者护理不良事件发生情况,探讨其影响因素。方法采用前瞻性调查方法,2011年6月-2012年5月调查上海市浦东新区4家社区卫生服务中心301例家庭病床患者1年内护理不良事件发生情况、原因以及对患者健康的影响。对患者一般情况、健康状况进行评估,并对照顾者的情况进行调查。结果301例家庭病床患者1年共发生护理不良事件506起,平均每位患者发生护理不良事件1.7起。护理不良事件中以感染事件的发生率最高(31.9%),其次为饮食护理事件(22.6%)、用药护理事件(20.9%)、皮肤护理事件(16.9%)、伤害事件(15.9%)。随着年龄的增长,护理不良事件发生率有增高的趋势(χ2趋势=13.54,P <0.001)。不同患者配偶情况、居住情况、照顾情况,照顾者有无照顾护理培训,照顾者为外聘或家人,患者不同生活能力、视力、听力、是否卧床不起、有无负性情绪,其家庭病床护理不良事件发生率比较,差异均有统计学意义(P <0.05)。结论家庭病床患者护理不良事件发生率较高,其原因有管理因素和照护因素,还与患者自身的健康状况及疾病特征有关。%Objective To investigate the incidence of nursing adverse events in the family ward and to explore the in-fluencing factors. Methods By using prospective study method,nursing adverse events were analyzed among 301 family ward pa-tients in four community centers in Pudong New Area in Shanghai from June 2011 to May 2012. Categories of nursing adverse e-vents,as well as their causes and effects on health were collected. Patients′ general circumstances,health status,and caregivers′circumstances were also analyzed. Results Of the 301 family ward patients,a total of 506 nursing adverse events were recorded with an average of 1. 7 per patient. Infection had the highest incidence(31. 9% ),followed by dietary

  16. Association of prognosis with insulin-like growth factor receptor type expression in gastric cancer patients:a meta-analysis%胰岛素样生长因子受体-1在胃癌中的表达及与患者预后关系的Meta分析

    Institute of Scientific and Technical Information of China (English)

    高云鹤; 陈凛; 崔建新; 郗洪庆; 申伟松; 张珂诚; 李佶阳; 梁文全; 胡翀; 卫勃

    2015-01-01

    Objective To systemically evaluate the relationship between the expression of insulin-like growth factor receptor type I ﹙IGF-1R) and prognosis in gastric cancer ﹙GC) patients. Methods A literature search was conducted from PubMed, EMBASE, Web of Science, CNKI, Wanfang and VIP databases to retrieve the clinical studies relevant to IGF-1R expression and its prognostic value in GC patients. Meta-analysis was performed using STATA 12.0 software. The methodology was assessed according to the European Lung Cancer Working Party Quality Scale for Biological Prognostic Factors for Lung Cancer. The quality of studies was assessed using the Newcastle-Ottawa scale. Results Four eligible studies including 685 patients were enrolled for this meta-analysis. Analysis results suggested that up-regulation of IGF-1R in GC patients was significantly associated with TNM staging ﹙OR=5.20, 95%CI:1.12 to 24.15, P=0.035), lymph node metastasis ﹙OR=8.24, 95%CI:2.68 to 25.34, P=0.000) and distant metastasis﹙OR=17.34, 95%CI:6.52 to 46.15, P=0.000). Moreover, up-regulated IGF-1R expression was significantly associated with poor overall survival of gastric cancer patients﹙HR=2.63, 95%CI:1.29 to 5.40, Z=2.64, P=0.008). Conclusion High IGF-1R expression may be an adverse prognostic factor in gastric cancer patients.%目的:系统评价胰岛素样生长因子受体1﹙IGF-1R)的表达与胃癌患者临床病理因素及预后的关系。方法计算机检索Pubmed、EMBASE、Web of Science、CNKI、万方数据库和维普数据库等发表的有关IGF-1R在胃癌组织中的表达及与患者预后的研究;采用Stata 12.0软件进行Meta分析,文献方法学评价参照“欧洲肺癌工作组对肺癌预后因子的评价标准”,文献质量采用纽卡斯尔-渥太华量表来评价。结果共纳入相关文献4篇,累计病例685例。Meta分析结果显示,IGF-1R表达与胃癌肿瘤TNM分期﹙OR=5.20,95%CI:1.12~24.15,P=0.035)、淋巴结转移﹙OR=8.24,95%CI:2

  17. Prognosis

    DEFF Research Database (Denmark)

    Myers, Jonathan; Brawner, Clinton A; Haykowsky, Mark J F

    2015-01-01

    benefits of exercise and the mechanisms underlying these benefits. Studies on the outcome benefits of exercise training, including mortality and hospitalization, have been convincing. This article reviews the physiologic benefits of exercise training in HF, studies on exercise training in women, results......Patients with heart failure (HF) were once discouraged from participating in exercise programs because of concerns regarding safety and the potential for harm to an already damaged myocardium. However, studies over the last 3 decades have provided extensive insights into both the health outcome...

  18. 肝内胆汁淤积症患者围生儿预后不良因素分析%Analysis of perinatal poor prognosis factor in patients with intrahepatic cholestasis of perinatal

    Institute of Scientific and Technical Information of China (English)

    刘娟; 陈雄; 汪宇平; 金玉珍; 吴颖

    2012-01-01

    目的:探讨影响肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)患者围生儿预后的相关因素.为临床采取恰当的分娩方式和选择适时的手术时机提供可靠依据.方法:随机抽取我院2009年1月-2012年4月发生胎儿窘迫50例与未发生胎儿窘迫的ICP患者50例瘙痒出现孕周、天冬氨酸转氨酶、总胆红素、血清总胆汁酸、脐血流、胎心监护、分娩方式、及新生儿吸入性肺炎、新生儿窒息(Apgar评分)、围生儿死亡率、早产率、小于胎龄儿发生率等进行对比分析,探讨影响ICP患者围生儿预后的因素.结果:发生胎儿窘迫的ICP患者脐血流(S/D值)异常升高及产前胎心监护NST评分、血清总胆汁酸水平、早产率明显高于未发生胎儿窘迫的ICP患者(P<0.05),但瘙痒出现的孕周及AL T、血清总胆红素值,两组间差异无统计学意义(P>0.05).前组新生儿吸入性肺炎、新生儿窒息、围生儿死亡率均较对照组高,其差异均有统计学意义(P<0.05);两组小于胎龄儿发生率无明显差异,无统计学意义(P>0.05).结论:脐血流S/D值及血清总胆汁酸、NST评分与ICP患者胎儿窘迫有关,致使新生儿早产率、吸入性肺炎、新生儿窒息、围生儿死亡率均升高,而瘙痒出现的孕周、AL T水平、血清总胆红素水平与之无关.妊娠期ICP严重影响围生儿的预后,应做到早期诊断、早期治疗,适时终止妊娠,降低ICP对围生儿的危害.%Objective:To study the factors influencing the perinatal prognosis in patients with intrahepatic cho-testasis of pregnancy (ICP) and to provide a reliable basis for taking appropriate mode of delivery and choosing timely moment of surgery. Methods: 50 ICP cases with fetal distress and 50 ICP cases without fetal distress were randomly selected in our hospital from January 2009 to April 2012. The comparative analysis about itching gestational age, aspartate aminotransferase, total

  19. 西藏地区脑出血危险因素及预后10年趋势分析%Trend analysis of risk factors and prognosis of cerebral hemorrhage in Tibet in 10 years

    Institute of Scientific and Technical Information of China (English)

    李泽文; 潘冬生; 邱克军; 秦妍; 贾红运

    2015-01-01

    Objective To analyze the basic characteristics , risk factors and prognosis of cerebral hemorrhage in high-altitude area of Tibet in the last 10 years, and to summarize the therapeutic experience .Methods The patients with cerebral hemorrhage to receive treatment in General Hospital of Tibet Military Command from 2002 to 2012 were selected as the research subjects and divided into two groups per five years;and then, the clinical data in the two groups were compared and analyzed .Results According to the comparison between the two groups , the annual average number of the hospitalized people was 61 from 2002 to 2007, but it increased to 143 from 2007 to 2012, and the males decreased from 75% to 66%, while the females increased from 25% to 34% in the same periods (P<0.01); the ratio of smoking patients decreased from 38% to 29% (P <0.01), and the ratio of application of antihypertensive drugs in patients increased from 13%to 27%(P<0.01);the hospitalization period was shortened from 21d to 16 d (P<0.05).Modified Rankin scale (mRS) was used to assess the recovery of neurological function , and the ratio of patients of mRS 0-3 increased from 43% to 58% (P <0.01), while that of mRS 4-5 decreased from 46% to 34% (P <0.01).Conclusion Although the number of patients with cerebral hemorrhage in Tibet has increased in recent years , the prognosis was improved overall;the reason maybe due to that the health consciousness of the residents , the medical equipment , and the methods of treatment have been improved.%目的:分析西藏高海拔地区过去10年脑出血的基本特征、危险因素及预后,并总结其治疗经验。方法以西藏军区总院2002~2012年收治的脑出血病例每5年分成一组,对前后二组临床资料进行对比分析。结果后5年组与前5年组对比,住院人数从2002~2007年的年均61例增加至2007~2012年的年均143例,男性比例从75%下降至66%,而女性比例从25%增加至34%(P<0.01

  20. 心搏骤停后综合征预后相关影响因素的分析%An analysis of relevant factors influencing the prognosis of post cardiac arrest syndrome

    Institute of Scientific and Technical Information of China (English)

    张东; 赵淑杰; 李南; 刘忠民; 王育珊

    2015-01-01

    .001), SIRS occurred after ROSC (χ2= 46.687,P 5 minutes (χ2 = 4.190,P = 0.041), and ROSC time was longer than 10 minutes (χ2 = 20.042,P 10 minutes (χ2 = 36.451,P 2 mmol/L (χ2 = 28.926, P 15 (χ2 = 33.558,P< 0.001). Multivariate logistic regression analysis showed that the risk factors affecting the prognosis were ROSC time [odds ratio (OR) after adjustment = 36.643, 95% confidence interval (95%CI) = 2.382-563.767,P = 0.010], the number of organs with dysfunction (OR = 9.010, 95%CI = 1.140-71.199,P = 0.037), and APACHEⅡ score (OR = 10.001, 95%CI =1.336-74.893,P = 0.025).Conclusions ROSC time, the number of organs with dysfunction, and APACHEⅡ score were independent predictors of PCAS prognosis. Efforts should be given to shorten the rescue time, to shorten the time for restoring the spontaneous circulation, to prevent and treat SIRS after ROSC, and to protect the function of organs, in order to improve the prognosis of patients with PCAS.

  1. Stage classification and prognosis: an intersection of medicine, quantum physics and religion?

    Science.gov (United States)

    Detterbeck, Frank C

    2011-11-01

    Estimating prognosis is an important part of caring for patients with cancer. However, predicting prognosis is complicated and depends on many factors. Simply amassing more data alone is not the answer; we have to learn to intellectually manage the inherent complexity and uncertainty if we are to make progress.

  2. 73例重型肝炎临床特点及预后影响因素分析%Analyse related factors of impact and prognosis of 73 cases of severe hepatitis

    Institute of Scientific and Technical Information of China (English)

    赵俊梅; 张璐; 杜庆玮; 穆彩琴; 任玉莲; 胡蕾平; 申戈; 庄立伟; 路遥

    2013-01-01

    Objective A retrospective study was conducted to investigate the clinical features and prognostic factors of 73 cases of severe hepatitis.Methods To summarize clinical features of 73 cases of severe hepatitis,grouping by etiology and pathogenesis.A retrospective analysis was performed to evaluate the relationship between biochemical characteristics (liver function,renal function,electrolytes,PTA,etc) and complications (hepatic encephalopathy,upper gastrointestinal bleeding,hepatorenal syndrome,ascites,abdominal infections,etc) and prognosis.Results (1) HBV infection alone accounted for 65.75%.Alcoholic liver disease,drug-induced liver injury,hepatitis E,autoimmune hepatitis,overlapping causes and other factors were five cases (6.85%),six cases (8.22%),two cases (2.74%),two cases (2.74%),seven cases (9.59%) and three cases (4.11%) respectively.According to the incidence rate,severity and underlying liver condition,subacute hepatitis,cases based on chronic hepatitis and on cirrhosis were 12 cases (16.43%),11 cases (15.07%),50 cases (68.49%) respectively.Clinical manifestations with or without hepatic encephalopathy accounted for 58.90% or 41.10%.(2) The highest mortality of severe hepatitis was alcoholic liver disease and patients on the basis of overlapping factors (66.67%),followed by autoimmune liver disease(50%).The mortality of HBV-related hepatitis was 18.75%.Overall mortality of 73 cases of severe hepatitis was 28.77%,of which cirrhosis group was higher than non-cirrhotic group(40% vs 4.3%,P =0.002).The difference was statistically significant.Patients without hepatic encephalopathy had lower mortality than with hepatic encephalopathy(3.33% vs 46.51%).The mortality of patients with hepatic encephalopathy Stage Ⅲ and Ⅳ was 72.73%.(3) Independent samples t test filtered nine factors associated with death,namely cirrhosis,upper gastrointestinal bleeding,hepatic encephalopathy,hepatorenal syndrome,serum creatinine

  3. High serum vascular endothelial growth factor level is an adverse prognostic factor for high-risk diffuse large B-cell lymphoma patients treated with dose-dense chemoimmunotherapy

    DEFF Research Database (Denmark)

    Riihijärvi, Sari; Nurmi, Heidi; Holte, Harald;

    2012-01-01

    To determine whether serum vascular endothelial growth factor (s-VEGF) levels and VEGF gene expression in tumor tissue predict survival of diffuse large B-cell lymphoma (DLBCL) patients treated with chemoimmunotherapy....

  4. 重度子痫前期并发不良结局149例危险因素分析%Risk factors of adverse outcomes in severe preeclampsia patients

    Institute of Scientific and Technical Information of China (English)

    张丽志; 温克; 李虹; 张洪; 王得玲

    2011-01-01

    Objective To explore clinical features of severe preeclampsia patients with adverse outcome, and the risk factors of adverse outcomes. Methods From Jan. 2008 to Dec. 2009 149 severepreeclampsia impatients who occurred adverse outcome enrolled as case,and 278 severe preeclampsia impatientswithout adverse outcome at the same period enrolled as control. The clinical features between the two groups were compared and the risk factors were investigated. Results No significant differences were found between the two groups in maternal age,times of previous prenancies. The gestation ages at the onset of preeclampsia and at delivery in the cases were less than controls(P < 0. 05). There was significant difference in irregular antenatal checks between the two groups(x2 = 8. 515, P < 0. 05). Proterinuria and the level of oedema in cases were higher than controls( P < 0. 05). Fetal growth restriction (FGR) occurred more frequently in the cases (P <0. 05). Indirect bilirubin, total bilirubin, glutamic oxalacetic transaminase, glutamic pyruvic transaminase, uric acid, creatinine, white blood cell, thrombin time, D-dimeride of cases were higher than those of controls(Ps <0. 05). Albumin, platelet and profibrin of cases were lower than those of controls(Ps < 0. 05 =. Multivariate logistic analysis showed that the gestation ages at the onset of preeclampsia, regular antenatal checks were significantly associated with adverse outcome(OR = 0. 899, P < 0. 001; OR = 0. 600, P = 0. 022, respectively =Indirect bilirubin and D-dimeride were significantly associated with preeclampsia complications(OR = 1. 533,P =0. 010; OR = 1.001, P = 0. 003, respectively). Mean arterial pressure and creatinine were significantly associated with eyeground changes(respectively OR = 1. 030,P = 0. 048; OR = 1. 025, P = 0. 022, respectively).Regular antenatal checks was associated with dead fetus(OR = 0. 317, P = 0. 046). No significant differenceswere found between the two group in uterine

  5. 原发性肝细胞癌根治术后肿瘤复发的影响因素及预后%Influencing factors and prognosis of tumor recurrence after radical resection of primary hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    蔡荣耀; 黄志勇; 梁宾勇; 李开艳; 陈孝平

    2011-01-01

    Objective To investigate the influencing factors and prognosis of early and late recurrence after radical resection of primary hepatocellular carcinoma(HCC).Methods The clinical data of 117 patients who received radical resection of HCC at the Tongji Hospital of Huazhong University of Science and Technology from January 2003 to December 2006 were retrospectively analyzed.Tumor recurrence occurred within 2 years after operation was defined as early recurrence,and tumor recurrence occurred latter than 2 years after operation was defined as late recurrence.Relationship between postoperative tumor recurrence and level of alpha-fetoprotein (AFP),AFP/V,tumor diameter,tumor number,blood vessel invasion,tumor differentiation,hepatic cirrhosis,hepatic function,hepatitis B surface antigen,procedure of hepatic resection and blood transfusion was analyzed.The overall survival and disease-free survival rates were determined by Kaplan-Meier method,and the survival rate was analyzed by Log-rank test.Results Eighty-five(72.6%)patients were found with tumor recurrence,including 59(50.4%)with early tumor recurrence and 26(22.2%)with late tumor recurrence.Levels of AFP,AFP/V,tumor diameter,tumor number,blood vessel invasion,tumor differentiation and blood transfusion were the influencing factors of early recurrence(x2 = 12.78,13.40,5.79,9.98,10.26,9.48,8.32,P < 0.05).Level of AFP and hepatic cirrhosis were the influencing factors of late recurrence(x2 =4.46,7.75,P < 0.05).AFP/V,tumor number and blood vessel invasion were the independent risk factors of early recurrence(RR = 0.170,0.172,0.064,P < 0.05).Hepatic cirrhosis was the independent risk factor of late recurrence(RR = 2.809, P < 0.05).The 1-,3-,5-year overall survival rates and tumor-free survival rates were 82.6%,60.8%,54.9% and 65.0%,38.5%,23.1%.There were significant differences in overall survival and disease-free survival rates among patients with AFP <20 μg/L,AFP/V < 14 μg/(L · cm3)or AFP

  6. 463例脑出血患者的预后分析%Prognosis of patients with intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    谭光林; 段文涛; 杨思芸; 李四新; 孙志勇; 郭明刚

    2010-01-01

    目的 分析脑出血患者的相关因素,指导脑出血的治疗及判断预后.方法 回顾性分析463例脑出血患者的临床资料及随访结果,应用单因素分析及Logistic多元回归分析,探讨预后的相关因素.结果 年龄、Glasgow昏迷指数、出血量、NIHSS评分、平均动脉压、出血有无破入脑室、有无中线移位、发病时随机血糖水平及并发症在两组中比较差异无统计学意义.预后不良组平均年龄71岁、平均血肿体积29 ml、平均GCS评分11.2,而预后良好组分别为65岁、15 ml、15.1,P值<0.05,差异有统计学意义.Logistic多元回归分析表明,年龄、出血量、意识障碍是脑出血发病3个月后预后不良的独立影响因素,其OR值分别为1.32、8.66、1.08.结论 ICH发病诱因较多,维持血压正常是预防ICH的重要措施.血肿体积、意识障碍、年龄可用于预测脑出血的预后.%Objective To study the related factors of patients with intracerebral hemorrhage (ICH)so as to guide treatment and predict prognosis. Methods The prognostic factors of 463 cases with intracerebral hemorrhage were analyzed with single factor and Logistic regression analyses. Results Age,Glasgow coma scale, amount of hemorrhage, NIHSS score, mean arterial blood pressure, with or without ventricular breakage, with or without midline shift and the incidence of complications at random blood glucose levels were analyzed for the correlation with the prognosis of patients. The poor prognosis group had significant differences with the good prognosis group with regards to these factors. The average age of patients with a poor prognosis was 71 years old, the average hematoma volume 29 ml and the average GCS score 11. 2versus 65 years old, 15 ml, 15. 1 for those with a good prognosis ( P < 0.05 ). Logistic regression analysis showed that age, amount of hemorrhage and disturbance of consciousness was an independent adverse prognostic factor for cerebral hemorrhage at

  7. Prognosis of ventricular fibrillation in hospital

    DEFF Research Database (Denmark)

    Jensen, G V; Torp-Pedersen, C; Køber, L

    1992-01-01

    In a retrospective study of 520 patients with in-hospital ventricular fibrillation 421 (81%) had acute myocardial infarction (MI), 66 (13%) had ischaemic heart disease (IHD) without MI, 33 (6%) had no signs of IHD. The in-hospital mortality of these three groups was 51%, 52%, and 27%, respectively...... (P = 0.01). Logistic regression analysis demonstrated that heart failure and cardiogenic shock were significant risk factors for in-hospital death among patients with IHD. Among discharged patients 1 and 5 years survival was 78% and 51% for patients with MI, 63% and 25% for patients with IHD, 67...... with known IHD suffering in-hospital VF without AMI have a very poor short- and long-term prognosis. These patients need extensive cardiac examination....

  8. Analysis of risk factors for prognosis of patients with acute paraquat intoxication%急性百草枯中毒患者预后危险因素分析

    Institute of Scientific and Technical Information of China (English)

    焦峰军; 祝文; 王涛宁; 袁亚迎; 亢锴; 刘敏龙

    2015-01-01

    Objective To explore the risk factors influencing the prognosis by analyzing clinical data of patients with acute paraquat intoxication, and to assess the prognostic values of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, and Acute Kidney Injury Network (AKIN) stage.Methods The clinical data of patients with acute paraquat intoxication admitted into the First People's Hospital of Xianyang City during October 2005 to May 2015 were retrospectively analyzed.The patients were divided into death group and survival group according to 28-day outcome after poisoning.The gender, age, body weight index, toxin dose, time elapsed from poisoning to gastric lavage, time elapsed from poisoning to hemoperfusion (HP), times of HP treatment, white blood cell count (WBC), alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBil), serum creatinine (SCr), blood urea nitrogen (BUN), creatine kinase (CK) were determined at admission.Arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), arterial lactate (Lac), and APACHE Ⅱ score, SOFA score and AKIN stage were recorded and compared between two groups.The receiver operating characteristic (ROC) curve was plotted for APACHE Ⅱ score, SOFA score and AKIN stage to analyze the prognostic value for patients with acute paraquat intoxication.Results There were 118 cases in total,with 64 survivors and 54 deaths in 28 days, and the fatality rate was 45.76%.Compared with survival group, the toxic dose (mL: 66.29 ± 27.40 vs.29.16 ± 19.40), time elapsed from poisoning to gastric lavage (minutes: 60.37 ± 26.68 vs.41.17± 14.82), WBC count (× 109/L: 16.86±2.77 vs.10.25 ± 2.60), ALT (U/L: 53.94± 10.85 vs.36.40±9.21),SCr (μmol/L: 159.69±42.85 vs.81.73±34.40) at admission as well as Lac (mmol/L: 3.06± 1.33 vs.1.71 ±0.88),APACHE Ⅱ score (6.46±2.38 vs.3.31 ± 1.51), SOFA score (3.31 ± 1.06 vs.2

  9. Risk factors and prognosis for 894 cases of esophageal neoplasm patients with preoperative nutritional risk%894例食管癌术前营养风险危险因素分析与预后

    Institute of Scientific and Technical Information of China (English)

    汤敏; 潘琪; 吴俊伟; 田希贵; 刘德森

    2015-01-01

    Objective To provide the reference basis for reducing the occurrence of nutritional risk by analyzing possible risk factors for nutritional risk status and investigating the relationship between preoperative nutritional risk status and prognosis.Methods We retrospectively analyzed the clinical data of 894 patients(nutritional risk group of 491 cases,non-nutritional risk group of 403 cases) with esophageal cancer resection.The univariate analysis was used to analyze the relationships between nutritional risk status with postoperative complications and length of hospitalization.And the multiple Logistic regression model analysis was applied to analyze the risk factors of nutritional risk status.Results The nutritional risk group had a higher rate of postoperative complications (33.60 % vs.19.60 %,U =-3.429,P =0.001),higher incidence of serious complications (23.01% vs.8.68%,U =-3.611,P =0.000) and longer hospital stays [(37.20 ± 13.89) days vs.(31.69 ± 13.49) days,t =4.124,P =0.000] than that of non-nutritional risk group.The results of the multiple logistic regression analysis showed that the preoperative nutritional risk factors were associated with the patients' age (OR =1.58,95% CI:1.101-2.268),number of symptoms entries(OR =7.97,95 % CI:6.071-10.463),symptom severity (OR =0.26,95% CI:0.186 -0.385),and dietary intake (OR =0.62,95 % CI:0.482-0.813),P < 0.05 for all.Conclusion The older patients with more severe symptoms and poor diet are more likely to suffer from nutritional risk.Prolonged hospital stay and postoperative complications easily happen in patients with nutritional risk.So patients with preoperative nutritional risk should be given timely and effective nutrition intervention measures,in order to reduce postoperative complications and length of hospitalization.%目的 探讨食管癌患者术前营养风险状况与预后的关系,分析营养风险的危险因素.方法 回顾性分析894例食管癌切除患者的临床资料.根

  10. 青年短暂性脑缺血发作患者危险因素及预后随访研究%Risk Factors and Prognosis in Youth Transient Ischemic Attack

    Institute of Scientific and Technical Information of China (English)

    骆迪; 毕齐

    2012-01-01

    Objective Researching in youth transient ischemic attack(TIA)( 18-45 years old) in our hospital, to analyze its risk factors and prognosis, in order to guide clinical treatment.Methods To analyze the clinical data of the patients retrospectively, The patients were divided into young group(n=22), middle-aged and above group(n=44), to compare their previous history, TIA vascular risk events within the 7 d, cerebrovascular disease risk factors and related inspection indicators between the two groups.Results Smoking history in young group is longer than in middle-aged and above group(P<0.01); Diabetes history in young group is shorter than in middle-aged and above group(P<0.01); weight, cholesterol(P=0.022), low density lipoprotein cholesterol(P=0.04) level are higher than in middle-aged and above group(P=0.03, 0.022, 0.44 respectively); High-density lipoprotein cholesterol, fasting blood glucose, plasma fibrinogen level in young group are lower than in middle-aged and above group(P=0.014, 0.009,0.048 respectively); TIA vascular risk events within the 7 d have no statistical difference; but the incidence is much higher in middle-aged and above group(over 45 years).Conclusions We speculate that major risk factors in youth TIA include weight, cholesterol, low density lipoprotein cholesterol and smoking history. Diabetes history and higher fibrinogen may have more impact on TIA patients over 45 years, comparing with young group.%目的 对我院年龄在18~45岁青年短暂性脑缺血发作(transient ischemic attack,TIA)患者进行TIA危险因素及预后研究,指导临床治疗.方法 回顾性的分析青年组(n=22)和中年及以上组(n=44)患者的临床资料,对两组患者的既往病史、TIA后7天内血管危险事件、脑血管病危险因素及相关检查指标进行比较.结果 青年组的吸烟史高于中年及以上组(P<0.01);糖尿病史低于中年及以上组(P<0.01);体重、胆固醇、低

  11. Risk factors and prognosis of neurological complications in patients with infective endocarditis%感染性心内膜炎合并神经系统并发症的危险因素及预后

    Institute of Scientific and Technical Information of China (English)

    王辉; 郭立琳; 方理刚; 崔丽英; 苗齐; 李太生; 朱文玲; 方全

    2016-01-01

    Objective To identify risk factors of neurological complications (NC) in left-sided infective endocarditis (IE) and to assess its impact on the outcome and cardiac surgery.Methods Clinical data,NC,treatment and outcome of patients with definite left-sided IE admitted to our hospital during 2001-2012 were retrospectively analyzed.Results A total of 308 patients with age of (45.3 ± 15.9) years were enrolled.Among them,65 (21.1%) experienced at least one NC.Independent risk factors associated with NC were large vegetation (HR =1.681,95% CI 1.013-2.788,P =0.044),non-neurologic embolism (HR=1.820,95%CI 1.068-3.100,P =0.028),mitral valve involvement (HR =1.888,95% CI 1.089-3.274,P =0.024),Staphylococcus aureus infection (HR =2.054,95% CI 1.097-3.846,P =0.044),and uncontrolled infection (HR =4.680,95% CI 2.563-8.546,P < 0.001).During a median follow-up for 17 months,70 (22.7%) patients died.NC had a negative impact on long-term outcome (HR =2.292,95% CI 1.274-4.122,P =0.006).Valve replacement surgery was performed in 156 (50.6%)patients,which was associated with a lower rate of 1-year IE-related death (HR =0.160,95% CI 0.063-0.405,P <0.001).Among patients with NC,valve replacement surgery was associated with lower rates of in-hospital mortality and 1-year IE-related mortality (14.8% vs 5.3%,18.5% vs 73.7%,respectively,P < 0.001).Conclusions Independent risk factors of NC include large vegetation,nonneurologic embolism,mitral valve involvement,Staphylococcus aureus infection,and uncontrolled infection.Neurologic complications link to the poor prognosis in patients with left-sided IE.Valve surgery is considered as a safe procedure and improves the survival.%目的 明确左心感染性心内膜炎(IE)发生神经系统并发症(NC)的危险因素及其对心脏手术和预后的影响.方法 分析2001-2012年入院并确诊左心IE患者的临床资料、NC、治疗及预后.结果 共入选308例患者,年龄(45.3 ±15.9)岁,65例(21.1

  12. 妊娠期糖尿病母儿不良妊娠结局的危险因素分析%ANALYSIS OF RISK FACTORS FOR ADVERSE MATERNAL AND FETAL OUTCOMES IN PREGNANT WOMEN WITH GESTATIONAL DIABETES MELLITUS

    Institute of Scientific and Technical Information of China (English)

    胡矩锋

    2015-01-01

    Objective To investigate the influencing factors for adverse maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM) .Methods The pregnant women diagnosed with GDM and with complete clinical data were chosen for study from January ,2014 to December ,2014 .59 of them in the observation group received strict dietary and exercise management ,snd 52 cases who disregard the doctor's orders ,food control or exercise formed the contrast group .The maternal and neonatal outcomes of these 2 groups were compared .The effect of age ,BMI before pregnancy ,excessive weight gain during pregnancy ,the way to control blood sugar ,the history of abnormal gestation and birth ,the family history of diabetes , w hether or not taking insulin and gestational age on maternal and neonatal outcomes were also analyzed . Results T he usage of insulin in the ob‐servation group were lower than that in the control group ( P <0 .05) ,and the gestational weight gain in the observation group was less than that in the control group ( P<0 .05) .The occurrence of hypertensive disorder in the observation group were significantly lower than that in the control group ( P <0 .05) ,and the total occurrence of adverse maternal and neonatal outcomes in the observation group were significantly lower than that in the control group ( P <0 .05) .Excessive weight gain during pregnancy ,the history of abnormal gestation and birth ,high BMI before pregnancy and te use of insulin were risk factors for adverse neonatal outcomes ,while enough gestational age was the protective factor for both maternal and neonatal outcomes( P <0 .05) .Conclusion For patients with GDM ,there are risk factors influencing maternal and fetal adverse outcomes ,and it is useful to conduct health education and to standardize the clinical manage‐ment .%目的:探讨影响妊娠期糖尿病(GDM )患者母儿不良妊娠结局的相关因素。方法自2014年1月至2014年12月间在临沂市妇幼保健

  13. Course prognosis of cervical osteochondrosis

    Directory of Open Access Journals (Sweden)

    Kolesov V.N.

    2012-06-01

    Full Text Available

    Today we can state that in spite of a considerable number of cervical osteochondrosis studies, there is a lack of research devoted to analysis of its course. There is no correlation between initial expert evaluations of cervical osteo-chondrosis cases and further course of pathological process. Goal of the research is to develop system of course prognosis of cervical osteochondrosis taking into account environmental infuence, heredity, living conditions, psychological profle of patient’s personality. Materials and methods. Dynamics of degenerative-dystrophic changes progressing of cervical vertebrae in 236 patients was analyzed. Results. Received data demonstrated that probability of stage I changing to stage II, III and IV depended on patients’ sex, age and type of labour activity, frequent supercooling and stress. Probability of fast progression of cervical osteochondrosis (5-year cycle of stage I changing to stage III and IV was to a great extent associated with heredity, urban living, presence of endocrine system diseases, syndrome of nonspecifc dysplasia of connective tissue and low indices of quality of life. Conclusion. Proposed system allows making prognosis of morphologic changes in spinal cord, and is based on radiation methods of verifcation without taking into consideration dynamics of neurological symptomatology.

  14. 急性冠脉综合征患者Lp-PLA2水平对短期心血管不良预后的影响%Effect of lipoprotein-associated phospholipase A2 level on prognosis of short-term adverse cardiovascular outcomes in patients with acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    花颖

    2015-01-01

    group and low level group. The primary cardiovascular events and the involved cardiovascular events within 30 days were analyzed. Results: The Lp-PLA2 Levels was significantly higher in ACS group compared with control group ( P<0 . 01 ) . In hospital , there was no correlation between the Lp-PLA2 levels and the incidence of the primary cardiovascular events(P=0.230). However at 30-day follow-up, patients in high Lp-PLA2 level group had a significantly higher incidence of the combined cardiovascular events than those in low level group(P<0.01). The logistics regression analysis displayed that Lp-PLA2 is an independent risk factors which may predict the combined cardiovascular events of ACS patients within 30 days after admission. Conclusion: Lp-PLA2 is an independent predictive biomarker in the risk stratification of ACS patients within 30 days after onset.

  15. Analyses of factors affecting prognosis of patients with sepsis and evaluation of their predicting values%脓毒症预后影响因素分析及预后价值评估

    Institute of Scientific and Technical Information of China (English)

    曾文美; 毛璞; 黄勇波; 庞晓清; 吴苏龙; 刘晓青; 黎毅敏

    2015-01-01

    factors affecting the prognosis of patients with sepsis and evaluate their values in predicting the disease outcome. Methods A clinical prospective study was conducted. Fifty-three septic patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangzhou Medical University from October 17th, 2012 to August 8th, 2013 were enrolled, and in the same term 35 volunteers having passedphysical check-up were assigned in the healthy control group. According to the severity of the patients, they were divided into sepsis, severe sepsis and septic shock groups. Furthermore, based on the difference in scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), the patients were divided into low-risk (APACHE Ⅱ scores 0.05). The IL-8 level of non-coagulation defect group was significantly lower than that of adjusted (ng/L:24.67 vs. 27.23, P0.05). Conclusions The grade of sepsis severity, APACHEⅡscore, whether existence of coagulation dysfunction being present or not and whether its presence being adjusted or not during the septic patients' stay in ICU, the levels of blood lactate, PCT, IL-6 and IL-8 on the first day in ICU are significantly correlated to the prognosis of septic patients. Whether the existence of coagulation dysfunction being present or not, whether coagulation dysfunction being adjusted or not and the blood lactate level are the independent prognostic factors of septic patients, and the plasma concentrations of IL-6 and IL-8 are the independent affecting factors of whether coagulation dysfunction occurring or not, therefore they have predicting value concerning the occurrence of coagulation dysfunction in septic patients.

  16. Avaliação imunoistoquímica da proteína ciclooxigenase-2 nas neoplasias colorretais e sua relação com fatores patológicos prognósticos Immunohistochemical evaluation of cyclooxygenase-2 in colorectal neoplasias and relationship with pathological factors in prognosis

    Directory of Open Access Journals (Sweden)

    E Brambilla

    2007-09-01

    Full Text Available OBJETIVOS: Avaliar a prevalência da proteína ciclooxigenase-2 (COX-2 nas neoplasias colorretais e sua relação com os parâmetros patológicos prognósticos para o câncer colorretal. MÉTODO: 65 lesões neoplásicas colorretais foram avaliadas através de imunoistoquímica para a presença de COX-2, também foram analisados fatores patológicos prognósticos e estadiamento das lesões. RESULTADOS: A COX-2 expressou-se positivamente em 27% dos adenomas tubulares, 40% dos adenomas vilosos e 70% nos carcinomas. Diferença estatisticamente significante foi obtida na expressão da COX-2 entre adenomas e carcinomas, porém não houve significância nas demais variáveis estudadas. CONCLUSÃO: A expressão da COX-2 parece variar progressivamente com a progressão da lesão neoplásica, mas não influencia os parâmetros patológicos de mau prognóstico.OBJECTIVES: To evaluate the prevalence of cyclooxygenase-2 (COX-2 in colorectal neoplasia and to establish the relationship with pathological factors in the prognosis of colorectal cancer. METHODS: 65 colorectal neoplastic lesions were investigated by immunohistochemistry for the expression of COX-2, along with the pathological factors in prognosis and staging of lesions. RESULTS: COX-2 was positively expressed in 27% of tubular adenomas, 40% of villous adenomas, and 70% of carcinomas. A statistically significant difference was observed among COX-2 expression in adenomas and carcinomas, but such significance was not seen among the other variables studied. CONCLUSION: COX-2 expression seems to correlate positively with the progression of neoplasias, yet with no influence on the pathological patterns of poor prognosis.

  17. Adverse renal effects of hydrochlorothiazide in rats with myocardial infarction treated with an ACE inhibitor

    NARCIS (Netherlands)

    Westendorp, Bart; Hamming, Inge; Szymanski, Mariusz K.; Navis, Gerjan; van Goor, Harry; Buikema, Hendrik; van Gilst, Wiek H.; Schoemaker, Regien G.

    2009-01-01

    Diuretics, when added to angiotensin-converting enzyme inhibitors (ACE inhibitors) treatment, can augment the response to ACE inhibitors, but may have adverse effects on renal function, which negatively affect prognosis. While in heart failure rats combined therapy initially improved cardiac functio

  18. Prognosis of Brain Tumours with Epilepsy

    OpenAIRE

    1991-01-01

    The prognosis of 560 patients with a clinical and CT diagnosis of intrinsic supratentorial brain tumour was examined retrospectively at the Department of Neurosciences, Walton Hospital, Liverpool, England.

  19. Adverse Reactions to Hallucinogenic Drugs.

    Science.gov (United States)

    Meyer, Roger E. , Ed.

    This reports a conference of psychologists, psychiatrists, geneticists and others concerned with the biological and psychological effects of lysergic acid diethylamide and other hallucinogenic drugs. Clinical data are presented on adverse drug reactions. The difficulty of determining the causes of adverse reactions is discussed, as are different…

  20. Future Directions in Childhood Adversity and Youth Psychopathology.

    Science.gov (United States)

    McLaughlin, Katie A

    2016-01-01

    Despite long-standing interest in the influence of adverse early experiences on mental health, systematic scientific inquiry into childhood adversity and developmental outcomes has emerged only recently. Existing research has amply demonstrated that exposure to childhood adversity is associated with elevated risk for multiple forms of youth psychopathology. In contrast, knowledge of developmental mechanisms linking childhood adversity to the onset of psychopathology-and whether those mechanisms are general or specific to particular kinds of adversity-remains cursory. Greater understanding of these pathways and identification of protective factors that buffer children from developmental disruptions following exposure to adversity is essential to guide the development of interventions to prevent the onset of psychopathology following adverse childhood experiences. This article provides recommendations for future research in this area. In particular, use of a consistent definition of childhood adversity, integration of studies of typical development with those focused on childhood adversity, and identification of distinct dimensions of environmental experience that differentially influence development are required to uncover mechanisms that explain how childhood adversity is associated with numerous psychopathology outcomes (i.e., multifinality) and identify moderators that shape divergent trajectories following adverse childhood experiences. A transdiagnostic model that highlights disruptions in emotional processing and poor executive functioning as key mechanisms linking childhood adversity with multiple forms of psychopathology is presented as a starting point in this endeavour. Distinguishing between general and specific mechanisms linking childhood adversity with psychopathology is needed to generate empirically informed interventions to prevent the long-term consequences of adverse early environments on children's development.

  1. Uncertainty Quantification in Fatigue Crack Growth Prognosis

    Directory of Open Access Journals (Sweden)

    Shankar Sankararaman

    2011-01-01

    Full Text Available This paper presents a methodology to quantify the uncertainty in fatigue crack growth prognosis, applied to structures with complicated geometry and subjected to variable amplitude multi-axial loading. Finite element analysis is used to address the complicated geometry and calculate the stress intensity factors. Multi-modal stress intensity factors due to multi-axial loading are combined to calculate an equivalent stress intensity factor using a characteristic plane approach. Crack growth under variable amplitude loading is modeled using a modified Paris law that includes retardation effects. During cycle-by-cycle integration of the crack growth law, a Gaussian process surrogate model is used to replace the expensive finite element analysis. The effect of different types of uncertainty – physical variability, data uncertainty and modeling errors – on crack growth prediction is investigated. The various sources of uncertainty include, but not limited to, variability in loading conditions, material parameters, experimental data, model uncertainty, etc. Three different types of modeling errors – crack growth model error, discretization error and surrogate model error – are included in analysis. The different types of uncertainty are incorporated into the crack growth prediction methodology to predict the probability distribution of crack size as a function of number of load cycles. The proposed method is illustrated using an application problem, surface cracking in a cylindrical structure.

  2. Association of FOXM1 expression with tumor histology and prognosis in Wilms tumor: Potential for a new prognostic marker

    Science.gov (United States)

    Apelt, Nadja; Hubertus, Jochen; Mayr, Doris; Graf, Norbert; Furtwängler, Rhoikos; Von Schweinitz, Dietrich; Kappler, Roland

    2016-01-01

    Wilms tumor (WT) is the most common pediatric renal malignancy. A recent ontogenic model suggests that undifferentiated tumor state, and hence poor prognosis, in WT is determined by stabilization of β-catenin in the nucleus. Forkhead box M1 (FOXM1) is a downstream component of the Wnt pathway and promotes nuclear localization of β-catenin. As elevation of FOXM1 gene expression is prognostic in various types of malignancy, we hypothesized that high FOXM1 expression in WT is associated with undifferentiated histology and thus poor prognosis. In the current study, the expression of FOXM1 mRNA was determined in 46 WT specimens and 11 renal tissue controls from patients undergoing tumor nephrectomy, and these data were assessed with regard to clinicopathological parameters. The results demonstrated an upregulation of FOXM1 in WT by 10-fold compared to normal tissue. Expression differed significantly between controls and tumors of intermediate- and high-risk histopathology (P<0.001, Kruskal-Wallis), and distinguished normal tissue from tumors of good and adverse clinical outcome (P<0.001, Kruskal-Wallis). Notably, FOXM1 expression was significantly lower (P=0.009) in patients that received preoperative doxorubicin. These results suggest that FOXM1 may serve as a companion diagnostic factor for doxorubicin-based therapies in WT.

  3. Endoscopic retrograde cholangiopancreatography-related adverse events: general overview.

    Science.gov (United States)

    Rustagi, Tarun; Jamidar, Priya A

    2015-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) represents a monumental advance in the management of patients with pancreaticobiliary diseases, but is a complex and technically demanding procedure with the highest inherent risk of adverse events of all routine endoscopic procedures. Overall adverse event rates for ERCP are typically reported as 5-10%. The most commonly reported adverse events include post-ERCP pancreatitis, bleeding, perforation, infection (cholangitis), and cardiopulomary or "sedation related" events. This article evaluates patient-related and procedure-related risk factors for ERCP-related adverse events, and discusses strategies for the prevention, diagnosis and management of these events.

  4. Impact of Obstructive Sleep Apnea on the Levels of Placental Growth Factor (PlGF and Their Value for Predicting Short-Term Adverse Outcomes in Patients with Acute Coronary Syndrome.

    Directory of Open Access Journals (Sweden)

    Antonia Barcelo

    Full Text Available Placental growth factor (PlGF induces angiogenesis and promotes tissue repair, and plasma PlGF levels change markedly during acute myocardial infarction (AMI. Currently, the impact of obstructive sleep apnea (OSA in patients with AMI is a subject of debate. Our objective was to evaluate the relationships between PlGF levels and both the severity of acute coronary syndrome (ACS and short-term outcomes after ACS in patients with and without OSA.A total of 538 consecutive patients (312 OSA patients and 226 controls admitted for ACS were included in this study. All patients underwent polygraphy in the first 72 hours after hospital admission. The severity of disease and short-term prognoses were evaluated during the hospitalization period. Plasma PlGF levels were measured using an electrochemiluminescence immunoassay.Patients with OSA were significantly older and more frequently hypertensive and had higher BMIs than those without OSA. After adjusting for age, smoking status, BMI and hypertension, PlGF levels were significantly elevated in patients with OSA compared with patients without OSA (19.9 pg/mL, interquartile range: 16.6-24.5 pg/mL; 18.5 pg/mL, interquartile range: 14.7-22.7 pg/mL; p1, even after adjustment.The results of this study show that in patients with ACS, elevated plasma levels of PlGF are associated with the presence of OSA and with adverse outcomes during short-term follow-up.ClinicalTrials.gov NCT01335087.

  5. Poorer Prognosis With Ethylenediaminetetraacetic Acid-dependent Pseudothrombocytopenia

    Science.gov (United States)

    Ohashi-Fukuda, Naoko; Inokuchi, Ryota; Sato, Hajime; Nakamura, Kensuke; Iwagami, Masao; Wada, Tomoki; Jona, Masahiro; Hisasue, Takashi; Nakajima, Susumu; Yahagi, Naoki

    2015-01-01

    Abstract In ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia (PTCP), automated platelet counts are lower than actual counts because of EDTA-induced aggregation. Factors contributing to the incidence of EDTA-PTCP are unknown, and no study has assessed the prognosis of EDTA-PTCP patients. This retrospective study assessed characteristics in EDTA-PTCP patients and matched controls to determine differences in prognosis. A retrospective case–control study was designed. From the University of Tokyo Hospital database, we identified patients diagnosed with EDTA-PTCP between 2009 and 2012, and performed 1:2 case:control matching for age and sex. A control group of sex- and age-matched patients was selected at random from the same database. We investigated differences in the frequency of complications, medication history, and blood transfusion history between the groups at the time of blood collection. Prognosis was evaluated using multivariate Cox regression analysis adjusting for age, sex, autoimmune disease, liver disease, and malignant tumor. We identified 104 EDTA-PTCP patients and 208 matched controls. The median age was 69.0 years (interquartile range: 54–76), with men comprising 51%. EDTA-PTCP patients had a higher frequency of malignant tumor and a lower frequency of hypertension and diabetes than controls. After adjustment for background factors, prognosis of EDTA-PTCP patients was significantly poorer than controls (hazard ratio, 11.8; 95% confidence intervals, 2.62–53.54). In conclusion, EDTA-PTCP patients had higher mortality, and EDTA-PTCP may need to be recognized as an indicator of worse prognosis. PMID:25881844

  6. 肝硬化静脉曲张套扎及硬化术后近期不良预后危险因素%Risk factors in poor prognosis after endoscopic variceal ligation and endoscopic injection sclerotherapy of esophageal varices caused by liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    葛秀珍; 王玉明; 郑忠青; 王涛; 王邦茂

    2015-01-01

    ABSTRACT:Objective To evaluate the risk factors in poor prognosis after endoscopic variceal ligation(EVL)and endoscopic injection sclerotherapy(EIS)of esophageal varices caused by liver cirrhosis.Methods A total of 142 cirrhotic patients with esophageal varices who received EVL or EIS at Endoscopy Center of Tianjin Medical University General Hospital were collected in this study.In order to discover risk factors,some items were analyzed,including gender,age, types of cirrhosis, existence of diabetes, atherosclerosis or splenectomy, serum examination and radiology examination and endoscopy treatment selection. Results The rate of poor prognosis after endoscopic treatment of esophageal varices was 22.5%(32/142),the mortality 2.1%(3/142),9.4%(3/32)in the patients with high risk factors,the rate of early rebleeding and infection after operation was 11.3%(16/142)and 9.2%(13/142), respectively.Single factor analysis showed significant differences in liver function Child-Pugh classification,treatment method,portal vein thrombosis(PVT),ascites degree and plasma bilirubin between good prognosis group and poor prognosis group(all P <0.05).Multi-factors logistic regression analysis showed that liver function Child-Pugh classification and PVT were the independent factors of poor prognosis after endoscopic treatment(both P<0.01),OR values were 4.006,14.06,95%CI 1.742-9.215,3.527-56.113.Conclusion Child-Pugh classification,treatment method,PVT,ascites degree and plasma bilirubin were associated with prognosis,PVT and Child-Pugh classification were independant risk factors of poor prognosis after endoscopic treatment.Good enrolling standard and close monitor after treatment were needed for preventing poor prognosis after EVL and EIS.%目的:探讨肝硬化静脉曲张套扎及硬化术后不良预后的危险因素。方法收集天津医科大学总医院内镜中心行内镜下食管胃底静脉曲张套扎术(endoscopic variceal ligation

  7. Cox′s proportional hazards regression model for prognosis of hepatocellular carcinoma based on factor analysis with SPSS%基于SPSS因子分析的肝细胞癌预后因素的Cox比例风险回归模型

    Institute of Scientific and Technical Information of China (English)

    李仕来; 黎乐群

    2015-01-01

    Objective To explore the feasibility of Cox′s proportional hazards regression model for the prognosis of hepatocellular carcinoma based on the factor analysis with SPSS.Methods One hundred and forty cases of hepatocellular carcinomas and 44 related prognosis factors were analyzed with SPSS13.0 and Microsoft Office Excel 2007.The comparative analysis of traditional Cox′s proportional hazards regression model and Cox′s proportional hazards regression model based on the factor analysis was conducted to determine which one was more feasible.Results In traditional Cox′s proportional hazards regression model,25 of 44 factors entered the multivariate analysis, of them 5 were reserved in the final equation.Remarkably,the results of the univariate analysis and the multivariate analysis for the factor X5 were contradictory,which implied the multicollinearity among the prognosis factors.Thirteen common factors were extracted by the factor analysis and then they all entered Cox′s proportional hazards regression model,and of them 7 were reserved in the final equation.They were professional meaning and reasonable after being renamed.Conclusion It′s feasible to solve the multicollinearity by Cox′s proportional hazards regression model for the prognosis of hepatocellular carcinoma based on the factor analysis with SPSS.%目的:探讨基于SPSS因子分析的肝细胞癌(肝癌)预后因素的Cox比例风险回归模型的可行性。方法采用SPSS13.0统计软件及Microsoft Office Excel 2007对140例肝癌患者以及44个预后因素进行分析,比较传统Cox比例风险回归模型与基于因子分析的Cox比例风险回归模型分析结果的优缺点。结果传统Cox比例风险回归模型中,44个预后因素中经单因素分析后有25个进入多因素分析,多因素分析中有5个因素进入Cox比例风险回归模型方程,其中因素X5在单因素分析和多因素分析中的结论相反,提示预后因素存在多重共

  8. 晚期早产儿与足月新生儿呼吸衰竭发生及预后的影响因素%Risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants

    Institute of Scientific and Technical Information of China (English)

    朱天闻; 张永红; 陈妍; 夏红萍; 赵冬莹; 杨凌云; 朱建幸

    2013-01-01

    Objective To investigate the risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants.Methods Sixty-eight neonates with respiratory failure hospitalized in neonatal intensive care unit (NICU) were divided into late preterm infants group (n =34) and full-term infants group (n =34),the general clinical characteristics,perinatal parameters,treatment process of respiratory failure,main disease diagnosis and prognosis evaluation were compared between these two groups.Besides,the clinical parameters and respiratory parameters were compared between favorable prognosis group and unfavorable prognosis group.Results The average birth weight in late preterm infants group was significantly lower than that in full-term infants group (P < 0.01),and the proportion of infants with low body weight in late preterm infants group was significantly higher than that in full-term infants group (P <0.05).However,there was no significant difference in the gender constituent ratio,age at NICU admission and proportion of infants small for gestational age between two groups (P > 0.05).There was no significant difference in the healthy status and other perinatal parameters between late preterm infants group and full-term infants group (P > 0.05).Apnea was only found in late preterm infants group,and NO inhalation treatment and high frequency ventilation were only adopted in full-term infants group,while there was no significant difference in the main disease diagnosis,respiratory treatment modality and prognosis between two groups (P > 0.05).The proportion of infants small for gestational age in favorable prognosis group was significantly lower than that in unfavorable prognosis group (P < 0.05),while the Caesarean section rate in favorable prognosis group was significantly higher than that in unfavorable prognosis group (P < 0.05).Conclusion Relationship between gestational age and body weight of neonates with respiratory failure and way of

  9. Investigation in adverse event reporting of nurses and its influencing factors%护士对不良事件报告的现状及相关因素探讨

    Institute of Scientific and Technical Information of China (English)

    周娟; 匡莉; 翟颖娟

    2009-01-01

    目的 了解护士对不良事件报告现状及探讨相关影响因素.方法 翻译美国医院患者安全文化评估问卷,将所形成的中文版量表对801名护士进行评估.结果 82.65%的被调查护士在过去12个月内未报告过不良事件,维度"不良事件的报告频率"和"对错误的非惩罚性反应"的积极反应率分别为29.92%、29.38%.本科及以上学历护士在维度"不良事件的报告频率"的得分高于大中专护士,门诊护士的得分低于其他科室护士.结论 护士对不良事件的报告亟待提高,主要影响因素为报告文化是否具有惩罚性以及护士的学历等.%Objective To investigate the adverse event reporting of nurses and analyze the influenc-ing factors. Methods A sample of 801 nurses were assessed by completing AHRQ Hospital Survey On Patient Safety Culture (Chinese version). Results 82.65% of respondents within hospital didn't reported a single event in the past 12 months. The positive responsive rates for "frequency of event reported"and "nonpunitive response to error"was 29.92% and 29.38% respectively, where higher scores were found in the respondents possessing bachelor degrees and the average score of the respondents from out-patients unit was lower than those from other units. Conclusions The findings illustrate that it is necessary to improve the performance of event reporting of nurses and the influence factors lie in the level of the nurses' educa-tion degree and whether the event reporting system is punitive or not.

  10. The Prognosis of Patients With Nonobstructive Coronary Artery Disease Versus Normal Arteries Determined by Invasive Coronary Angiography or Computed Tomography Coronary Angiography: A Systematic Review.

    Science.gov (United States)

    Huang, Fang-Yang; Huang, Bao-Tao; Lv, Wen-Yu; Liu, Wei; Peng, Yong; Xia, Tian-Li; Wang, Peng-Ju; Zuo, Zhi-Liang; Liu, Rui-Shuang; Zhang, Chen; Gui, Yi-Yue; Liao, Yan-Biao; Chen, Mao; Zhu, Ye

    2016-03-01

    Limited data exist regarding the outcomes of patients with nonobstructive coronary artery disease (CAD) detected by computed tomography coronary angiography (CTCA) or invasive coronary angiography (ICA). Our aim was to compare the prognosis of patients with nonobstructive coronary artery plaques with that of patients with entirely normal arteries. The MEDLINE, Cochrane Library, and Embase databases were searched. Studies comparing the prognosis of individuals with nonobstructive CAD versus normal coronary arteries detected by CTCA or ICA were included. The primary outcome was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, hospitalization due to unstable angina or revascularization. A fixed effects model was chosen to pool the estimates of odds ratios (ORs). Forty-eight studies with 64,905 individuals met the inclusion criteria. Patients in the nonobstructive CAD arm had a significantly higher risk of MACE compared to their counterparts in the normal artery arm (pooled OR, 3.17, 95% confidence interval, 2.77-3.63). When excluding revascularization as an endpoint, hard cardiac composite outcomes were also more frequent among patients with nonobstructive CAD (pooled OR, 2.10; 95%CI, 1.79-2.45). All subgroups (age, sex, follow-up duration, different outcomes, diagnostic modality, and CAD risk factor) consistently showed a poorer prognosis with nonobstructive CAD than with normal arteries. When dividing the studies into a CTCA and ICA group for further analysis based on the indications for diagnostic tests, we also found nonobstructive CAD to be associated with a higher risk of MACE in both stable and acute chest pain. Patients with nonobstructive CAD had a poorer prognosis compared with their counterparts with normal arteries.

  11. Adverse Event Reporting System (AERS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Adverse Event Reporting System (AERS) is a computerized information database designed to support the FDA's post-marketing safety surveillance program for all...

  12. Risk stratification for prognosis in intracerebral hemorrhage: A decision tree model and logistic regression

    Directory of Open Access Journals (Sweden)

    Gang WU

    2016-01-01

    Full Text Available Objective  To analyze the risk factors for prognosis in intracerebral hemorrhage using decision tree (classification and regression tree, CART model and logistic regression model. Methods  CART model and logistic regression model were established according to the risk factors for prognosis of patients with cerebral hemorrhage. The differences in the results were compared between the two methods. Results  Logistic regression analyses showed that hematoma volume (OR-value 0.953, initial Glasgow Coma Scale (GCS score (OR-value 1.210, pulmonary infection (OR-value 0.295, and basal ganglia hemorrhage (OR-value 0.336 were the risk factors for the prognosis of cerebral hemorrhage. The results of CART analysis showed that volume of hematoma and initial GCS score were the main factors affecting the prognosis of cerebral hemorrhage. The effects of two models on the prognosis of cerebral hemorrhage were similar (Z-value 0.402, P=0.688. Conclusions  CART model has a similar value to that of logistic model in judging the prognosis of cerebral hemorrhage, and it is characterized by using transactional analysis between the risk factors, and it is more intuitive. DOI: 10.11855/j.issn.0577-7402.2015.12.13

  13. Determining prognosis in acute exacerbation of COPD

    Directory of Open Access Journals (Sweden)

    Flattet Y

    2017-01-01

    Full Text Available Yves Flattet,1 Nicolas Garin,1,2 Jacques Serratrice,1 Arnaud Perrier,1 Jérome Stirnemann,1 Sebastian Carballo1 1Department of Internal Medicine, Service of General Internal Medicine, Geneva University Hospitals, Geneva, 2Service of Internal Medicine, Riviera Chablais Hospital, Monthey, Switzerland Background: Acute exacerbations are the leading causes of hospitalization and mortality in patients with COPD. Prognostic tools for patients with chronic COPD exist, but there are scarce data regarding acute exacerbations. We aimed to identify the prognostic factors of death and readmission after exacerbation of COPD.Methods: This was a retrospective study conducted in the Department of Internal Medicine of Geneva University Hospitals. All patients admitted to the hospital with a diagnosis of exacerbation of COPD between 2008 and 2011 were included. The studied variables included comorbidities, Global Initiative for Chronic Obstructive Lung Disease (GOLD severity classification, and biological and clinical parameters. The main outcome was death or readmission during a 5-year follow-up. The secondary outcome was death. Survival analysis was performed (log-rank and Cox.Results: We identified a total of 359 patients (195 men and 164 women, average age 72 years. During 5-year follow-up, 242 patients died or were hospitalized for the exacerbation of COPD. In multivariate analysis, age (hazard ratio [HR] 1.03, 95% CI 1.02–1.05; P<0.0001, severity of airflow obstruction (forced expiratory volume in 1 s <30%; HR 4.65, 95% CI 1.42–15.1; P=0.01, diabetes (HR 1.47, 95% CI 1.003–2.16; P=0.048, cancer (HR 2.79, 95% CI 1.68–4.64; P<0.0001, creatinine (HR 1.003, 95% CI 1.0004–1.006; P=0.02, and respiratory rate (HR 1.03, 95% CI 1.003–1.05; P=0.028 on admission were significantly associated with the primary outcome. Age, cancer, and procalcitonin were significantly associated with the secondary outcome.Conclusion: COPD remains of ominous prognosis

  14. Syncope: epidemiology, etiology and prognosis.

    Directory of Open Access Journals (Sweden)

    Rose M F Lisboa Da Silva

    2014-12-01

    Full Text Available Syncope is a common medical problem, with a frequency between 15% and 39%. In the general population, the annual number episodes are 18.1 to 39.7 per 1000 patients, with similar incidence between genders. The first report of the incidence of syncope is 6.2 per 1000 person-years. However, there is a significant increase in the incidence of syncope after 70 years of age with rate annual 19.5 per thousand individuals after 80 years. It presents a recurrence rate of 35% and 29% of physical injury. Among the causes of syncope, the mediated neural reflex, known as neurocardiogenic or vasovagal syncope, is the most frequent. The others are of cardiac origin, orthostatic hypotension, carotid sinus hypersensitivity, neurological and endocrinological causes and psychiatric disorders. The diagnosis of syncope can be made by clinical method associated with the electrocardiogram in up 50% of patients. Its prognosis is determined by the underlying etiology specifically the presence and severity of cardiac disease. The annual mortality can reach between 18 and 33% if cardiac cause, and between 0 and 12% if the noncardiac cause. Thus, it is imperative to identify its cause and risk stratification for positive impact in reducing morbidity and mortality.

  15. Multivariate Analysis of the Factors on Prognosis in Patients with Severe Craniocerebral Injury after the Decompressive Craniectomy%影响重型颅脑损伤患者大骨瓣减压术后预后的多因素分析

    Institute of Scientific and Technical Information of China (English)

    柏鲁宁; 周雄波; 罗卫; 胡珍渊; 王更新; 侯文; 赵晓平; 张毅; 柯尊华; 周振国; 范小璇; 周峰; 方永军; 畅涛

    2012-01-01

    Objective To analyze the prognosis and the related factors of severe craniocerebral injury patients with Decompressive Craniectomy (DC). Methods The clinical data of 121 DC patients were reviewed and analyzed. The patients were divided into two groups: poor prognosis group (n= 72) and good prognosis group (n = 49) iased on Glasgow Outcome Scale (GOS) one month after discharge. Logistic multiple regression analysis was used to analyze the clinical data including age, sex, mean interval between injury and operation, admission Glasgow Coma Scale (GCS), and pupil change, preoperative midline. shifted, compressed or obliterated basal cisterns and blood sugar. Results Single factor analysis showed that there were significant differences in the mean interval between injury and operation, admission GCS score, pupil changes, preoperative midline shifted, compressed or obliterated basal cisterns and blood sugar (P < 0.05). Logistic multiple regression revealed that the related factors associated with poor prognosis are admission GCS, pupil changes, preoperative midline shifted, compressed or obliterated basal cisterns, mean interval between injury and operation and blood sugar before the operation. Conclusion Prognosis for DC patients is associated with admission GCS, pupil change, preoperative midline shifted, compressed or oblilerated basal cisterns, mean interval between injury and operation and blood sugar before the operation.%目的 分析重型颅脑损伤(severe craniocerebral injury,sTBI)患者大骨瓣减压(deeompressive craniectomy,DC)术后的预后及相关因素.方法 回顾分析121例DC术后患者的临床资料.出院1个月后,根据格拉斯哥预后评分(Glasgow outcome scale,GOS)分为预后不良组(n=72)和预后良好组(n=49),比较两组患者的年龄、性别、受伤至手术时间、入院时格拉斯哥昏迷评分(Glasgow coma scale,GCS)、瞳孔变化、术前中线移位、术前基底池形态、术前血糖等因素,Logistic多元

  16. The logistic regression analysis of the inlfuencing factors on the effects and prognosis of 120 cases of patients with sudden deafness%突发性耳聋120例疗效与预后的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    陆俊; 洪惠敏; 沈伟

    2016-01-01

    Objective: To investigate the effects of related factors on the effectiveness and prognosis of sudden deafness so as to provide a reference for its clinical treatment.Methods: The data of 120 cases of patients with sudden deafness were analyzed by logistic regression and the various factors including gender, age, duration, degree of hearing loss, hearing curve type, with or without tinnitus and dizziness were screened so as to obtain the factors associated with the efifcacy and prognosis in the clinical treatment of sudden deafness.Results: Forty-one cases were cured and iffty-seven cases were excellent and effective recovery in 120 cases. The total effective rate reached 81.7%. The results showed that efifcacy and prognosis were associated with age (OR=1.223), newly diagnosed disease duration (OR=1.556), the extent of pre-treatment of deafness (OR=6.225), hearing curve type (OR=6.247), with tinnitus (OR=6.238) and dizziness (OR=5.332) (P0.05).Conclusion:The younger the patients with sudden deafness and the shorter duration, the better the efifcacy and prognosis are; the higher the degree of hearing loss and hearing curve with deaf and tinnitus and dizziness, the worse the prognosis of the patients would be.%目的:探讨相关因素对突发性耳聋疗效及预后的影响,为临床治疗提供参考。方法:应用Logistic回归分析120例突发性耳聋病例资料,对性别、年龄、病程、听力损失程度、听力曲线类型、就诊是否伴有耳聋眩晕等多种因素进行筛选,获得临床上与突发性耳聋效疗及预后相关的因素。结果:120例中治愈41例,显效及有效57例,总有效率为81.7%。结果发现,患者的年龄(OR=1.223)、初诊病程(OR=1.556),治疗前耳聋程度(OR=6.225)、听力曲线类型(OR=6.247)、伴有耳鸣(OR=6.238)及伴有眩晕(OR=5.322)均与疗效、预后相关(P0.05)。结论:突聋患者年龄越小、病程越短,其疗效和预后越好

  17. Analysis on the adverse drug reaction signal and its impact factors induced by oral hypoglycemic agents%口服抗糖尿病药物不良反应信号及其相关因素分析

    Institute of Scientific and Technical Information of China (English)

    柯俊; 汤文璐; 薛浩; 庞露微

    2012-01-01

    目的 研究口服抗糖尿病药物不良反应特征,并提供相应临床合理用药的依据.方法 通过上海市不良反应监测中心收集2006至2010年有关口服抗糖尿病药物不良反应的数据,使用描述性统计,logistic回归模型及不相称性,对不良反应发生的特征、风险因子和相关因素进行分析.结果 共获得812例口服抗糖尿病药物的不良反应报告.结果显示老年人和女性占不良反应发生的多数;不良反应级别以一般为主;2009至2010年间作为药品说明书中未记载的新的不良反应有上升的趋势;双胍类及磺酰脲类(SU)不良反应最为突出;logistic回归模型显示女性、日服用药频次多、单一用药是胃肠道不良反应的危险因素.体质量是皮肤损害的危险因素,联合用药、患者年龄大是SU致低血糖的危险因素.不相称性研究同时也得到一些口服抗糖尿病药物致不良反应的信号.结论 口服抗糖尿病药物不良反应累及系统器官广泛,像性别、年龄、体质量、用药频次、是否联合用药都会在一定程度上影响不良反应的发生.故口服抗糖尿病药物在临床使用时应加强不良反应监测,重视和控制其风险因子,以期更合理安全地用药.%AIM To study the feature and regularity of adverse drug reaction (ADR) induced by oral hypoglycemic agents (OHAs) and provide reasonable advice for clinical use.METHODS By collecting ADR reports of OHAs from database of Shanghai ADR spontaneous reporting system from 2006 to 2010,we made through analysis on the character and risk factors of ADR induced by OHAs using descriptive statistics and logistic regression model,and also applied disproportional measures on data mining of ADR signal and its relevant factors.RESULTS A total of 812 ADR reports induced by OHAs were included in this study.The results indicated that the senior and female patients were mostly concerned,and mainly marked as moderately injured

  18. Brief Depression Screening with the PHQ-2 Associated with Prognosis Following Percutaneous Coronary Intervention with Paclitaxel-Eluting Stenting

    NARCIS (Netherlands)

    Pedersen, Susanne S.; Denollet, Johan; de Jonge, Peter; Simsek, Cihan; Serruys, Patrick W.; van Domburg, Ron T.

    2009-01-01

    BACKGROUND: Depression is associated with adverse prognosis in cardiac patients, warranting the availability of brief and valid instruments to identify depressed patients in clinical practice. OBJECTIVES: We examined whether the two-item Patient Health Questionnaire (PHQ-2) was associated with adver

  19. A scoring model for predicting the prognosis of severe viral hepatitis

    Institute of Scientific and Technical Information of China (English)

    DING Hui-guo; XIANG Hai-ping; SHAN Jing; ZHOU Li; MA Bing; LIU Min; WANG Jun-tao

    2005-01-01

    @@ The prognosis of patients with severe viral hepatitis is concerned by clinicians, patients and their relatives. Many factors may influence on the prognosis of patients with this disease. Many studies on the prognosis of severe viral hepatitis by multiple logistic regression analysis have shown generally consistent results.1-4 Previouly we established a scoring model of severe viral hepatitis (SMSVH) by logistic regression analysis.1 The aim of this study was to estimate prospectively the 6-month survival rate of patients with severe viral hepatitis using SMSVH.

  20. Analysis of the Factors and Corresponding Nursing Strategies for Patients With Adverse Emotional Factors in Department of Orthopedics%手术室骨科患者不良情绪的因素分析及相应护理对策

    Institute of Scientific and Technical Information of China (English)

    卢春芝

    2016-01-01

    Objective To analyze the factors of adverse emotional factors and nursing countermeasures of patients with department of orthopedics in operation room. Methods From November 2013 to December 2015,90 cases of department of orthopedics in our hospital were randomly divided into study group and routine group,45 cases in each group,conventional nursing,while the research group was given the operation room management measures,analysis of patients with adverse emotional factors and nursing measures. Results The main adverse mood of the patients included :pain,operation process,environmental unfamiliar,anesthesia process,etc. After taking different nursing measures,the anxiety and depression of the study group was significantly lower than that of the conventional group(P < 0.05). Conclusion The effective nursing intervention can reduce the bad mood of patients in department of orthopedics,and the corresponding stress state plays an improving role.%目的:分析手术室骨科患者不良情绪的因素分析与护理对策。方法2013年11月~2015年12月将我院90例手术室骨科患者通过电脑随机分组的方式,分为研究组和常规组,每组患者均为45例。常规组采用传统护理,而研究组给予手术室管理措施。分析患者不良情绪因素以及护理措施。结果患者不良情绪主要包括:疼痛、手术过程、环境陌生、麻醉过程等。采取不同护理措施后,研究组患者的焦虑和抑郁低于常规组(P <0.05),组间比较具备差异。结论实施有效的护理干预能够降低手术室骨科患者的不良情绪,对应激状态起到改善作用,为良好手术奠定基础。

  1. 胶质母细胞瘤全切术后患者预后影响因素的前瞻性研究%Influences of partial correlation factors such as dietary, psychotherapy and hybaroxia etceteras in prognosis of patients suffered glioblastoma multiforme under total resection: a perspective study

    Institute of Scientific and Technical Information of China (English)

    韩利江; 张俊廷; 杜洪涛; 韩小弟; 李健; 薛凤文; 范艳竹; 张鹏飞

    2014-01-01

    Objective To research the influence of partial correlation factors in the prognosis of patients suffered glioblastoma multiforme (GBM) after total resection.Methods Thirty-nine patients,admitted to our hospitals from November 2007 to November 2009 and performed total resection,were chosen in our study; after the resections,26 patients (control group) accepted radiotherapies and chemotherapies; 13 patients (experimental group) were furthermore treated by caloric restriction combined with psychotherapy and chemotherapy associated by hybaroxia (CRPH).Survival curve of the two groups were compared; the correlations of clinical data of the GBM patients with survival time were analyzed.Results The survival time in the experimental group ([36.6 ±12.6] months) were significantly longer than that in the control group ([19.1 ±11.3] months,P<0.05); the cumulative survival rate in the experimental group was significantly higher than that in the control group (P<0.05).CRPH and resection times were significantly positively correlated with the prognosis of GBM (P=0.000 and 0.013).Volume of tumor was negatively correlated with the prognosis of GBM significantly (P=0.013).Ki-67,O6-methylguanine-DNA methyltransferase (MGMT) and vascular endothelial growth factor (VEGF) were significantly correlated with the prognosis ofGBM (P=0.001,0.022 and 0.001).Conclusions CRPH can apparently prolong the life span of the patients suffered GBM.The volume of tumor,and MGMT,Ki-67 and VEGF levels are correlated to the prognosis of GBM.%目的 分析影响胶质母细胞瘤全切术后患者预后的相关因素. 方法 选择北京天坛医院和北京天坛普华医院神经外科自2007年11月至2009年11月手术切除的胶质母细胞瘤患者39例,其中术后行单纯放化疗患者26例(对照组),术后除单纯放化疗外,添加热量限制饮食+心理引导+高压氧同步辅助化疗(CRPH)患者13例(实验组).比较2组患者的生存曲线,分析胶质母细胞瘤患者临

  2. Analysis of risk factors and prognosis of pneumonia in elderly patients of cerebral stroke sequelae period%老年脑卒中患者后遗症期反复并发肺炎的危险因素及预后分析

    Institute of Scientific and Technical Information of China (English)

    王惠芳; 王惠民

    2013-01-01

    Objective To investigate the risk factors and prognosis of pneumonia in elderly patients of cerebral stroke sequelae period.Methods Eighty-eight cases of pneumonia in elderly patients with cerebral stroke sequelae period were selected as stroke group,with non-stroke patients of the same period suffering from pneumonia 1 ∶ 1 matched as control group.The risk factors and prognosis of pneumonia in elderly patients of cerebral stroke sequelae period were analyzed.Results Pneumonia in stroke group was related with hypertension,diabetes,conscious disturbance,bucking or nasogastric feeding,dyscinesia,incision of trachea,multiple organ disfunction syndrome (MODS),hospitalizations,hospital stay and abandon treatment or death (P < 0.05),and not related with smoking,coronary heart disease,kindey dysfunction,malignant tumor,phlegm bacterial culture,hypoxemia and mechanical ventilation was tested by conditioned Logistic regression quantitatively(P> 0.05).The independent risk factors for pneumonia in elderly patients of cerebral stroke sequelae period were bucking or nasogastric feeding,and MODS by two-way unconditional Logistic regression.Conclusions Hypertension,diabetes,conscious disturbance,bucking or nasogastric feeding,dyscinesia,incision of trachea,MODS,hospitalizations are risk factors for pneumonia in elderly patients of cerebral stroke sequelae period,and lead to relatively poor prognosis.Three-grade prevention and control of risk factors can improve prognosis.%目的 分析老年脑卒中患者后遗症期反复并发肺炎的危险因素与预后.方法 选择老年脑卒中后遗症期反复并发肺炎的患者作为脑卒中组,与同期住院的非脑卒中老年肺炎患者1∶1配对,组成对照组,分析老年脑卒中患者后遗症期反复并发肺炎的危险因素及预后.结果 脑卒中组反复并发肺炎与高血压、糖尿病、意识障碍、呛咳与鼻饲、肢体运动障碍、气管切开、多器官功能障碍综合征(MODS)、住

  3. The impact of sex difference on short-term prognosis risk factors for ischemic infarct in Northern Han Chinese young ischemic stroke patients%北方汉族青年缺血性脑梗死短期预后危险因素的性别差异

    Institute of Scientific and Technical Information of China (English)

    杨姗杉; 贾建平

    2012-01-01

    目的 本研究针对中国北方汉族青年缺血性脑梗死患者,分析危险因素及对短期预后影响是否存在性别差异.方法 回顾性分析2000年~ 2011年北京宣武医院青年脑卒中住院患者,经数字减影造影(DSA)检查或经颅多普勒(TCD)检查诊断为动脉粥样硬化,CT或MRI诊断缺血性脑梗死,单因素分析危险因素存在的性别差异,非条件logistic回归模型进一步确定影响短期预后的危险因素.结果 男性青年缺血性脑梗死中吸烟、饮酒者较女性多,红细胞比积测定值(Hct)高于女性,差异均有统计学意义(P<0.05);预测青年男性短期预后危险因素为NIHSS评分,TOAST分型多因素型;预测青年女性短期预后危险因素为年龄,NIHSS评分.结论 北方汉族青年缺血性脑梗死危险因素因性别不同存在差异,且不同性别预测其短期预后危险因素亦不同.%Objective To analyze whether there is sex difference in risk factors for young ischemic stroke, and whether they affect short-term prognosis. Methods A retrospective analysis was conducted for young patients during 2000 ~2011 in Xuanwu Hospital,and ischemic cerebral infarction was confirmed by the cranial CT or MRI,with atherosclerosis detected by DSA or TCD. A single factor analysis of risk factors was used for the presence of gender differences. Non-conditional logistic regression model was used to determine the risk factors that affect the short-term prognosis. Results In ischemic cerebral infarction,male had a higher risk of smoking,and drinking alcohol than female,and Hct content in male was higher than that of female (P 〈 0. 05). The predictors for the short-term prognosis for young male were NIHSS scores and multiple potential causes of TOAST, while for young female, the predictors were age and NIHSS scores. Conclusion There are differences in risk factors of ischemic stroke in young Northern Han people and in predicting the short-term prognosis because of

  4. Azacitidine. Poor-prognosis myelodysplasia: promising, but more data needed.

    Science.gov (United States)

    2011-02-01

    Some myelodysplastic syndromes carry a poor prognosis. This is also the case for chronic myelomonocytic leukaemia (related to myelodysplastic syndromes), and acute myeloblastic leukaemia, a frequent complication of myelodysplasia. The only treatment capable of providing long-term remission (in about 1 in 2 patients on average) is haematopoietic stem cell transplantation, but this burdensome treatment can only be used in a minority of cases. Azacitidine (Vidaza, Celgene), an agent that blocks DNA synthesis, is the first drug to receive EU marketing authorisation in these settings. Its clinical evaluation is based on an unblinded trial that included 358 patients comparable to those discussed in the marketing authorisation. In addition to individually tailored symptomatic care, they were randomised to receive either azacitidine or conventional care regimens chosen by their physician (no treatment, low-dose cytarabine, or an anthracycline plus cytarabine). The median overall survival time was significantly longer with azacitidine (24.5 versus 15 months), and transfusion requirements were also reduced. Another comparative trial versus symptomatic treatment alone in 191 patients with various prognoses also showed an increase in survival time with azacitidine, but this study suffered from methodological flaws. The main adverse effects of azacitidine are potentially severe toxicity for various blood cells, gastrointestinal disorders, and reactions at the injection site. In practice, when haematopoietic stem cell transplantation is not feasible for poor-prognosis patients with myelodysplastic syndromes or related disorders, azacitidine can be used instead of disappointing standard treatments, even though more clinical evaluation is needed.

  5. Subsequent pregnancy and prognosis in breast cancer survivors.

    Science.gov (United States)

    Kasum, Miro; Beketić-Orešković, Lidija; Orešković, Slavko

    2014-09-01

    An increase in the incidence of breast cancer in women aged breast cancer in women of childbearing age has significantly improved, they are often concerned whether subsequent pregnancy will alter their risk of disease recurrence. In the modern era, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer and women can bear children after breast cancer treatment without compromising their survival. Therefore, they should not be discouraged from becoming pregnant, and currently the usual waiting time of at least 2 years after the diagnosis of breast cancer is recommended. However, a small, nonsignificant adverse effect of pregnancy on breast carcinoma prognosis among women who conceive within 12 months of breast cancer diagnosis and a higher risk of relapse in women younger than 35 up to 5 years of the diagnosis may be found. Fortunately, for women with localized disease, earlier conception up to six months after completing their treatment seems unlikely to reduce their survival. Ongoing and future prospective studies evaluating the risks associated with pregnancy in young breast cancer survivors are required.

  6. Eventos adversos pós-vacina contra a difteria, coqueluche e tétano e fatores associados à sua gravidade Adverse events following diphtheria, pertussis and tetanus vaccinations and factors associated with severity

    Directory of Open Access Journals (Sweden)

    Fabiana Ramos Martin de Freitas

    2007-12-01

    Full Text Available OBJETIVO: Avaliar os eventos adversos pós-vacina contra a difteria, coqueluche e tétano (EAPV-DPT e os fatores associados à sua gravidade. MÉTODOS: Estudo transversal com componente descritivo e analítico, abrangendo os eventos adversos pós-vacina DPT notificados no Estado de São Paulo, de 1984 a 2001, entre crianças menores de sete anos de idade. A definição de caso foi a adotada pela vigilância de EAPV-DPT; os dados obtidos foram originados da vigilância passiva desses eventos. No cálculo das taxas, o numerador foram os EAPV e o denominador o número de doses aplicadas. A associação entre a gravidade dos EAPV-DPT e as exposições de interesse foi investigada pelas estimativas não ajustadas e ajustadas da odds ratio, com os respectivos intervalos de 95% de confiança, usando regressão logística não condicional. RESULTADOS: Identificaram-se 10.059 EAPV-DPT relativos a 6.266 crianças, apresentando um ou mais EAPV, 29,5% foram internadas e em 68,2% houve contra-indicação das doses subseqüentes de DPT. Cerca de 75% dos eventos ocorreram nas primeiras seis horas após a aplicação da vacina. Os eventos mais freqüentes foram: febreOBJECTIVE: To analyze adverse events following vaccinations against diphtheria, pertussis and tetanus (AEFV-DPT and to investigate factors associated with event severity. METHODS: A cross-sectional study was carried out with a descriptive and analytical component covering AEFV-DPT that were notified in the State of São Paulo, Brazil, between 1984 and 2001, among children less than seven years old. Cases were defined as used in AEFV-DPT surveillance; the data source was AEFV-DPT passive surveillance. In calculating the rates, the numerator was the number of AEFV-DPT and as denominator was the number of doses applied. The association between severity of AEFV-DPT and the exposures of interest was investigated by means of non-adjusted and adjusted estimates of odds ratios, with their respective 95

  7. Improved prognosis of diabetic nephropathy in type 1 diabetes

    DEFF Research Database (Denmark)

    Andrésdóttir, Gudbjörg; Jensen, Majken L; Carstensen, Bendix

    2015-01-01

    -term renin-angiotensin system inhibition), lipids, and glycemia, along with less smoking and other lifestyle and treatment advancements, is inadequately analyzed. To clarify this, we studied 497 patients with type 1 diabetes and diabetic nephropathy at the Steno Diabetes Center and compared them...... and nephropathy onset occurred later in life, mortality was reduced by 30%. Risk factors for decline in glomerular filtration rate, death, and other renal end points were generally in agreement with prior studies. Thus, with current treatment of nephropathy in type 1 diabetes, the prognosis and loss of renal......The natural history of diabetic nephropathy offered an average survival of only 5-7 years. During the past decades, multiple changes in therapy and lifestyle have occurred. The prognosis of diabetic nephropathy after implementing stricter control of blood pressure (including increased use of long...

  8. Poorer Prognosis With Ethylenediaminetetraacetic Acid-dependent Pseudothrombocytopenia: A Single-center Case-control Study.

    OpenAIRE

    2015-01-01

    Abstract In ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia (PTCP), automated platelet counts are lower than actual counts because of EDTA-induced aggregation. Factors contributing to the incidence of EDTA-PTCP are unknown, and no study has assessed the prognosis of EDTA-PTCP patients. This retrospective study assessed characteristics in EDTA-PTCP patients and matched controls to determine differences in prognosis. A retrospective case–control study was designed. From ...

  9. The prognosis of idiopathic generalized epilepsy.

    Science.gov (United States)

    Seneviratne, Udaya; Cook, Mark; D'Souza, Wendyl

    2012-12-01

    Prognosis describes the trajectory and long-term outcome of a condition. Most studies indicate a better prognosis in idiopathic generalized epilepsy (IGE) in comparison with other epilepsy syndromes. Studies looking at the long-term outcome of different IGE syndromes are relatively scant. Childhood absence epilepsy appears to have a higher rate of remission compared to juvenile absence epilepsy. In absence epilepsies, development of myoclonus and generalized tonic-clonic seizures predicts lower likelihood of remission. Although most patients with juvenile myoclonic epilepsy (JME) achieve remission on antiepileptic drug therapy, remission without treatment. Data on the prognosis of other IGE syndromes are scarce. There are contradictory findings reported on the value of electroencephalography as a predictor of prognosis. Comparisons are made difficult by study heterogeneity, particularly in methodology and diagnostic criteria.

  10. Radiation Therapy Overcomes Adverse Prognostic Role of Cyclooxygenase-2 Expression on Reed-Sternberg Cells in Early Hodgkin Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Mestre, Francisco [Service of Radiation Therapy, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain); Gutiérrez, Antonio, E-mail: antoniom.gutierrez@ssib.es [Service of Hematology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain); Rodriguez, Jose [MD Anderson Cancer Center, Madrid (Spain); Ramos, Rafael [Service of Pathology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain); Garcia, Juan Fernando [Spanish National Cancer Research Centre, Madrid (Spain); Martinez-Serra, Jordi [Service of Hematology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain); Casasus, Marta; Nicolau, Cristina [Service of Radiation Therapy, Policlinica Miramar, Palma de Mallorca (Spain); Bento, Leyre; Herraez, Ines [Service of Hematology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain); Lopez-Perezagua, Paloma [Service of Radiology, IDISPA, Palma de Mallorca (Spain); Daumal, Jaime [Service of Nuclear Medicine, IDISPA, Palma de Mallorca (Spain); Besalduch, Joan [Service of Hematology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain)

    2015-05-01

    Purpose: To analyze the role of radiation therapy (RT) on the adverse prognostic influence of cyclooxygenase-2 (COX-2) expression on Reed-Sternberg (RS) cells, in the setting of early Hodgkin lymphoma (HL) treated with ABVD (adriamycin, vinblastine, bleomycin, dacarbazine). Methods and Materials: In the present study we retrospectively investigated the prognostic value of COX-2 expression in a large (n=143), uniformly treated early HL population from the Spanish Network of HL using tissue microarrays. Univariate and multivariate analyses were done, including the most recognized clinical variables and the potential role of administration of adjuvant RT. Results: Median age was 31 years; the expression of COX-2 defined a subgroup with significantly worse prognosis. Considering COX-2{sup +} patients, those who received RT had significantly better 5-year progression-free survival (PFS) (80% vs 54% if no RT; P=.008). In contrast, COX-2{sup −} patients only had a modest, nonsignificant benefit from RT in terms of 5-year PFS (90% vs 79%; P=.13). When we compared the outcome of patients receiving RT considering the expression of COX-2 on RS cells, we found a nonsignificant 10% difference in terms of PFS between COX-2{sup +} and COX-2{sup −} patients (P=.09), whereas the difference between the 2 groups was important (25%) in patients not receiving RT (P=.04). Conclusions: Cyclooxygenase-2 RS cell expression is an adverse independent prognostic factor in early HL. Radiation therapy overcomes the worse prognosis associated with COX-2 expression on RS cells, acting in a chemotherapy-independent way. Cyclooxygenase-2 RS cell expression may be useful for determining patient candidates with early HL to receive consolidation with RT.

  11. Machinery prognostics and prognosis oriented maintenance management

    CERN Document Server

    Yan, Jihong

    2014-01-01

    This book gives a complete presentatin of the basic essentials of machinery prognostics and prognosis oriented maintenance management, and takes a look at the cutting-edge discipline of intelligent failure prognosis technologies for condition-based maintenance.  Latest research results and application methods are introduced for signal processing, reliability moelling, deterioration evaluation, residual life prediction and maintenance-optimization as well as applications of these methods.

  12. Relationship between the expression of vascular endothelial growth factor and prognosis in elderly advanced gastric cancer%VEGF在老年进展期胃癌的表达及其与预后的关系

    Institute of Scientific and Technical Information of China (English)

    胡杰; 吴慧群; 张文发

    2011-01-01

    Objective To explore the relationship between the expression of vascular endothelial growth fac tor (VEGF) and prognostic evaluation in patients with elderly advanced gastric cancer. Methods Sixty patients of el derly advanced gastric cancer were selected as the study group, and 32 healthy individuals were enrolled as the control group. Immunohistochemical study was performed in the two groups to investigate the expression of VEGF and microvessel density (MVD). The relationship between the levels of VEGF and MVD and prognosis was analyzed. Results The positive rates of VEGF and MVD were much higher in the study group than the control group (P<0.01); There was statistically significant difference in the expression of MVD and VEGF in different TNM stages and lym phatic metastasis (P<0.05). The three-year survival rate and five-year survival rate were significantly lower in patients with positive expression of VEGF than patients with negative expression of VEGF. Conclusion The expression of VEGF is closely associated with angiogenesis, tumor growth and tumor metastasis. VEGF can be the prognostic dis criminators in prostate cancer.%目的 探讨血管内皮生长因子(VEGF)在老年进展期胃癌的表达及其与预后的关系.方法 选择60例老年进展期胃癌患者为观察组,同期32例健康体检者为对照组.应用免疫组织化学法检测胃癌组织与正常胃黏膜组织VEGF及微血管密度(MVD)的表达情况,并对MVD、VEGF表达水平与患者预后进行分析.结果 观察组胃癌组织VEGF及MVD阳性率显著高于对照组(P<0.01);观察组不同肿瘤TNM分期和有无淋巴结转移癌患者中VEGF及MVD表达差异有统计学意义(P<0.01);VEGF阳性者3年生存率和5年生存率显著低于VEGF阴性胃癌患者(P<0.01).结论 VEGF表达与血管生成和肿瘤进展、淋巴结转移密切相关,可作为判断老年进展胃癌预后的重要参考指标.

  13. Correlation analysis of prognosis of patients with severe trauma and traumatic coagulopathy and its related influ-encing factors%严重创伤患者预后与创伤性凝血病的相关性及其相关影响因素分析

    Institute of Scientific and Technical Information of China (English)

    杨琼柳; 杨寿吉; 徐登敢; 林金伟; 王俊道

    2014-01-01

    Objective To investigate the correlation of prognosis of patients with severe trauma and traumatic coagu-lopathy, and analysis the related influencing prognostic factors. Methods Ninety-six cases of patients with severe trauma were selected in emergency department. After admission, 10ml venous blood and 2 ml arterial blood were collected for de-tecting blood routine, coagulation, related biochemical tests and arterial blood gas analysis. All cases were divided into survival group(n=81) and death group(n=15) according to the prognosis of patients. The relationship between prognosis of patients with severe trauma and traumatic coagulopathy was analyzed and the influence to prognosis of the gender, age, traumatic time, APACHE Ⅱ scores, GCS scores, ISS scores, AIS scores and low body temperature and other indicators were analyzed. The severe trauma-related prognostic factors were analyzed. Results The incident rate of TIC in the deaths group was 53.33% which was significantly higher than the survival group of 12.34%(χ2=13.96, P<0.05). TIC was posi-tively correlated with prognosis of patients with severe trauma(r=0.38, P<0.05). The APACHEⅡ score, GCS score, ISS score, glucose, hemoglobin(Hb), hematocrit(HCT), platelet(Plt), prothrombin time(PT), activated partial thromboplas-tin time (APTT), international normalized ratio (INR), shock index≥1, the temperature<35℃ between two group were significantly different(t=4.01,4.94,3.93,3.42,4.81,6.23,4.85,6.48,4.36,3.64,χ2=7.19,7.82,P<0.05). The logistic anal-1.10,0.96,5.37,P<0.05). Conclusion Prognosis of patients with severe trauma was closely related to traumatic coagu-lopathy. Trauma severity, Plt count and APTT times were risk factors of prognosis of patients with severe trauma. It sug-gested that the prevention and treatment of traumatic coagulopathy should be further strengthen in clinical practice.%目的:探讨严重创伤患者预后与创伤性凝血病(TIC)相关性,分析影响预后的相关因素

  14. Tetany: Possible adverse effect of bevacizumab

    Directory of Open Access Journals (Sweden)

    S R Anwikar

    2011-01-01

    Full Text Available Background: Bevacizumab a recombinant humanized monoclonal antibody was approved in 2004 by US FDA for metastatic colorectal cancer. It is reported to cause potentially serious toxicities including severe hypertension, proteinuria, and congestive heart failure. Aim: To correlate adverse event tetany with the use of bevacizumab. Materials and Methods : World Health Organization′s Uppsala Monitoring Centre, Sweden, for reporting of adverse drug reactions from all over the world, identified 7 cases with tetany-related symptoms to bevacizumab from four different countries. These 7 patients reported to UMC database developed adverse events described as musculoskeletal stiffness (1, muscle spasm (1, muscle cramps (1, lock jaw or jaw stiffness (4, and hypertonia (1, with hypocalcaemia. Results: After detailed study of the possible mechanism of actions of bevacizumab and factors causing tetany, it is proposed that there is a possibility of tetany by bevacizumab, which may occur by interfering with calcium metabolism. Resorption of bone through osteoclasts by affecting VEGF may interfere with calcium metabolism. Another possibility of tetany may be due to associated hypomagnesaemia, hypokalemia, or hyponatremia. Conclusions: Tetany should be considered as a one of the signs. Patient on bevacizumab should carefully watch for tetany-related symptoms and calcium and magnesium levels for their safety.

  15. 湖北民族学院附属民大医院药品不良反应相关因素分析%Related Factors of Adverse Drug Reactions in Hubei University for Nationalities Affiliated Minda Hospital

    Institute of Scientific and Technical Information of China (English)

    李红玲; 庄红玲; 谭娜; 郭淑敏; 覃正碧

    2015-01-01

    OBJECTIVE:To analyze the related factors of the adverse drug reactions ( ADRs) in Hubei University for Nationalities Affiliated Minda Hospital so as to probe into the characteristics of the ADRs for clinical reference of safe medication.METHODS:A total of 75 ADR cases reported from January 2012 to October 2014 in this hospital were analyzed with regard to patients'age, drug type, routes of administration, ADR-involved organs or systems, and medication information and outcomes of the new and severe ADR cases.RESULTS: The ADRs occurred in different age group, and induced mostly by intravenously administered drugs, by anti-infective drugs and traditional Chinese medicine injections, and manifested mostly by the damage of skin and its appendages.The new and serious ADR occurred more often in patients with a history of allergy and in thosev treated with combination of multiple drugs. CONCLUSION:To avoid the risk of medication and reduce the occurrence of ADR in this hospital, it is important to attach great importance to the special population including the infants and elderly and those with hypersensitivity, reduce the ratio of intravenous administration, avoid excessive use of antimicrobial drugs and regulate the use of traditional Chinese medicine injections.%目的:通过对湖北民族学院附属民大医院上报的药品不良反应( ADR)及相关因素进行分析,了解药品不良反应发生特点,为临床安全用药提供依据。方法:收集该院2012年1月至2014年10月上报的200例ADR报告,对发生ADR的患者年龄、药品类别、用药途径、发生部位以及新发严重ADR的用药信息及转归等情况进行汇总统计分析。结果:ADR可涉及任意年龄阶段,静脉给药方式是引起ADR的主要途径,涉及药物以抗感染药物、中药注射剂为主,临床表现以皮肤及其附件损害的表现多见。新发严重ADR多发生在有过敏史的患者,且联合用药品种较多。结论:关

  16. Dynamic Insurance and Adverse Selection

    NARCIS (Netherlands)

    M.C.W. Janssen (Maarten); V.A. Karamychev (Vladimir)

    2001-01-01

    textabstractWe take a dynamic perspective on insurance markets under adverse selection and study a generalized Rothschild and Stiglitz model where agents may differ with respect to the accidental probability and their expenditure levels in case an accident occurs. We investigate the nature of dynami

  17. 超高龄后循环缺血性脑卒中患者的临床特点及其预后影响因素研究%Clinical Features and Influencing Factors of Prognosis in Super - aged Patients with Posterior Circulation Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    刘扣琴

    2015-01-01

    Objective To investigate the clinical features and influencing factors of prognosis in super - aged patients with posterior circulation ischemic stroke. Methods A total of 82 super - aged patients with posterior circulation ischemic stroke (equal or over 80 years old) were selected in Traditional Chinese Medicine Hospital of Zhangjiagang from 2010 to 2014,and their clinical data was immediately collected after admission,including gender,age,past medical history,symptoms and signs, NIHSS; related influencing factors of prognosis were recorded, including hypertension, diabetes, elevated LDL, hyperhomocysteinemia,coronary heart disease,atrial fibrillation,coronary heart disease,smoking history,drinking history and stroke history. All of the patients were followed up for 3 months,modified Rankin scale was used to evaluate the prognosis,and multivariate Logistic regression analysis was used to analyze the influencing factors of prognosis. Results The main clinical symptoms were dizziness/ vertigo( accounted for 69. 5% ) and weakness of extremities( accounted for 68. 3% ),the main clinical signs were acroparalysis( accounted for 54. 9% ),positive Babinski sign/ Chaddock sign( accounted for 46. 3% ), ataxia(accounted for 43. 9% )and central facial paralysis(accounted for 40. 2% ). After 3 - month fellow - up,56 patients got good prognosis( accounted for 68. 3% ),26 patients got bad prognosis( accounted for 31. 7% ). Multivariate Logistic regression analysis showed that,lower NIHSS at admission〔OR = 2. 648,95% CI(1. 552,4. 463)〕,longer time for seeing a doctor after attack〔 OR = 1. 784,95% CI(1. 142,2. 864)〕,stroke history〔 OR = 4. 402,95% CI(1. 165,16. 458)〕, hyperhomocysteinemia〔OR = 3. 624,95% CI(2. 360,5. 714)〕,hypertension〔OR = 2. 991,95% CI(1. 886,4. 705)〕, diabetes〔OR = 5. 903,95% CI ( 3. 884,9. 025 )〕, elevated LDL 〔 OR = 3. 052,95% CI ( 1. 663,7. 152 )〕 were independent risk factors of the bad prognosis. Conclusion The main clinical

  18. Differences in risk factors between anterior and posterior circulation affecting young ischemic stroke onset and prognosis%影响青年缺血性脑卒中短期预后危险因素的前后循环差异

    Institute of Scientific and Technical Information of China (English)

    杨姗杉; 贾建平

    2013-01-01

    目的 探讨常见危险因素与中国北方青年前后循环缺血性脑卒中及其短期预后的关系,为临床的预防和治疗提供依据.方法 本研究人选中国北方青年缺血性脑卒中患者446例,均来自首都医科大学宣武医院神经科2001-2010年间住院患者,其中单纯前循环353例、非前循环93例;单纯后循环56例、非后循环390例;同时累及前后循环37例,非前后循环同时受累409例.用非条件Logistic回归方法分析确定预测前后循环病变发生及影响其短期预后的危险因素.结果 Logistic回归分析得出的预测因素包括:年龄增长、高白细胞计数增加非前循环病变发生风险(OR0.951,P =0.030;OR0.876,P=0.014);饮酒史增加单纯后循环病变发生风险(OR1.856,P=0.047);高NIHSS评分,高总胆固醇含量预示单纯前循环病变短期预后不良(OR 1.884,P=0.000;OR1.792,P=0.008).结论 年龄、白细胞计数、饮酒、NIHSS评分和总胆固醇与中国北方青年缺血性脑卒中前后循环不同部位病变的发生及短期预后不良密切相关.%Objective To explore different risk factors between anterior and posterior circulation affecting onset and prognosis in the North Chinese young ischemic stroke patients.Methods This study included 446 cases of young ischemic stroke patients in northern China.All patients were recruited from our department from 2001 to 2010,Among them,the lesion sites were anterior circulation infarction (n =353),posterior circulation infarction (n =56) and both anterior and posterior circulation infarction (n =37).Nonconditional Logistic regression analysis was used to determine the risk factors of predicting the onset of either anterior or posterior or mixed stroke and their short-term prognosis.Results Advanced age and a higher white blood cell count (WBC) increased the risk of non-anterior circulation lesions (OR 0.951,P =0.030 ;OR 0.876,P =0.014).Patients with a history of alcohol drinking had an

  19. Kinome expression profiling and prognosis of basal breast cancers

    Directory of Open Access Journals (Sweden)

    Jacquemier Jocelyne

    2011-07-01

    Full Text Available Abstract Background Basal breast cancers (BCs represent ~15% of BCs. Although overall poor, prognosis is heterogeneous. Identification of good- versus poor-prognosis patients is difficult or impossible using the standard histoclinical features and the recently defined prognostic gene expression signatures (GES. Kinases are often activated or overexpressed in cancers, and constitute targets for successful therapies. We sought to define a prognostic model of basal BCs based on kinome expression profiling. Methods DNA microarray-based gene expression and histoclinical data of 2515 early BCs from thirteen datasets were collected. We searched for a kinome-based GES associated with disease-free survival (DFS in basal BCs of the learning set using a metagene-based approach. The signature was then tested in basal tumors of the independent validation set. Results A total of 591 samples were basal. We identified a 28-kinase metagene associated with DFS in the learning set (N = 73. This metagene was associated with immune response and particularly cytotoxic T-cell response. On multivariate analysis, a metagene-based predictor outperformed the classical prognostic factors, both in the learning and the validation (N = 518 sets, independently of the lymphocyte infiltrate. In the validation set, patients whose tumors overexpressed the metagene had a 78% 5-year DFS versus 54% for other patients (p = 1.62E-4, log-rank test. Conclusions Based on kinome expression, we identified a predictor that separated basal BCs into two subgroups of different prognosis. Tumors associated with higher activation of cytotoxic tumor-infiltrative lymphocytes harbored a better prognosis. Such classification should help tailor the treatment and develop new therapies based on immune response manipulation.

  20. Adverse effects of anti TB drugs in the treatment of elderly patients with pulmonary tuberculosis and its influencing factors%抗结核药物治疗老年肺结核的不良反应及影响因素

    Institute of Scientific and Technical Information of China (English)

    马安翠

    2016-01-01

    Objective:To explore the adverse effects of anti TB drugs in the treatment of elderly patients with pulmonary tuberculosis and its influencing factors.Methods:400 cases of elderly patients with pulmonary tuberculosis were selected. They were treated with anti tuberculosis drugs.We analyzed the influencing factors using single factor and multiple factors Logistic regression analysis.Results:In 400 patients,adverse drug reactions occurred in 118 cases(29.5%).Single factor analysis showed that age,body mass index,history of liver disease,treatment type and type of diagnosis were the factors that influence the adverse drug reaction.Multivariate Logistic regression analysis showed that age and history of liver disease were the risk factors of adverse drug reaction.Conclusion:Anti TB drugs were used in the treatment of elderly patients with pulmonary tuberculosis,and the incidence of adverse drug reactions was higher.Old age and history of liver disease were the risk factors of adverse drug reactions.In clinical work,we should fully investigate the patient’s medical history and reduce the incidence of adverse reactions.%目的:探讨抗结核药物治疗老年肺结核的不良反应和影响因素。方法:收治老年肺结核患者400例,采用抗结核药物治疗,采用单因素和多因素Logistic回归分析对影响疾病的相关因素进行分析。结果:在400例患者中,118例(29.5%)发生药物不良反应。单因素分析表明,年龄、体重指数、肝病史、治疗类型、诊断类型是影响药物发生不良反应的因素,多因素Logistic回归分析表明,年龄和肝病史是影响药物发生不良反应的危险因素。结论:使用抗结核药物治疗老年肺结核,其药物不良反应发生率较高,高龄和有肝病史是影响药物发生不良反应的危险因素,临床应对患者的病史做好充分调查,降低不良反应发生率。

  1. Risk factors and prognosis of posttraumatic cerebral infarction in patients with moderate or severe traumatic brain injury%中重度颅脑外伤患者继发急性外伤性脑梗死的危险因素和预后

    Institute of Scientific and Technical Information of China (English)

    魏小川

    2016-01-01

    Objective To study the risk factors and prognosis of posttraumatic cerebral infarction(PTCI)in patients with moderate or severe traumatic brain injury,so as to provide clinical reference.Methods Totally253 patients with severe traumatic brain injury were selected,of which 39 cases had PTCI within a week.Risk factors of PTCI were analyzed by using multi -factor Logistic regression.Re-sults Five patients died,6 patients in a vegetative state,28 cases of recovery of consciousness in 39 case of PTCI.Logistic regression analysis showed that Glasgow Coma Scale(GCS)after admission,a merger of the hernia,hypotension,intracranial hypertension,diffuse intravascular coagulation(DIC)score were PTCI risk factors(P <0.05);GCS score on admission,combined with hernia,hypotension, DIC score,concurrent infection were the independent image factors of poor prognosis of PTCI(P <0.05).Conclusions The GCS score on admission,combined with cerebral hernia,hypotension,DIC score are related with PTCI,and GCS score on admission,combined with cerebral hernia,hypotension,DIC score,concurrent infection are related to the prognosis of PTCI.%目的:研究中重度颅脑外伤患者继发急性外伤性脑梗死(PTCI)的危险因素和预后,为临床提供临床依据。方法选取中重度颅脑外伤患者253例,其中39例1周内发生 PTCI,应用多因素 Logistic 回归分析 PTCI 的危险因素。结果39例 PTCI患者中5例死亡,6例成植物人,28例意识恢复;Logistic 回归分析显示:入院后格拉斯哥昏迷量表(GCS)评分、是否合并脑疝、低血压、颅高压、弥漫性血管内凝血(DIC)评分是发生 PTCI 的危险因素(P <0.05);入院 GCS 评分、合并脑疝、低血压、DIC 评分、合并感染是引起 PTCI 预后不良的独立影像因素(P <0.05)。结论入院 GCS 评分、合并脑疝、低血压、DIC 评分与 PTCI有关,入院 GCS 评分、合并脑疝、低血压、DIC 评分、合并感染与 PTCI

  2. Influence factor of the prognosis of traumatic subretinal hemorrhage after vitreo-retinal surgery%玻璃体视网膜手术治疗外伤性视网膜下出血的预后影响因素

    Institute of Scientific and Technical Information of China (English)

    高新晓; 姜燕荣

    2010-01-01

    Objective To evaluate the influence factor of the prognosis of traumatic subretinal hemorrhage after vitreo-retinal surgery. Methods The clinical data of 50 patients with traumatic subretinal hemorrhage who had undergone vitreo-retinal surgery were retrospectively analyzed. All patients had ocular traurnatie history and subretinal hemorrhage diagnosed by fundus and B-scan examination; the preoperative visual acuity was less than 0. 1. According to different conditions, the traumatic eyes were treated with vitreo-retinal surgery, combined with lensectomy, retinotomy or silicone oil tamponade, respectively. The period of follow-up after surgery was 2-53 months, and the average period was 7.27 months. The corrected visual acuity and retinal reattachment at the last follow-up were observed. The visual acuity ≥0. 1 was the standard of good prognosis; retina[ reattachment was observed by indirect ophthalmoscope and color fundus photography. The prognostic factors mainly included type of injury, open or closed injury, the disease course, preoperative visual acuity, retinal detachment, hemorrhagic choroidal detachment, vitreous hemorrhage, the sites of submacular hemorrhage, methods of surgery. The relationships between those prognostic factors and visual acuity outcome or retinal reattachment were analyzed by χ2 test and logistic regression analysis. Results About 46.0% patients had good prognosis of the visualacuity. In the eyes with preoperative visual acuity of no light perception to hand moving and finger counting to 0. 1, the rate of good visual aeuitywas 34. 2% and 83.3%, respectively; the difference between the two groups was significant(χ2=8. 860, P = 0.003). In the eyes with or without preoperative retinal detachment, the rate of good visual acuity was 37.5% and 80. 0%, respectively; the difference between the two groups was significant (χ2=4. 232,P=0. 040). In the eyes with subretinal hemorrhage involving the macular fovea or not, the rate of good visual

  3. Worse Prognosis in Papillary, Compared to Tubular, Early Gastric Carcinoma

    Science.gov (United States)

    Yu, Huiping; Fang, Cheng; Chen, Lin; Shi, Jiong; Fan, Xianshan; Zou, Xiaoping; Huang, Qin

    2017-01-01

    Purpose: Papillary early gastric carcinoma (EGC) is uncommon but shows worse prognosis in our most recent study in a Chinese population with unknown reasons. The aim of the present study was to further investigate risk factors for worse prognosis in patients with papillary adenocarcinoma, compared to those with tubular adenocarcinoma. Methods: We searched the electronic pathology databank for radical gastrectomy cases over an 8-year period at a single medical center in Nanjing, China, and identified consecutive 240 EGC cases that were classified as either papillary (n=59) or tubular (n=181) EGC tumors in accordance with the World Health Organization (WHO) gastric cancer diagnosis criteria. We investigated and compared clinicopathologic risk factors for prognosis between papillary and tubular EGC groups. All patients were followed up and their 5-year survival rate was compared statistically with the Kaplan-Meier method with a log rank test. Results: Compared to tubular EGCs, papillary EGCs were significantly more common in elderly patients, more frequently occurred in the proximal stomach with protruding/elevated growth patterns, submucosal invasion, and a micropapillary component. Although lymphovascular invasion (16.9%), nodal (13.6%) and distant (11.8%) metastases in papillary EGCs were more frequent than those (8.3%, 7.2%, and 3.7%, respectively) in tubular EGCs, the differences approached but did not reach statistically significant levels. Significant risk factors for nodal metastasis included lymphovascular invasion in both EGC groups, but the ulcerative pattern and submucosal invasion only in tubular EGCs. The 5-year survival rate was significantly worse in papillary (80.5%) than in tubular (96.8%) EGCs. Conclusions: Compared to tubular EGCs, papillary EGCs diagnosed with the WHO criteria in Chinese patients were more frequent in elderly patients, proximal stomach and showed the significantly worse 5-year survival rate with more protruding/elevated growth

  4. Risk factors for the long-term prognosis of patients undergoing heart valve replacement and coronary artery bypass grafting%心瓣膜置换术同期行冠状动脉旁路移植术患者长期预后的危险因素探讨

    Institute of Scientific and Technical Information of China (English)

    缪丙荣

    2012-01-01

    Objective To investigate the risk factors for the long-term prognosis of patients undergoing heart valve replacement ( HVR ) and coronary artery bypass grafting ( CABG). Methods Fifty-seven patients who underwent HVR combined with CABG in our center were selected as the study objects, CABG combined with aortic operation were performed in 13 cases,CABG combined with double valve replacement were performed in 16 cases and CABG combined with mitral surgery were peformed in 28 cases; The mean number of the graft vessels was ( 1. 97 ?1. 36 ). The follow-up data were collected. Cox proportional hazard model was used to perform the univariate and multivariate analysis of risk factors. Results Fifty-five patients were followed up with the mean time of(57. 37 ?13. 98)months. Two patients were out of follow-up and 7 patients died; Cox proportional hazard model revealed that age > 70 years, pre-existing diabetes,history of myocardical infarction,chronic lung diseases,previous infarction,and left ventricular e-jection fraction (LVEF) =S40% were the independent risk factors for the long-term prognosis in patients undergoing HVR combined with CABG. Conclusion Age, pre-existing diabetes, history of myocardical infarction, chronic lung diseases,previous infarction,and LVEF<40% were the risk factors for the long-term prognosis in patients undergoing HVR combined with CABG.%目的 探讨影响心瓣膜置换术同期行冠状动脉旁路移植术(CABG)患者长期预后的危险因素.方法 57例同期行心脏瓣膜置换术和冠状动脉旁路移植术的患者,同行CABG和主动脉手术13例,同行CABG和双瓣膜手术16例,同行CABG和二尖瓣手术28例;移植血管(1.97±1.36)支.通过随访获取数据,对潜在危险因素先用Cox比例风险模型进行单变量分析,再将有统计学意义(P<0.05)的危险因素纳入Cox多变量回归.结果 失访2例,随访55例,平均随访时间(57.37±13.98)个月,随访期间共7例死亡;高龄(年龄>70岁)、

  5. Association of -260 polymorphism in the promoter of CD14 gene and prognosis factors of prostate cancer%CD14基因启动子区-260位点单核苷酸多态性与前列腺癌预后因素的研究

    Institute of Scientific and Technical Information of China (English)

    刘多; 刘成; 丁保军

    2011-01-01

    目的 研究白细胞分化抗原14(cluster of differentiation antigen 14,CD14)启动子区-260位点单核苷酸多态性(SNP)与影响前列腺癌预后因索的关系.方法 应用聚合酶链反应-连接酶特异检测技术(PCR-LDR)分析168例前列腺癌患者CD14基因-260位点的多态性,比较不同基因型与前列腺癌患者诊断时的前列腺癌特异性抗原(PSA)、Gleason评分和TNM临床分期的关系.结果 CD14-260 T(CT+TT)等位基因与PSA、Gleason评分和TNM临床分期均具有显著的相关性(adjusted OR=4.63,3.09,2.86;95%CI:2.87-9.28,2.12-7.33,2.21-5.31).结论 CD14-260 T(CT+TT)等位基因可能与前列腺癌预后有关,携带CD14-260 T(CT+TT)等位基因的前列腺癌患者可能预后较差.%Objectives To investigate the potential association between the polymorphism of -260 in the promoter of CD14 gene and prognosis factors (PSA, Gleason score and TNM clinical stage) of prostate cancer.Methods The polymorphism of CD14 -260 sites were analyzed by polymerase chain reaction - ligase detection reaction ( PCR - LDR) technique using genomic DNA isolated from peripheral blood. The association between the risk factors of prostate cancer and different genotypes was evaluated. Results The CD14 - 260T variant allele (CT+TT) was associated with higher PSA value of prostate cancer ( adjusted OR = 4.63; 95% CI = 2.87 - 9.28 ).It was also noted that the CD14 -260T variant allele was associated with higher Gleason score and advanced TNM clinical stage of prostate cancer patients ( adjusted OR = 3.09,2.86; 95% CI = 2.12 - 7.33, 2.21 - 5. 31, respectively). Conclusions The results demonstrated that the CD14 -260 C to T variant influenced the PSSA value,Gleason score and TNM clinical stage of prostate cancer. The CD14 -260T variant might be a risk factor in the prognosis of prostate cancer.

  6. Analysis of the clinical features of and responsive factors on the prognosis in patients with fulminant hepatic failure%暴发性肝功能衰竭患者的临床特征及其预后的影响因素

    Institute of Scientific and Technical Information of China (English)

    张琳; 韩峰; 吴丹; 张丹; 冯国和

    2010-01-01

    of the patients with fulminant hepatic failure were analyzed. Indexes including prothrombin time(PT), the routine biochemical analysis of liver and kidney functions, the plasma levels of glucose and ammonia, cortisol, lipases, amylase, age, gender and complications were analyzed using the software Statistical Product and Service Solutions (SPSS)15.0. The differences between the died and living patients were compared. Results The mortality of the patients was 65% and the highest was 80% for those with HBV and HEV coinfection. The age and gender had no influence on mortality (P value was 0.423 and 0.728 respectively).HBV infection was the main factor which caused fulminant hepatic failure(52%), The next was hepatitis E virus infection (39%). Among the indexes analyzed, the plasma levels of total bilirubin, usea nitrogen, creatinine,glucose, cholesterol and prothrombin time had positive correlations with the prognosis of the patients (P value was 0.005, 0.001, 0.001, 0.005, 0.010 and 0.049 respectively). The incidence rate of hepatic coma,hepatorenal syndrome, and adrenal insufficiency were higher in the died group than that in the living group (P value was 0.005, 0.012 and 0.025 respectively). But prothrombin time was the only factor which had correlation with the prognosis (P=0.035) analyzed by multivariate logistic regression analysis. The scores of MELD were higher in the died group than that in living group (t=18.236, P<0.01) and especially in the patients with hepatic coma and hepatorenal syndrome.The scores of MELD also had positive correlation with the plasma level of TNFα(r=0.585, P<0.01). Conclusions The HBV infection was the main cause of fulminant hepatic failure and HBV and HEV coinfection had the highest mortality. The plasma levels of total bilirubin, cholesterol, glucose, prothrombin time and some complications including hepatic coma, hepatorenal syndrome, and adrenal insufficiency maybe had positive correlations with the prognosis of fulminant hepatic

  7. Value of dual time point F-18 FDG-PET/CT imaging for the evaluation of prognosis and risk factors for recurrence in patients with stage I non-small cell lung cancer treated with stereotactic body radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Satoh, Yoko, E-mail: pecampecam@yahoo.co.jp [PET Center, Kofu Neurosurgical Hospital, ZIP Code 400-0805, Sakaori 1-16-18, Kofu city, Yamanashi Prefecture (Japan); Nambu, Atsushi, E-mail: nambu-a@gray.plala.or.jp [Department of Radiology, University of Yamanashi, ZIP Code 409-3898, Yamanashi University Faculty of Medicine, Shimokato 1110, Chuo City, Yamanashi Prefecture (Japan); Onishi, Hiroshi, E-mail: honishi@yamanashi.ac.jp [Department of Radiology, University of Yamanashi, ZIP Code 409-3898, Yamanashi University Faculty of Medicine, Shimokato 1110, Chuo City, Yamanashi Prefecture (Japan); Sawada, Eiichi, E-mail: e_sawaday_61674@ybb.ne.jp [Department of Radiology, University of Yamanashi, ZIP Code 409-3898, Yamanashi University Faculty of Medicine, Shimokato 1110, Chuo City, Yamanashi Prefecture (Japan); Tominaga, Licht, E-mail: lichtt@gmail.com [Department of Radiology, University of Yamanashi, ZIP Code 409-3898, Yamanashi University Faculty of Medicine, Shimokato 1110, Chuo City, Yamanashi Prefecture (Japan); Kuriyama, Kengo, E-mail: kuriyama@yamanashi.ac.jp [Department of Radiology, University of Yamanashi, ZIP Code 409-3898, Yamanashi University Faculty of Medicine, Shimokato 1110, Chuo City, Yamanashi Prefecture (Japan); Komiyama, Takafumi, E-mail: takafumi-ymu@umin.ac.jp [Department of Radiology, Kofu Municipal Hospital, ZIP Code 400-0832, Masutsubo-cho 366, Kofu City, Yamanashi Prefecture (Japan); Marino, Kan, E-mail: marino-akrf@ych.pref.yamanashi.jp [Department of Radiology, Yamanashi Prefectural Hospital, ZIP Code 400-8506, Fujimi 1-1-1, Kofu City, Yamanashi Prefecture (Japan); Aoki, Shinichi, E-mail: aokis@yamanashi.ac.jp [Department of Radiology, University of Yamanashi, ZIP Code 409-3898, Yamanashi University Faculty of Medicine, Shimokato 1110, Chuo City, Yamanashi Prefecture (Japan); and others

    2012-11-15

    Purpose: To investigate prognostic and risk factors for recurrence after stereotactic body radiation therapy (SBRT) in patients with stage I non-small cell lung carcinoma (NSCLC), focusing on dual time point [18]F-fluorodeoxyglucose positron emission tomography (FDG PET). Materials and methods: We prospectively evaluated 57 patients with stage I NSCLC (45 T1N0M0 and 12 T2N0M0) who had undergone pretreatment FDG-PET/CT and were subsequently treated with SBRT. All patients received a whole-body PET/CT scan at 60 min and a whole-lung at 120 min after the injection. The maximum standardized uptake value (SUV) and retention index (RI) of the lesions were calculated. Local recurrence, regional lymph node metastasis, distant metastasis, and the recurrence pattern were evaluated. Cox proportional hazard regression analyses were performed to evaluate prognostic factors or risk factors of recurrence. Results: During the median follow-up period of 27 months, local recurrence, regional lymph node metastasis, and distant metastasis were seen in 17 (30%), 12 (21%), and 17 (30%) of the 57 patients, respectively. The 3-year overall survival rate was 63.4%. SUV{sub max} did not affect any recurrence, DFS, OS, or CSS. RI significantly predicted higher distant metastasis (HR 47.546, p = 0.026). In contrast, RI tended to predict lower local recurrence (HR 0.175, p = 0.246) and regional lymph node metastasis (HR 0.109, p = 0.115). Conclusions: SUV{sub max} at staging FDG-PET does not predict any recurrence, DFS, OS or CSS. In contrast, higher RI predicts higher distant metastasis and tended to predict lower local or regional lymph node metastasis.

  8. Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis

    Directory of Open Access Journals (Sweden)

    Rima eMoghnieh

    2015-02-01

    Full Text Available Bacteremia remains a major cause of life-threatening complications in patients receiving anticancer chemotherapy. The spectrum and susceptibility profiles of causative microorganisms differ with time and place. Data from Lebanon are scarce. We aim at evaluating the epidemiology of bacteremia in cancer patients in a university hospital in Lebanon, emphasizing antibiotic resistance and risk factors of multi-drug resistant organism (MDRO-associated bacteremia.This is a retrospective study of 75 episodes of bacteremia occurring in febrile neutropenic patients admitted to the hematology-oncology unit at Makassed General Hospital, Lebanon, from October 2009-January 2012.It corresponds to epidemiological data on bacteremia episodes in febrile neutropenic cancer patients including antimicrobial resistance and identification of risk factors associated with third generation cephalosporin resistance (3GCR and MDRO-associated bacteremia. Out of 75 bacteremias, 42.7% were gram-positive (GP, and 57.3% were gram-negative (GN. GP bacteremias were mostly due to methicillin-resistant coagulase negative staphylococci (28% of total bacteremias and 66% of GP bacteremias. Among the GN bacteremias, Escherichia coli (22.7% of total, 39.5% of GN organisms and Klebsiellapneumoniae(13.3% of total, 23.3% of GN organisms were the most important causative agents. GN bacteremia due to 3GC sensitive (3GCS bacteria represented 28% of total bacteremias, while 29% were due to 3GCR bacteria and 9% were due to carbapenem-resistant organisms. There was a significant correlation between bacteremia with MDRO and subsequent intubation, sepsis and mortality. Among potential risk factors, only broad spectrum antibiotic intake >4 days before bacteremia was found to be statistically significant for acquisition of 3GCR bacteria. Using carbapenems or piperacillin/ tazobactam>4 days before bacteremia was significantly associated with the emergence of MDRO (p value<0.05.

  9. Analysis of Influential Factors on the Recent Prognosis in Patients with Premature Acute Myocardial Infarction%早发急性心肌梗死患者影响近期预后危险因素分析

    Institute of Scientific and Technical Information of China (English)

    游波

    2013-01-01

    Objective:The purpose of this study is to investigate the influential factors of patients with premature acute myocardial infarction to put forward directed intervention according to their risk factors of premature acute myocardial infarction.Methods:We collected clinical data of two hundred seventy-one cases of patients with acute myocardial infarction who were treated in the department of cardiology in our hospital from October 2005 to October 2011 by the self-made general data questionnaire,then they were divided into death group and survival group according to whether death or not within three months.Results:Univariate Logistic regression analysis showed that body mass index,gender,animal fat intake,hyperlipidemia,cardiogenic shock,heart failure,old myocardial infarction history and family history of coronary heart disease were the risk factors for death patients with acute myocardial infarction within three months;Multivariate logistic analysis showed that hyperlipidemia,cardiogenic shock,heart failure and ventricular fibrillation had a risk effect on death patients with acute myocardial infarction within three months.Conclusion:The influential factors of patients with acute myocardial infarction was affected by many factors,it is a significant poor predictor symptoms of cardiogenic shock and heart failure in patients with acute myocardial infarction,paid more attention for these significant rsikers,woulb be reduced morbility of premature acute myocardial infarction.%  目的:探讨影响早发急性心肌梗死患者近期预后的危险因素,旨在为早期针对性对中青年急性心肌梗死患者进行干预提供参考依据。方法:收集我院心内科2005年10月~2011年10月期间住院治疗的983例早发急性心肌梗死患者为观察对象,按照患者3个月内死亡与否将其分为死亡组与存活组,采用自编问卷收集2组患者的临床资料。结果:单因素Logistic回归分析结果示体重指数、性别

  10. Human eating: diagnosis and prognosis.

    Science.gov (United States)

    Herman, C P

    1996-01-01

    Despite substantial recent progress, we remain without a comprehensive theory of human eating. The constraining influence of the single-factor, hunger-satiety model of feeding in animals is addressed. Three aspects of human eating--counter-regulation in dieters, the effects of social models, and the influence of distress on eating--are reviewed briefly, in an attempt to demonstrate that a simple hunger-satiety model cannot handle the data. It is imperative that we consider social, cognitive, and other influences on eating as important casual agents in their own right; these influences are not necessarily mediated by their effect on hunger-satiety. A comprehensive theory of human eating is not likely to appear soon, but there are grounds for optimism in the process (rather than the final result) of research.

  11. Risk factors of combined hospital-acquired pneumonia in patients with acute intracerebral hemorrhage and analysis of prognosis%急性脑出血术后合并医院获得性肺炎危险因素及预后分析

    Institute of Scientific and Technical Information of China (English)

    徐将荣

    2011-01-01

    目的 分析急性脑出血术后合并医院获得性肺炎(HAP)患者的危险因素及其影响预后.方法 选取2007年4月-2010年4月医院神经外科住院的72例急性脑出血术后合并HAP患者,按年龄分为:高龄组(≥75岁)36例,低龄组(<75岁)36例;分析两组患者的收缩压(SP)、舒张压(DP)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、白色假丝酵母菌(CAL)感染率、MRSA感染率、肺炎克雷伯菌(KPN)感染率与随访1年后生活自理能力评分(BI)的相关性,并比较两组BI、再出血率及死亡率的差异.结果 两组患者的SP、HbA1c、TC、CAL感染率、MRSA感染率、KPN感染率与BI值均呈负相关关系,r值分别为-0.854、-0.901、-0.742、-0.886、-0.911、-0.798;而DP与BI值均无明显相关,r值为-0.114.结论 急性脑出血术后合并HAP患者危险因素有SP、HbAlc、TC、CAL感染率、MRSA感染率、KPN感染率,且高龄患者预后差.%OBJECTIVE To analyze the risk factors effecting on prognosis of patients with acute intracerebral hemorrhage(ICH) post-operation complicated hospital-acquired pneumonia ( HAP). METHODS A total of 72 patients with acute 1CH post-operation complicated HAP in our hospital were divided into two groups, senility group (age>75) and young group (age<75), each group involved 36 patients, according the age. The factors of SP, DP, HbAlc, TC, Candida albicans(CA) infection rate, MRSA infection rate and Klebsiella pneumoniae(KP) infection rate were analyzed, the correlation to the value of Barthel index(BI) after 1 year follow-up. And Bl, recurrency rate and mortality rate were compared between two groups. RESULTS The negative correlation coefficients of SP, HbAlc, TC, CA infection rate, MRSA infection rate, KP infection rate with BI were confirmed, and DP was no correlation coefficients with these indexs. And the difference of BI, recurrency rate and mortality rate were present between two groups(P<0. 05). CONCLUSION The risk factors effecting on

  12. Factors of poor prognosis of visceral leishmaniasis among children under 12 years of age. A retrospective monocentric study in Belo Horizonte, State of Minas Gerais, Brazil, 2001-2005

    Directory of Open Access Journals (Sweden)

    Alexandre Sérgio da Costa Braga

    2013-01-01

    Full Text Available INTRODUTION: A major concern with the visceral leishmaniasis (V