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Sample records for prognosis dnr status

  1. DNR Watersheds - DNR Level 08 - All Catchments

    Data.gov (United States)

    Minnesota Department of Natural Resources — These data consists of over 10,000 polygon delineations in one seamless dataset of drainage area delineations called Minnesota Department of Natural Resources (DNR)...

  2. DNR Watersheds - DNR Level 02 - HUC 04

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    Minnesota Department of Natural Resources — These data consists of watershed delineations in one seamless dataset of drainage areas called Minnesota Department of Natural Resources (DNR) Level 02 Watersheds....

  3. DNR 24K Lakes

    Data.gov (United States)

    Minnesota Department of Natural Resources — Medium scale lake polygons derived from the National Wetlands Inventory (NWI) polygons and MnDOT Basemap lake delineations. Integrated with the DNR 24K Streams...

  4. DNR Watersheds - DNR Level 04 - HUC 08 - Majors

    Data.gov (United States)

    Minnesota Department of Natural Resources — These data consists of 81 watershed delineations in one seamless dataset of drainage areas called Minnesota Department of Natural Resources (DNR) Major Watersheds....

  5. Wildfires Tracked by Minnesota DNR

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    Minnesota Department of Natural Resources — This theme shows the locations of wildfires for which the DNR was the primary responding agency. These include fires not only on state lands, but also rural private...

  6. Minnesota DNR Forest Stand Inventory Version 2

    Data.gov (United States)

    Minnesota Department of Natural Resources — This layer is a digital inventory of individual forest stands. The data is collected by DNR Foresters in each DNR Forestry Administrative Area, and is updated on a...

  7. State Lands by Administrator - Other DNR Units

    Data.gov (United States)

    Minnesota Department of Natural Resources — DNR land ownership and administrative interest mapped to the PLS forty level. This layer merges the DNR Control Point Generated PLS layer with IBM mainframe-based...

  8. Socioeconomic status and prognosis of COPD in Denmark.

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    Lange, Peter; Marott, Jacob Louis; Vestbo, Jørgen; Ingebrigtsen, Truls Sylvan; Nordestgaard, Børge Grønne

    2014-08-01

    We investigated the association between length of school education and 5-year prognosis of chronic obstructive lung disease (COPD), including exacerbations, hospital admissions and survival. We used sample of general population from two independent population studies: The Copenhagen City Heart Study and Copenhagen General Population Study. A total of 6,590 individuals from general population of Copenhagen with COPD defined by the Global initiative for obstructive lung disease criteria were subdivided into 4 groups based on the length of school education: 1,590 with education education 8-10 years, 1,244 with more than 10 years, but no college/university education and 625 with college/university education. Compared with long education, short education was associated with current smoking (p education (in comparison with university education), was associated with a higher risk of COPD exacerbations (hazards ratio 1.65, 95% CI 1.15-2.37) and higher risk of all-cause mortality (hazards ratio 1.96, 95% CI 1.28-2.99). We conclude that even in an economically well-developed country with a health care system (which is largely free of charge), low socioeconomic status, assessed as the length of school education, is associated with a poorer clinical prognosis of COPD.

  9. Socioeconomic status in HCV infected patients – risk and prognosis

    Directory of Open Access Journals (Sweden)

    Oml

    2013-05-01

    medium income persons. The OR was 1.35 (95% CI: 1.20–1.52 for low education (no more than basic schooling. When compared to employed patients, MRRs were 1.71 (95% CI: 1.22–2.40 for unemployed patients and 2.24 (95% CI: 1.63–3.08 for disability pensioners. When compared to high income patients, MRRs were 1.47 (95% CI: 1.05–2.05 for medium income patients and 1.64 (95% CI: 1.13–2.34 for low income patients. Educational status was not associated with mortality.Conclusion: Low SES was associated with an increased risk of HCV infection and with poor prognosis in HCV infected patients.Keywords: survival, socioeconomic status, risk factor, prognosis

  10. The Karamazov complex: Dostoevsky and DNR orders.

    Science.gov (United States)

    Montello, Martha M; Lantos, John D

    2002-01-01

    Families making difficult end-of-life decisions in the intensive care unit often do not exercise their autonomy in accord with the individualistic philosophic and legal models that currently prevail. Instead, they try to avoid responsibility and deny complicity, even for decisions that they ultimately approve. This paper examines two novels and a recent case from a neonatal intensive care unit that reveal how people actually make tragic decisions for family members. Dostoevsky's The Brothers Karamazov and Kenzaburo Oe's A Personal Matter explore the patterns of communication by which people in such situations test complicity and share or submerge accountability. The psychological similarities between the novelists' portrayals and the actual processes that families undergo in the ICU have practical clinical implications for the ways physicians approach discussions about do not resuscitate (DNR) orders with patients' family members.

  11. Socioeconomic status and prognosis of COPD in Denmark

    DEFF Research Database (Denmark)

    Lange, Peter; Marott, Jacob Louis; Vestbo, Jørgen

    2014-01-01

    We investigated the association between length of school education and 5-year prognosis of chronic obstructive lung disease (COPD), including exacerbations, hospital admissions and survival. We used sample of general population from two independent population studies: The Copenhagen City Heart......,131 with education 8-10 years, 1,244 with more than 10 years, but no college/university education and 625 with college/university education. Compared with long education, short education was associated with current smoking (p ... volume in the first second in percent of predicted value (FEV1%pred) (p smoking we observed that shortest school education (in comparison with university education), was associated with a higher risk of COPD...

  12. DNR Division of Parks and Trails District Boundaries

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data shows the DNR Division of Parks and Trails District Boundaries as of May 2010. The boundaries were created by the Division Leadership Team. Boundaries are...

  13. The DNR Order: What Does it Mean?

    Directory of Open Access Journals (Sweden)

    John Y.C. Tsang Md

    2010-04-01

    Full Text Available As medical science continues to advance, patients nowadays with progressive cardiopulmonary diseases live to older ages. However, they too will eventually reach their unsustainable physiological limit and many die in poor health and discomfort prior to their demise. Regrettably many physicians have not kept pace in dealing with the inevitable end-of- life issues, along with modern technological developments. Without proper guidance, ill-informed patients often face unnecessary anxiety, receive futile resuscitation at the expense of their dignity and public cost which has and will become increasingly overwhelming according to our current demographic trends. In any health care reform, experts often suggest that difficult questions will have to be asked but the solutions are at least partly in the logistical details. From time to time, we see an isolated “Do Not Resuscitate” or DNR order in the chart, which is not always followed by thoughtful discussion on the boundary of care, either simultaneously or known to be followed up soon. This paper attempts to begin asking some of these difficult questions, point out the fallacies of this order and expose the weaknesses in the present state of entitlement by public demand if physicians retreats more from the discussion. The solution does not lie in asking the questions but in changing the practice pattern in real life on a continuous basis, hopefully to be eventually accepted by most, if not all.

  14. Association of Preoperative Nutritional Status with Prognosis in Patients with Esophageal Cancer Undergoing Salvage Esophagectomy.

    Science.gov (United States)

    Sakai, Makoto; Sohda, Makoto; Miyazaki, Tatsuya; Yoshida, Tomonori; Kumakura, Yuji; Honjo, Hiroaki; Hara, Keigo; Ozawa, Daigo; Suzuki, Shigemasa; Tanaka, Naritaka; Yokobori, Takehiko; Kuwano, Hiroyuki

    2018-02-01

    To investigate whether malnutrition is associated with poor prognosis of patients who undergo salvage esophagectomy. We examined the association between the preoperative prognostic nutritional index (PNI) and prognosis of patients who undergo salvage esophagectomy. We conducted a single-center retrospective study and reviewed hospital patient records for tumor characteristics and patient outcomes. Univariate and multivariate survival analyses were carried out using the Cox proportional hazards regression model. Thirty-two patients with esophageal squamous cell carcinoma (ESCC) who underwent salvage esophagectomy between 1998 and 2015 at our Institute were included in this study. Univariate analysis revealed that clinical response (p=0.045), preoperative PNI (pnutritional status is associated with the prognosis of patients undergoing salvage esophagectomy. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  15. A communication training perspective on AND versus DNR directives.

    Science.gov (United States)

    Levin, Tomer T; Coyle, Nessa

    2015-04-01

    From a communication perspective, the term "do not resuscitate" (DNR) is challenging to use in end-of-life discussions because it omits the goals of care. An alternative, "Allow Natural Death" (AND), has been proposed as a better way of framing this palliative care discussion. We present a case where a nurse unsuccessfully discusses end-of-life goals of care using the term DNR. Subsequently, with the aid of a communication trainer, he is coached to successfully use the term "AND" to facilitate this discussion and advance his goal of palliative care communication and planning. We contrast the advantages and disadvantages of the term AND from the communication training perspective and suggest that AND-framing language replace DNR as a better way to facilitate meaningful end-of-life communication. One well-designed, randomized, controlled simulation study supports this practice. We also consider the communication implications of "natural" versus "unnatural" death.

  16. MRI Features and IDH Mutational Status of Grade II Diffuse Gliomas: Impact on Diagnosis and Prognosis.

    Science.gov (United States)

    Villanueva-Meyer, Javier E; Wood, Matthew D; Choi, Byung Se; Mabray, Marc C; Butowski, Nicholas A; Tihan, Tarik; Cha, Soonmee

    2018-03-01

    Grade II diffuse gliomas (DGs) with isocitrate dehydrogenase (IDH) mutations are associated with better prognosis than their IDH wild-type counterparts. We sought to determine the MRI characteristics associated with IDH mutational status and ascertain whether MRI considered in combination with IDH mutational status can better predict the clinical outcomes of grade II DGs. Preoperative MRI examinations were retrospectively studied for qualitative tumor characteristics, including location, extent, cortical involvement, margin sharpness, cystic component, mineralization or hemorrhage, and contrast enhancement. Quantitative diffusion and perfusion metrics were also assessed. Logistic regression and ROC analyses were used to evaluate the relationship between MRI features and IDH mutational status. The association between IDH mutational status, 1p19q codeletion, MRI features, extent of resection, and clinical outcomes was assessed by Kaplan-Meier and Cox proportional hazards models. Of 100 grade II DGs, 78 were IDH mutant and 22 were IDH wild type. IDH wild-type tumors were associated with older age, multifocality, brainstem involvement, lack of cystic change, and a lower apparent diffusion coefficient (ADC). Multivariable regression showed that age older than 45 years as well as low minimum ADC (ADC min ), mean ADC, and maximum ADC values were independently associated with IDH mutational status. Of these, an ADC min threshold of 0.9 × 10 -3 mm 2 /s or less provided the greatest sensitivity and specificity (91% and 76%, respectively) in defining IDH wild-type grade II DGs. Combining low ADC min with IDH wild-type status conferred worse outcomes than did IDH wild-type status alone. IDH wild-type grade II DGs are associated with a lower ADC and poor clinical outcomes. Combining IDH mutational status and ADC may allow more accurate prediction of clinical outcomes for patients with grade II DGs.

  17. Preoperative controlling nutritional status (CONUT) is useful to estimate the prognosis after esophagectomy for esophageal cancer.

    Science.gov (United States)

    Yoshida, Naoya; Harada, Kazuto; Baba, Yoshifumi; Kosumi, Keisuke; Iwatsuki, Masaaki; Kinoshita, Koichi; Nakamura, Kenichi; Sakamoto, Yasuo; Miyamoto, Yuji; Karashima, Ryuichi; Mima, Kosuke; Sawayama, Hiroshi; Ohuchi, Mayuko; Chikamoto, Akira; Imamura, Yu; Watanabe, Masayuki; Baba, Hideo

    2017-03-01

    The aim of this study is to confirm the predictive value of controlling nutritional status (CONUT), as a postoperative prognostic marker for esophageal cancer patients undergoing esophagectomy. We retrospectively analyzed 373 patients who underwent three-incision esophagectomy with 2- or 3-field lymphadenectomy for esophageal cancer between April 2005 and March 2016. The patients were divided into three groups based on the degree of preoperative malnutrition as assessed by CONUT: normal, light malnutrition, and moderate or severe malnutrition. The patients with moderate or severe malnutrition experienced a significantly higher frequency of reoperation (normal or light malnutrition, 6.3%; moderate or severe malnutrition, 18.2%; P = 0.033) and a higher tendency for respiratory morbidities (normal or light malnutrition, 14.0%; moderate or severe malnutrition, 27.3%; P = 0.088). Cox regression analysis identified a significantly poor prognosis, in both overall survival (hazard ratio (HR), 3.56; 95% confidence interval (CI), 1.714-7.390; P cancer-specific survival (HR, 3.41; 95% CI, 1.790-6.516; P = 0.046). CONUT is convenient and useful for preoperatively assessing malnutrition and prognosis of esophageal cancer patients who underwent surgery.

  18. HER2 status for prognosis and prediction of treatment efficacy in adenocarcinomas: a review.

    Science.gov (United States)

    Thibault, Constance; Khodari, Wassim; Lequoy, Marie; Gligorov, Joseph; Belkacémi, Yazid

    2013-10-01

    The past few years have seen flourish new biologic parameters for cancer prognosis that are revolutionizing therapeutic strategies. HER-2 is in this perspective a striking example, as it is now a key element for the care of 15-20% of breast cancer. HER-2 overexpression has first been reported as a prognostic factor before its consideration as a main parameter to predict treatment efficacy. However, although HER-2 status is now also used as a prognostic factor for many cancers, its ability to predict the action of trastuzumab in these new contexts is much lower than in breast cancer. In this literature review, we aimed to discuss HER-2 overexpression as a prognostic factor and as a predictive parameter of treatment response in selected solid tumors with a focus on adenocarcinomas. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. [Phase angle as an indicator of nutritional status and prognosis in critically ill patients].

    Science.gov (United States)

    Reis de Lima e Silva, Renata; Porto Sabino Pinho, Cláudia; Galvão Rodrigues, Isa; Gildo de Moura Monteiro Júnior, José

    2014-09-12

    The phase angle (PA) has been considered a sensitive tool to assess nutritional status and effectiveness of interventions dietetics. To evaluate the PA as an indicator of nutritional status and prognosis in critically ill patients. Prospective observational study of patients admitted to the Coronary Intensive Care Unit between May and October 2013. The PA was determined by bioelectrical impedance analysis, PA was considered low below 5º values for men and 4.6º for women. The values obtained were related to other evaluation parameters of nutritional status: anthropometric (arm circumference - AC , triceps skinfold thickness - TST , corrected arm muscle area - AMAc and calf circumference - CC) and biochemical (total lymphocyte count, hemoglobin, hematocrit), in addition to clinical prognostic APACHE II (Acute Physiology and Chronic Health Disease Classification System II) and serum albumin. The tabulation and analysis were performed using SPSS version 13.0. The sample consisted of 110 patients, in which an association was found between low AF and renal failure on dialysis (p < 0.001), % adequacy AC (p = 0.028), % adequacy of TST (p = 0.043), albumin level (p = 0.042), anemia (p = 0.040) and APACHE II (p = 0.012) scores. The AF was positively correlated with CC (p= 0.043) and inversely with the length of hospitalization (p = 0.006). PA in the ICU may be useful to identify early and malnourished patients as a prognostic indicator. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Interaction of gonadal status with systemic inflammation and opioid use in determining nutritional status and prognosis in advanced pancreatic cancer.

    Science.gov (United States)

    Skipworth, Richard J E; Moses, Alastair G W; Sangster, Kathryn; Sturgeon, Catharine M; Voss, Anne C; Fallon, Marie T; Anderson, Richard A; Ross, James A; Fearon, Kenneth C H

    2011-03-01

    Hypogonadism has been linked with systemic inflammation and opioid use in males with advanced cancer. We aimed to investigate the interaction of gonadal status with systemic inflammation and opioids in determining nutritional status and prognosis in advanced pancreatic cancer. One hundred and seventy-five patients (92 males, 83 postmenopausal females) with unresectable pancreatic cancer were studied. Serum sex steroids (total testosterone [TT], calculated free testosterone [cFT], oestradiol, sex hormone binding globulin), gonadotropins (follicle-stimulating hormone and luteinising hormone) and pro-inflammatory mediators (C-reactive protein [CRP], interleukin-6 [IL-6], soluble tumour necrosis factor receptor 75 [sTNFR75]) were measured, and nutritional assessment and opioid use recorded. Seventy-three percent of males were hypogonadal (by cFT definition). cFT correlated positively with BMI (r (2) =0.349; pcancer, systemic inflammation and opioid use are associated with hypogonadism. Male hypogonadism and female hyperoestrogenism are associated with shortened survival in advanced pancreatic cancer.

  1. Human papilloma virus (HPV) status associated with prognosis of cervical cancer after radiotherapy

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    Harima, Yoko; Miyazaki, Yuki; Imamura, Masahiro; Sougawa, Mitsuharu; Sawada, Satoshi [Kansai Medical Univ., Moriguchi, Osaka (Japan)

    2002-06-01

    Our study explored whether the HPV status of tumors is associated with the outcome of radiotherapy in patients with cervical cancer. A total of 84 patients with cervical cancer (6 stage I, 10 stage II, 49 stage III, and 19 stage IV) who underwent definitive radiotherapy between January 1995 and June 2000 were included in this study. Tumor samples were obtained from all patients by punch biopsy prior to radiotherapy. The presence of HPV and its type were analyzed by PCR-based assay using the consensus primers for E6 and L1 regions. Actuarial methods were used to calculate overall survival, and disease-free survival. A total of 42 patients (50%) had cancer recurrence after radiotherapy. HPV-positive tumors were found in 76.2% (64 cases) of the patients. HPV-negative patients survived significantly shorter compared to the HPV-positive patients in the overall survival (p=0.007) and the disease-free survival (p=0.005). According to multivariate analysis, HPV status is a significant predictor of both overall (p=0.02) and disease-free survival time (p=0.005). These results of this study suggest that HPV-negative patients with cervical carcinoma are have a significantly poorer prognosis after radiotherapy, and may be used as a marker in order to optimize the treatment of patients with this type of cancer. (author)

  2. Impact of income status on prognosis of acute coronary syndrome patients during Greek financial crisis.

    Science.gov (United States)

    Andrikopoulos, George; Tzeis, Stylianos; Terentes-Printzios, Dimitrios; Varounis, Christos; Vlachopoulos, Charalampos; Mantas, Ioannis; Patsilinakos, Sotirios; Lampropoulos, Stylianos; Olympios, Christoforos; Kartalis, Athanasios; Manolis, Athanasios; Gotsis, Alexandros; Triposkiadis, Filippos; Tsaknakis, Themistoklis; Goudevenos, Ioannis; Kaprinis, Ioannis; Pras, Athanasios; Vasiliou, Fotios; Skoumpourdis, Emmanouil; Sakka, Gerasimoula; Draganigos, Antonios; Vardas, Panos

    2016-06-01

    The effect of income status on patient outcome merits investigation during periods of financial crisis. We evaluated the impact of income status on out-of-hospital prognosis in a cohort of acute coronary syndrome (ACS) patients, included in a countrywide study during a period of financial crisis. The study is a secondary analysis of a prospective, multicenter, observational study-the PHAETHON study-enrolling consecutive ACS patients in 37 hospitals in Greece. Patients were classified as low or high income based on the reported net annual household income using as a cut-off point the relative poverty threshold for Greece of 12,000 Euros. The outcome measure was survival free of the primary composite endpoint (cardiovascular death, myocardial infarction, stroke/transient ischemic attack, urgent revascularization and urgent hospitalization due to cardiovascular causes). The study population included 794 patients. The administration rate of evidence-based medications was similar in the low- (n = 455) and high-income (n = 339) groups during hospitalization and upon discharge. In a median follow-up of 189 days (interquartile range: 180-212 days), low-income patients had 92 % higher risk of the combined endpoint as compared to high-income patients [Hazard ratio (HR):1.92, 95 % CI:1.25-2.94, p = 0.003]. The effect of low-income status on the combined outcome remained significant after adjustment for age, gender and depression (HR:1.59, 95 % CI:1.02-2.49; p = 0.043). In a period of financial crisis, low income is a significant and independent predictor of poor out-of-hospital outcome in ACS patients. This association has profound implications and should be taken into consideration by public health policy makers.

  3. The Sulu-Sulawesi Sea: environmental and socioeconomic status, future prognosis and ameliorative policy options.

    Science.gov (United States)

    DeVantier, Lyndon; Alcala, Angel; Wilkinson, Clive

    2004-02-01

    The Sulu-Sulawesi Sea, with neighboring Indonesian Seas and South China Sea, lies at the center of the world's tropical marine biodiversity. Encircled by 3 populous, developing nations, the Philippines, Indonesia and Malaysia, the Sea and its adjacent coastal and terrestrial ecosystems, supports ca. 33 million people, most with subsistence livelihoods heavily reliant on its renewable natural resources. These resources are being impacted severely by rapid population growth (> 2% yr-1, with expected doubling by 2035) and widespread poverty, coupled with increasing international market demand and rapid technological changes, compounded by inefficiencies in governance and a lack of awareness and/or acceptance of some laws among local populations, particularly in parts of the Philippines and Indonesia. These key root causes all contribute to illegal practices and corruption, and are resulting in severe resource depletion and degradation of water catchments, river, lacustrine, estuarine, coastal, and marine ecosystems. The Sulu-Sulawesi Sea forms a major geopolitical focus, with porous borders, transmigration, separatist movements, piracy, and illegal fishing all contributing to environmental degradation, human suffering and political instability, and inhibiting strong trilateral support for interventions. This review analyzes these multifarious environmental and socioeconomic impacts and their root causes, provides a future prognosis of status by 2020, and recommends policy options aimed at amelioration through sustainable management and development.

  4. Current status of cardiac resynchronization therapy with defibrillators and factors influencing its prognosis in Japan

    Directory of Open Access Journals (Sweden)

    Akihiko Shimizu

    2013-06-01

    Conclusions: Japanese patients with CRT-D devices had a better prognosis than did those in the COMPANION trial, but no significant differences were observed between patients fulfilling and those not fulfilling the above mentioned criteria.

  5. DNR 100K Lakes - Fishing in the Neighborhood (FiN) Ponds

    Data.gov (United States)

    Minnesota Department of Natural Resources — This layer represents ponds included in DNR's Fishing in the Neighborhood (FiN) program. This program establishes local ponds to provide urban fishing opportunities...

  6. Molecular grading of tumors of the upper urothelial tract using FGFR3 mutation status identifies patients with favorable prognosis

    Directory of Open Access Journals (Sweden)

    Lyle SR

    2012-12-01

    Full Text Available Stephen R Lyle,1 Chung-Cheng Hsieh,1 Cecilia A Fernandez,2 Anthony P Shuber21University of Massachusetts, Worcester, MA, 2Predictive Biosciences Inc., Lexington, MA, USABackground: Mutations in FGFR3 have been shown to occur in tumors of the upper urothelial tract and may be indicative of a good prognosis. In bladder tumors, the combination of FGFR3 mutation status and Ki-67 level has been used to define a tumor's molecular grade and predict survival. Pathological evaluation of upper urothelial tumors is currently the best predictor of prognosis, but suffers from variability in pathological assessments. This study investigated the association with prognosis of FGFR3 mutations alone and in combination with Ki-67 in this patient population.Methods: Genomic DNA was isolated from tumor samples of 80 patients with upper urothelial cancer. The presence of mutation in FGFR3 was evaluated using real-time polymerase chain reaction. Ki-67 protein expression was determined by immunohistochemistry. Kaplan–Meier survival analysis evaluated the relationship of FGFR3 mutations and Ki-67 levels with survival.Results: FGFR3 mutations were identified in 40% of tumors and were predominantly associated with noninvasive tumors. Overall survival was higher in patients with FGFR3 mutant tumors (P = 0.02 and in molecular grade 1 tumors as determined by FGFR3 and Ki-67 (P = 0.02.Conclusion: In this study, we confirm the occurrence of FGFR3 mutations in tumors of the upper urothelial tract and its association with a good prognosis. Both FGFR3 and molecular grading are predictors of overall survival. Molecular grading can help to assess the prognosis of patients with upper urinary tract cancer and may represent a new tool for managing this population of patients.Keywords: upper tract, urothelial carcinoma, ureter, renal pelvis, Ki-67, survival

  7. Patient-rated health status predicts prognosis following percutaneous coronary intervention with drug-eluting stenting

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Versteeg, Henneke; Denollet, Johan

    2011-01-01

    In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events.......In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events....

  8. Status and prognosis of lymph node metastasis in patients with cardia cancer – A systematic review

    DEFF Research Database (Denmark)

    Okholm, Cecilie; Svendsen, Lars Bo; Achiam, Michael P

    2014-01-01

    . Therefore, the optimal treatment of cardia cancer remains controversial. A systematic review of English publications dealing with adenocarcinoma of the cardia was conducted to elucidate patterns of nodal spread and prognostic implications. METHODS: A systematic literature search based on PRISMA guidelines...... identifying relevant studies describing lymph node metastasis and the associated prognosis. Lymph node stations were classified according to the Japanese Gastric Cancer Association guidelines. RESULTS: The highest incidence of metastasis is seen in the nearest regional lymph nodes, station no. 1......-3 and additionally in no. 7, 9 and 11. Correspondingly the best survival is seen when metastasis remain in the most locoregional nodes and survival equally tends to decrease as the metastasis become more distant. Furthermore, the presence of lymph node metastasis significantly correlates to the TNM-stage. Incidences...

  9. Anthropometric Indices Added the Predictive Ability of Iron Status in Prognosis of Atherosclerosis

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    Motahar Heidari-Beni

    2012-12-01

    Full Text Available Background: Abnormal homeostasis of iron such as deficiency or overload is associated with the pathogenesis of cardiovascular disease (CVD. Another risk factor for CVD is obesity whose added predictive ability to iron status has been assessed by few study. This study aimed to eva-luate the effect of adding anthropometric indices to a model based on iron status as risk factors of CVD.Methods: This cross-sectional study included 140 adult women aged 18-50 years randomly se-lected from Sheikhorrais Clinic that is one of the Tabriz University sub-specialized clinics in 2011. Anthropometric indices, carotid intima-media thickness (CIMT and body iron status were measured by standard protocol, non-invasive ultrasound and concentrations of serum iron, ferri-tin, TIBC (Total iron Binding Capacity and complete blood cell counts (CBC, respectively. In-tegrated discriminatory improvement index (IDI and net reclassification improvement index (NRI were used as the measures of added predictive ability of anthropometric measures to the iron statues.Results: IDI (SE after adding Waist Circumference (WC, Waist to Heap Ratio (WHR, Waist to Height Ratio (WHtR, Body Mass Index (BMI and Body fat (% to base model was 0.12 (0.028, 0.09 (0.026, 0.12 (0.028, 0.07 (0.022 and 0.10 (0.026 respectively. The NRI (SE was 0.10 (0.065 for WC, 0.03 (0.058 for WHR, 0.07 (0.067 for WHtR, 0.05 (0.067 for BMI, and 0.08 (0.064 for Body fat.Conclusions: Anthropometric indices could significantly add to the predictive ability of the iron statues, with highest IDI when WC and WHtR were added to the base model. It suggests that by adding WC and WHtR to the iron status lead us to a more optimal model for predicting the ini-tial stage of atherosclerosis.

  10. High levels of D-dimer correlated with disease status and poor prognosis of inoperable metastatic colorectal cancer patients treated with bevacizumab

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    Liming Zhu

    2014-01-01

    Conclusion: High levels of plasma baseline D-dimer correlated with high tumor load, advanced disease status and poor prognosis of inoperable mCRC patients treated with bevacizumab. However, clinical research on a much larger cohort of patients will be required to verify these findings.

  11. [Multicenter Prospective Observational Study of Fungal Keratitis--Current Status of Patients' Background, Clinical Findings, Treatment and Prognosis].

    Science.gov (United States)

    Inoue, Yoshitsugu; Ohashi, Yuichi; Suzuki, Takashi; Shimomura, Yoshikazu; Fukuda, Masahiko; Sotozono, Chie; Hatano, Hiroshi; Eguchi, Hiroshi; Araki-Sasaki, Kaoru; Hoshi, Saichi; Sunada, Atsuko; Asari, Seishi; Yaguchi, Takashi; Makimura, Koichi; Yokokura, Shunji; Mochizuki, Kiyofumi; Monden, Yu; Nejima, Ryohei

    2016-01-01

    To investigate the current status of fungal keratitis in Japan. The patients with fungal keratitis were examined at 27 facilities in Japan from November 1st 2011 to October 31st 2013, concerning isolates, patient background, clinical findings, treatment and prognosis. Out of 139 cases, 133 were diagnosed as fungal keratitis, of which fungi were isolated from 72 samples of 71 cases (yeast-like fungi 32 strains and filamentous fungi 40 strains). The corrected visual acuity at the first visit of 88 cases (66.2%) was less than 20/200 and 42 cases (31.6%) were involved with deep stromal lesions, indicating high proportion of severe cases in this study. Three months later, 56 cases (42.1%) were still under treatment, and corrected visual acuity of 57 cases (42.9%) was less than 20/200. In cases with yeast-like fungi, there were significantly more cases with past history of corneal diseases, ocular surgery including keratoplasty, and eye drops' use such as steroids than those with filamentous fungi. On the other hand, there were significantly more cases of filamentous fungi, with trauma on the onset and with intervention of previously attending doctors than those with yeast-like fungi. Logistic regression analyses revealed that contact lens wearing was a significant factor of good prognosis, and yeast-like fungi as one of poor outcome compared with no fungal isolation. Although the choice of antifungal drugs has been increasing, fungal keratitis is still severe, refractory and vision-threatening disease.

  12. Materials released from spill incidents reported to Iowa DNR and tracked in the Hazardous Substance Incident database

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    Iowa State University GIS Support and Research Facility — Materials released from spill incidents reported to Iowa DNR and tracked in the Hazardous Substance Incident database. These Emergency Release Notifications are...

  13. The association between religiosity and resuscitation status preference among patients with advanced cancer.

    Science.gov (United States)

    Delgado-Guay, Marvin O; Chisholm, Gary; Williams, Janet; Bruera, Eduardo

    2015-10-01

    The potential influence of patient religious and spiritual beliefs on the approach to end-of-life care and resuscitation status preferences is not well understood. The aim of this study was to assess the association between religiosity and resuscitation preferences in advanced-cancer patients. We performed a secondary analysis of a randomized controlled trial that evaluated the influence of physician communication style on patient resuscitation preferences. All patients completed the Santa Clara Strength of Religious Faith Questionnaire-Short Form (SCSRFQ-SF) and expressed their resuscitation preferences. We determined the frequency of resuscitation preferences and its association with intensity of religiosity. A total of 78 patients completed the study. The median age was 54 years, with a range of 18-78. Some 46 (59%) were women; 57 patients (73%) were Caucasian, 15 (19%) African American, and 5 (7%) Hispanic. A total of 46 patients (56%) were Protestant and 13 (17%) Catholic. Some 53 of 60 patients who chose Do Not Resuscitate status (DNR) (88%) and 16 of 18 patients who refused DNR (89%) for a video-simulated patient were highly religious (p = 0.64). When asked about a DNR for themselves after watching the videos, 43 of 48 who refused DNR (90%) and 26 of 30 patients who chose DNR (87%) were highly religious (p = 0.08). The Spearman correlation coefficient for patients choosing DNR for themselves and intensity of religiosity was r = -0.16 (p = 0.16). Some 30 patients (38%) who chose DNR for the video patient refused DNR for themselves, and 42 who chose DNR for both the video patient and themselves (54%) were highly religious (p = NS). There was no significant association between intensity of patient religiosity and DNR preference for either the video patient or the patients themselves. Other beliefs and demographic factors likely impact end-of-life discussions and resuscitation status preferences.

  14. Heme and nitric oxide binding by the transcriptional regulator DnrF from the marine bacterium Dinoroseobacter shibae increases napD promoter affinity.

    Science.gov (United States)

    Ebert, Matthias; Schweyen, Peter; Bröring, Martin; Laass, Sebastian; Härtig, Elisabeth; Jahn, Dieter

    2017-09-15

    Under oxygen-limiting conditions, the marine bacterium Dinoroseobacter shibae DFL12(T) generates energy via denitrification, a respiratory process in which nitric oxide (NO) is an intermediate. Accumulation of NO may cause cytotoxic effects. The response to this nitrosative (NO-triggered) stress is controlled by the Crp/Fnr-type transcriptional regulator DnrF. We analyzed the response to NO and the mechanism of NO sensing by the DnrF regulator. Using reporter gene fusions and transcriptomics, here we report that DnrF selectively repressed nitrate reductase (nap) genes, preventing further NO formation. In addition, DnrF induced the expression of the NO reductase genes (norCB), which promote NO consumption. We used UV-visible and EPR spectroscopy to characterize heme binding to DnrF and subsequent NO coordination. DnrF detects NO via its bound heme cofactor. We found that the dimeric DnrF bound one molecule of heme per subunit. Purified recombinant apo-DnrF bound its target promoter sequences (napD, nosR2, norC, hemA, and dnrE) in electromobility shift assays, and we identified a specific palindromic DNA-binding site 5'-TTGATN4ATCAA-3' in these target sequences via mutagenesis studies. Most importantly, successive addition of heme as well as heme and NO to purified recombinant apo-DnrF protein increased affinity of the holo-DnrF for its specific binding motif in the napD promoter. On the basis of these results, we propose a model for the DnrF-mediated NO stress response of this marine bacterium. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

  15. Prognosis of Differentiated Thyroid Cancer in Relation to Serum Thyrotropin and Thyroglobulin Antibody Status at Time of Diagnosis

    Science.gov (United States)

    Cooper, David S.; Ladenson, Paul W.; Ain, Kenneth B.; Brierley, James D.; Fein, Henry G.; Haugen, Bryan R.; Jonklaas, Jacqueline; Magner, James; Ross, Douglas S.; Skarulis, Monica C.; Steward, David L.; Maxon, Harry R.; Sherman, Steven I.

    2014-01-01

    Background: Serum thyrotropin (TSH) concentration and thyroid autoimmunity may be of prognostic importance in differentiated thyroid cancer (DTC). Preoperative serum TSH level has been associated with higher DTC stage in cross-sectional studies; data are contradictory on the significance of thyroid autoimmunity at the time of diagnosis. Objective: We sought to assess whether preoperative serum TSH and perioperative antithyroglobulin antibodies (TgAb) were associated with thyroid cancer stage and outcome in DTC patients followed by the National Thyroid Cancer Treatment Cooperative Study, a large multicenter thyroid cancer registry. Methods: Patients registered after 1996 with available preoperative serum TSH (n=617; the TSH cohort) or perioperative TgAb status (n=1770; the TgAb cohort) were analyzed for tumor stage, persistent disease, recurrence, and overall survival (OS; median follow-up, 5.5 years). Parametric tests assessed log-transformed TSH, and categorical variables were tested with chi square. Disease-free survival (DFS) and OS was assessed with Cox models. Results: Geometric mean serum TSH levels were higher in patients with higher-stage disease (Stage III/IV=1.48 vs. 1.02 mU/L for Stages I/II; p=0.006). The relationship persisted in those aged ≥45 years after adjusting for sex (p=0.01). Gross extrathyroidal extension (p=0.03) and presence of cervical lymph node metastases (p=0.003) were also significantly associated with higher serum TSH. Disease recurrence and all-cause mortality occurred in 37 and 38 TSH cohort patients respectively, which limited the power for survival analysis. Positive TgAb was associated with lower stage on univariate analysis (positive TgAb in 23.4% vs. 17.8% of Stage I/II vs. III/IV patients, respectively; p=0.01), although the relationship lost significance when adjusting for age and sex (p=0.34). Perioperative TgAb was not an independent predictor of DFS (hazard ratio=1.12 [95% confidence interval=0.74–1.69]) or OS (hazard

  16. The role of BRCA status on the prognosis of patients with epithelial ovarian cancer: a systematic review of the literature with a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Chaoyang Sun

    Full Text Available OBJECTIVE: The role of BRCA dysfunction on the prognosis of patients with epithelial ovarian cancer (EOCs remains controversial. This systematic review tried to assess the role of BRCA dysfunction, including BRCA1/2 germline, somatic mutations, low BRCA1 protein/mRNA expression or BRCA1 promoter methylation, as prognostic factor in EOCs. METHODS: Studies were selected for analysis if they provided an independent assessment of BRCA status and prognosis in EOC. To make it possible to aggregate survival results of the published studies, their methodology was assessed using a modified quality scale. RESULTS: Of 35 evaluable studies, 23 identified BRCA dysfucntion status as a favourable prognostic factor. No significant differences were detected in the global score of quality assessment. The aggregated hazard ratio (HR of overall survival (OS of 34 evaluable studies suggested that BRCA dysfunction status had a favourable impact on OS (HR = 0.69, 95% CI 0.61-0.79, and when these studies were categorised into BRCA1/2 mutation and low protein/mRNA expression of BRCA1 subgroups, all of them demonstrated positive results (HR = 0.67, 95% CI: 0.57-0.78; HR = 0.62, 95% CI: 0.51-0.75; and HR = 0.51, 95% CI: 0.33-0.78, respectively, except for the subgroup of BRCA1 promoter methylation (HR = 1.59, 95% CI: 0.72-3.50. The meta-analysis of progression-free survival (PFS, which included 18 evaluable studies, demonstrated that BRCA dysfunction status was associated with a longer PFS in EOC (HR = 0.69, 95% CI: 0.63-0.76. CONCLUSIONS: Patients with BRCA dysfunction status tend to have a better outcome, but further prospective clinical studies comparing the different BRCA statuses in EOC is urgently needed to specifically define the most effective treatment for the separate patient groups.

  17. Extent and Distribution of Old Forest Conditions on DNR-Managed State Trust Lands in Eastern Washington

    Science.gov (United States)

    Jerry F. Franklin; Miles Hemstrom; Robert Van Pelt; Joe Buchanan; Sabra Hull; Rex Crawford; Steve Curry; Walt Obermeyer

    2007-01-01

    An inventory was conducted of old forests on state trust lands in Eastern Washington managed by the Washington State Department of Natural Resources (DNR), in response to legislative direction (ESSB 6384, Section 189,2006). This inventory was conducted with guidance from an independent science panel, chaired by Jerry Franklin of the University of Washington. As...

  18. Performance comparison of machine learning methods for prognosis of hormone receptor status in breast cancer tissue samples.

    Science.gov (United States)

    Kalinli, Adem; Sarikoc, Fatih; Akgun, Hulya; Ozturk, Figen

    2013-06-01

    We examined the classification and prognostic scoring performances of several computer methods on different feature sets to obtain objective and reproducible analysis of estrogen receptor status in breast cancer tissue samples. Radial basis function network, k-nearest neighborhood search, support vector machines, naive bayes, functional trees, and k-means clustering algorithm were applied to the test datasets. Several features were employed and the classification accuracies of each method for these features were examined. The assessment results of the methods on test images were also experimentally compared with those of two experts. According to the results of our experimental work, a combination of functional trees and the naive bayes classifier gave the best prognostic scores indicating very good kappa agreement values (κ=0.899 and κ=0.949, p<0.001) with the experts. This combination also gave the best dichotomization rate (96.3%) for assessment of estrogen receptor status. Wavelet color features provided better classification accuracy than Laws texture energy and co-occurrence matrix features. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Influence of False Lumen Status on the Prognosis of Acute Type A Aortic Dissection without Urgent Surgical Treatment.

    Science.gov (United States)

    Tanaka, Akihito; Ishii, Hideki; Suzuki, Susumu; Ota, Tomoyuki; Oshima, Hideki; Usui, Akihiko; Komori, Kimihiro; Murohara, Toyoaki

    2017-02-01

    Recently, much attention has been focused on partial thrombosis of the false lumen in patients with acute aortic dissection. However, its effect on clinical outcomes in these patients, especially in case of acute type A aortic dissection, has not been clearly elucidated. This study evaluated the influence of the false lumen status, including partial thrombosis, on short-term clinical outcomes in acute type A aortic dissection patients without urgent surgical treatment. Sixty-two patients (29 males, mean age 73±13 years) with acute type A aortic dissection who did not receive urgent surgical treatment at four hospitals were enrolled. Patients were divided into three groups based on the false lumen status on enhanced computed tomography image (complete thrombosis, n=28; partial thrombosis, n=27; patent, n=7). Patients with partial thrombosis were further divided into two groups (thrombus-dominant, n=15; flow-dominant, n=12). The short-term mortality rate (in-hospital and 30-day) was significantly higher in patients with a patent false lumen, while no significant difference was seen between the other two groups. Patients with flow-dominant partial thrombosis had significantly higher short-term mortality rate than those with thrombus-dominant partial thrombosis (in-hospital, p=0.001 and 30-day, p<0.001). The short-term mortality rate in acute type A aortic dissection patients without urgent surgical treatment was lower in patients with partial thrombosis of the false lumen than in those with a patent false lumen. Furthermore, patients with flow-dominant partial thrombosis had higher mortality rate than those with thrombus-dominant partial thrombosis.

  20. Status of White Sturgeon (Acipenser transmontanus Richardson, 1863) throughout the species range, threats to survival, and prognosis for the future

    Science.gov (United States)

    Hildebrand, L R; Drauch-Schreier, A; Lepla, K.; McAdam, S. O.; McLellan, J; Parsley, Michael J.; Paragamian, V L; Young, S P

    2017-01-01

    White Sturgeon, Acipenser transmontanus (WS), are distributed throughout three major river basins on the West Coast of North America: the Sacramento-San Joaquin, Columbia, and Fraser River drainages. Considered the largest North American freshwater fish, some WS use estuarine habitat and make limited marine movements between river basins. Some populations are listed by the United States or Canada as threatened or endangered (upper Columbia River above Grand Coulee Dam; Kootenai River; lower, middle and, upper Fraser River and Nechako River), while others do not warrant federal listing at this time (Sacramento-San Joaquin Rivers; Columbia River below Grand Coulee Dam; Snake River). Threats that impact WS throughout the species’ range include fishing effects and habitat alteration and degradation. Several populations suffer from recruitment limitations or collapse due to high early life mortality associated with these threats. Efforts to preserve WS populations include annual monitoring, harvest restrictions, habitat restoration, and conservation aquaculture. This paper provides a review of current knowledge on WS life history, ecology, physiology, behavior, and genetics and presents the status of WS in each drainage. Ongoing management and conservation efforts and additional research needs are identified to address present and future risks to the species.

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

    Directory of Open Access Journals (Sweden)

    Chenlei Shi

    Full Text Available To investigate the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC for surgery by comparing the difference between PTMC and larger papillary thyroid carcinoma (LPTC.We analyzed the differences in the clinicopathological characteristics, prognosis, B-type RAF kinase (BRAFV600E 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.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.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.

  2. Understanding Cancer Prognosis

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    Full Text Available ... your chances of survival. The estimate of how the disease will go for you is called prognosis. It ... to discuss cancer prognosis (the likely course of the disease). Learn key points about prognosis and how to ...

  3. Understanding Cancer Prognosis

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    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 ...

  4. Rethinking biology instruction: The application of DNR-based instruction to the learning and teaching of biology

    Science.gov (United States)

    Maskiewicz, April Lee

    Educational studies report that secondary and college level students have developed only limited understandings of the most basic biological processes and their interrelationships from typical classroom experiences. Furthermore, students have developed undesirable reasoning schemes and beliefs that directly affect how they make sense of and account for biological phenomena. For these reasons, there exists a need to rethink instructional practices in biology. This dissertation discusses how the principles of Harel's (1998, 2001) DNR-based instruction in mathematics could be applied to the teaching and learning of biology. DNR is an acronym for the three foundational principles of the system: Duality, Necessity, and Repeated-reasoning. This study examines the application of these three principles to ecology instruction. Through clinical and teaching interviews, I developed models of students' existing ways of understanding in ecology and inferred their ways of thinking. From these models a hypothetical learning trajectory was developed for 16 college level freshmen enrolled in a 10-week ecology teaching experiment. Through cyclical, interpretive analysis I documented and analyzed the evolution of the participants' progress. The results provide empirical evidence to support the claim that the DNR principles are applicable to ecology instruction. With respect to the Duality Principle, helping students develop specific ways of understanding led to the development of model-based reasoning---a way of thinking and the cognitive objective guiding instruction. Through carefully structured problem solving tasks, the students developed a biological understanding of the relationship between matter cycling, energy flow, and cellular processes such as photosynthesis and respiration, and used this understanding to account for observable phenomena in nature. In the case of intellectual necessity, the results illuminate how problem situations can be developed for biology learners

  5. Processes of code status transitions in hospitalized patients with advanced cancer.

    Science.gov (United States)

    El-Jawahri, Areej; Lau-Min, Kelsey; Nipp, Ryan D; Greer, Joseph A; Traeger, Lara N; Moran, Samantha M; D'Arpino, Sara M; Hochberg, Ephraim P; Jackson, Vicki A; Cashavelly, Barbara J; Martinson, Holly S; Ryan, David P; Temel, Jennifer S

    2017-12-15

    Although hospitalized patients with advanced cancer have a low chance of surviving cardiopulmonary resuscitation (CPR), the processes by which they change their code status from full code to do not resuscitate (DNR) are unknown. We conducted a mixed-methods study on a prospective cohort of hospitalized patients with advanced cancer. Two physicians used a consensus-driven medical record review to characterize processes that led to code status order transitions from full code to DNR. In total, 1047 hospitalizations were reviewed among 728 patients. Admitting clinicians did not address code status in 53% of hospitalizations, resulting in code status orders of "presumed full." In total, 275 patients (26.3%) transitioned from full code to DNR, and 48.7% (134 of 275 patients) of those had an order of "presumed full" at admission; however, upon further clarification, the patients expressed that they had wished to be DNR before the hospitalization. We identified 3 additional processes leading to order transition from full code to DNR acute clinical deterioration (15.3%), discontinuation of cancer-directed therapy (17.1%), and education about the potential harms/futility of CPR (15.3%). Compared with discontinuing therapy and education, transitions because of acute clinical deterioration were associated with less patient involvement (P = .002), a shorter time to death (P cancer were because of full code orders in patients who had a preference for DNR before hospitalization. Transitions due of acute clinical deterioration were associated with less patient engagement and a higher likelihood of inpatient death. Cancer 2017;123:4895-902. © 2017 American Cancer Society. © 2017 American Cancer Society.

  6. The survival prognosis of elderly undernourished inpatients admitted to the internal medical department of an emergency hospital as assessed using the nutritional screening, tool CONUT (for CONtrolling NUTritional status).

    Science.gov (United States)

    Niwano, Mototaka

    2017-01-01

    CONUT, a tool for "CONtrolling NUTritional status" assesses the nutritional status of a subject by taking into account their serum albumin level, total cholesterol level and total lymphocyte count. Elderly undernourished inpatients admitted to the internal medical department were divided into two groups, those who left the hospital and those who died in the hospital. The goal of this study was to analyze whether or not the CONUT score, serum albumin level, total cholesterol level and total lymphocyte count could predict the survival prognosis of elderly undernourished inpatients and to show the ratio of patients discharged with artificial hydration and nutrition (AHN). We divided elderly undernourished inpatients into two groups, those who left the hospital (229 patients) and those who died in the hospital (363 patients), and examined the serum albumin level, total cholesterol level and total lymphocyte count within 10 days before discharge or death. Based on the degree of undernutrition as determined by CONUT, we further classified the patients 4-into four levels of nutrition status, normal, light undernutrition, moderate undernutrition and severe undernutrition. In addition, based on the serum albumin level, total cholesterol level and total lymphocyte count, the patients were also classified 4-into four levels of nutrition status, and we calculated the ratio of AHN patients in the discharged group. On comparing the discharge and death groups according to the degree of undernutrition, serum albumin level, total cholesterol level and total lymphocyte count, significant differences were found between the groups of all nutrition statuses except moderate undernutrition. Furthermore, the patients with moderate undernutrition status demonstrated no statistically significant difference in both groups, except the serum albumin level. Among the discharged patients, the ratio of AHN was 37.0% in those with a normal nutrition status and more than 50% in the patients with

  7. The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study.

    Science.gov (United States)

    Notara, Venetia; Panagiotakos, Demosthenes B; Kogias, Yannis; Stravopodis, Petros; Antonoulas, Antonis; Zombolos, Spyros; Mantas, Yannis; Pitsavos, Christos

    2016-07-01

    The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (14 years). Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, peducation group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, peducation on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (peducational status with all-cause mortality and ACS events were observed. A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

  8. The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

    Science.gov (United States)

    Notara, Venetia; Kogias, Yannis; Stravopodis, Petros; Antonoulas, Antonis; Zombolos, Spyros; Mantas, Yannis; Pitsavos, Christos

    2016-01-01

    Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, peducation group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, peducation on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (peffects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity. PMID:27499164

  9. Structure-Function Relationships in the Gas-Sensing Heme-Dependent Transcription Factors RcoM and DNR

    Science.gov (United States)

    Bowman, Hannah E.

    Transition metals play an important role in many biological processes, however, they are also toxic at high concentrations. Therefore, the uptake and efflux of these metals must be tightly regulated by the cell. Bacteria have evolved a variety of pathways and regulatory systems to monitor the presence and concentration of metals in the cellular environment. A key component of those systems are transcription factors that either "sense metals" or use "metal sensors". The first class of these proteins have metals as their allosteric effector ligand. The second class of these proteins utilize transition metal containing cofactors to sense other environmental cues through the specific chemistry afforded by the cofactor. Chapter 1 reviews the current literature regarding both types of transcription factors. The focus of this work has been on two heme-containing, gas-sensing transcription factors found in bacteria, RcoM (regulator of CO metabolism) and DNR (dissimilative nitrate respiration regulator). RcoM is a CO-dependent protein found in Burkholderia xenovorans and sits upstream of the cox operon for oxidative CO metabolism. RcoM senses the presence of CO, as well as changes in redox potential, through a ligand switch process at its heme cofactor. Chapter 2 details spectroscopic characterization of several methionine mutants to identify the Fe(II) ligand trans to His 74. That study concludes that Met104 acts as the CO-replacable ligand. Met105, while not the ligand, does play an important role in reversibility of the ligand switch process. RcoM has a unique tertiary structure that combines a sensory domain and a DNA-binding domain normally found in two-component systems. Chapter 3 provides evidence that RcoM adopts a dimeric state. Further biophysical and structural characterization gives further insight into how the two domains are organized and the implications for the DNA-binding mechanism. DNR is a NO-sensing transcription factor from Pseudomonas aeruginosa and

  10. Association of the type of 5q loss with complex karyotype, clonal evolution, TP53 mutation status, and prognosis in acute myeloid leukemia and myelodysplastic syndrome.

    Science.gov (United States)

    Volkert, Sarah; Kohlmann, Alexander; Schnittger, Susanne; Kern, Wolfgang; Haferlach, Torsten; Haferlach, Claudia

    2014-05-01

    We analyzed 1,200 patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) harboring a 5q deletion in order to clarify whether the type of 5q loss is associated with other biological markers and prognosis. We investigated all patients by chromosome banding analysis, FISH with a probe for EGR1 (5q31) and, if necessary, to resolve complex karyotypes with 24-color-FISH. Moreover, 420 patients were analyzed for mutations in the TP53 gene. The patient cohort was subdivided based on type of 5q loss: Patients with interstitial deletions and patients with 5q loss due to unbalanced rearrangements or monosomy 5. Loss of the long arm of chromosome 5 due to an unbalanced rearrangement occurred more often in AML (286/627; 45.6%) than MDS (188/573; 32.8%; P evolution (109/188; 58.0% vs. 124/385; 32.2%; P HR = 5.34; P = 0.032), whereas in AML presence of TP53 mutations was the strongest adverse prognostic factor (HR = 2.21; P = 0.026). In conclusion, in AML and MDS, loss of the long arm of chromosome 5 due to unbalanced translocations is associated with complex karyotype and in MDS, moreover, with clonal evolution, mutations in the TP53 gene and adverse prognosis. Copyright © 2014 Wiley Periodicals, Inc.

  11. Understanding Cancer Prognosis

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    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 ...

  12. Understanding Cancer Prognosis

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    Full Text Available ... Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a national expert on doctor-patient communications, talks with one of his patients about what she'd like to know of her prognosis. Credit: National ...

  13. Understanding Cancer Prognosis

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    Full Text Available ... during a certain period of time after diagnosis. Disease-free survival This statistic is the percentage of ... discuss cancer prognosis (the likely course of the disease). Learn key points about prognosis and how to ...

  14. Understanding Cancer Prognosis

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    Full Text Available ... doctor may tell you that you have a good prognosis if statistics suggest that your cancer is ... about how to discuss prognosis with their patients. Good communication, he says, is part of providing good ...

  15. Understanding Cancer Prognosis

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    Full Text Available ... Prognosis Questions to Ask about Your Diagnosis Research Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a national expert on doctor-patient communications, talks with one of his patients about what ...

  16. Understanding Cancer Prognosis

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    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 ...

  17. Understanding Cancer Prognosis

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    Full Text Available ... chances of survival. The estimate of how the disease will go for you is called prognosis. It can be hard to understand what prognosis means and also hard to talk about, even for doctors. Many Factors Can Affect Your Prognosis Some of the factors that affect ...

  18. Hormone Receptor Status Does Not Affect Prognosis in Metaplastic Breast Cancer: A Population-Based Analysis with Comparison to Infiltrating Ductal and Lobular Carcinomas

    National Research Council Canada - National Science Library

    Paul Wright, G; Davis, Alan T; Koehler, Tracy J; Melnik, Marianne K; Chung, Mathew H

    2014-01-01

    Metaplastic breast cancer is a rare histologic variant among breast cancers. We sought to investigate the impact of hormone receptor status in metaplastic breast cancer and compare outcomes with common histologic variants of breast...

  19. β-catenin-independent WNT signaling and Ki67 in contrast to the estrogen receptor status are prognostic and associated with poor prognosis in breast cancer liver metastases.

    Science.gov (United States)

    Bleckmann, Annalen; Conradi, Lena-Christin; Menck, Kerstin; Schmick, Nadine Annette; Schubert, Antonia; Rietkötter, Eva; Arackal, Jetcy; Middel, Peter; Schambony, Alexandra; Liersch, Torsten; Homayounfar, Kia; Beißbarth, Tim; Klemm, Florian; Binder, Claudia; Pukrop, Tobias

    2016-04-01

    Liver metastasis development in breast cancer patients is common and confers a poor prognosis. So far, the prognostic significance of surgical resection and clinical relevance of biomarker analysis in metastatic tissue have barely been investigated. We previously demonstrated an impact of WNT signaling in breast cancer brain metastasis. This study aimed to investigate the value of established prognostic markers and WNT signaling components in liver metastases. Overall N = 34 breast cancer liver metastases (with matched primaries in 19/34 cases) were included in this retrospective study. Primaries and metastatic samples were analyzed for their expression of the estrogen (ER) and progesterone receptor, HER-2, Ki67, and various WNT signaling-components by immunohistochemistry. Furthermore, β-catenin-dependent and -independent WNT scores were generated and analyzed for their prognostic value. Additionally, the influence of the alternative WNT receptor ROR on signaling and invasiveness was analyzed in vitro. ER positivity (HR 0.09, 95 % CI 0.01-0.56) and high Ki67 (HR 3.68, 95 % CI 1.12-12.06) in the primaries had prognostic impact. However, only Ki67 remained prognostic in the metastatic tissue (HR 2.46, 95 % CI 1.11-5.44). Additionally, the β-catenin-independent WNT score correlated with reduced overall survival only in the metastasized situation (HR 2.19, 95 % CI 1.02-4.69, p = 0.0391). This is in line with the in vitro results of the alternative WNT receptors ROR1 and ROR2, which foster invasion. In breast cancer, the value of prognostic markers established in primary tumors cannot directly be translated to metastases. Our results revealed β-catenin-independent WNT signaling to be associated with poor prognosis in patients with breast cancer liver metastasis.

  20. The Impact of Educational Status on 10-Year (2004-2014 Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Venetia Notara

    2016-07-01

    Full Text Available Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014 assessment was performed for 1918 participants (participation rate, 88%. Each patient’s educational status was classified as low (14 years. Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001. Additionally, 10-year recurrent ACS events (fatal and non-fatal were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001, and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001; however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness. Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

  1. Multiplication of Chromosome 17 Centromere Is Associated with Prognosis in Patients with Invasive Breast Cancers Exhibiting Normal HER2 and TOP2A Status.

    Science.gov (United States)

    Kim, Aeri; Shin, Hyung Chan; Bae, Young Kyung; Kim, Min Kyoung; Kang, Su Hwan; Lee, Soo Jung; Lee, Eun Hee

    2012-03-01

    This study aimed to investigate the clinical significance of chromosome 17 centromere (CEP17) multiplication (increased copy number of CEP17) related to human epidermal growth factor receptor 2 (HER2) and topoisomerase II alpha (TOP2A) status in patients with invasive breast cancer. We constructed tissue microarrays using 594 invasive breast cancer samples and performed single-color silver-enhanced in situ hybridization (SISH) assay for HER2, TOP2A, and CEP17 to assess for copy number aberrations. The association of CEP17 multiplication with patient survival was analyzed according to HER2 and TOP2A status. Among 567 informative cases, HER2 amplification was noted in 22.8%, TOP2A amplification in 8.3% and TOP2A deletion in 11.1%. CEP17 multiplication was identified in 33.2% and was significantly associated with worse overall survival (OS) (p=0.02) and disease-free survival (DFS) (p=0.02). CEP17 multiplication correlated with patient survival in patients with normal TOP2A or non-amplified HER2 status, but the prognostic significance was lost in those with altered TOP2A or amplified HER2. On multivariate analyses, CEP17 multiplication was an independent prognostic factor for poorer OS (p=0.02) and DFS (p=0.01) in patients with normal TOP2A and non-amplified HER2. CEP17 multiplication was identified as a promising prognostic marker in patients with invasive breast cancer exhibiting either non-amplified HER2 or normal TOP2A status.

  2. THE PARAMETERS OF THE OXYGEN STATUS IN THE ASSESSMENT OF PROGNOSIS OF A HEMODYNAMICALLY SIGNIFICANT PATENT DUCTUS ARTERIOSUS PRETERM NEONATAL INFANTS

    Directory of Open Access Journals (Sweden)

    M. V. Perestoronina

    2015-01-01

    Full Text Available Objective: to estimate the significance of capillary blood oxygen parameters for the prognosis of longstanding hemodynamically significant patent ductus arteriosus (HSPDA in extremely low birthweight (ELBW neonates. Subjects and methods. On day 8 of their life, two groups of ELBW newborn infants with and without HSPDA were examined for capillary blood рН, рkО2, %SO2с, O2ct, АkDO2, and RIk, as well as mechanical ventilation (MV parameters (Pip, MAP, and FiO2. Comparison of two independent samples used nonparametric statistical tests: MannWhitney test, Wald Wolfowitz test, and Kolmogorov-Smirnov test. A logistic regression analysis was used to assess the relationship between the examined parameters and the presence or absence of HSPDA. ROC curves were constructed, by choosing the cut-off point, to estimate the predictive power of the model developed using logistic regression. Results. The developed model has high sensitivity and high specificity (84,6 and 97% respectively. The logistic regression equation takes the form: -0.479•О2сt+0.708•Pip-6.823. Conclusion. Capillary blood oxygen parameters proved suitable for predicting the duration of HSPDA functioning. The resultant good predictive power of the model developed for day 8 of life points to the fact that this period is critical from the viewpoint of resolution of respiratory distress syndrome or development of bronchopulmonary dysplasia, which is crucially significant for MV duration and further prediction. HSPDA is one of the most important factors contributing to the development of bronchopulmonary dysplasia in ELBW neonatal infants.

  3. Understanding Cancer Prognosis

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    Full Text Available ... Diagnosis Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer Adjusting to ...

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    Full Text Available ... our information on Coping With Cancer helpful. Understanding Statistics About Survival Doctors estimate prognosis by using statistics that researchers have collected over many years about ...

  6. Understanding Cancer Prognosis

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    Full Text Available ... and Prevention Risk Factors Genetics Cancer Prevention Overview Research Cancer Screening Cancer Screening Overview Screening Tests Research Diagnosis and Staging Symptoms Diagnosis Staging Prognosis Questions ...

  7. [EATING DISORDERS AND VISCERAL ADIPOSE TISSUE - TWO INTERCONNECTED INFORMATIVE MARKERS OF PROGNOSIS OF DISORDERS OF NUTRITIONAL STATUS AND RISK OF DEVELOPMENT OF COMORBIDITY CHRONIC NON-COMMUNICABLE DISEASES].

    Science.gov (United States)

    Fadieienko, G; Nikiforova, Y

    2017-01-01

    The purpose of research was to study the characteristics of eating behaviour (EB) and indicators visceral adipose tissue (VAT) in patients with NAFLD and obesity stage of 1-2 or excessive body mass on the background of hypertension (H). We examined 100 patients with NAFLD in combination with overweight and obesity of 1-2 degrees (body mass index - BMI ≥25 kg/m2) on the background of H I-II stage. Patients with NAFLD and visceral obesity on the background of stage H of I-II the identified three types of violations of EB with a significant predominance of external breach type EB (pnutritional status and risk of development of metabolic disorders, which depends on EB. Identified isolated cases of violations of EB among patients in the control group indicate the possible risk of increase VAT and the development of hormonal and metabolic disorders. Therefore, it is necessary to study the violations of EB on a larger scale to diagnose possible disorders of nutritional status, and to measure these standard anthropometric indicators such as BMI, WC, HC, WC/HC it is advisable to further carry out the measurement % VАT and IVO.

  8. Understanding Cancer Prognosis

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  9. Understanding Cancer Prognosis

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    Full Text Available ... with the same type of cancer. Several types of statistics may be used to estimate prognosis. The most ... see the benefit of new treatments and ways of finding cancer. So, the statistics your doctor uses to make a prognosis may ...

  10. Understanding Cancer Prognosis

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    Full Text Available ... hard to talk about, even for doctors. Many Factors Can Affect Your Prognosis Some of the factors that affect prognosis include: The type of cancer ... think they are too impersonal to be of value to you. It is up to you to ...

  11. Associations between cigarette smoking status and colon cancer prognosis among participants in North Central Cancer Treatment Group Phase III Trial N0147.

    Science.gov (United States)

    Phipps, Amanda I; Shi, Qian; Newcomb, Polly A; Nelson, Garth D; Sargent, Daniel J; Alberts, Steven R; Limburg, Paul J

    2013-06-01

    By using data from North Central Cancer Treatment Group Phase III Trial N0147, a randomized adjuvant trial of patients with stage III colon cancer, we assessed the relationship between smoking and cancer outcomes, disease-free survival (DFS), and time to recurrence (TTR), accounting for heterogeneity by patient and tumor characteristics. PATIENTS AND METHODS Before random assignment to infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX) or FOLFOX plus cetuximab, 1,968 participants completed a questionnaire on smoking history and other risk factors. Cox models assessed the association between smoking history and the primary trial outcome of DFS (ie, time to recurrence or death), as well as TTR, adjusting for other clinical and patient factors. The median follow-up was 3.5 years among patients who did not experience events. Compared with never-smokers, ever smokers experienced significantly shorter DFS (3-year DFS proportion: 70% v 74%; hazard ratio [HR], 1.21; 95% CI, 1.02 to 1.42). This association persisted after multivariate adjustment (HR, 1.23; 95% CI, 1.02 to 1.49). There was significant interaction in this association by BRAF mutation status (P = .03): smoking was associated with shorter DFS in patients with BRAF wild-type (HR, 1.36; 95% CI, 1.11 to 1.66) but not BRAF mutated (HR, 0.80; 95% CI, 0.50 to 1.29) colon cancer. Smoking was more strongly associated with poorer DFS in those with KRAS mutated versus KRAS wild-type colon cancer (HR, 1.50 [95% CI, 1.12 to 2.00] v HR, 1.09 [95% CI, 0.85 to 1.39]), although interaction by KRAS mutation status was not statistically significant (P = .07). Associations were comparable in analyses of TTR. Overall, smoking was significantly associated with shorter DFS and TTR in patients with colon cancer. These adverse relationships were most evident in patients with BRAF wild-type or KRAS mutated colon cancer.

  12. Iowa DNR - NRGIS Library

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — The Natural Resources Geographic Information System (NRGIS) Library is a Geographic Information System (GIS) repository developed and maintained by the GIS Section...

  13. DNR 100K Hydrography

    Data.gov (United States)

    Minnesota Department of Natural Resources — Polygons representing hydrographic features originating from the USGS 1:100,000 (100K)DLG (Digital Line Graph) dataset. The data have been converted into ArcView and...

  14. DNR 24K Streams

    Data.gov (United States)

    Minnesota Department of Natural Resources — 1:24,000 scale streams captured from USGS seven and one-half minute quadrangle maps, with perennial vs. intermittent classification, and connectivity through lakes,...

  15. Understanding Cancer Prognosis

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    Full Text Available ... Treatment Types of Cancer Treatment Side Effects Clinical Trials Information A to Z List of Cancer Drugs ... Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer ...

  16. Understanding Cancer Prognosis

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    Full Text Available ... Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung ... need for different kinds of information about her colorectal cancer prognosis. Diving Out of the Dark View this ...

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  18. Understanding Cancer Prognosis

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    Full Text Available ... Diagnosis Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer Adjusting to Cancer Self Image & Sexuality Day to Day Life Survivorship Support for Caregivers ...

  19. Understanding Cancer Prognosis

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    Full Text Available ... help coping with your prognosis, you may find our information on Coping With Cancer helpful. Understanding Statistics ... comments on this post. All comments must follow our comment policy . National Cancer Institute at the National ...

  20. Understanding Cancer Prognosis

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    Full Text Available ... to estimate cancer-specific survival that does not use information about the cause of death. It is ... of finding cancer. So, the statistics your doctor uses to make a prognosis may not be based ...

  1. Understanding Cancer Prognosis

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    Full Text Available ... hard to talk about, even for doctors. Many Factors Can Affect Your Prognosis Some of the factors ... Services Website Linking U.S. Department of Health and Human Services National Institutes of Health National Cancer Institute ...

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  12. Understanding Cancer Prognosis

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    Full Text Available ... Recurrent Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer Leukemia Liver Cancer Lung ... need for different kinds of information about her colorectal cancer prognosis. Diving Out of the Dark View this ...

  13. Understanding Cancer Prognosis

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  16. Understanding Cancer Prognosis

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    Full Text Available ... spread. Certain traits of the cancer cells Your age and how healthy you were before cancer How ... Your Cancer Prognosis Video View this video on YouTube. Three cancer patients and their doctor share their ...

  17. Understanding Cancer Prognosis

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    Full Text Available ... medical records. Relative survival This statistic is another method used to estimate cancer-specific survival that does ... poor prognosis if the cancer is harder to control. Whatever your doctor tells you, keep in mind ...

  18. Understanding Cancer Prognosis

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  19. Understanding Cancer Prognosis

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    Full Text Available ... in a clear and supportive way. Two viewer guides are also available: for patients (PDF-210KB) and for provider care teams (PDF-210KB). Understanding Your Cancer Prognosis Video View this video on YouTube. ...

  20. Understanding Cancer Prognosis

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    Full Text Available ... M.D., a national expert on doctor-patient communications, talks with one of his patients about what ... how to discuss prognosis with their patients. Good communication, he says, is part of providing good care. ...

  1. Understanding Cancer Prognosis

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    Full Text Available ... treatment Seeking Information About Your Prognosis Is a Personal Decision When you have cancer, you and your ... about it, and gain valuable insight from the personal ways each patient has approached questions about their ...

  3. Understanding Cancer Prognosis

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    Full Text Available ... suggest that your cancer is likely to respond well to treatment. Or, he may tell you that you have a poor prognosis if the cancer is harder to control. Whatever your doctor tells you, keep in mind ...

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  6. Understanding Cancer Prognosis

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  7. Understanding Cancer Prognosis

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  8. Understanding Cancer Prognosis

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    Full Text Available ... to you. Everyone is different. Treatments and how people respond to treatment can differ greatly. Also, it takes years to see the benefit of new treatments and ways of finding cancer. So, the statistics your doctor uses to make a prognosis may not be based on treatments ...

  9. Understanding Cancer Prognosis

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    Full Text Available ... Your Cancer Prognosis Video View this video on YouTube. Three cancer patients and their doctor, Anthony L. ... One Couple's Creative Response View this video on YouTube. Vanessa, an artist, and her husband Roy discover ...

  10. Understanding Cancer Prognosis

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    Full Text Available ... Your Diagnosis Research Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a national expert on doctor- ... Centered Approach View this video on YouTube. Anthony L. Back, M.D., coaches other oncologists about how ...

  11. Prognosis of dementia

    NARCIS (Netherlands)

    van de Vorst, IE

    2016-01-01

    Background: In this thesis, we focused on the prognosis of patients with dementia who visited a hospital (inpatient or day clinic care) in the Netherlands. So far, absolute mortality risks for dementia were lacking in the Netherlands, whereas these risks have been available for years for cancer or

  12. Understanding Cancer Prognosis

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  13. Understanding Cancer Prognosis

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    Full Text Available ... it in a clear and supportive way. Two viewer guides are also available: for patients (PDF-210KB) and for provider care teams (PDF-210KB). Understanding Your Cancer Prognosis Video View this video on YouTube. Three cancer patients and their doctor, Anthony L. ...

  14. Understanding Cancer Prognosis

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    Full Text Available ... about what she'd like to know of her prognosis. Credit: National Cancer Institute If you have ... this video on YouTube. Vanessa, an artist, and her husband Roy discover how to support each other’s ...

  15. Understanding Cancer Prognosis

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    Full Text Available ... Your Diagnosis Research Understanding Cancer Prognosis Oncologist Anthony L. Back, M.D., a national expert on doctor- ... YouTube. Three cancer patients and their doctor, Anthony L. Back, M.D. -- an oncologist who is also ...

  16. Understanding Cancer Prognosis

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    Full Text Available ... Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) ... may have questions about how serious your cancer is and your chances of survival. The estimate of how the disease will go for you is called prognosis. It ...

  17. Understanding Cancer Prognosis

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    Full Text Available ... decisions you may face include: Which treatment is best for you If you want treatment How to best take care of yourself and manage treatment side ... the most about your situation is in the best position to discuss your prognosis and explain what ...

  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. Prognosis for year 2013.

    Science.gov (United States)

    Silva, John S; Ball, Marion J

    2002-11-20

    New knowledge from biotechnology and new capabilities provided by the evolving global information infrastructure are already transforming health care. Three clusters of technologies hold particular promise: grid computing, intimate computing, and micro laboratory computing. The confluence of these technologies will change clinical laboratory equipment into portable devices, easing the administrative details involved in delivering care and ushering in a new age of monitoring clinical states. Two vignettes, an office visit and a clinical trial, are offered as prognosis for clinical care in 2013. New capabilities hold the power to transform health care, making it truly patient centered as the Institute of Medicine (IOM) has urged.

  20. Understanding Cancer Prognosis

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    Full Text Available ... more details about its operating status, please visit https://cc.nih.gov . Updates regarding government operating status ... resumption of normal operations can be found at https://www.opm.gov . Español 1-800-4-CANCER ...

  1. Discordance of Patient-Reported and Clinician-Ordered Resuscitation Status in Patients Hospitalized With Acute Decompensated Heart Failure.

    Science.gov (United States)

    Young, Kathleen A; Wordingham, Sara E; Strand, Jacob J; Roger, Vėronique L; Dunlay, Shannon M

    2017-04-01

    Accurate documentation of preferences for cardiopulmonary resuscitation at hospital admission is critical to ensure that patients receive resuscitation or not in accordance with their wishes. We sought to identify and characterize inconsistencies in patient-reported and clinician-ordered resuscitation status in patients hospitalized with acute decompensated heart failure (ADHF). Southeastern Minnesota residents hospitalized with ADHF were prospectively enrolled into a study that included the administration of face-to-face questionnaires from January 2014 to February 2016. Patient-reported resuscitation status was assessed at enrollment using a validated question. Clinician-ordered resuscitation preferences at hospital admission were abstracted from the electronic medical record. Of the 400 patients administered the questionnaire; 213 (53.3%) stated their resuscitation preference as Full Code, 166 (41.5%) do-not-resuscitate (DNR), and 21 (5.3%) were unsure. In comparison, clinician-ordered resuscitation status was Full Code in 263 (65.8%) patients, DNR in 133 (33.3%), and not documented in four (1.0%). Patient-reported and clinician-ordered resuscitation status was discordant in 20% of patients, of whom 5.6% elected Full Code by questionnaire and had a DNR clinician order, and 14.4% elected DNR by questionnaire but had a Full Code clinician order. Differences in age, comorbidities, health literacy, marital status, completion of advance directives, hospital length of stay, and discharge destination in patients with discordant vs. concordant resuscitation preferences were observed. Patient-reported and clinician-ordered resuscitation preferences were discordant in 20% of patients hospitalized with ADHF. The underlying etiology of these inconsistencies may reflect factors such as patient indecisiveness or patient-clinician miscommunication and requires further exploration. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc

  2. Code Status Reconciliation to Improve Identification and Documentation of Code Status in Electronic Health Records.

    Science.gov (United States)

    Jain, Viral G; Greco, Peter J; Kaelber, David C

    2017-03-08

    Code status (CS) of a patient (part of their end-of-life wishes) can be critical information in healthcare delivery, which can change over time, especially at transitions of care. Although electronic health record (EHR) tools exist for medication reconciliation across transitions of care, much less attention is given to CS, and standard EHR tools have not been implemented for CS reconciliation (CSR). Lack of CSR creates significant potential patient safety and quality of life issues. To study the tools, workflow, and impact of clinical decision support (CDS) for CSR. We established rules for CS implementation in our EHR. At admission, a CS is required as part of a patient's admission order set. Using standard CDS tools in our EHR, we built an interruptive alert for CSR at discharge if a patient did not have the same inpatient (current) CS at discharge as that prior to admission CS. Of 80,587 admissions over a four year period (2 years prior to and post CSR implementation), CS discordance was seen in 3.5% of encounters which had full code status prior to admission, but Do Not Resuscitate (DNR) CS at discharge. In addition, 1.4% of the encounters had a different variant of the DNR CS at discharge when compared with CS prior to admission. On pre-post CSR implementation analysis, DNR CS per 1000 admissions per month increased significantly among patients discharged and in patients being admitted (mean ± SD: 85.36 ± 13.69 to 399.85 ± 182.86, pCSR is effective and represents a significant informatics opportunity to help honor patients' end-of-life wishes. CSR represents one example of non-medication reconciliation at transitions of care that should be considered in all EHRs to improve care quality and patient safety.

  3. [Prognosis improvements in children with acute myelocytic leucemia after more intensive induction therapy (author's transl)].

    Science.gov (United States)

    Scheer, U; Schellong, G; Riehm, H

    1979-03-01

    Between October 1974 and October 1978 23 children with acute myelocytic leucemia (AML) received intensive therapy in the Univ.-Kinderklinik Münster: 4 children were treated according to the ALGB-protocol consisting of 5-7 day courses of ARA-C-infusion and 3 DNR-injections. 19 patients received the West-Berlin-protocol: The first 7 the original ALL protocol, 11 the modified form of AML, which will be presented here as AML-therapy-study BFM 78. 4 of the 23 patients died with early acute cerebral bleeding. 2 patients were nonresponders. 17 children went into remission. One girl died in remission of septicemic aspergillosis. 4 children had a relapse. In November 1978 there were still 12 patients in continuous complete remission, 3 of them already without therapy. 13 of the 19 patients, who were treated with the West-Berlin-protocol went into remission. 1 had a relapse. At present there are 11 patients in continuous complete remission. The above results and those found in the literature could signify that the long term prognosis of children with AML will be improved. To coordinate efforts toward this goal a cooperative AML-therapy-study in the "Deutsche Arbeitsgemeinschaft für Leukämieforschung" (BFM-group) using the here presented therapy protocol was formed in November 1978.

  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. Accidental Haemorrhage and Fetal Prognosis

    African Journals Online (AJOL)

    1974-04-17

    Apr 17, 1974 ... perinatal mortality associated with accidental haemorrhage. The importance of clinical signs in determining fetal prognosis is discussed. A suggested clinical approach to cases of accidental haemorrhage, where on admission the fetus is found to be alive in utero, is given. S. Afr. Med. l., 48, 764 (1974).

  6. HPV status, cancer stem cell marker expression, hypoxia gene signatures and tumour volume identify good prognosis subgroups in patients with HNSCC after primary radiochemotherapy: A multicentre retrospective study of the German Cancer Consortium Radiation Oncology Group (DKTK-ROG)

    DEFF Research Database (Denmark)

    Linge, Annett; Lohaus, Fabian; Löck, Steffen

    2016-01-01

    OBJECTIVE: To investigate the impact of the tumour volume, HPV status, cancer stem cell (CSC) marker expression and hypoxia gene signatures, as potential markers of radiobiological mechanisms of radioresistance, in a contemporary cohort of patients with locally advanced head and neck squamous cell...... expression and hypoxia-associated gene signatures on outcome of primary RCTx was retrospectively analyzed. The primary endpoint of this study was loco-regional control (LRC). RESULTS: Univariate Cox regression revealed a significant impact of tumour volume, p16 overexpression, and SLC3A2 and CD44 protein...... signatures are potential prognostic biomarkers for patients with locally advanced HNSCC, who were treated by primary RCTx. The study also supports that the individual tumour volumes should generally be included in biomarker studies and that panels of biomarkers are superior to individual parameters....

  7. 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...

  8. 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...

  9. 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.

  10. 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...

  11. 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...

  12. Does age affect prognosis in salivary gland carcinoma patients?

    DEFF Research Database (Denmark)

    Bjørndal, Kristine; Larsen, Stine R; Therkildsen, Marianne H

    2016-01-01

    AIM: To compare incidence, histology, treatment modalities, disease stages, and outcome in elderly patients (≥70 years) compared to younger (gland carcinoma database, 871 patients diagnosed with a primary salivary gland carcinoma from January...... in the young group were WHO performance status 0 and in disease stage I + II, and they presented with significantly more histological low grade tumors. In multivariate analysis, chronological age seemed to be of no prognostic significance to salivary gland carcinoma patients as opposed to performance status......, disease stage and histological grade. CONCLUSIONS: Salivary gland carcinoma patients over the age of 70 years have a poor prognosis compared to younger patients, which can be explained by higher disease stages, more histological high grade subtypes and a poorer performance status at the time of diagnosis....

  13. New Nuclear Emergency Prognosis system in Korea

    Science.gov (United States)

    Lee, Hyun-Ha; Jeong, Seung-Young; Park, Sang-Hyun; Lee, Kwan-Hee

    2016-04-01

    This paper reviews the status of assessment and prognosis system for nuclear emergency response in Korea, especially atmospheric dispersion model. The Korea Institute of Nuclear Safety (KINS) performs the regulation and radiological emergency preparedness of the nuclear facilities and radiation utilizations. Also, KINS has set up the "Radiological Emergency Technical Advisory Plan" and the associated procedures such as an emergency response manual in consideration of the IAEA Safety Standards GS-R-2, GS-G-2.0, and GS-G-2.1. The Radiological Emergency Technical Advisory Center (RETAC) organized in an emergency situation provides the technical advice on radiological emergency response. The "Atomic Computerized Technical Advisory System for nuclear emergency" (AtomCARE) has been developed to implement assessment and prognosis by RETAC. KINS developed Accident Dose Assessment and Monitoring (ADAMO) system in 2015 to reflect the lessons learned from Fukushima accident. It incorporates (1) the dose assessment on the entire Korean peninsula, Asia region, and global region, (2) multi-units accident assessment (3) applying new methodology of dose rate assessment and the source term estimation with inverse modeling, (4) dose assessment and monitoring with the environmental measurements result. The ADAMO is the renovated version of current FADAS of AtomCARE. The ADAMO increases the accuracy of the radioactive material dispersion with applying the LDAPS(Local Data Assimilation Prediction System, Spatial resolution: 1.5 km) and RDAPS(Regional Data Assimilation Prediction System, Spatial resolution: 12km) of weather prediction data, and performing the data assimilation of automatic weather system (AWS) data from Korea Meteorological Administration (KMA) and data from the weather observation tower at NPP site. The prediction model of the radiological material dispersion is based on the set of the Lagrangian Particle model and Lagrangian Puff model. The dose estimation methodology

  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. Prognosis of symptomatic patients with the A3243G mutation of mitochondrial DNA

    Directory of Open Access Journals (Sweden)

    Chi-Hung Liu

    2012-09-01

    Conclusion: Our study found that seizures and status epilepticus are the most important predictive values for a poor outcome in patients with the mtA3243G mutation of mtDNA. Age of onset and visceral organ involvement had no prominent influence on the prognosis. Some medical complications could be well controlled or even reversed after management.

  16. Novel Biomarker for Prognosis, Treatment Response

    Science.gov (United States)

    An NCI Cancer Currents blog about a study of a new type of cancer biomarker that measures the extent of chromosomal instability as a way to potentially predict patient prognosis and help guide cancer treatment choices.

  17. Atypical odontalgia. Its aetiology and prognosis.

    Science.gov (United States)

    Brooke, R I; Schnurr, R F

    1993-12-01

    Atypical odontalgia is a chronic pain disorder in which persistent pain develops in clinically normal teeth. Its possible aetiology and long-term prognosis are discussed. Suggested management regimes are reviewed.

  18. 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.

  19. Are Early Relapses in Advanced-Stage Ovarian Cancer Doomed to a Poor Prognosis?

    Directory of Open Access Journals (Sweden)

    Fabien Vidal

    Full Text Available Early recurrence (ER after completion of therapeutic regimen in advanced-stage ovarian cancer is a challenging clinical situation. Patients are perceived as invariably having a poor prognosis. We investigated the possibility of defining different prognostic subgroups and the parameters implicated in prognosis of ER patients.We analyzed a multi-centric database of 527 FIGO stage IIIC and IV ovarian cancer patients. We defined patients relapsing within 12 months as ER and investigated using Cox logistic regression the prognostic factors in ER group. We subsequently divided ER patients into good and poor prognosis groups according to a lower or higher overall survival (OS at 12 months after relapse and determined parameters associated to poor prognosis.The median follow up was 49 months. One hundred and thirty eight patients recurred within 12 months. OS and Disease Free Survival (DFS were 24.6 and 8.6 months, respectively, in this group of patients. Among the ER patients, 73 had a poor prognosis with an OS after relapse below 12 months (mean OS = 5.2 months and 65 survived after one year (mean OS = 26.9 months. Residual disease (RD after debulking surgery and mucinous histological subtype negatively impacted prognosis (HR = 1.758, p = 0.017 and HR = 8.641, p = 0.001 respectively. The relative risk of death within 12 months following relapse in ER patients was 1.61 according to RD status. However, RD did not affect DFS (HR = 0.889, p = 0.5.ER in advanced-stage ovarian cancer does not inevitably portend a short-term poor prognosis. RD status after initial cytoreduction strongly modulates OS, that gives additional support to the concept of maximum surgical effort even in patients who will experience early recurrence. The heterogeneity in outcomes within the ER group suggests a role for tumor biology in addition to classical clinical parameters.

  20. Prognosis of severe head injuries.

    Science.gov (United States)

    Levati, A; Farina, M L; Vecchi, G; Rossanda, M; Marrubini, M B

    1982-12-01

    The authors have analyzed retrospectively a series of 288 consecutive patients with severe head injury observed between January, 1977, and May, 1980. Seventy-three patients were excluded as not being compatible with those of the International Data Bank. The remaining 215 patients complied with the definition of coma given by Jennett. All patients, after appropriate cardiopulmonary resuscitation, diagnostic measures, and, when required, surgical treatment, were managed in the Neurosurgical Intensive Care Unit with endotracheal intubation, controlled hyperventilation, mild dehydration, dexamethasone in standard doses, and sedation. The mortality rate was 39.5%. Of the survivors, 59.2% made a good recovery, 18.4% remained moderately disabled, 6.1% were severely disabled, and 1.5% were in a persistent vegetative state. The most reliable predictive criteria were: absence of brain-stem reflexes, neurological status, abnormal motor patterns, arterial hypotension, and presence of mass lesions. It is concluded that no sign has an absolute prognostic value when considered independently of its time course.

  1. Improving Prognosis Estimation in Patients with Heart Failure and the Cardiorenal Syndrome

    Directory of Open Access Journals (Sweden)

    Husam M. Abdel-Qadir

    2011-01-01

    Full Text Available The coexistence of heart failure and renal dysfunction constitutes the “cardiorenal syndrome” which is increasingly recognized as a marker of poor prognosis. Patients with cardiorenal dysfunction constitute a large and heterogeneous group where individuals can have markedly different outcomes and disease courses. Thus, the determination of prognosis in this high risk group of patients may pose challenges for clinicians and for researchers alike. In this paper, we discuss the cardiorenal syndrome as it pertains to the patient with heart failure and considerations for further refining prognosis and outcomes in patients with heart failure and renal dysfunction. Conventional assessments of left ventricular function, renal clearance, and functional status can be complemented with identification of coexistent comorbidities, medication needs, microalbuminuria, anemia, biomarker levels, and pulmonary pressures to derive additional prognostic data that can aid management and provide future research directions for this challenging patient group.

  2. Improving Prognosis Estimation in Patients with Heart Failure and the Cardiorenal Syndrome

    Science.gov (United States)

    Abdel-Qadir, Husam M.; Chugh, Shaan; Lee, Douglas S.

    2011-01-01

    The coexistence of heart failure and renal dysfunction constitutes the “cardiorenal syndrome” which is increasingly recognized as a marker of poor prognosis. Patients with cardiorenal dysfunction constitute a large and heterogeneous group where individuals can have markedly different outcomes and disease courses. Thus, the determination of prognosis in this high risk group of patients may pose challenges for clinicians and for researchers alike. In this paper, we discuss the cardiorenal syndrome as it pertains to the patient with heart failure and considerations for further refining prognosis and outcomes in patients with heart failure and renal dysfunction. Conventional assessments of left ventricular function, renal clearance, and functional status can be complemented with identification of coexistent comorbidities, medication needs, microalbuminuria, anemia, biomarker levels, and pulmonary pressures to derive additional prognostic data that can aid management and provide future research directions for this challenging patient group. PMID:21660113

  3. Prognosis of synchronous bilateral breast cancer

    DEFF Research Database (Denmark)

    Holm, Marianne; Tjønneland, Anne; Balslev, Eva

    2014-01-01

    Currently, no consistent evidence-based guidelines for the management of synchronous bilateral breast cancer (SBBC) exist and it is uncertain how presenting with SBBC affects patients' prognosis. We conducted a review of studies analyzing the association between SBBC and prognosis. The studies...... that reported adjusted effect measures were included in meta-analyses of effect of bilaterality on breast cancer mortality. From 57 initially identified records 17 studies from 11 different countries including 8,050 SBBC patients were included. The quality of the studies varied but was generally low with small...

  4. [Syncope : epidemiology, definition, classification, pathophysiology and prognosis].

    Science.gov (United States)

    Heeger, C-H; Rillig, A; Ouyang, F; Kuck, K-H; Tilz, R R

    2014-06-01

    Syncope is a common clinical issue. Around 40 % of the total population experience syncope during their lifetime. Serious injuries and reduced quality of life are often observed after syncope. Furthermore, in some cases syncope can be associated with an unfavorable prognosis. Due to the complex etiology and pathophysiology, syncope provides challenges for doctors both in private and in clinical practices. This review is based on the latest European guidelines for syncope which were formulated by internists, neurologists, emergency physicians and cardiologists and gives an overview of the current epidemiology, definition, classification, pathophysiology and prognosis of syncope.

  5. Laryngeal Electromyography for Prognosis of Vocal Fold Paralysis.

    Science.gov (United States)

    Pardo-Maza, Adriana; García-Lopez, Isabel; Santiago-Pérez, Susana; Gavilán, Javier

    2017-01-01

    This study aimed to determine the value of laryngeal electromyography in the prognosis of vocal fold paralysis. This is a retrospective descriptive study. This study included 80 patients diagnosed with unilateral or bilateral vocal fold paralysis on flexible laryngoscopy between 2002 and 2014 in a tertiary medical center. Laryngeal electromyography using a standardized protocol was performed; the outcome measures were classified and analyzed into two groups according to the degree of injury. Group 1 included patients with mild to moderate injury, and group 2 included patients with severe to complete injury. Prognosis was correlated with vocal fold motion recovery status with a minimum of 6 months of follow-up since the symptoms onset using positive and negative predictive values. Sixty patients showed acute or chronic recurrent laryngeal neuropathy in laryngeal electromyography. Twelve of 41 patients included in group 1 recovered motion, and 30 of 35 patients included in group 2 did not recover, resulting in 88.2% of positive predictive value and 35.7% of negative predictive value. Our data confirm that laryngeal electromyography is a useful clinical tool in predicting poor recovery in patients with vocal fold paralysis. It allows identification of candidates for early intervention. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  6. Biomarkers and Prognosis in Malignant Lymphomas

    NARCIS (Netherlands)

    Hagenbeek, Anton; Gascoyne, Randy D.; Dreyling, Martin; Kluin, Philip; Engert, Andreas; Salles, Gilles

    Approximately 100 hematologists and pathologists from Europe, the United States, and Canada participated in the workshop Biomarkers and Prognosis in Malignant Lymphomas, held in Mandelieu, France,April 11-13, 2008, under the leadership of Anton Hagenbeek, Randy Gascoyne, and Gilles Salles.

  7. User's Guide to the Stand Prognosis Model

    Science.gov (United States)

    William R. Wykoff; Nicholas L. Crookston; Albert R. Stage

    1982-01-01

    The Stand Prognosis Model is a computer program that projects the development of forest stands in the Northern Rocky Mountains. Thinning options allow for simulation of a variety of management strategies. Input consists of a stand inventory, including sample tree records, and a set of option selection instructions. Output includes data normally found in stand, stock,...

  8. Clinical severity and prognosis of hand eczema

    DEFF Research Database (Denmark)

    Hald, M; Agner, T; Blands, J

    2009-01-01

    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...

  9. Pulmonary embolism : diagnostic management and prognosis

    NARCIS (Netherlands)

    Klok, Frederikus Albertus

    2010-01-01

    This thesis describes the diagnostic management, short term prognosis and long term complications of pulmonary embolism. We have validated a newly derived clinical decision rule, the revised Geneva score, for predicting the pre-test probability of having acute pulmonary embolism. This rule can be

  10. The natural history and prognosis of epilepsy.

    Science.gov (United States)

    Beghi, Ettore; Giussani, Giorgia; Sander, Josemir W

    2015-09-01

    Epilepsy is a brain condition characterized by the recurrence of unprovoked seizures. Generally, prognosis refers to the probability of attaining seizure freedom on treatment and little is known about the natural history of the untreated condition. Here, we summarize aspects of the prognosis and prognostic predictors of treated and untreated epilepsy and of its different syndromes. Usually, epilepsy is a fairly benign condition. Most epilepsies have a good prognosis for full seizure control and eventual discontinuation of AEDs, but epilepsy syndromes have differing outcomes and responses to treatment. Prognostic factors include aetiology, EEG abnormalities, type of seizures and the number of seizures experienced before treatment onset, and poor early effects of drugs. Early response to treatment is an important positive predictor of long-term prognosis, while the history of a high number of seizures at the time of diagnosis, intellectual disability, and symptomatic aetiology are negative predictors. Different prognostic patterns can be identified, suggesting that the epileptogenic process is not static. Epilepsy carries a greater than expected risk of premature death. Aetiology is the single most important risk factor for premature death.

  11. Expression quantitative trait loci for PAX8 contributes to the prognosis of hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Shijie Ma

    Full Text Available Paired-box family member PAX8 encodes a transcription factor that has a role in cell differentiation and cell growth and may participate in the prognosis of hepatocellular carcinoma (HCC. By bioinformatics analysis, we identified several single nucleotide polymorphisms (SNPs within a newly identified long non-coding RNA (lncRNA AC016683.6 as expression quantitative trait loci (eQTLs for PAX8. Hence, we hypothesized that PAX8eQTLs in lncRNA AC016683.6 may influence the HCC prognosis. We then performed a case-only study to assess the association between the two SNPs as well as the prognosis of HCC in 331 HBV-positive HCC patients without surgical treatment. Cox proportional hazard models were used for survival analysis with adjustments for the age, gender, smoking status, drinking status, Barcelona-Clinic Liver Cancer (BCLC stage, and chemotherapy or TACE (transcatheter hepatic arterial chemoembolization status. We found that the G allele of rs1110839 and the T allele of rs4848320 in PAX8was significantly associated with a better prognosis compared with the T allele of rs1110839 and the C allele of rs4848320 (adjusted HR = 0.74, 95% CI = 0.61-0.91, P = 0.004 for rs1110839 and adjusted HR = 0.71, 95% CI = 0.54-0.94, P = 0.015 for rs4848320 in the additive model. Furthermore, the combined effect of the variant genotypes for these two SNPs was more prominent in patients with the BCLC-C stage orpatients with chemotherapy or TACE. Although the exact biological function remains to be explored, our findings suggest a possible association of PAX8eQTLs in lncRNA AC016683.6 with the HCC prognosis inthe Chinese population. Further large and functional studies are needed to confirm our findings.

  12. 2012 South Carolina DNR Lidar: Aiken County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Towill Inc. collected LiDAR for over 3,300 square miles in Calhoun, Aiken, Barnwell, Edgefield, McCormick, and Abbeville counties in South Carolina. This metadata...

  13. 2012 South Carolina DNR Lidar: Barnwell County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Towill Inc. collected LiDAR for over 3,300 square miles in Calhoun, Aiken, Barnwell, Edgefield, McCormick, and Abbeville counties in South Carolina. This metadata...

  14. 2012 South Carolina DNR Lidar: Abbeville County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Towill Inc. collected LiDAR for over 3,300 square miles in Calhoun, Aiken, Barnwell, Edgefield, McCormick, and Abbeville counties in South Carolina. This metadata...

  15. 2012 South Carolina DNR Lidar: Edgefield County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Towill Inc. collected LiDAR for over 3,300 square miles in Calhoun, Aiken, Barnwell, Edgefield, McCormick, and Abbeville counties in South Carolina. This metadata...

  16. 2006 South Carolina DNR Lidar: Aiken County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The LiDAR data acquisition was executed in five sessions, on March 15, 16 & 17, 2006, using a Leica ALS50 LiDAR System. Specific details about the ALS50 system...

  17. DNR 100K Lakes and Rivers

    Data.gov (United States)

    Minnesota Department of Natural Resources — Polygons representing hydrographic features (lakes, ponds, some rivers, and open water areas) originating from the USGS 1:100,000 (100K)DLG (Digital Line Graph)...

  18. 2010 South Carolina DNR Lidar: Sumter County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Provide high density LiDAR elevation data map of Sumter County, SC. Provide Bare Earth DEM (vegetation removal) of Sumter County, SC.

  19. DNR State Forest Roads - WHEELS Database

    Data.gov (United States)

    Minnesota Department of Natural Resources — Roads administered by the Commissioner of Natural Resources to provide access to lands administered by the Division of Forestry. These roads are generally open to...

  20. 2011 South Carolina DNR Lidar: York County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Towill Inc. collected LiDAR for over 3,500 square miles in York, Pickens, Anderson, and Oconee Counties in South Carolina. This metadata covers the LiDAR produced...

  1. 2010 South Carolina DNR Lidar: Kershaw County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Provide high density LiDAR elevation data map of Kershaw County, SC. Provide Bare Earth DEM (vegetation removal) of Kershaw County, SC.

  2. 2012 South Carolina DNR Lidar: Calhoun County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Towill Inc. collected LiDAR for over 3,300 square miles in Calhoun, Aiken, Barnwell, Edgefield, McCormick, and Abbeville counties in South Carolina. This metadata...

  3. BMI and breast cancer prognosis benefit: mammography screening reveals differences between normal weight and overweight women.

    Science.gov (United States)

    Crispo, Anna; Grimaldi, Maria; D'Aiuto, Massimiliano; Rinaldo, Massimo; Capasso, Immacolata; Amore, Alfonso; D'Aiuto, Giuseppe; Giudice, Aldo; Ciliberto, Gennaro; Montella, Maurizio

    2015-02-01

    Few studies are available on the potential impact of body weight on breast cancer prognosis in screen-detected patients. Moreover, it is not known whether body mass index (BMI) could have a different prognostic impact in screen-detected versus symptomatic breast cancer patients. To investigate these unsolved issues, we carried out a retrospective study evaluating the effect of BMI on breast cancer prognosis in screen-detected vs symptomatic breast cancer patients. We conducted a follow-up study on 448 women diagnosed with incident, histologically-confirmed breast cancer. Patients were categorized according to their BMI as normal weight, overweight and obese. Disease free survival (DFS), overall survival (OS), and BMI curves were compared according to mode of cancer detection. Among screen-detected patients, higher BMI was associated with a significant lower DFS, whereas no significant difference was observed among symptomatic patients. OS showed similar results. In the multivariate analysis adjusting for age, education, tumor size, nodal status, estrogen receptor (ER), progesterone receptor (PR) and menopausal status, the risk for high level of BMI among screen-detected patients did not reach the statistical significance for either recurrence or survival. Our study highlights the potential impact of high bodyweight in breast cancer prognosis, the findings confirm that obesity plays a role in women breast cancer prognosis independently from diagnosis mode. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. The alteration of Id-1 and TSP-1 expression in mucoepidermoid carcinoma associated with its clinical features and prognosis.

    Science.gov (United States)

    Yang, S; Guo, L-J; Tang, X-F; Tan, K; Gong, R-G; Li, A; Yu, T; Gao, Q-H; Xuan, M; Wen, Y-M; Wang, C-M; Wang, X-Y

    2010-01-01

    Expression of Id-1 (inhibitors of DNA binding/differentiation protein 1) and TSP-1 (thrombospondin-1) in mucoepidermoid carcinoma and their relationship to pathological features and prognosis was studied. Moderately and poorly differentiated groups had significantly higher Id-1 positive expression rate (pTSP-1 in mucoepidermoid carcinoma was negative (pTSP-1 positive expression rate than well differentiated groups (pTSP-1 positive expression were detected with clinical stage. TSP-1 positive expression was significantly lower in patients with cervical lymph node metastasis or relapse at 5 years (pTSP-1 expression had significantly higher tumor-free survival than patients with negative TSP-1. Positive Id-1 expression is associated with high malignancy/poor prognosis; positive TSP-1 expression is associated with low malignancy/good prognosis. Protein expression status may help assess tumor malignancy and patient prognosis. Copyright 2009 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Wild-type APC predicts poor prognosis in microsatellite-stable proximal colon cancer.

    Science.gov (United States)

    Jorissen, Robert N; Christie, Michael; Mouradov, Dmitri; Sakthianandeswaren, Anuratha; Li, Shan; Love, Christopher; Xu, Zheng-Zhou; Molloy, Peter L; Jones, Ian T; McLaughlin, Stephen; Ward, Robyn L; Hawkins, Nicholas J; Ruszkiewicz, Andrew R; Moore, James; Burgess, Antony W; Busam, Dana; Zhao, Qi; Strausberg, Robert L; Lipton, Lara; Desai, Jayesh; Gibbs, Peter; Sieber, Oliver M

    2015-09-15

    APC mutations (APC-mt) occur in ∼70% of colorectal cancers (CRCs), but their relationship to prognosis is unclear. APC prognostic value was evaluated in 746 stage I-IV CRC patients, stratifying for tumour location and microsatellite instability (MSI). Microarrays were used to identify a gene signature that could classify APC mutation status, and classifier ability to predict prognosis was examined in an independent cohort. Wild-type APC microsatellite stable (APC-wt/MSS) tumours from the proximal colon showed poorer overall and recurrence-free survival (OS, RFS) than APC-mt/MSS proximal, APC-wt/MSS distal and APC-mt/MSS distal tumours (OS HR⩾1.79, P⩽0.015; RFS HR⩾1.88, P⩽0.026). APC was a stronger prognostic indicator than BRAF, KRAS, PIK3CA, TP53, CpG island methylator phenotype or chromosomal instability status (P⩽0.036). Microarray analysis similarly revealed poorer survival in MSS proximal cancers with an APC-wt-like signature (P=0.019). APC status did not affect outcomes in MSI tumours. In a validation on 206 patients with proximal colon cancer, APC-wt-like signature MSS cases showed poorer survival than APC-mt-like signature MSS or MSI cases (OS HR⩾2.50, P⩽0.010; RFS HR⩾2.14, P⩽0.025). Poor prognosis APC-wt/MSS proximal tumours exhibited features of the sessile serrated neoplasia pathway (P⩽0.016). APC-wt status is a marker of poor prognosis in MSS proximal colon cancer.

  6. Endometrial cancer, types, prognosis, female hormones and antihormones

    DEFF Research Database (Denmark)

    Ulrich, L S G

    2011-01-01

    . Prognosis is also dependent on tumor differentiation and stage, and treatment should be adjusted accordingly. In this paper, the different types of endometrial cancer, staging, prognosis, diagnosis, prevention, treatment and their relationship to estrogen and other female hormones are reviewed....

  7. Vital prognosis after hospitalization for COPD

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P

    1998-01-01

    STUDY AIM: To examine survival after admission due to chronic obstructive pulmonary disease (COPD) in a population sample over a time span of 15 years. DESIGN: Linkage between a prospective population cohort and register information on hospitalization and mortality. SETTING: The Copenhagen City...... Heart Study (CCHS). PARTICIPANTS: A total of 267 men and 220 women who had participated in the CCHS and who were hospitalized with a discharge diagnosis of COPD (ICD-8 491-2). MAIN RESULTS: The crude 5-yr survival rate after a COPD admission was 45% (37% for men and 52% for women). Mortality risk...... associated with prognosis. Survival after admission due to COPD did not change significantly over time. CONCLUSION: Compared to previous studies of COPD patients, the present study indicates that prognosis after hospital admission remains virtually unchanged over the last decades. FEV1 is still the strongest...

  8. Melanoma prognosis in Europe: far from equal.

    Science.gov (United States)

    Forsea, A M; Del Marmol, V; Stratigos, A; Geller, A C

    2014-07-01

    Comprehensive, population-based analysis of melanoma survival throughout Europe is hindered by the uneven coverage and quality of European cancer registries, and by logistical and financial shortcomings. Mortality-to-incidence ratios (MIRs) have been used as a proxy for estimating survival for multiple cancers and to model melanoma prognosis, higher MIR values reflecting poorer prognosis. Updated and improved pan-European estimates of mortality and incidence rates for melanoma have become available through the International Agency for Research of Cancer project Globocan 2008, showing marked differences among European countries. To analyse MIRs for melanoma across Europe and their relationship with national health expenditures, aiming to identify countries and regions with disproportionately poor prognosis. Estimated age-standardized rates of melanoma incidence and mortality provided by Globocan 2008 were used to calculate the MIR for each European country and region. Total health expenditures per capita in European countries for 2008 were provided by the World Health Organization/Global Health Observatory. The potential correlation between MIR and total health expenditure per capita was analysed through Pearson's correlation. Mortality-to-incidence ratios for melanoma ranged between 0·09 in Switzerland and 0·44 in Latvia. The regional average MIR was the highest in Central and Eastern Europe at 0·35; the lowest was in Western Europe, at 0·13. We found a strong inverse correlation between the individual nation's total health expenditure per capita and the calculated melanoma MIR (r = -0·76, P < 0·05). While further improvement of melanoma registration is necessary, our findings reveal sharp disparities in the prognosis of melanoma across the Continent, correlated with significant differences in health care expenditures. © 2014 British Association of Dermatologists.

  9. Activated allogeneic NK cells preferentially kill poor prognosis B-cell chronic lymphocytic leukemia cells

    Directory of Open Access Journals (Sweden)

    Diego Sanchez-Martinez

    2016-10-01

    Full Text Available Mutational status of TP53 together with expression of wild type (wt IGHV represents the most widely accepted biomarkers, establishing a very poor prognosis in B-cell chronic lymphocytic leukemia (B-CLL patients. Adoptive cell therapy using allogeneic HLA mismatched Natural Killer (NK cells has emerged as an effective and safe alternative in the treatment of acute myeloid and lymphoid leukemias that do not respond to traditional therapies. We have described that allogeneic activated NK cells eliminate hematological cancer cell lines with multidrug resistance acquired by mutations in the apoptotic machinery. This effect depends on the activation protocol, being B-lymphoblastoid cell lines (LCLs the most effective stimulus to activate NK cells. Here we have further analyzed the molecular determinants involved in allogeneic NK cell recognition and elimination of B-CLL cells, including the expression of ligands of the main NK cell activating receptors (NKG2D and NCRs and HLA mismatch. We present preliminary data suggesting that B-CLL susceptibility significantly correlates with HLA mismatch between NK cell donor and B-CLL patient. Moreover, we show that the sensitivity of B-CLL cells to NK cells depends on the prognosis based on TP53 and IGHV mutational status. Cells from patients with worse prognosis (mutated TP53 and wt IGHV are the most susceptible to activated NK cells. Hence, B-CLL prognosis may predict the efficacy of allogenic activated NK cells and, thus, NK cell transfer represents a good alternative to treat poor prognosis B-CLL patients who present a very short life expectancy due to lack of effective treatments.□

  10. Differences in parent-provider concordance regarding prognosis and goals of care among children with advanced cancer.

    Science.gov (United States)

    Rosenberg, Abby R; Orellana, Liliana; Kang, Tammy I; Geyer, J Russell; Feudtner, Chris; Dussel, Veronica; Wolfe, Joanne

    2014-09-20

    Concordance between parents of children with advanced cancer and health care providers has not been described. We aimed to describe parent-provider concordance regarding prognosis and goals of care, including differences by cancer type. A total of 104 pediatric patients with recurrent or refractory cancer were enrolled at three large children’s hospitals. On enrollment, their parents and providers were invited to complete a survey assessing perceived prognosis and goals of care. Patients’ survival status was retrospectively abstracted from medical records. Concordance was assessed via discrepancies in perceived prognosis, statistics, and McNemar’s test. Distribution of categorical variables and survival rates across cancer type were compared with Fisher’s exact and log-rank tests, respectively. Data were available from 77 dyads (74% of enrolled). Parent-provider agreement regarding prognosis and goals of care was poor (kappa, 0.12 to 0.30). Parents were more likely to report cure was likely (P < .001). The frequency of perceived likelihood of cure and the goal of cure varied by cancer type for both parents and providers (P < .001 to .004). Relatively optimistic responses were more common among parents and providers of patients with hematologic malignancies, although there were no differences in survival. Parent-provider concordance regarding prognosis and goals in advanced pediatric cancer is generally poor. Perceptions of prognosis and goals of care vary by cancer type. Understanding these differences may inform parent-provider communication and decision making.

  11. Prognosis of chronic low back pain: design of an inception cohort study

    Directory of Open Access Journals (Sweden)

    McAuley James H

    2007-02-01

    Full Text Available Abstract Background Although clinical guidelines generally portray chronic low back pain as a condition with a poor prognosis this portrayal is based on studies of potentially unrepresentative survival cohorts. The aim of this study is to describe the prognosis of an inception cohort of people with chronic low back pain presenting for primary care. Methods/Design The study will be an inception cohort study with one year follow-up. Participants are drawn from a cohort of consecutive patients presenting with acute low back pain (less than 2 weeks duration to primary care clinics in Sydney, Australia. Those patients who continue to experience pain at three months, and are therefore classified as having chronic back pain, are invited to participate in the current study. The cohort will be followed up by telephone at baseline, 9 months and 12 months after being diagnosed with chronic low back pain. Recovery from low back pain will be measured by sampling three different outcomes: pain intensity, interference with function due to pain, and work status. Life tables will be generated to determine the one year prognosis of chronic low back pain. Prognostic factors will be assessed using Cox regression. Discussion This study will determine the prognosis of chronic non-specific low back pain in a representative cohort of patients sourced from primary care. The results of this study will improve understanding of chronic low back pain, allowing clinicians to provide more accurate prognostic information to their patients.

  12. Prognosis of chronic low back pain: design of an inception cohort study.

    Science.gov (United States)

    Costa, Luciola da Cunha Menezes; Henschke, Nicholas; Maher, Christopher G; Refshauge, Kathryn M; Herbert, Robert D; McAuley, James H; Das, Anurina; Costa, Leonardo O P

    2007-02-08

    Although clinical guidelines generally portray chronic low back pain as a condition with a poor prognosis this portrayal is based on studies of potentially unrepresentative survival cohorts. The aim of this study is to describe the prognosis of an inception cohort of people with chronic low back pain presenting for primary care. The study will be an inception cohort study with one year follow-up. Participants are drawn from a cohort of consecutive patients presenting with acute low back pain (less than 2 weeks duration) to primary care clinics in Sydney, Australia. Those patients who continue to experience pain at three months, and are therefore classified as having chronic back pain, are invited to participate in the current study. The cohort will be followed up by telephone at baseline, 9 months and 12 months after being diagnosed with chronic low back pain. Recovery from low back pain will be measured by sampling three different outcomes: pain intensity, interference with function due to pain, and work status. Life tables will be generated to determine the one year prognosis of chronic low back pain. Prognostic factors will be assessed using Cox regression. This study will determine the prognosis of chronic non-specific low back pain in a representative cohort of patients sourced from primary care. The results of this study will improve understanding of chronic low back pain, allowing clinicians to provide more accurate prognostic information to their patients.

  13. Prognosis of pregnancy-associated breast cancer.

    Science.gov (United States)

    Lee, Guek Eng; Mayer, Erica L; Partridge, Ann

    2017-06-01

    Conventionally, breast cancer diagnosed during pregnancy and within the years following have been referred to collectively as pregnancy-associated breast cancer. However, increasing evidence suggests that breast cancer diagnosed during pregnancy is a different entity from that diagnosed postpartum, both in terms of prognosis and biology. Given the increasing number of women who find themselves diagnosed with breast cancer during or following a pregnancy, future research and discussion should separate these two into distinct groups: breast cancer diagnosed during pregnancy and breast cancer diagnosed postpartum in an effort to enhance our understanding to inform and improve clinical management and counseling.

  14. Proteinuria can predict prognosis after liver transplantation.

    Science.gov (United States)

    Pan, Heng-Chih; Chen, Ying-Jen; Lin, Jhe-Ping; Tsai, Ming-Jung; Jenq, Chang-Chyi; Lee, Wei-Chen; Tsai, Ming-Hung; Fan, Pei-Chun; Chang, Chih-Hsiang; Chang, Ming-Yang; Tian, Ya-Chung; Hung, Cheng-Chieh; Fang, Ji-Tseng; Yang, Chih-Wei; Chen, Yung-Chang

    2016-09-15

    Proteinuria is a manifestation of renal dysfunction and it has been demonstrated to be a significant prognostic factor in various clinical situations. The study was designed to analyze prognosis of patients receiving liver transplantation as well as to determine predictive performance of perioperative proteinuria. We retrospectively reviewed data of patients who had received a liver transplant in a medical center between 2002 and 2010. Demographic information and clinical characteristic parameters were recorded on the day of intensive care unit admission before operation and on postoperative days 1, 7, and 14. Among a total of 323 patients, in-hospital mortality and 90-day mortality rates were 13.0 % (42/323) and 14.2 % (46/323), respectively. Patients with proteinuria on admission had higher rates of acute kidney injury (26.8 % vs. 8.8 %, p proteinuria on admission and Sequential Organ Failure Assessment (SOFA) score were independent predictors of in-hospital mortality. The discriminatory ability of proteinuria plus SOFA was even better than that of SOFA alone, especially on postoperative day 1. The presence of proteinuria before liver transplantation is supposed to be recognized as a negative predictor for in-hospital survival. Moreover, the presence of proteinuria after liver transplantation can assist in the early prediction of poor short-term prognosis for patients receiving liver transplantation.

  15. Acute kidney injury: can we improve prognosis?

    Science.gov (United States)

    Hsu, Christine W; Symons, Jordan M

    2010-12-01

    The incidence of pediatric acute kidney injury (AKI) is increasing. AKI has been found to be independently associated with increased mortality, and current management options are limited in that they are mainly supportive. The use of various definitions of AKI can still be found in the literature, making it difficult to discern the epidemiology behind pediatric AKI. The use of a more uniform definition is a necessary first step to clarify AKI epidemiology and direct our research efforts, and it will ultimately improve prognosis. There is evidence that neonates and infants may be at higher risk for AKI than adults. However, the least amount of research is found for this youngest age group, and more focused efforts on this population are necessary. This paper reviews existing data on and definitions for pediatric AKI, general preventive and treatment strategies, as well as ongoing research efforts on AKI. We are hopeful that the prognosis of AKI will improve with collaboration on a multicenter, multinational scale in the form of prospective, long-term studies on pediatric AKI.

  16. Fatigue damage prognosis using affine arithmetic

    Science.gov (United States)

    Gbaguidi, Audrey; Kim, Daewon

    2014-02-01

    Among the essential steps to be taken in structural health monitoring systems, damage prognosis would be the field that is least investigated due to the complexity of the uncertainties. This paper presents the possibility of using Affine Arithmetic for uncertainty propagation of crack damage in damage prognosis. The structures examined are thin rectangular plates made of titanium alloys with central mode I cracks and a composite plate with an internal delamination caused by mixed mode I and II fracture modes, under a harmonic uniaxial loading condition. The model-based method for crack growth rates are considered using the Paris Erdogan law model for the isotropic plates and the delamination growth law model proposed by Kardomateas for the composite plate. The parameters for both models are randomly taken and their uncertainties are considered as defined by an interval instead of a probability distribution. A Monte Carlo method is also applied to check whether Affine Arithmetic (AA) leads to tight bounds on the lifetime of the structure.

  17. Symptoms, location and prognosis of pulmonary embolism.

    Science.gov (United States)

    García-Sanz, M T; Pena-Álvarez, C; López-Landeiro, P; Bermo-Domínguez, A; Fontúrbel, T; González-Barcala, F J

    2014-01-01

    Pulmonary embolism (PE) is a common disease with variable symptoms and high overall mortality. The clinical relevance of the extent of PE is still debatable, and the role of anticoagulation in patients with subsegmental involvement has been contested. Our objective is to describe the clinical details of patients with PE in our hospital and to analyze their prognosis based on the extent of the disease. Retrospective study of 313 patients diagnosed with PE by chest computed tomography (CT) scan at the Hospital Complex of Pontevedra in Spain for six years. Predictors of mortality were determined by multivariate analysis. Women accounted for 56% of patients, and patient median age was 70 years (interquartile range 53-78 years). Subsegmental PE accounted for 7% of all cases; these patients were younger and had lower comorbidity; they reported chest pain more often, performed better in blood gas analysis and none of them had proximal deep vein thrombosis (DVT). Patients with subsegmental PE had a higher survival rate. Factors independently associated with mortality were cancer diagnosis and higher comorbidity. Patients with subsegmental PE clinically differ from those with more proximal PE. Underlying diseases have more influence on the prognosis than the extent of the disease. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  18. [Bronchial asthma pathogenesis and genetic prognosis development].

    Science.gov (United States)

    Balmasova, I P; Sepiashvili, R I; Sepiashvili, Ia R; Malova, E S

    2014-01-01

    The review is dedicated to an actual problem--genetic prognosis of risk of bronchial asthma development that is quite a complex aspect of studies from a methodological viewpoint. Bronchial asthma--heterogeneous disease by both etiology and clinical characteristics. At the same time genetic prognosis is based on the unity of pathogenetic mechanisms of development, though in immunological reactions that are the base of this disease, alternative variants are possible. The aim of this review is carrying out parallels between modern achievements in the field of deciphering trigger mechanisms of bronchial asthma pathogenesis and object of genetic studies based on these mechanisms. Among the examined conceptions--role of epithelial tissue in trigger mechanisms of bronchial asthma, variants of key role of immune system cells, first of all, T-helpers of various types for further development of inflammatory-effector reactions with damage characteristic for this disease. Compliance of contemporary approaches of genetic studies and novel concepts of bronchial asthma pathogenesis is shown.

  19. Status of B-vitamins and homocysteine in diabetic retinopathy: association with vitamin-B12 deficiency and hyperhomocysteinemia.

    Science.gov (United States)

    Satyanarayana, Alleboena; Balakrishna, Nagalla; Pitla, Sujatha; Reddy, Paduru Yadagiri; Mudili, Sivaprasad; Lopamudra, Pratti; Suryanarayana, Palla; Viswanath, Kalluru; Ayyagari, Radha; Reddy, Geereddy Bhanuprakash

    2011-01-01

    Diabetic retinopathy (DR) is a common cause of blindness. Although many studies have indicated an association between homocysteine and DR, the results so far have been equivocal. Amongst the many determinants of homocysteine, B-vitamin status was shown to be a major confounding factor, yet very little is known about its relationship to DR. In the present study, we, therefore, investigated the status of B-vitamins and homocysteine in DR. A cross-sectional case-control study was conducted with 100 normal control (CN) subjects and 300 subjects with type-2 diabetes (T2D). Of the 300 subjects with T2D, 200 had retinopathy (DR) and 100 did not (DNR). After a complete ophthalmic examination including fundus fluorescein angiography, the clinical profile and the blood levels of all B-vitamins and homocysteine were analyzed. While mean plasma homocysteine levels were found to be higher in T2D patients compared with CN subjects, homocysteine levels were particularly high in the DR group. There were no group differences in the blood levels of vitamins B1 and B2. Although the plasma vitamin-B6 and folic acid levels were significantly lower in the DNR and DR groups compared with the CN group, there were no significant differences between the diabetes groups. Interestingly, plasma vitamin-B12 levels were found to be significantly lower in the diabetes groups compared with the CN group; further, the levels were significantly lower in the DR group compared with the DNR group. Higher homocysteine levels were significantly associated with lower vitamin-B12 and folic acid but not with other B-vitamins. Additionally, hyperhomocysteinemia and vitamin-B12 deficiency did not seem to be related to subjects' age, body mass index, or duration of diabetes. These results thus suggest a possible association between vitamin-B12 deficiency and hyperhomocysteinemia in DR. Further, the data indicate that vitamin-B12 deficiency could be an independent risk factor for DR.

  20. Bayesian Network Based Fault Prognosis via Bond Graph Modeling of High-Speed Railway Traction Device

    Directory of Open Access Journals (Sweden)

    Yunkai Wu

    2015-01-01

    component-level faults accurately for a high-speed railway traction system, a fault prognosis approach via Bayesian network and bond graph modeling techniques is proposed. The inherent structure of a railway traction system is represented by bond graph model, based on which a multilayer Bayesian network is developed for fault propagation analysis and fault prediction. For complete and incomplete data sets, two different parameter learning algorithms such as Bayesian estimation and expectation maximization (EM algorithm are adopted to determine the conditional probability table of the Bayesian network. The proposed prognosis approach using Pearl’s polytree propagation algorithm for joint probability reasoning can predict the failure probabilities of leaf nodes based on the current status of root nodes. Verification results in a high-speed railway traction simulation system can demonstrate the effectiveness of the proposed approach.

  1. Effect of pregnancy on the prognosis for multiple sclerosis. A 5-year follow up investigation

    DEFF Research Database (Denmark)

    Stenager, Egon; Stenager, E N; Jensen, Knud

    1994-01-01

    INTRODUCTION: The purpose of the study was to evaluate the effect of pregnancy and childbirth on the longterm prognosis for women with multiple sclerosis (MS). METHOD AND MATERIAL: A cohort of 39 women with definite MS were identified on 1.1.1986 using a reproducible selection method. The investi......INTRODUCTION: The purpose of the study was to evaluate the effect of pregnancy and childbirth on the longterm prognosis for women with multiple sclerosis (MS). METHOD AND MATERIAL: A cohort of 39 women with definite MS were identified on 1.1.1986 using a reproducible selection method....... The investigation was initiated in 1986 when handicap was evaluated by Kurtzke Disability Status Score (DSS). At a 5-year follow up 4 had died and 6 could not participate. There were 29 women in the investigation of whom 7 were childless, 10 had onset of MS at least 6 months after last childbirth, and 12 had onset...

  2. Clinical value of prognosis gene expression signatures in colorectal cancer: a systematic review.

    Directory of Open Access Journals (Sweden)

    Rebeca Sanz-Pamplona

    Full Text Available INTRODUCTION: The traditional staging system is inadequate to identify those patients with stage II colorectal cancer (CRC at high risk of recurrence or with stage III CRC at low risk. A number of gene expression signatures to predict CRC prognosis have been proposed, but none is routinely used in the clinic. The aim of this work was to assess the prediction ability and potential clinical usefulness of these signatures in a series of independent datasets. METHODS: A literature review identified 31 gene expression signatures that used gene expression data to predict prognosis in CRC tissue. The search was based on the PubMed database and was restricted to papers published from January 2004 to December 2011. Eleven CRC gene expression datasets with outcome information were identified and downloaded from public repositories. Random Forest classifier was used to build predictors from the gene lists. Matthews correlation coefficient was chosen as a measure of classification accuracy and its associated p-value was used to assess association with prognosis. For clinical usefulness evaluation, positive and negative post-tests probabilities were computed in stage II and III samples. RESULTS: Five gene signatures showed significant association with prognosis and provided reasonable prediction accuracy in their own training datasets. Nevertheless, all signatures showed low reproducibility in independent data. Stratified analyses by stage or microsatellite instability status showed significant association but limited discrimination ability, especially in stage II tumors. From a clinical perspective, the most predictive signatures showed a minor but significant improvement over the classical staging system. CONCLUSIONS: The published signatures show low prediction accuracy but moderate clinical usefulness. Although gene expression data may inform prognosis, better strategies for signature validation are needed to encourage their widespread use in the clinic.

  3. DACH1: its role as a classifier of long term good prognosis in luminal breast cancer.

    Directory of Open Access Journals (Sweden)

    Desmond G Powe

    appears to be a Luminal A biomarker predictive of good prognosis, but is not independent of clinical stage, tumour size, NPI status or systemic therapy.

  4. Undertreatment strongly decreases prognosis of breast cancer in elderly women.

    Science.gov (United States)

    Bouchardy, Christine; Rapiti, Elisabetta; Fioretta, Gérald; Laissue, Paul; Neyroud-Caspar, Isabelle; Schäfer, Peter; Kurtz, John; Sappino, André-Pascal; Vlastos, Georges

    2003-10-01

    No consensus exists on therapy of elderly cancer patients. Treatments are influenced by unclear standards and are usually less aggressive. This study aims to evaluate determinants and effect of treatment choice on breast cancer prognosis among elderly patients. We reviewed clinical files of 407 breast cancer patients aged >/= 80 years recorded at the Geneva Cancer Registry between 1989 and 1999. Patient and tumor characteristics, general health status, comorbidity, treatment, and cause of death were considered. We evaluated determinants of treatment by logistic regression and effect of treatment on mortality by Cox model, accounting for prognostic factors. Age was independently linked to the type of treatment. Overall, 12% of women (n = 48) had no treatment, 32% (n = 132) received tamoxifen only, 7% (n = 28) had breast-conserving surgery only, 33% (n = 133) had mastectomy, 14% (n = 57) had breast-conserving surgery plus adjuvant therapy, and 2% (n = 9) received miscellaneous treatments. Five-year specific breast cancer survival was 46%, 51%, 82%, and 90% for women with no treatment, tamoxifen alone, mastectomy, and breast-conserving surgery plus adjuvant treatment, respectively. Compared with the nontreated group, the adjusted hazard ratio of breast cancer mortality was 0.4 (95% CI, 0.2 to 0.7) for tamoxifen alone, 0.4 (95% CI, 0.1 to 1.4) for breast-conserving surgery alone, 0.2 (95% CI, 0.1 to 0.7) for mastectomy, and 0.1 (95% CI, 0.03 to 0.4) for breast-conserving surgery plus adjuvant treatment. Half of elderly patients with breast cancer are undertreated, with strongly decreased specific survival as a consequence. Treatments need to be adapted to the patient's health status, but also should offer the best chance of cure.

  5. Idiopathic Pulmonary Fibrosis: Treatment and Prognosis

    Directory of Open Access Journals (Sweden)

    Hajime Fujimoto

    2015-01-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF is a chronic progressive lung disease with a prognosis that can be worse than for many cancers. The initial stages of the condition were thought to mainly involve chronic inflammation; therefore, corticosteroids and other drugs that have anti-inflammatory and immunosuppressive actions were used. However, recently, agents targeting persistent fibrosis resulting from aberrant repair of alveolar epithelial injury have been in the spotlight. There has also been an increase in the number of available antifibrotic treatment options, starting with pirfenidone and nintedanib. These drugs prevent deterioration but do not improve IPF. Therefore, nonpharmacologic approaches such as long-term oxygen therapy, pulmonary rehabilitation, and lung transplantation must be considered as additional treatment modalities.

  6. Stress cardiomyopathy: diagnosis, pathophysiology, management, and prognosis.

    Science.gov (United States)

    Sharma, Ajay K; Singh, Jagmeet P; Heist, E Kevin

    2011-09-01

    Stress cardiomyopathy is now a well-recognized reversible cardiomyopathy, with a clinical presentation mimicking Acute Coronary syndrome in the absence of significant coronary artery disease. It is often encountered in postmenopausal females and is usually precipitated by acute emotional or physical stressors. In this review, we have attempted to summarize relevant data regarding diagnosis, typical and atypical presentations, pathophysiology, management options, and prognosis. Typically, patients present with chest pain and shortness of breath, transient electrocardiographic changes, moderate troponin elevation, and are found to have wall motion abnormalities (apical and midventricular akinesis with preserved basal segment systolic function) without obstructive coronary lesions, with complete resolution in next few weeks. The precise pathophysiology remains unclear, but excessive catecholamine stimulation, metabolic disturbances, and dysfunction of microcirculation are thought to be the underlying mechanisms.

  7. Prognosis of depression in the elderly.

    Science.gov (United States)

    Meats, P; Timol, M; Jolley, D

    1991-11-01

    Fifty-six consecutively admitted elderly (65 and over) patients with depression were assessed on mental, physical and social states. They were followed up and assessed at home one year later. A group of 24 depressed in-patients aged under 65 years admitted to the same ward during the same period was also assessed. Outcome was different for the two groups, with 68% of the elderly 'well' at one year, against 50% of the younger group. The younger group were more likely to have 'poor' outcome (41%) than the elderly (16%). However, there were more deaths than expected, particularly in the elderly. These findings differ from some previous studies, and indicate an excellent prognosis for depression in the elderly. Outcome in younger patients is less good.

  8. 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....

  9. Health status as a risk factor in cardiovascular disease

    DEFF Research Database (Denmark)

    Mommersteeg, Paula M C; Denollet, Johan; Spertus, John A

    2009-01-01

    Patient-perceived health status is receiving increased recognition as a patient-centered outcome in chronic heart failure (CHF) and coronary artery disease (CAD), but poor health status is also associated with adverse prognosis. In this systematic review, we examined current evidence on the influ...

  10. Clinicopathological Features and Prognosis of Metaplastic Breast Carcinoma: Experience of a Major Chinese Cancer Center.

    Directory of Open Access Journals (Sweden)

    Yiqian Zhang

    Full Text Available Metaplastic breast carcinoma (MBC is a rare heterogeneous group of primary breast malignancies, with low hormone receptor expression and poor outcomes. To date, no prognostic markers for this tumor have been validated. The current study was undertaken to evaluate the clinicopathologic characteristics, the response to various therapeutic regimens and the prognosis of MBCs in a large cohort of patients from Tianjin Medical University Cancer Hospital in China. Ninety cases of MBCs diagnosed in our hospital between January 2000 and September 2014 were retrieved from the archives. In general, MBCs presented with larger size, a lower rate of lymph node metastasis, and demonstrated more frequent local recurrence/distant metastasis than 1,090 stage-matched cases of invasive carcinoma of no specific type (IDC-NST, independent of the status of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 expressions. The five-year disease-free survival (DFS of MBC was significantly worse than IDC-NST. Using univariate analysis, lymph node metastasis, advanced clinical stage at diagnosis, high tumor proliferation rate assessed by Ki-67 labeling, and epidermal growth factor receptor (EGFR overexpression/gene amplification were associated significantly with reduced DFS, while decreased OS was associated significantly with lymph node metastasis and EGFR overexpression/gene amplification. With multivariate analysis, lymph node status was an independent predictor for DFS, and lymph node status and EGFR overexpression/gene amplification were independent predictors for OS. Histologic subtyping and molecular subgrouping of MBCs were not significant factors in prognosis. We also found that MBCs were insensitive to neoadjuvant chemotherapy, routine chemotherapy, and radiation therapy. This study indicates that MBC is an aggressive type of breast cancer with poor prognosis, and that identification and optimization of an effective comprehensive

  11. Reproductive prognosis in daughters of women with and without endometriosis

    DEFF Research Database (Denmark)

    Dalsgaard, T; Hansen, Maj Vadskjær Hjordt; Hartwell, D

    2013-01-01

    Do daughters of women with endometriosis exhibit an increased risk of endometriosis and impaired long-term reproductive prognosis when compared with daughters of women without endometriosis?......Do daughters of women with endometriosis exhibit an increased risk of endometriosis and impaired long-term reproductive prognosis when compared with daughters of women without endometriosis?...

  12. Development of a perfect prognosis probabilistic model for ...

    Indian Academy of Sciences (India)

    A prediction model based on the perfect prognosis method was developed to predict the probability of lightning and probable time of its occurrence over the south-east Indian region. In the perfect prognosis method, statistical relationships are established using past observed data. For real time applications, the predictors ...

  13. Extracellular Matrix Biomarkers for Diagnosis, Prognosis, Imaging, and Targeting

    Science.gov (United States)

    2015-09-01

    AWARD NUMBER: W81XWH-14-1-0240 TITLE: Extracellular Matrix Biomarkers for Diagnosis, Prognosis, Imaging, and Targeting PRINCIPAL INVESTIGATOR...TITLE AND SUBTITLE Extracellular Matrix Biomarkers for Diagnosis, Prognosis, Imaging, and Targeting 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14...the management and treatment of metastatic breast cancer. 15. SUBJECT TERMS Breast Cancer, Metastasis, Extracellular Matrix , Tumor Microenvironment

  14. Fault Diagnosis and Prognosis Based on Lebesgue Sampling

    Science.gov (United States)

    2014-10-02

    prognosis (FDP), and decision-making, etc. Diagnosis and prognosis, as fundamental enabling techniques, are not new concepts ( Tumer & Bajwa, 2004...OF THE PROGNOSTICS AND HEALTH MANAGEMENT SOCIETY 2014 of the 9th ieee international conference on control and automation. Tumer , I., & Bajwa, A. (2004

  15. Symptoms, location and prognosis of pulmonary embolism

    Directory of Open Access Journals (Sweden)

    M.T. García-Sanz

    2014-07-01

    Full Text Available Background and objective: Pulmonary embolism (PE is a common disease with variable symptoms and high overall mortality. The clinical relevance of the extent of PE is still debatable, and the role of anticoagulation in patients with subsegmental involvement has been contested. Our objective is to describe the clinical details of patients with PE in our hospital and to analyze their prognosis based on the extent of the disease. Materials and methods: Retrospective study of 313 patients diagnosed with PE by chest computed tomography (CT scan at the Hospital Complex of Pontevedra in Spain for six years. Predictors of mortality were determined by multivariate analysis. Results: Women accounted for 56% of patients, and patient median age was 70 years (interquartile range 53–78 years. Subsegmental PE accounted for 7% of all cases; these patients were younger and had lower comorbidity; they reported chest pain more often, performed better in blood gas analysis and none of them had proximal deep vein thrombosis (DVT. Patients with subsegmental PE had a higher survival rate. Factors independently associated with mortality were cancer diagnosis and higher comorbidity. Conclusions: Patients with subsegmental PE clinically differ from those with more proximal PE. Underlying diseases have more influence on the prognosis than the extent of the disease. Resumo: Contexto e objectivo: A embolia pulmonar (PE é uma doença comum com sintomas variáveis e uma elevada taxa de mortalidade global. A relevância clínica da extensão da PE é ainda fonte de debate, e o papel da anticoagulação em pacientes com envolvimento de sub-segmentos foi contestado. O nosso objectivo é descrever os dados clínicos de doentes com PE no nosso hospital e analisar o seu prognóstico, com base na extensão da doença. Materiais e métodos: Estudo retrospectivo de 313 doentes, diagnosticados com PE, através de uma tomografia computadorizada de t

  16. The prognosis and clinical characteristics of advanced (malignant) solid pseudopapillary neoplasm of the pancreas.

    Science.gov (United States)

    Zhang, Hongkai; Wang, Wenze; Yu, Shuangni; Xiao, Yu; Chen, Jie

    2016-04-01

    Until today, there is no consistency about the prognosis and the diagnostic criteria of the "malignant" pancreatic solid pseudopapillary neoplasms (m-SPNs). We here made a retrospective study of 26 such cases and try to give a comprehensive description of their pathological characteristics and clinical course. We found out that among those malignant cases, the most common involved extrapancreatic organ was the duodenum, followed by the spleen and the portal vein. The lymph node and the liver metastasis were also seen in 19 % cases, respectively. Most of the patients were female (22/26). Calcification, foamy cytoplasm, and bizarre nuclei of tumor cells were more common in male patients. Every patient underwent surgical resection and had excellent prognosis. There were two patients who had metastasis to the liver 6 years after excision. The recurrence status correlated with the family history of malignant tumor. No patient died of the disease directly during the mean follow-up time of 73.9 months (21-135 months). Our results supported the idea that the prognosis of the advanced stage SPNs was excellent. The surgical resection seemed effectively enough for these patients. However, all the patients need close follow-ups, especially those who had family history of malignant tumors.

  17. High Expression of Glypican-1 Predicts Dissemination and Poor Prognosis in Glioblastomas.

    Science.gov (United States)

    Saito, Taiichi; Sugiyama, Kazuhiko; Hama, Seiji; Yamasaki, Fumiyuki; Takayasu, Takeshi; Nosaka, Ryo; Onishi, Shumpei; Muragaki, Yoshihiro; Kawamata, Takakazu; Kurisu, Kaoru

    2017-09-01

    Glioblastoma (GBM) relapses locally or in a disseminated pattern and is highly resistant to chemoradiotherapy. Although dissemination is associated with poor prognosis for patients with GBM, the clinicopathologic factors that promote dissemination have not been elucidated. Glypican-1 (GPC-1) is a heparin sulfate proteoglycan that is attached to the extracytoplasmic surface of the cell membrane and regulates cell motility. The aim of this study was to determine whether GPC-1 expression correlated with GBM dissemination and patient prognosis. GPC-1 expression was examined by immunohistochemistry in 53 patients with GBM who received radiotherapy and temozolomide treatment. We assessed the relationship between dissemination and clinicopathologic factors, including GPC-1 expression. We also evaluated the relationship between GPC-1 expression and overall survival (OS) by uni- and multivariate analyses of a range of clinicopathologic factors, including age, Karnofsky Performance Status, extent of resection, and O6-methylguanine-DNA methyltransferase (MGMT) status. Logistic regression analysis revealed that GPC-1 expression correlated with dissemination (P = 0.0116). Log-rank tests revealed that age, Karnofsky Performance Status, extent of resection, MGMT status, dissemination (P = 0.0008) and GPC-1 expression (P = 0.0011) were significantly correlated with OS. Multivariate analysis indicated that age, MGMT status, and GPC-1 expression were significantly correlated with OS. GPC-1 expression had the highest hazard ratio (2.392) among all regressors. GPC-1 expression significantly correlated with OS in patients with GBM who received radiotherapy and temozolomide treatment. GPC-1 expression can help predict the occurrence of dissemination and shorter OS in patients with GBM. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. [Impact of bariatric surgery on obstetric prognosis].

    Science.gov (United States)

    Fumery, L; Pigeyre, M; Fournier, C; Arnalsteen, L; Rivaux, G; Subtil, D; Deruelle, P

    2013-03-01

    Assessment of pregnancy outcomes after bariatric surgery and analysis of follow-up particularities of such pregnancies. A retrospective study of 63 post-bariatric surgery pregnancies compared to 259 pregnancies of obese un-operated patients. Pregnancy outcomes, neonatal datas, delay influence between surgery and pregnancy beginning, bariatric surgery type and gastric banding (GB) loosening consequences were analysed. In the surgical brand were developed less gestational diabetes (DG) (P=0,05), deliveries were more often normal (P=0,004) and births shown less macrosomias and small for gestational age newborns (P=0,04). Neonatal state was improved among operated patients: less Apgar scores less than 7 at 1 minute (P=0,05) and less cord blood pH less than 7,2 (P=0,03). They gained more weight during the pregnancy (P=0,0003) and only 53% had a nutritional management and assessment. Patients with GB loosening gained more weight (P=0,0003). Lastly, there were no difference due to the different bariatric surgery techniques or nutritional follow-up in the pregnancy course and neonatal state. Bariatric surgery improves obstetric and neonatal prognosis. Improvements have to be developed in the multidisciplinary follow-up in order to avoid nutritional deficiencies or important weight gain pregnancy in case of GB. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  19. Tumor Volumes and Prognosis in Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Mohamad R. Issa

    2015-11-01

    Full Text Available Tumor staging systems for laryngeal cancer (LC have been developed to assist in estimating prognosis after treatment and comparing treatment results across institutions. While the laryngeal TNM system has been shown to have prognostic information, varying cure rates in the literature have suggested concern about the accuracy and effectiveness of the T-classification in particular. To test the hypothesis that tumor volumes are more useful than T classification, we conducted a retrospective review of 78 patients with laryngeal cancer treated with radiation therapy at our institution. Using multivariable analysis, we demonstrate the significant prognostic value of anatomic volumes in patients with previously untreated laryngeal cancer. In this cohort, primary tumor volume (GTVP, composite nodal volumes (GTVN and composite total volume (GTVP + GTVN = GTVC had prognostic value in both univariate and multivariate cox model analysis. Interestingly, when anatomic volumes were measured from CT scans after a single cycle of induction chemotherapy, all significant prognosticating value for measured anatomic volumes was lost. Given the literature findings and the results of this study, the authors advocate the use of tumor anatomic volumes calculated from pretreatment scans to supplement the TNM staging system in subjects with untreated laryngeal cancer. The study found that tumor volume assessment after induction chemotherapy is not of prognostic significance.

  20. 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.

  1. Management of sigmoid volvulus: options and prognosis.

    Science.gov (United States)

    Maddah, Ghodratollah; Kazemzadeh, Gholam Hossein; Abdollahi, Abbas; Bahar, Mostafa Mehrabi; Tavassoli, Alireza; Shabahang, Hossein

    2014-01-01

    To describe the management of sigmoid volvulus with reference to the type of surgical procedures performed and to determine the prognosis of sigmoid volvulus. A case series. Ghaem Hospital of Mashhad, University of Medical Sciences, Mashhad, Iran, from 1996 to 2008. A total of 944 cases of colon obstruction were reviewed. Demographic, laboratory and treatment results, mortality and complications were recorded. The data was analyzed using descriptive statistics as frequency and percentage for the qualitative variables and mean and standard deviation values for the quantitative variables. Also chisquare and Fisher's exact test were used for the association between the qualitative variables. SPSS statistical software (version 18) was used for the data analysis. In all patients except those with symptoms or signs of gangrenous bowel, a long rectal tube was inserted via the rectosigmoidoscope which was successful in 80 (36.87%) cases. Rectosigmoidoscopic detorsion was unsuccessful in 137 (63.13%) patients, who underwent an emergent laparotomy. The surgical procedures performed in these cases were resection and primary anastomosis in 40 (29.1%), Mikulicz procedure in 9 (6.6%), laparotomy detorsion in 37 (27.01%), Hartmann procedure in 47 (34.3%), mesosigmoidoplasty in 3 (2.19%) patients and total colectomy in one (0.73%) case. The overall mortality was 9.8% (22) patients. In sigmoid volvulus, the most important determinant of patient outcome is bowel viability. The initial treatment of sigmoid colon volvulus is sigmoidoscopy with rectal tube placement.

  2. Clinical features, management, and prognosis of spontaneous coronary artery dissection.

    Science.gov (United States)

    Tweet, Marysia S; Hayes, Sharonne N; Pitta, Sridevi R; Simari, Robert D; Lerman, Amir; Lennon, Ryan J; Gersh, Bernard J; Khambatta, Sherezade; Best, Patricia J M; Rihal, Charanjit S; Gulati, Rajiv

    2012-07-31

    Spontaneous coronary artery dissection (SCAD) is an acute coronary event of uncertain origin. Clinical features and prognosis remain insufficiently characterized. A retrospective single-center cohort study identified 87 patients with angiographically confirmed SCAD. Incidence, clinical characteristics, treatment modalities, in-hospital outcomes, and long-term risk of SCAD recurrence or major adverse cardiac events were evaluated. Mean age was 42.6 years; 82% were female. Extreme exertion at SCAD onset was more frequent in men (7 of 16 versus 2 of 71; P<0.001), and postpartum status was observed in 13 of 71 women (18%). Presentation was ST-elevation myocardial infarction in 49%. Multivessel SCAD was found in 23%. Initial conservative management (31 of 87) and coronary artery bypass grafting (7 of 87) were associated with an uncomplicated in-hospital course, whereas percutaneous coronary intervention was complicated by technical failure in 15 of 43 patients (35%) and 1 death. During a median follow-up of 47 months (interquartile range, 18-106 months), SCAD recurred in 15 patients, all female. Estimated 10-year rate of major adverse cardiac events (death, heart failure, myocardial infarction, and SCAD recurrence) was 47%. Fibromuscular dysplasia of the iliac artery was identified incidentally in 8 of 16 femoral angiograms (50%) undertaken before closure device placement and in the carotid arteries of 2 others with carotid dissection. SCAD affects a young, predominantly female population, frequently presenting as ST-elevation myocardial infarction. Although in-hospital mortality is low regardless of initial treatment, percutaneous coronary intervention is associated with high rates of complication. Risks of SCAD recurrence and major adverse cardiac events in the long term emphasize the need for close follow-up. Fibromuscular dysplasia is a novel association and potentially causative factor.

  3. Clinical characteristics and prognosis of heart failure in elderly patients.

    Science.gov (United States)

    Martínez-Braña, Lucía; Mateo-Mosquera, Lara; Bermúdez-Ramos, María; Valcárcel García, María de los Ángeles; Fernández Hernández, Lorena; Hermida Ameijeiras, Álvaro; Lado Lado, Francisco Luis

    2015-01-01

    The aim of this study was to assess prevalence, clinical characteristics, and prognosis in elderly patients with heart failure with preserved ejection fraction (HFPEF) compared to patients with heart failure with reduced ejection fraction (HFREF) who were followed in an internal medicine unit. In this retrospective observational study, the sample consisted of 301 patients followed in an internal medicine referral unit between January 2007 and December 2010. All patients were checked to determine their vital status on 31 December 2012. Survival was analyzed using Kaplan-Meier curves, and compared using the log-rank test. Of the 301 patients, 165 (54.8%) were women. In the 263 cases (87.4%) who underwent echocardiographic assessment, 190 (72.2%) had HFPEF and 73 (27.8%) had HFREF. Mean age was similar in the two groups (80.1 and 79.9 years; p=0.905), with a predominance of women in the HFPEF group (60.5% women, 42.5% men; p=0.025). The main etiology was hypertensive heart disease in the HFPEF group. Regarding treatment, more beta-blockers were administered in the HFREF group. No statistically significant differences were observed between the groups in terms of cardiovascular risk factors, comorbidities, NYHA functional class, or mortality. Clinical characteristics were similar for both HFPEF and HFREF patients. Women were predominant in the HFPEF group, as was hypertensive etiology. No significant differences in mortality were observed between the groups. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  4. Prolonged Nightly Fasting and Breast Cancer Prognosis.

    Science.gov (United States)

    Marinac, Catherine R; Nelson, Sandahl H; Breen, Caitlin I; Hartman, Sheri J; Natarajan, Loki; Pierce, John P; Flatt, Shirley W; Sears, Dorothy D; Patterson, Ruth E

    2016-08-01

    Rodent studies demonstrate that prolonged fasting during the sleep phase positively influences carcinogenesis and metabolic processes that are putatively associated with risk and prognosis of breast cancer. To our knowledge, no studies in humans have examined nightly fasting duration and cancer outcomes. To investigate whether duration of nightly fasting predicted recurrence and mortality among women with early-stage breast cancer and, if so, whether it was associated with risk factors for poor outcomes, including glucoregulation (hemoglobin A1c), chronic inflammation (C-reactive protein), obesity, and sleep. Data were collected from 2413 women with breast cancer but without diabetes mellitus who were aged 27 to 70 years at diagnosis and participated in the prospective Women's Healthy Eating and Living study between March 1, 1995, and May 3, 2007. Data analysis was conducted from May 18 to October 5, 2015. Nightly fasting duration was estimated from 24-hour dietary recalls collected at baseline, year 1, and year 4. Clinical outcomes were invasive breast cancer recurrence and new primary breast tumors during a mean of 7.3 years of study follow-up as well as death from breast cancer or any cause during a mean of 11.4 years of surveillance. Baseline sleep duration was self-reported, and archived blood samples were used to assess concentrations of hemoglobin A1c and C-reactive protein. The cohort of 2413 women (mean [SD] age, 52.4 [8.9] years) reported a mean (SD) fasting duration of 12.5 (1.7) hours per night. In repeated-measures Cox proportional hazards regression models, fasting less than 13 hours per night (lower 2 tertiles of nightly fasting distribution) was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night (hazard ratio, 1.36; 95% CI, 1.05-1.76). Nightly fasting less than 13 hours was not associated with a statistically significant higher risk of breast cancer mortality (hazard ratio, 1.21; 95

  5. Survival Prognosis in Very Old Adults

    Science.gov (United States)

    Thinggaard, Mikael; McGue, Matt; Jeune, Bernard; Osler, Merete; Vaupel, James W.; Christensen, Kaare

    2016-01-01

    OBJECTIVES To determine whether simple functional indicators are predictors of survival prognosis in very old adults. DESIGN In-person survey conducted over a 3-month period in 1998; assessment of survival over a 15-year follow-up period. SETTING Denmark. PARTICIPANTS All 3,600 Danes born in 1905 and living in Denmark in 1998, were invited to participate regardless of residence and health; 2,262 (63%) participated in the survey: 1,814 (80.2%) in person and 448 (19.8%) through a proxy. MEASUREMENTS Socioeconomic factors, medications and diseases, activities of daily living, physical performance, cognition, depression symptomatology, self-rated health, and all-cause mortality, evaluated as average remaining lifespan and chance of surviving to 100 years. RESULTS Men aged 92 to 93 had an overall 6.0% chance of surviving to 100 years, whereas the chance for women was 11.4%. Being able to rise without use of hands increased the chance for men to 11.2% (95% confidence interval (CI) = 7.7–14.7) and for women to 22.0% (95% CI = 18.9–25.1). When combining this with a Mini-Mental State Examination (MMSE) scores from 28 to 30, the chances were 21.7% (95% CI = 11.5–31.9) for men and 34.2% (95% CI = 24.8–43.5) for women. CONCLUSION Chair stand score combined with MMSE score is a quick and easy way to estimate overall chance of survival in very old adults, which is particularly relevant when treatment with potential side effects for nonacute diseases is considered. J Am Geriatr Soc 64:81–88, 2016. PMID:26782855

  6. Grade and Prognosis in Localized Primary Angiosarcoma.

    Science.gov (United States)

    Pandey, Manjari; Sutton, Gregory R; Giri, Smith; Martin, Mike G

    2015-08-01

    Primary angiosarcoma of the breast (PAOB) is rare and institutional series have provided conflicting data on the effect of grade on prognosis. Using a case listing session of Surveillance, Epidemiology, and End Results (SEER) 18 (1973-2010) we examined outcomes for patients with PAOB. Analyses were conducted with SEER*Stat 8.1.2, Microsoft Excel 2007, and GraphPad Prism 6. Comparisons were made using the Fisher exact test and log rank test (Mantel-Cox); P values were 2-sided. Two hundred twenty-six women with PAOB were identified; median age was 49 (range, 15-107) years and 82% (185) were white. Seventy-two percent (162) had localized disease, 15% (34) regional disease, 7% (16) distant disease, and 6% (14) had unknown staging. Fourteen percent (32) had Grade 1, 24% (55) Grade 2, 30% (68) Grade 3 disease, and grade was unknown in 32% (72) of patients. Median overall survival (OS) for patients with localized, regional, and distant disease was 172, 24, and 16 months, respectively (P OS for patients with localized Grade 1 and 2 disease was not reached versus 36 months for Grade 3 disease (P OS was 89% (78) versus 47% (32). There was a strong trend for patients with Grade 3 disease to undergo mastectomy (44%, n = 30 vs. 23%, n = 20; P = .070) and 24% (55) of all patients received radiation. Radiation did not improve survival for localized Grade 1 and 2 disease (P = .676), or Grade 3 disease (P = .589); surgery and grade subgroups were too small for meaningful comparisons regarding radiation. Histologic grade is a significant predictor of survival for patients with localized PAOB. Regardless of grade, adjuvant radiation did not confer a survival benefit for patients with localized disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Prognosis of thin cutaneous head and neck melanoma (

    DEFF Research Database (Denmark)

    Andersson, A P; Dahlstrøm, Karin Kjærgaard; Drzewiecki, K T

    1996-01-01

    Thin malignant melanomas, i.e. tumours less than 1 mm, are generally considered to have a good prognosis. The records of 148 patients with thin invasive melanomas located to the head and neck region were reviewed. All patients were followed for the excision of the primary tumour until death...... of these 16 patients (75%) died of disseminated melanoma. We conclude that thin head and neck melanomas do not necessarily carry an excellent prognosis. Prognosis is not dependent upon tumour thickness when less than 1.00 mm....

  8. Stage-specific associations between beta blocker use and prognosis after colorectal cancer.

    Science.gov (United States)

    Jansen, Lina; Hoffmeister, Michael; Arndt, Volker; Chang-Claude, Jenny; Brenner, Hermann

    2014-04-15

    Recent observational studies have suggested that the use of beta blockers might be associated with better prognosis after cancer. Because evidence is limited for colorectal cancer (CRC), the association of beta blocker use and prognosis was investigated in a large population-based cohort of patients with CRC. Between 2003 and 2007, information on beta blocker use at diagnosis and potential confounders was collected by personal interviews for 1975 patients with CRC. Vital status, cause of death, and recurrence status were assessed during a median follow-up time of 5.0 years. The associations of beta blocker use and overall, CRC-specific, and recurrence-free survival were estimated by Cox proportional hazard regression. In addition, beta blocker subgroup, site, and stage-specific analyses were performed. After adjustment for covariates including sociodemographic, cancer-related, and lifestyle factors and comorbidity and medications, no significant association between beta blocker use at diagnosis and prognosis was observed for all stages combined. However, in stage-specific analyses, beta blocker use was associated with longer overall survival (hazard ratio = 0.50; 95% confidence interval = 0.33-0.78) and CRC-specific survival (hazard ratio = 0.47; 95% confidence interval = 0.30-0.75) in stage IV patients. For these patients, median overall survival was 18 months longer and CRC-specific survival was 17 months longer for beta blocker users than for nonusers (38 versus 20 months and 37 versus 20 months, respectively). These results suggest that beta blocker use might be associated with longer survival in patients with stage IV CRC. © 2013 American Cancer Society.

  9. Correlations of EZH2 and SMDY3 Gene Polymorphisms with Breast Cancer Susceptibility and Prognosis.

    Science.gov (United States)

    Ma, Shao-Jun; Liu, Yan-Mei; Zhang, Yue-Lang; Chen, Ming-Wei; Cao, Wei

    2017-10-31

    To investigate the correlation of EZH2 and SMYD3 gene polymorphisms with breast cancer susceptibility and prognosis. A total of 712 patients with breast cancer and 783 healthy individuals were selected. Normal breast epithelial cells MCF-10A and breast cancer cells MCF-7, MDA-MB-231, T47D and Bcap-37 were cultured. Polymerase chain reaction-restriction fragment length polymorphism method was applied for genotyping. Reverse transcription quantitative polymerase chain reaction and Western blotting were used to EZH2 and SMYD3 expression in breast cancer tissues and cells. The risk factors and prognostic factors for breast cancer were estimated. The C allele of EZH2 rs12670401 (odds ratio (OR) = 1.255, 95% confidence interval (95% CI): 1.085~1.452), T allele of EZH2 rs6464926 (OR = 1.240, 95% CI: 1.071~1.435) and 3 allele of SMYD3 VNTR (OR = 1.305, 95% CI: 1.097~1.552) could increase susceptibility to breast cancer. Combined genotypes of EZH2 rs12670401 (TC + CC) and EZH2 rs6464926 (CT + TT) were associated with breast cancer susceptibility. Breast cancer tissues had higher EZH2 and SMYD3 expression. EZH2 rs12670401, EZH2 rs6464926, age of menarche and menopausal status were associated with breast cancer susceptibility. Patients with TT genotype of EZH2 rs12670401 or with CC genotype of EZH2 rs6464926 had higher overall survival. EZH2 rs12670401, EZH2 rs6464926 and clinical staging were independent prognostic factors for breast cancer. SMYD3 VNTR polymorphism exhibited no association with susceptibility and prognosis. EZH2 rs12670401 and rs6464926 polymorphisms, EZH2 and SMYD3 expression, clinical staging, lymph node metastasis, HER2 status and metastasis may be correlated with breast cancer susceptibility and prognosis. ©2017 The Author(s).

  10. EMAST is associated with a poor prognosis in microsatellite instable metastatic colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Sabine Venderbosch

    Full Text Available To determine the frequency and prognostic value of elevated microsatellite alterations at selected tetranucleotide repeats (EMAST in metastatic colorectal cancer (mCRC patients in relation to microsatellite instability (MSI status and MSH3 protein expression.The frequency of EMAST was evaluated in mCRC patients with MSI tumors and microsatellite stable (MSS tumors. A literature overview was performed to compare the frequency of EMAST in our study with existing data. Immunohistochemistry for MSH3 was compared with EMAST status. Outcome was studied in terms of overall survival (OS of mCRC patients with MSI and MSS tumors.EMAST was evaluated in 89 patients with MSI tumors (including 39 patients with Lynch syndrome and 94 patients with MSS tumors. EMAST was observed in 45.9% (84 out of 183 of patients, with an increased frequency in MSI tumors (79.8% versus 13.8%, p < 0.001. We found no correlation between EMAST and MSH3 protein expression. There was no effect of EMAST on prognosis in patients with MSS tumors, but patients with MSI / non-EMAST tumors had a significantly better prognosis than patients with MSI / EMAST tumors (OS: HR 3.22, 95% CI 1.25-8.30.Frequency of EMAST was increased in mCRC patients with MSI tumors, compared to MSS tumors. Our data suggest that the presence of EMAST correlates with worse OS in these patients. There was no effect of EMAST on the prognosis of patients with MSS tumors. A limitation of our study is the small number of patients in our subgroup analysis.

  11. EMAST is associated with a poor prognosis in microsatellite instable metastatic colorectal cancer.

    Science.gov (United States)

    Venderbosch, Sabine; van Lent-van Vliet, Shannon; de Haan, Anton F J; Ligtenberg, Marjolijn J; Goossens, Monique; Punt, Cornelis J A; Koopman, Miriam; Nagtegaal, Iris D

    2015-01-01

    To determine the frequency and prognostic value of elevated microsatellite alterations at selected tetranucleotide repeats (EMAST) in metastatic colorectal cancer (mCRC) patients in relation to microsatellite instability (MSI) status and MSH3 protein expression. The frequency of EMAST was evaluated in mCRC patients with MSI tumors and microsatellite stable (MSS) tumors. A literature overview was performed to compare the frequency of EMAST in our study with existing data. Immunohistochemistry for MSH3 was compared with EMAST status. Outcome was studied in terms of overall survival (OS) of mCRC patients with MSI and MSS tumors. EMAST was evaluated in 89 patients with MSI tumors (including 39 patients with Lynch syndrome) and 94 patients with MSS tumors. EMAST was observed in 45.9% (84 out of 183) of patients, with an increased frequency in MSI tumors (79.8% versus 13.8%, p < 0.001). We found no correlation between EMAST and MSH3 protein expression. There was no effect of EMAST on prognosis in patients with MSS tumors, but patients with MSI / non-EMAST tumors had a significantly better prognosis than patients with MSI / EMAST tumors (OS: HR 3.22, 95% CI 1.25-8.30). Frequency of EMAST was increased in mCRC patients with MSI tumors, compared to MSS tumors. Our data suggest that the presence of EMAST correlates with worse OS in these patients. There was no effect of EMAST on the prognosis of patients with MSS tumors. A limitation of our study is the small number of patients in our subgroup analysis.

  12. Neural Analyses Validate and Emphasize the Role of Progesterone Receptor in Breast Cancer Progression and Prognosis.

    Science.gov (United States)

    Caronongan, Arturo; Venturini, Barbara; Canuti, Debora; Dlay, Satnam; Naguib, Raouf N G; Sherbet, Gajanan V

    2016-04-01

    Oestrogen receptor (ER) expression is routinely measured in breast cancer management, but the clinical merits of measuring progesterone receptor (PR) expression have remained controversial. Hence the major objective of this study was to assess the potential of PR as a predictor of response to endocrine therapy. We report on analyses of the relative importance of ER and PR for predicting prognosis using robust multilayer perceptron artificial neural networks. Receptor determinations use immunohistochemical (IHC) methods or radioactive ligand binding assays (LBA). In view of the heterogeneity of intratumoral receptor distribution, we examined the relative merits of the IHC and LBA methods. Our analyses reveal a more significant correlation of IHC-determined PR than ER with both nodal status and 5-year disease-free survival (DFS). In LBA, PR displayed higher correlation with survival and ER with nodal status. There was concordance of correlation of PR with DFS by both IHC and LBA. This study suggests a clear distinction between PR and ER, with PR displaying greater correlation than ER with disease progression and prognosis, and emphasizes the marked superiority of the IHC method over LBA. These findings may be valuable in the management of patients with breast cancer. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  13. An Integrated Model-Based Distributed Diagnosis and Prognosis Framework

    Data.gov (United States)

    National Aeronautics and Space Administration — Diagnosis and prognosis are necessary tasks for system reconfiguration and fault-adaptive control in complex systems. Diagnosis consists of detec- tion, isolation...

  14. Modeling and Prognosis of the Strouma River Pollution

    Directory of Open Access Journals (Sweden)

    Petrov M.

    2007-12-01

    Full Text Available A model for analysis and prognosis of river quality has been developed, which is a modified method of the time series analysis has been applied for an assessment and prognosis of water pollution of the Strouma river. The following indexes of the water pollution of the Strouma river have been investigated: BOD, oxidation, soluble and insoluble substance - the village of Marino Pole. Periodical seasonal and annual pollution variations have been determined, as well as basic tendencies in the evolution of the water quality for the period from years 2001 to 2003. A prognosis of the river pollution for the year 2004 has been made. The received results show the offered times series analysis modified method successfully could be used for modeling and prognosis of the water pollution of the river ecosystems.

  15. Integrated fatigue damage diagnosis and prognosis under uncertainties

    Data.gov (United States)

    National Aeronautics and Space Administration — An integrated fatigue damage diagnosis and prognosis framework is proposed in this paper. The proposed methodology integrates a Lamb wave-based damage detection...

  16. Prognosis renewable energy. 2013 report; Prognose hernieuwbare energie. Rapportage 2013

    Energy Technology Data Exchange (ETDEWEB)

    Neeft, J.; Dijkstra, J.; Van Erp, F.; Leguijt, T.

    2013-10-15

    A prognosis for the estimate share of renewable energy in the upcoming years in the Netherlands, including bottlenecks and risks [Dutch] Een vooruitblik op het geschatte aandeel hernieuwbare energie voor de komende jaren, inclusief knelpunten en risico's.

  17. Diagnosis-Driven Prognosis for Decision Making Project

    Data.gov (United States)

    National Aeronautics and Space Administration — One cannot build a system-level Prognosis and Health Management (PHM) solution by cobbling together a bunch of existing prognostic techniques; it will have a very...

  18. Oligosaccharide Markers for Prognosis of Low-Risk Breast Cancer

    National Research Council Canada - National Science Library

    Pettijohn, David

    1999-01-01

    The general goal of this study was to determine if there are specific combinations of oligosaccharide markers on ductal breast carcinoma cells that are useful in predicting the post surgical prognosis...

  19. Risk Factors for Breast Cancer and Its Prognosis

    National Research Council Canada - National Science Library

    Melbye, Mads

    2000-01-01

    This project investigated the influence of reproductive history on risk of breast cancer and its prognosis by taking advantage of very large linkages between population-based health and demographic registries in Denmark...

  20. [Osteoarthritis and obesity. Prognosis and treatment possibilities].

    Science.gov (United States)

    Bliddal, Henning; Christensen, Robin D K

    2006-01-09

    Increases in both overweight and life expectancy of the population will lead to a larger number of patients with knee problems due to osteoarthritis (OA). Several changes, metabolic as well as functional, link obesity with OA. Randomised controlled trials have shown substantial and clinically relevant disability and symptom relief in obese patients with knee OA following moderate weight loss. While exercises are good for the functional status in general, it is advisable initially to prescribe weight loss as therapy of patients with a combination of obesity and OA.

  1. THE PROGNOSIS IN TRANSCATHETER AORTIC VALVE IMPLANTATION

    Directory of Open Access Journals (Sweden)

    T. E. Imaev

    2016-01-01

    Full Text Available Aim. To study the effect of transcatheter aortic valve implantation (TAVI, performed by different types of prostheses and various surgical access, on the prognosis of patients with critical aortic stenosis and comorbidities.Material and methods. Patients (n=130 that had consistently performed 80 TAVI by Edwards valve transfemoral (n=50 and transapical (n=30 access, as well as 50 transcatheter aortic valve replacement by CoreValve system were included into the study. Complications including perioperative mortality, total 30-day mortality, as well as post-hospital mortality were registered during aortic valve replacement, immediately after surgery, before the expiry of 30 days. Mean follow-up was 2.2 years (range 0.2 to 5.2 years.Results. Hospital mortality was on average 6.9%. 121 patients had been discharged from the department after the surgery. The number of deaths in the post-hospital period was 14.8%. Valve type and the type of access had no effect on post-hospital mortality. Men died more than 2.5 times often than women, regardless of age. Atrioventricular block, pacemaker implantation, and history of chronic obstructive pulmonary disease were the most significant prognostic factors. An important role of minor stroke and renal failure should be noted. Mortality did not depend on the surgical access or valve type. All parameters characterizing the intervention were significantly associated with mortality, both during and after surgery. The proportion of survivors at the end of the first year of observation using Corvalve system was 86.9%, Edwards valve by transfemoral access - 88% and Edwards valve by transapical access – 85.4% (insignificant differences for all groups, p>0.05. Two-year survival was 77.5%, 82.5% and 82.7%, respectively (also insignificant differences for all groups, p>0.05.Conclusion. TAVI is the method of choice, reasonable alternative approach for surgical valve replacement in patients with high surgical risk, although

  2. Computed tomography. CT and prognosis of hemophilus influenza meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, H.; Ogawa, K.; Shiihara, H.; Ohkubo, O.; Utsumi, Y. (Nihon Univ., Tokyo. School of Medicine)

    1981-06-01

    CT scanning was performed on 18 patients with hemophilus influenza meningitis. These findings were classified into 4 groups, i.e., focal cortical necrosis (F.C.N.), subdural effusion (S.Ef.), ventricular dilatation (V.D.), and subdural empyema (S.Em.). These findings reflect the process developing encephalopathy, and can be graded mild, moderate, and severe concerning the prognosis. Therefore, follow-up CT scanning is of value in elucidating the mechanism of encephalopathy and predicting the prognosis.

  3. Conveying uncertainty in prognosis to patients with ESRD.

    Science.gov (United States)

    Parvez, Sanah; Abdel-Kader, Khaled; Song, Mi-Kyung; Unruh, Mark

    2015-01-01

    Prognosis is a component of medical practice imbued with uncertainty. In nephrology, where mortality rates of elderly patients on dialysis are comparable to those of cancer patients, the implications of prognosis are unavoidable. Yet while most patients with end-stage renal disease (ESRD) desire to hear their prognosis, many nephrologists balk at this prospect in part owing to the uncertainty inherent in prognostic estimates. In this review, the concept of 'uncertainty' in clinical practice is considered from physician and patient perspectives. From the training perspective, providers learn that uncertainty is inescapable in medicine and develop strategies to manage its presence, including the avoidance of communicating uncertainty to their patients. This presages infrequent discussions of prognosis, which in turn influence patient preferences for treatments that have little therapeutic benefits. A general approach to conveying prognostic uncertainty to ESRD patients includes confronting our own emotional reaction to uncertainty, learning how to effectively communicate uncertainty to our patients, and using an effective interdisciplinary team approach to demonstrate an ongoing commitment to our patients despite the presence of prognostic uncertainty. Uncertainty in prognosis is inevitable. Once providers learn to incorporate it into their discussions of prognosis and collaborate with their ESRD patients, such discussions can foster trust and reduce anxiety for both sides. © 2015 S. Karger AG, Basel.

  4. Adjusting breast cancer patient prognosis with non-HER2-gene patterns on chromosome 17.

    Directory of Open Access Journals (Sweden)

    Vassiliki Kotoula

    Full Text Available BACKGROUND: HER2 and TOP2A gene status are assessed for diagnostic and research purposes in breast cancer with fluorescence in situ hybridization (FISH. However, FISH probes do not target only the annotated gene, while chromosome 17 (chr17 is among the most unstable chromosomes in breast cancer. Here we asked whether the status of specifically targeted genes on chr17 might help in refining prognosis of early high-risk breast cancer patients. METHODS: Copy numbers (CN for 14 genes on chr17, 4 of which were within and 10 outside the core HER2 amplicon (HER2- and non-HER2-genes, respectively were assessed with qPCR in 485 paraffin-embedded tumor tissue samples from breast cancer patients treated with adjuvant chemotherapy in the frame of two randomized phase III trials. PRINCIPAL FINDINGS: HER2-genes CN strongly correlated to each other (Spearman's rho >0.6 and were concordant with FISH HER2 status (Kappa 0.6697 for ERBB2 CN. TOP2A CN were not concordant with TOP2A FISH status (Kappa 0.1154. CN hierarchical clustering revealed distinct patterns of gains, losses and complex alterations in HER2- and non-HER2-genes associated with IHC4 breast cancer subtypes. Upon multivariate analysis, non-HER2-gene gains independently predicted for shorter disease-free survival (DFS and overall survival (OS in patients with triple-negative cancer, as compared to luminal and HER2-positive tumors (interaction p = 0.007 for DFS and p = 0.011 for OS. Similarly, non-HER2-gene gains were associated with worse prognosis in patients who had undergone breast-conserving surgery as compared to modified radical mastectomy (p = 0.004 for both DFS and OS. Non-HER2-gene losses were unfavorable prognosticators in patients with 1-3 metastatic nodes, as compared to those with 4 or more nodes (p = 0.017 for DFS and p = 0.001 for OS. CONCLUSIONS: TOP2A FISH and qPCR may not identify the same pathology on chr17q. Non-HER2 chr17 CN patterns may further predict outcome in breast cancer

  5. Obesity and prognosis in endometrial cancer.

    Science.gov (United States)

    Anderson, B; Connor, J P; Andrews, J I; Davis, C S; Buller, R E; Sorosky, J I; Benda, J A

    1996-04-01

    We tested the null hypothesis that morbid obesity as measured by the Quetelet index has no influence on survival in endometrial cancer. A retrospective study of 492 women with endometrial carcinoma was performed. Age, height, weight, Quetelet index, stage, cell type, grade, node status, peritoneal cytologic findings, and depth of myometrial invasion were analyzed for influence on survival. Mean Quetelet index was 34 (range 16 to 89). Quetelet index was 40 in 22%. Five percent of those with a Quetelet index > 40 had positive nodes, but 64% of patients with a Quetelet index > 40 did not have lymph node sampling done. Lack of sampling of lymph nodes in the entire group had no adverse effect on survival. In a proportional hazards regression model for time from diagnosis to death from disease, grade, node status, myometrial invasion, and stage had highly significant effects. When Quetelet index was analyzed as a continuous variable, as Quetelet index increased, time to recurrence was significantly increased (p = 0.0136), and significance was approached for survival (p = 0.0645). Quetelet index was strongly related to grade (p = 0.013), depth of myometrial invasion (p = 0.031), negative cytologic findings (p = 0.004), and stage (p = 0.011) with obese patients having better differentiated, less invasive tumors of lower stage with negative washings. Morbid obesity positively affects survival in endometrial carcinoma. This effect is accounted for by the association of obesity with less aggressive disease. Morbid obesity is not associated with increased death from other causes. Lack of sampling of negative lymph nodes does not adversely affect survival.

  6. SIRT1 expression is associated with poor prognosis of lung adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Li C

    2015-04-01

    Full Text Available Chong Li,1,2,* Lingling Wang,3,* Liang Zheng,4 Xianghong Zhan,4 Bin Xu,1,2 Jingting Jiang,1,2 Changping Wu1,2 1Department of Tumor Biological Treatment, the Third Affiliated Hospital, Soochow University, Changzhou, 2Cancer Immunotherapy Engineering Research Center of Jiangsu Province, Changzhou, 3Department of Medical Education, Jinling Hospital, Medical School of Nanjing University, Nanjing, 4Department of Thoracic Surgery, the Third Affiliated Hospital, Soochow University, Changzhou, Jiangsu, People’s Republic of China *These authors contributed equally to this work Abstract: Several studies have reported that the overexpression of Sirtuin 1 (SIRT1 was associated with poor prognosis in various human cancers. However, little is known regarding the prognostic value of SIRT1 in lung adenocarcinoma. Therefore, the aim of this study is to evaluate the role of SIRT1 in the prognosis of lung adenocarcinoma patients. Using a tissue microarray, we detected SIRT1 expression by immunohistochemistry in lung adenocarcinoma tissue, as well as in corresponding noncancerous tissues (NCTs. A high expression level of SIRT1 was observed in 74.7% (56/75 of patients with lung adenocarcinoma and 6.7% (5/75 of NCTs (P<0.001. SIRT1 expression was significantly associated with high pathological stage. Importantly, we found that SIRT1 expression was associated with worse overall survival in these lung adenocarcinoma patients (67.0 months vs 104.5 months; P=0.005. In addition, anaplastic lymphoma kinase, epidermal growth factor receptor, vascular endothelial growth factor (VEGF, and Survivin expression were evaluated by fluorescent in situ hybridization or immunohistochemistry, respectively. We found that VEGF and Survivin were both highly expressed in the lung adenocarcinoma tissues, as compared to NCTs. Moreover, the SIRT1 and VEGF expression statuses were significantly positively correlated (r=0.238, P=0.039, while SIRT1 and Survivin expression status were not

  7. Prognosis of critical limb ischemia: Major vs. minor amputation comparison.

    Science.gov (United States)

    Matsuzaki, Kyoichi; Hayashi, Ruka; Okabe, Keisuke; Aramaki-Hattori, Noriko; Kishi, Kazuo

    2015-09-01

    Healthcare providers treating wounds have difficulties assessing the prognosis of patients with critical limb ischemia who had been discharged after complete healing of major amputation wounds. The word "major" in "major amputation" gives the impression of "being more severe" than "minor amputation." Therefore, even if wounds are healed after major amputation, they imagine that prognosis after major amputation would be poorer than that after minor amputation. We investigated the prognosis of diabetic nephropathy patients 2 years after amputations. Those patients underwent dialysis as well as amputation following percutaneous transluminal angioplasty for their foot wounds. They were ambulatory prior to these surgeries. Among 56 cases of minor amputation, 45 were males and 11 were females, and mortality was 41.1%. The mortality of cases with and without a coronary intervention history was 53.1% and 25.0%, respectively (p = 0.034). Among 10 cases of major amputation, 9 were males and 1 was female, and mortality was 60%. The mortality of cases with and without a coronary intervention history was 75.0% and 0%, respectively. Although we predicted poor prognosis in cases with major amputation, there was no significant difference in mortality 2 years after amputations (p = 0.267). Thus far poor prognosis has been reported for major amputation. It might be due to inclusion of the following patients: patients with wounds proximal to ankle joints, patients with extensive gangrene spreading to the lower legs, patients with septicemia from wound infection and who died around the time of operation, and patients with malnutrition. The results of our present study showed that the outcomes at 2 years postoperatively were similar between patients with major amputations and those with minor amputations, if surgical wounds were able to heal. We should not estimate the prognosis by the level of amputation, rather we should consider the effect of coronary intervention history on

  8. Prognosis of Patients with Cirrhosis and AKI Who Initiate RRT.

    Science.gov (United States)

    Allegretti, Andrew S; Parada, Xavier Vela; Eneanya, Nwamaka D; Gilligan, Hannah; Xu, Dihua; Zhao, Sophia; Dienstag, Jules L; Chung, Raymond T; Thadhani, Ravi I

    2018-01-06

    Literature on the prognosis of patients with cirrhosis who require RRT for AKI is sparse and is confounded by liver transplant eligibility. An update on outcomes in the nonlisted subgroup is needed. Our objective was to compare outcomes in this group between those diagnosed with hepatorenal syndrome and acute tubular necrosis, stratifying by liver transplant listing status. Retrospective cohort study of patients with cirrhosis acutely initiated on hemodialysis or continuous RRT at five hospitals, including one liver transplant center. Multivariable regression and survival analysis were performed. Four hundred seventy-two subjects were analyzed (341 not listed and 131 listed for liver transplant). Among nonlisted subjects, 15% (51 of 341) were alive at 6 months after initiating RRT. Median survival was 21 (interquartile range [IQR], 8, 70) days for those diagnosed with hepatorenal syndrome and 12 (IQR, 3, 43) days for those diagnosed with acute tubular necrosis ( P =0.25). Among listed subjects, 48% (63 of 131) received a liver transplant. Median transplant-free survival was 15 (IQR, 5, 37) days for those diagnosed with hepatorenal syndrome and 14 (IQR, 4, 31) days for those diagnosed with acute tubular necrosis ( P =0.60). When stratified by transplant listing, with adjusted Cox models we did not detect a difference in the risk of death between hepatorenal syndrome and acute tubular necrosis (hazard ratio [HR], 0.81; 95% confidence interval [95% CI], 0.59 to 1.11, among those not listed; HR, 0.73; 95% CI, 0.44 to 1.19, among those listed). Cause of AKI was not significantly associated with mortality in patients with cirrhosis who required RRT. Among those not listed for liver transplant, mortality rates were extremely high in patients both with hepatorenal syndrome and acute tubular necrosis. This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2017_11_09_CJASNPodcast_18_1_A.mp3. Copyright © 2018 by the American Society of Nephrology.

  9. Bioaugmentation for Remediation of Chlorinated Solvents: Technology Development, Status, and Research Needs

    Science.gov (United States)

    2005-10-01

    calcoaceticus, Aspergillus oryzae , Bacillus cereus, Bacillus megaterium, Animal and Wastes, Fibrous Wastes, Filamentous Organisms, Fats, Oils and...and mold (includes Candida albicans, Aspergillus fumigatus), fecal coliforms, and Enterococci (monitored semi- annually) DNR Community

  10. 77 FR 59488 - Endangered and Threatened Wildlife and Plants; Endangered Status for Grotto Sculpin and...

    Science.gov (United States)

    2012-09-27

    ... social reactions to the designation of critical habitat and how the consequences of such reactions, if... ( http://dnr.mo.gov/env/swmp/dumping/enf_instruct.htm ; Pobst 2012, pers. comm). Moss and Pobst (2010, p...

  11. Obvious emphysema on computed tomography during an acute exacerbation of chronic obstructive pulmonary disease predicts a poor prognosis.

    Science.gov (United States)

    Cheng, T; Wan, H Y; Cheng, Q J; Guo, Y; Qian, Y R; Fan, L; Feng, Y; Song, Y Y; Zhou, M; Li, Q Y; Shi, G C; Huang, S G

    2015-05-01

    Emphysematous change on computed tomography (CT) during the stable phase of chronic obstructive pulmonary disease (COPD) is reported to correlate with COPD prognosis. Acute exacerbation of COPD (AECOPD) is associated with a high risk of mortality and a poor prognosis. This study aims to study the relationship between prognosis and emphysematous changes on CT during an AECOPD. Histories were recorded, and CT acquired for 106 patients who visited the emergency department for an AECOPD. Emphysematous change was quantified by measuring the percentage of low-attenuation areas (LAA%) in the entire lung on CT images with a threshold of -950 Hounsfield units. Other factors that could influence AECOPD prognosis were also recorded on admission and analysed. At follow ups conducted in 1 year, patient survival, the modified Medical Research Council (mMRC) Dyspnoea Scale, and performance status (PS) were evaluated, and a COPD Assessment Test (CAT) was completed. The 1-year follow up was completed by 103 of 106 patients. The median LAA% was significantly higher in non-survivors (11%, n = 16) than in survivors (5.69%, n = 87) (P = 0.006) at the 1-year follow up. LAA% was significantly correlated with mMRC grade (r = 0.285, P = 0.008), PS (r = 0.397, P 7.5% was a significant predictor of 1-year mortality, higher mMRC and PS at the 3-month and 1-year follow ups, after adjustment for other prognostic predictors. Obvious emphysematous changes on CT (LAA% > 7.5%) during an AECOPD predicts a poor prognosis independent of other known indicators. © 2015 Royal Australasian College of Physicians.

  12. Prognosis of breast cancer is associated with one-carbon metabolism related nutrients among Korean women.

    Science.gov (United States)

    Lee, Yunhee; Lee, Sang-Ah; Choi, Ji-Yeob; Song, Minkyo; Sung, Hyuna; Jeon, Sujee; Park, Sue K; Yoo, Keun-Young; Noh, Dong-Young; Ahn, Sei-Hyun; Kang, Daehee

    2012-08-28

    The 5-year survival rate for breast cancer among Korean women has increased steadily; however, breast cancer remains the leading cause of cancer mortality among women. One-carbon metabolism, which requires an adequate supply of methyl group donors and B vitamins, may affect the prognosis of breast cancer. This aim of this study was to investigate the associations of dietary intake of vitamin B2, vitamin B6 and folate before diagnosis on the prognosis of breast cancer. We assessed the dietary intake using a food frequency questionnaire with 980 women who were newly diagnosed and histopathologically confirmed to have primary breast cancer from hospitals in Korea, and 141 disease progression events occurred. Cox's proportional hazard regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) adjusting for age, education, recruitment sites, TNM stage, hormone status, nuclear grade and total calorie. There was no significant association between any one-carbon metabolism related nutrients (vitamin B2, B6 and folate) and the progression of breast cancer overall. However, one-carbon metabolism related nutrients were associated with disease progression in breast cancer patients stratified by subtypes. In ER + and/or PR + breast cancers, no association was observed; however, in ER-/PR- breast cancers, a high intake of vitamin B2 and folate statistically elevated the HR of breast cancer progression (HR = 2.28; 95% CI, 1.20-4.35, HR = 1.84; 95% CI, 1.02-3.32, respectively) compared to a low intake. This positive association between the ER/PR status and progression of the disease was profound when the nutrient intakes were categorized in a combined score (Pinteraction = 0.018). In ER-/PR- breast cancers, high combined scores were associated with a significantly poor DFS compared to those belonging to the low score group (HR = 3.84; 95% CI, 1.70-8.71). In conclusion, our results suggest that one-carbon related nutrients have a role in the

  13. Status epilepticus

    NARCIS (Netherlands)

    Hensiek, AE; Absalom, Anthony

    2006-01-01

    Status epilepticus is defined as epileptic activity that continues for more than 30 minutes as a single seizure or as recurrent seizures without inter-ictal return of consciousness. The seizure activity is usually classified as partial or generalized. Although status epilepticus is an uncommon

  14. The Danish Nephrology Registry.

    Science.gov (United States)

    Heaf, James

    2016-01-01

    The Danish Nephrology Registry's (DNR) primary function is to support the Danish public health authorities' quality control program for patients with end-stage renal disease in order to improve patient care. DNR also supplies epidemiological data to several international organizations and supports epidemiological and clinical research. The study population included patients treated with dialysis or transplantation in Denmark from January 1, 1990 to January 1, 2016, with retrospective data since 1964. DNR registers patient data (eg, age, sex, renal diagnosis, and comorbidity), predialysis specialist treatment, details of eight dialysis modalities (three hemodialysis and five peritoneal dialysis), all transplantation courses, dialysis access at first dialysis, treatment complications, and biochemical variables. The database is complete (nutritional and uremia status. Date and cause of death are also included. Six quality indicators are published annually, and have been associated with improvements in patient results, eg, a reduction in dialysis patient mortality, improved graft survival, and earlier referral to specialist care. Approximately, ten articles, mainly epidemiological, are published each year. DNR contains a complete description of end-stage renal disease patients in Denmark, their treatment, and prognosis. The stated aims are fulfilled.

  15. Factors affecting epilepsy development and epilepsy prognosis in cerebral palsy.

    Science.gov (United States)

    Mert, Gulen Gul; Incecik, Faruk; Altunbasak, Sakir; Herguner, Ozlem; Mert, Mustafa Kurthan; Kiris, Nurcihan; Unal, Ilker

    2011-08-01

    A study was conducted between November 2006 and October 2009 to determine the factors predicting the presence and prognosis of epilepsy in patients with cerebral palsy. We enrolled 2 groups of patients: 42 with cerebral palsy in group 1 and 56 patients with cerebral palsy and epilepsy in group 2. The subjects in group 2 were considered to have good epilepsy prognosis if they were free of seizures for the previous year; otherwise they were considered to have poor epilepsy prognosis. In group 2, neonatal epilepsy, family history of epilepsy, and moderate to severe mental retardation were significantly higher than in group 1 (P history of epilepsy, and mental retardation were found to be important and independent predictors of development of epilepsy in patients with cerebral palsy. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Two wind power prognosis criteria and regulating power costs

    DEFF Research Database (Denmark)

    Nielsen, Claus S.; Ravn, Hans F.; Schaumburg-Müller, Camilla

    2003-01-01

    The objective of the present work is to investigate the consequences of the choice of criterion in short-term wind power prognosis. This is done by investigating the consequences of choice of objective function in relation to the estimation of the power curve that is applied in the prognoses...... the prices of regulating power will be estimated. Then the two mentioned power curves may be estimated using wind speed production from the numerical weather prediction model from the Danish Meteorological Institute and the corresponding short term prognoses of wind power will be elaborated. From wind power...... production measurement the errors may be calculated. Combining this information it is possible to find the consequences of inconsequent use of prognosis criterion, i.e., using one criterion in estimating the power curve and another in assessing the quality of the prognosis....

  17. [Neuroimaging and Blood Biomarkers in Functional Prognosis after Stroke].

    Science.gov (United States)

    Branco, João Paulo; Costa, Joana Santos; Sargento-Freitas, João; Oliveira, Sandra; Mendes, Bruno; Laíns, Jorge; Pinheiro, João

    2016-11-01

    Stroke remains one of the leading causes of morbidity and mortality around the world and it is associated with an important long-term functional disability. Some neuroimaging resources and certain peripheral blood or cerebrospinal fluid proteins can give important information about etiology, therapeutic approach, follow-up and functional prognosis in acute ischemic stroke patients. However, among the scientific community, there is currently more interest in the stroke vital prognosis over the functional prognosis. Predicting the functional prognosis during acute phase would allow more objective rehabilitation programs and better management of the available resources. The aim of this work is to review the potential role of acute phase neuroimaging and blood biomarkers as functional recovery predictors after ischemic stroke. Review of the literature published between 2005 and 2015, in English, using the terms "ischemic stroke", "neuroimaging" e "blood biomarkers". We included nine studies, based on abstract reading. Computerized tomography, transcranial doppler ultrasound and diffuse magnetic resonance imaging show potential predictive value, based on the blood flow study and the evaluation of stroke's volume and localization, especially when combined with the National Institutes of Health Stroke Scale. Several biomarkers have been studied as diagnostic, risk stratification and prognostic tools, namely the S100 calcium binding protein B, C-reactive protein, matrix metalloproteinases and cerebral natriuretic peptide. Although some biomarkers and neuroimaging techniques have potential predictive value, none of the studies were able to support its use, alone or in association, as a clinically useful functionality predictor model. All the evaluated markers were considered insufficient to predict functional prognosis at three months, when applied in the first hours after stroke. Additional studies are necessary to identify reliable predictive markers for functional

  18. Biomarkers of the Metabolic Syndrome and Breast Cancer Prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Qiu-Li; Xu, Wang-Hong, E-mail: mtao@buffalo.edu [Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032 (China); Tao, Meng-Hua, E-mail: mtao@buffalo.edu [Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214 (United States)

    2010-04-28

    In spite of its public health importance, our understanding of the mechanisms of breast carcinogenesis and progress is still evolving. The metabolic syndrome (MS) is a constellation of biochemical abnormalities including visceral adiposity, hyperglycemia, hyperinsulinemia, dyslipidemia and high blood pressure. The components of the MS have all been related to late-stage disease and even to a poor prognosis of breast cancer through multiple interacting mechanisms. In this review, we aim to present a summary of recent advances in the understanding of the contribution of the MS to breast cancer with the emphasis on the role of biomarkers of the MS in the prognosis of breast cancer.

  19. Biomarkers of the Metabolic Syndrome and Breast Cancer Prognosis

    Directory of Open Access Journals (Sweden)

    Meng-Hua Tao

    2010-04-01

    Full Text Available In spite of its public health importance, our understanding of the mechanisms of breast carcinogenesis and progress is still evolving. The metabolic syndrome (MS is a constellation of biochemical abnormalities including visceral adiposity, hyperglycemia, hyperinsulinemia, dyslipidemia and high blood pressure. The components of the MS have all been related to late-stage disease and even to a poor prognosis of breast cancer through multiple interacting mechanisms. In this review, we aim to present a summary of recent advances in the understanding of the contribution of the MS to breast cancer with the emphasis on the role of biomarkers of the MS in the prognosis of breast cancer.

  20. Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score

    Science.gov (United States)

    Kim, Hee Yeon; Jang, Jeong Won

    2015-01-01

    Estimating the prognosis of patients with cirrhosis remains challenging, because the natural history of cirrhosis varies according to the cause, presence of portal hypertension, liver synthetic function, and the reversibility of underlying disease. Conventional prognostic scoring systems, including the Child-Turcotte-Pugh score or model for end-stage liver diseases are widely used; however, revised models have been introduced to improve prognostic performance. Although sarcopenia is one of the most common complications related to survival of patients with cirrhosis, the newly proposed prognostic models lack a nutritional status evaluation of patients. This is reflected by the lack of an optimal index for sarcopenia in terms of objectivity, reproducibility, practicality, and prognostic performance, and of a consensus definition for sarcopenia in patients with cirrhosis in whom ascites and edema may interfere with body composition analysis. Quantifying skeletal muscle mass using cross-sectional abdominal imaging is a promising tool for assessing sarcopenia. As radiological imaging provides direct visualization of body composition, it is useful to evaluate sarcopenia in patients with cirrhosis whose body mass index, anthropometric measurements, or biochemical markers are inaccurate on a nutritional assessment. Sarcopenia defined by cross-sectional imaging-based muscular assessment is prevalent and predicts mortality in patients with cirrhosis. Sarcopenia alone or in combination with conventional prognostic systems shows promise for a cirrhosis prognosis. Including an objective assessment of sarcopenia with conventional scores to optimize the outcome prediction for patients with cirrhosis needs further research. PMID:26167066

  1. The Importance of Haemogram Parameters in the Diagnosis and Prognosis of Septic Patients

    Directory of Open Access Journals (Sweden)

    Orfanu Alina Elena

    2017-07-01

    Full Text Available Sepsis represents a severe pathology that requires both rapid and precise positive and differential diagnosis to identify patients who need immediate antimicrobial therapy. Monitoring septic patients′ outcome leads to prolonged hospitalisation and antibacterial therapy, often accompanied by substantial side effects, complications and a high mortality risk. Septic patients present with complex pathophysiological and immunological disorders and with a predominance of pro-inflammatory or anti-inflammatory mediators which are heterogeneous with respect to the infectious focus, the aetiology of sepsis or patients′ immune status or comorbidities. Previous studies performed have analysed inflammatory biomarkers, but a test or combinations of tests that can quickly and precisely establish a diagnosis or prognosis of septic patients has yet to be discovered. Recent research has focused on re-analysing older accessible parameters found in the complete blood count to determine the sensitivity, specificity, positive and negative predictive values for the diagnosis and prognosis of sepsis. The neutrophil/lymphocyte count ratio (NLCR, mean platelet volume (MPV and red blood cells distribution width (RDW are haemogram indicators which have been evaluated and which are of proven use in septic patients′ management.

  2. Low serum 25-hydroxyvitamin d concentrations are associated with increased risk for melanoma and unfavourable prognosis.

    Directory of Open Access Journals (Sweden)

    Benjamin Bade

    Full Text Available Low vitamin D status (serum 25(OHD concentration is associated with increased incidence and unfavourable outcome of various types of cancer. However, there are limited data on influence of serum 25(OHD on risk and prognosis of malignant melanoma.Basal serum 25(OHD concentrations were retrospectively analyzed in a cohort of melanoma patients (n = 324 and healthy controls (n = 141. We tested the hypothesis that serum 25(OHD concentrations are predictive of melanoma risk, thickness of primary melanomas, and overall survival (OS.Median serum 25(OHD concentrations were significantly lower (p = 0.004 in melanoma patients (median = 13.6 ng/ml as compared to controls (median = 15.6 ng/ml. Primary tumors of patients with low serum 25(OHD concentrations (20 ng/ml; median: 1.00 mm. Patients with 25(OHD serum concentrations in the lowest quartile had inferior overall survival (median: 80 months comparing with the highest quartile (median: 195 months; p = 0.049.Our data support the concept that serum 25(OHD concentrations are associated with risk and prognosis of melanoma. Whether normalizing serum 25(OHD concentrations in these patients improves outcomes will require testing in future clinical trials.

  3. High Nuclear Expression of HDGF Correlates with Disease Progression and Poor Prognosis in Human Endometrial Carcinoma

    Directory of Open Access Journals (Sweden)

    Lijing Wang

    2014-01-01

    Full Text Available Aims. This study examined the correlation between high nuclear expression of hepatoma-derived growth factor (HDGF and clinicopathologic data in endometrial carcinoma (EC, including patient survival. Methods. One hundred and twenty-two endometrial carcinoma (EC patients from 2002 to 2008 were reviewed in the study. HDGF expression in tumor tissues was examined using immunohistochemistry (IHC, and its association with clinicopathological parameters was evaluated. Tumors with 80% or more nuclei staining were regarded as high expression and tumors with less than 80% nuclei staining considered as low expression. Results and Conclusions. Immunohistochemical analysis revealed that HDGF was expressed in both the nucleus and cytoplasm. High nuclear expression of HDGF was positively correlated with FIGO stage (P=0.032, but not associated with other clinical features, such as histological grading or lymph node status. Patients with high expression of HDGF had poorer overall survival rates than those with low expression of HDGF (P=0.001. However, multivariate analyses showed that high nuclear expression of HDGF protein was not an independent predictor of prognosis for EC patients (P=0.111. Our results suggest that high nuclear expression of HDGF is a potential unfavorable factor for the progression and prognosis of EC.

  4. Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy

    DEFF Research Database (Denmark)

    de Vos Andersen, Nils-Bo; Kent, Peter; Hjort, Jakob

    2017-01-01

    BACKGROUND: Danish patients with musculoskeletal disorders are commonly referred for primary care physiotherapy treatment but little is known about their general health status, pain diagnoses, clinical course and prognosis. The objectives of this study were to 1) describe the clinical course...... of patients with musculoskeletal disorders referred to physiotherapy, 2) identify predictors associated with a satisfactory outcome, and 3) determine the influence of the primary pain site diagnosis relative to those predictors. METHODS: This was a prospective cohort study of patients (n = 2,706) newly...... referred because of musculoskeletal pain to 30 physiotherapy practices from January 2012 to May 2012. Data were collected via a web-based questionnaire 1-2 days prior to the first physiotherapy consultation and at 6 weeks, 3 and 6 months, from clinical records (including primary musculoskeletal symptom...

  5. Quantitative Multiplex Immunohistochemistry Reveals Myeloid-Inflamed Tumor-Immune Complexity Associated with Poor Prognosis

    Directory of Open Access Journals (Sweden)

    Takahiro Tsujikawa

    2017-04-01

    Full Text Available Here, we describe a multiplexed immunohistochemical platform with computational image processing workflows, including image cytometry, enabling simultaneous evaluation of 12 biomarkers in one formalin-fixed paraffin-embedded tissue section. To validate this platform, we used tissue microarrays containing 38 archival head and neck squamous cell carcinomas and revealed differential immune profiles based on lymphoid and myeloid cell densities, correlating with human papilloma virus status and prognosis. Based on these results, we investigated 24 pancreatic ductal adenocarcinomas from patients who received neoadjuvant GVAX vaccination and revealed that response to therapy correlated with degree of mono-myelocytic cell density and percentages of CD8+ T cells expressing T cell exhaustion markers. These data highlight the utility of in situ immune monitoring for patient stratification and provide digital image processing pipelines to the community for examining immune complexity in precious tissue sections, where phenotype and tissue architecture are preserved to improve biomarker discovery and assessment.

  6. Research on a Rotating Machinery Fault Prognosis Method Using Three-Dimensional Spatial Representations

    Directory of Open Access Journals (Sweden)

    Xiaoni Dong

    2016-01-01

    Full Text Available Process models and parameters are two critical steps for fault prognosis in the operation of rotating machinery. Due to the requirement for a short and rapid response, it is important to study robust sensor data representation schemes. However, the conventional holospectrum defined by one-dimensional or two-dimensional methods does not sufficiently present this information in both the frequency and time domains. To supply a complete holospectrum model, a new three-dimensional spatial representation method is proposed. This method integrates improved three-dimensional (3D holospectra and 3D filtered orbits, leading to the integration of radial and axial vibration features in one bearing section. The results from simulation and experimental analysis on a complex compressor show that the proposed method can present the real operational status and clearly reveal early faults, thus demonstrating great potential for condition-based maintenance prediction in industrial machinery.

  7. Increased angiogenesis and FGFR protein expression indicate a favourable prognosis in bladder cancer.

    Science.gov (United States)

    Bertz, Simone; Abeé, Christine; Schwarz-Furlan, Stephan; Alfer, Joachim; Hofstädter, Ferdinand; Stoehr, Robert; Hartmann, Arndt; Gaumann, Andreas K A

    2014-12-01

    Compared to other members of the fibroblast growth factor receptor (FGFR) family, only few studies investigate FGFR3 in tumour angiogenesis. We investigated the connection between angiogenesis and FGF/FGFR expression including FGFR3 mutation status in urothelial carcinomas. Immunohistochemistry was performed in invasive and non-invasive urothelial cancers of 61 patients. Protein expression of CD31, factor VIII (FVIII), FGF-1/2, FGFR1, FGFR3 and FGFR4 and FGFR3 mutation status were evaluated. Morphometric assessment of angiogenesis including microvessel count (MVC) and vascular surface area (VSA) was analysed. Correlation and survival analyses (overall survival (OS) and disease-free survival (DFS)) with univariate and multivariate analyses were performed. CD31 values (MVC and VSA) significantly correlated with OS and DFS. OS and DFS were significantly better in patients with FGFR3 overexpression. Multivariate analysis revealed FGFR3 protein expression and tumour grading (WHO classification 2004) as independent prognostic factors of OS and VSA of CD31 and FGFR3 protein expression of DFS. FGFR3 mutation status was correlated with VSA measured by FVIII. FGFR3 may be able to induce a pro-angiogenic phenotype in urothelial carcinomas and significantly influence prognosis. Consequently, FGFR3 is a potential therapeutic target also from the angiogenesis perspective.

  8. The Role of BRCA2 Mutation Status as Diagnostic, Predictive, and Prognosis Biomarker for Pancreatic Cancer.

    Science.gov (United States)

    Martinez-Useros, Javier; Garcia-Foncillas, Jesus

    2016-01-01

    Pancreatic cancer is one of the deadliest cancers worldwide, and life expectancy after diagnosis is often short. Most pancreatic tumours appear sporadically and have been highly related to habits such as cigarette smoking, high alcohol intake, high carbohydrate, and sugar consumption. Other observational studies have suggested the association between pancreatic cancer and exposure to arsenic, lead, or cadmium. Aside from these factors, chronic pancreatitis and diabetes have also come to be considered as risk factors for these kinds of tumours. Studies have found that 10% of pancreatic cancer cases arise from an inherited syndrome related to some genetic alterations. One of these alterations includes mutation in BRCA2 gene. BRCA2 mutations impair DNA damage response and homologous recombination by direct regulation of RAD51. In light of these findings that link genetic factors to tumour development, DNA damage agents have been proposed as target therapies for pancreatic cancer patients carrying BRCA2 mutations. Some of these drugs include platinum-based agents and PARP inhibitors. However, the acquired resistance to PARP inhibitors has created a need for new chemotherapeutic strategies to target BRCA2. The present systematic review collects and analyses the role of BRCA2 alterations to be used in early diagnosis of an inherited syndrome associated with familiar cancer and as a prognostic and predictive biomarker for the management of pancreatic cancer patients.

  9. The Role of BRCA2 Mutation Status as Diagnostic, Predictive, and Prognosis Biomarker for Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Javier Martinez-Useros

    2016-01-01

    Full Text Available Pancreatic cancer is one of the deadliest cancers worldwide, and life expectancy after diagnosis is often short. Most pancreatic tumours appear sporadically and have been highly related to habits such as cigarette smoking, high alcohol intake, high carbohydrate, and sugar consumption. Other observational studies have suggested the association between pancreatic cancer and exposure to arsenic, lead, or cadmium. Aside from these factors, chronic pancreatitis and diabetes have also come to be considered as risk factors for these kinds of tumours. Studies have found that 10% of pancreatic cancer cases arise from an inherited syndrome related to some genetic alterations. One of these alterations includes mutation in BRCA2 gene. BRCA2 mutations impair DNA damage response and homologous recombination by direct regulation of RAD51. In light of these findings that link genetic factors to tumour development, DNA damage agents have been proposed as target therapies for pancreatic cancer patients carrying BRCA2 mutations. Some of these drugs include platinum-based agents and PARP inhibitors. However, the acquired resistance to PARP inhibitors has created a need for new chemotherapeutic strategies to target BRCA2. The present systematic review collects and analyses the role of BRCA2 alterations to be used in early diagnosis of an inherited syndrome associated with familiar cancer and as a prognostic and predictive biomarker for the management of pancreatic cancer patients.

  10. Current status of diagnosis and prognosis of infant acute leukemia in China.

    Science.gov (United States)

    Huang, Li-Bin; Guan, Xiao-Qing; Zhang, Ying-Chuan; Zhang, Xiao-Li; Ke, Zhi-Yong; Luo, Xue-Qun

    2009-12-01

    Treatment and outcome of infant acute leukemia (IAL) in developed countries have been well documented. However, reports summarizing diagnosis and outcome of IAL in developing countries are limited. Five hundred ninety seven pediatric patients were diagnosed with acute leukemia in our hospital between January 1997 and June 2008, of which 19 were younger than 12 months. Data from our 19 cases and the Chinese literature were analyzed. Of the 19 cases, 14 had acute lymphoblastic leukemia (ALL) and 5 had acute myeloid leukemia (AML) based on FAB classification. Immunophenotyping and molecular genetic analysis were performed in only 6 cases. Only 16% (3/19) of the infants received treatment. Two infants with immunophenotypic AML who abandoned treatment achieved spontaneous remission without chemotherapy within 2 and 4 months respectively. Combining our data with those from Chinese literature, less than one third of the infants had immunophenotypic and genetic verification of leukemia and 29% (18/63) of them received treatment. Family financial difficulties and physicians' lack of confidence in treatment outcome in IAL contributed to a high treatment abandonment rate and poor outcome. Public health insurance as well as physician education on current IAL treatment strategies may decrease treatment abandonment in China.

  11. Clonal Evaluation of Prostate Cancer by ERG/SPINK1 Status to Improve Prognosis Prediction

    Science.gov (United States)

    2016-10-01

    these aims, we developed a tri-institutional collaboration between Drs. Tomlins ( PI ; University of Michigan [UM]), Larry True (University of...1) Gleason score 3+4=7 or 4+3=7 with at least 3 yrs PSA follow-up. Review of these cases is ongoing and approximately 80% complete. With local...and PSA recurrence (months 32-34) 4) Prepare manuscript on study (months 34-36) We have modified data fields from pre-existing databases at each

  12. Stock Status

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data inform the public of the most recent stock status for all stocks (FSSI and non-FSSI) in the fishery management unit contained in a fishery managment plan....

  13. Impact of Body Weight and Body Composition on Ovarian Cancer Prognosis.

    Science.gov (United States)

    Purcell, Sarah A; Elliott, Sarah A; Kroenke, Candyce H; Sawyer, Michael B; Prado, Carla M

    2016-02-01

    Measures of body weight and anthropometrics such as body mass index (BMI) are commonly used to assess nutritional status in clinical conditions including cancer. Extensive research has evaluated associations between body weight and prognosis in ovarian cancer patients, yet little is known about the potential impact of body composition (fat mass (FM) and fat-free mass (FFM)) in these patients. Thus, the purpose of this publication was to review the literature (using PubMed and EMBASE) evaluating the impact of body weight and particularly body composition on surgical complications, morbidity, chemotherapy dosing and toxicity (as predictors of prognosis), and survival in ovarian cancer patients. Body weight is rarely associated with intra-operative complications, but obesity predicts higher rates of venous thromboembolism and wound complications post-operatively in ovarian cancer patients. Low levels of FM and FFM are superior predictors of length of hospital stay compared to measures of body weight alone, but the role of body composition on other surgical morbidities is unknown. Obesity complicates chemotherapy dosing due to altered pharmacokinetics, imprecise dosing strategies, and wide variability in FM and FFM. Measurement of body composition has the potential to reduce toxicity if the results are incorporated into chemotherapy dosing calculations. Some findings suggest that excess body weight adversely affects survival, while others find no such association. Limited studies indicate that FM is a better predictor of survival than body weight in ovarian cancer patients, but the direction of this relationship has not been determined. In conclusion, body composition as an indicator of nutritional status is a better prognostic tool than body weight or BMI alone in ovarian cancer patients.

  14. [Effect of educational level on the prognosis of acute myocardial infarction].

    Science.gov (United States)

    Nazzal, Carolina; Corbalán, Ramón; Díaz, Claudia; Sepúlveda, Pablo; Schacht, Eliana

    2015-07-01

    Socioeconomic status is associated with cardiovascular mortality. To evaluate the effect of educational level, on the prognosis of patients with acute myocardial infarction in Chile. Cohort study of 3,636 patients aged 63.1 ± 13.2 years, 27% women, hospitalized in 16 centers participating in the Chilean Myocardial Infarction Registry (GEMI) between 2009 and 2012. Vital status was obtained from the National Mortality Database. Patients were divided, according to educational level, in four groups, namely none (no formal education), basic ( 12 years). Crude and adjusted (age, sex, cardiovascular risk factors and treatments) hazard ratios (HR) were estimated using Cox regression models. The distribution by educational level was 3.2% none, 31.8% basic, 43.0% secondary and 22.0% tertiary. During a median follow-up period of 22 months (interquartile range 11-37 years), 631 patients died (17.3%), of whom 198 died during hospitalization (5.5%). The 30 day case-fatality rate according to educational level was 3.4% in tertiary, 4.7% in secondary, 11.9% in basic, 19.1% in none (p education compared with individuals with tertiary education, persisted in the multivariate analysis with a hazard ratio for secondary education 1.58 (95% confidence intervals (CI), 1.18-2.10); for basic education 1.90 (95% CI, 1.41-2.47) and for none 3.50 (95% CI, 2.35-5.21). A lower educational level was associated with a worse prognosis in patients with myocardial infarction, even after controlling for potential confounding factors.

  15. Cohort Profile : The Chronic Kidney Disease Prognosis Consortium

    NARCIS (Netherlands)

    Matsushita, Kunihiro; Ballew, Shoshana H.; Astor, Brad C.; de Jong, Paul E.; Gansevoort, Ronald; Hemmelgarn, Brenda R.; Levey, Andrew S.; Levin, Adeera; Wen, Chi-Pang; Woodward, Mark; Coresh, Josef

    2013-01-01

    The Chronic Kidney Disease Prognosis Consortium (CKD-PC) was established in 2009 to provide comprehensive evidence about the prognostic impact of two key kidney measures that are used to define and stage CKD, estimated glomerular filtration rate (eGFR) and albuminuria, on mortality and kidney

  16. Prognosis for long-term survivors of cancer

    NARCIS (Netherlands)

    M.L.G. Janssen-Heijnen (Maryska); S. Houterman (Saskia); V.E.P.P. Lemmens (Valery); H. Brenner (Hermann); E.W. Steyerberg (Ewout); J.W.W. Coebergh (Jan Willem)

    2007-01-01

    textabstractBackground: Many cancer patients who have already survived some time want to know about their prognosis, given the pre-condition that they are still alive. We described and interpreted population-based conditional 5-year relative survival rates. Patients and methods: The long-standing

  17. Prognosis of patients with whiplash-associated disorders consulting physiotherapy

    DEFF Research Database (Denmark)

    Bohman, Tony; Côté, Pierre; Boyle, Eleanor

    2012-01-01

    BACKGROUND: Patients with whiplash-associated disorders (WAD) have a generally favourable prognosis, yet some develop longstanding pain and disability. Predicting who will recover from WAD shortly after a traffic collision is very challenging for health care providers such as physical therapists....

  18. Prognosis of senile cataract extraction with increasing age | Idu ...

    African Journals Online (AJOL)

    In order to determine the prognosis of senile cataract extraction with increasing age, a case series of 240 patients without ocular or systemic comorbidity aged 51 to 80 years who underwent intracapsular cataract extraction (ICCE), and extracapsular cataract extraction (ECCE), between January 1991 andDecembers 2000 ...

  19. Estimating and communicating prognosis in advanced neurologic disease.

    Science.gov (United States)

    Holloway, Robert G; Gramling, Robert; Kelly, Adam G

    2013-02-19

    Prognosis can no longer be relegated behind diagnosis and therapy in high-quality neurologic care. High-stakes decisions that patients (or their surrogates) make often rest upon perceptions and beliefs about prognosis, many of which are poorly informed. The new science of prognostication--the estimating and communication "what to expect"--is in its infancy and the evidence base to support "best practices" is lacking. We propose a framework for formulating a prediction and communicating "what to expect" with patients, families, and surrogates in the context of common neurologic illnesses. Because neurologic disease affects function as much as survival, we specifically address 2 important prognostic questions: "How long?" and "How well?" We provide a summary of prognostic information and highlight key points when tailoring a prognosis for common neurologic diseases. We discuss the challenges of managing prognostic uncertainty, balancing hope and realism, and ways to effectively engage surrogate decision-makers. We also describe what is known about the nocebo effects and the self-fulfilling prophecy when communicating prognoses. There is an urgent need to establish research and educational priorities to build a credible evidence base to support best practices, improve communication skills, and optimize decision-making. Confronting the challenges of prognosis is necessary to fulfill the promise of delivering high-quality, patient-centered care.

  20. Implications of random variation in the Stand Prognosis Model

    Science.gov (United States)

    David A. Hamilton

    1991-01-01

    Although the Stand Prognosis Model has several stochastic components, features have been included in the model in an attempt to minimize run-to-run variation attributable to these stochastic components. This has led many users to assume that comparisons of management alternatives could be made based on a single run of the model for each alternative. Recent analyses...

  1. Development and validation of a clinical score for prognosis ...

    African Journals Online (AJOL)

    Several independent risk factors at baseline are associated with a poor prognosis after ART initiation. These include: male sex, low body mass index, anemia, low CD4 count and stage-4 WHO disease. The aim of this research was evaluate prospectively a new scoring system composed by these factors. Methods: An open ...

  2. Management and Prognosis of Community-Acquired Pneumonia in Adults

    NARCIS (Netherlands)

    Postma, D.F.

    2016-01-01

    Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality worldwide. In this thesis, different aspects of both management and prognosis of adults admitted with CAP have been addressed in separate parts. In the first part, we evaluated empirical antibiotic therapy and statins as

  3. [Outcome prognosis of esophagoplasty of esophagus burns with colonic segment ].

    Science.gov (United States)

    Ksenofontov, S S; Get'man, V G; Polinkevich, B S; Belozertsev, A M

    2003-07-01

    Peculiarities of postburn esophagitis course and subsequent rehabilitation of patients with burn of esophagus were studied. The authors had systematized and proposed classification of postburn esophagitis, considering prognosis of autoplastic results using segment of colon for postburn esophageal impassability. Right calculation and logical interpretation, determination of significance of postburn esophagitis will provide success of autoplastic rehabilitation of patients with burn disease of the esophagus.

  4. Atlantoaxial Langerhans cell histiocytosis radiographic characteristics and corresponding prognosis analysis

    Directory of Open Access Journals (Sweden)

    Lihua Zhang

    2017-01-01

    Conclusions: The atlas and axis were affected by LCH, mainly in children. The lateral mass was easily affected and compressed, destruction of the atlas and axis could lead to atlantoaxial joint instability. The prognosis was good in most of the patients.

  5. Prognosis of Acute Post-streptococcal Glomerulonephritis in ...

    African Journals Online (AJOL)

    Prognosis of Acute Post-streptococcal Glomerulonephritis in Sudanese Children. EMA Ali, AMTA Babikir, S El-Assad, MB Abdelrahim. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL.

  6. Clinical aspects and prognosis of Brugada syndrome in children

    NARCIS (Netherlands)

    Probst, Vincent; Denjoy, Isabelle; Meregalli, Paola G.; Amirault, Jean-Christophe; Sacher, Frederic; Mansourati, Jacques; Babuty, Dominique; Villain, Elisabeth; Victor, Jacques; Schott, Jean-Jacques; Lupoglazoff, Jean-Marc; Mabo, Philippe; Veltmann, Christian; Jesel, Laurence; Chevalier, Philippe; Clur, Sally-Ann B.; Haissaguerre, Michel; Wolpert, Christian; Le Marec, Herve; Wilde, Arthur A. M.

    2007-01-01

    BACKGROUND: Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and augmented risk of sudden cardiac death. Little is known about the clinical presentation and prognosis of this disease in children. METHODS AND RESULTS:

  7. A genetic programming approach to oral cancer prognosis.

    Science.gov (United States)

    Tan, Mei Sze; Tan, Jing Wei; Chang, Siow-Wee; Yap, Hwa Jen; Abdul Kareem, Sameem; Zain, Rosnah Binti

    2016-01-01

    The potential of genetic programming (GP) on various fields has been attained in recent years. In bio-medical field, many researches in GP are focused on the recognition of cancerous cells and also on gene expression profiling data. In this research, the aim is to study the performance of GP on the survival prediction of a small sample size of oral cancer prognosis dataset, which is the first study in the field of oral cancer prognosis. GP is applied on an oral cancer dataset that contains 31 cases collected from the Malaysia Oral Cancer Database and Tissue Bank System (MOCDTBS). The feature subsets that is automatically selected through GP were noted and the influences of this subset on the results of GP were recorded. In addition, a comparison between the GP performance and that of the Support Vector Machine (SVM) and logistic regression (LR) are also done in order to verify the predictive capabilities of the GP. The result shows that GP performed the best (average accuracy of 83.87% and average AUROC of 0.8341) when the features selected are smoking, drinking, chewing, histological differentiation of SCC, and oncogene p63. In addition, based on the comparison results, we found that the GP outperformed the SVM and LR in oral cancer prognosis. Some of the features in the dataset are found to be statistically co-related. This is because the accuracy of the GP prediction drops when one of the feature in the best feature subset is excluded. Thus, GP provides an automatic feature selection function, which chooses features that are highly correlated to the prognosis of oral cancer. This makes GP an ideal prediction model for cancer clinical and genomic data that can be used to aid physicians in their decision making stage of diagnosis or prognosis.

  8. Prognosis in patients presenting with non-traumatic coma.

    Science.gov (United States)

    Forsberg, Sune; Höjer, Jonas; Ludwigs, Ulf

    2012-03-01

    Studies of patients presenting with coma are limited, and little is known about the prognosis of these cases. The aim of this study was to investigate the acute and long-term prognosis after an episode of non-traumatic coma. Adults admitted consecutively to an emergency department in Stockholm, Sweden between February 2003 and May 2005 with a Glasgow Coma Scale (GCS) score of 10 or below were enrolled prospectively. All available data were used to explore the cause of the impaired consciousness on admission. Patients surviving hospitalization were followed-up for 2 years regarding survival. The final study population of 865 patients had the following eight different coma etiologies: poisoning (n = 329), stroke (n = 213), epilepsy (n = 113), circulatory failure (n = 60), infection (n = 56), metabolic disorder (n = 44), respiratory insufficiency (n = 33), and intracranial malignancy (n = 17). The hospital mortality rate among the 865 patients was 26.5%, varying from 0.9% for epilepsy to 71.7% for circulatory failure. The accumulated total 2-year mortality rate was 43.0%, varying from 13.7% for poisoning to 88.2% for malignancy. The level of consciousness on admission also influenced the prognosis: a GCS score of 3-6 was associated with a significantly higher hospital mortality rate than a GCS score of 7-10. The prognosis in patients presenting with non-traumatic coma is serious and depends largely on both the level of consciousness on admission and the etiology of the coma. Adding the suspected coma etiology to the routine coma grading of these emergencies may more accurately predict their prognosis. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Psychological factors and preferences for communicating prognosis in esophageal cancer patients

    NARCIS (Netherlands)

    Franssen, Sanne J.; Lagarde, Sjoerd M.; van Werven, Jochem R.; Smets, Ellen M. A.; Tran, Khe T. C.; Plukker, John Th. M.; van Lanschot, J. Jan B.; de Haes, Hanneke C. J. M.

    2009-01-01

    Objective: Discussing prognosis is often confronting and complex for cancer patients. This study investigates bow patients' psychological characteristics relate to their preferences concerning the disclosure of prognosis. Methods: One hundred and seventy-six esophageal cancer patients participated

  10. Differential Associations Between Specific Depressive Symptoms and Cardiovascular Prognosis in Patients With Stable Coronary Heart Disease

    NARCIS (Netherlands)

    Hoen, Petra W.; Whooley, Mary A.; Martens, Elisabeth J.; Na, Beeya; van Melle, Joost P.; de Jonge, Peter

    2010-01-01

    Objectives The purpose of this research was to evaluate the relationship between cognitive and somatic depressive symptoms and cardiovascular prognosis. Background Depression in patients with stable coronary heart disease (CHD) is associated with poor cardiac prognosis. Whether certain depressive

  11. Long-term prognosis for transplant-free survivors of paracetamol-induced acute liver failure

    DEFF Research Database (Denmark)

    Jepsen, P; Schmidt, L E; Larsen, F S

    2010-01-01

    The prognosis for transplant-free survivors of paracetamol-induced acute liver failure remains unknown.......The prognosis for transplant-free survivors of paracetamol-induced acute liver failure remains unknown....

  12. The differential impact of microsatellite instability as a marker of prognosis and tumour response between colon cancer and rectal cancer.

    Science.gov (United States)

    Hong, Sung Pil; Min, Byung So; Kim, Tae Il; Cheon, Jae Hee; Kim, Nam Kyu; Kim, Hoguen; Kim, Won Ho

    2012-05-01

    Microsatellite instability (MSI) is a distinct molecular phenotype of colorectal cancer related to prognosis and tumour response to 5-fluorouracil (5-FU)-based chemotherapy. We investigated the differential impact of MSI between colon and rectal cancers as a marker of prognosis and chemotherapeutic response. PCR-based MSI assay was performed on 1125 patients. Six hundred and sixty patients (58.7%) had colon cancer and 465 patients (41.3%) had rectal cancer. Among 1125 patients, 106 (9.4%) had high-frequency MSI (MSI-H) tumours. MSI-H colon cancers (13%) had distinct phenotypes including young age at diagnosis, family history of colorectal cancer, early Tumor, Node, Metastasis (TNM) stage, proximal location, poor differentiation, and high level of baseline carcinoembryonic antigen (CEA), while MSI-H rectal cancers (4.3%) showed similar clinicopathological characteristics to MSS/MSI-L tumours except for family history of colorectal cancer. MSI-H tumours were strongly correlated with longer disease free survival (DFS) (P=0.005) and overall survival (OS) (P=0.009) than MSS/MSI-L tumours in colon cancer, while these positive correlations were not observed in rectal cancers. The patients with MSS/MSI-L tumours receiving 5-FU-based chemotherapy showed good prognosis (P=0.013), but this positive association was not observed in MSI-H (P=0.104). These results support the use of MSI status as a marker of prognosis and response to 5-FU-based chemotherapy in patients with colon cancers. Further study is mandatory to evaluate the precise role of MSI in patients with rectal cancers and the effect of 5-FU-based chemotherapy in MSI-H tumours. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Ethnic Variations in Prognosis of Patients with Dementia

    DEFF Research Database (Denmark)

    Agyemang, Charles; van de Vorst, Irene E.; Koek, Huiberdina L.

    2017-01-01

    rate, ethnic minority patients with dementia did not have a worse prognosis. Given the poor prognosis of dementia, timely and targeted advance care planning is essential, particularly in ethnic minority groups who are mired by cultural barriers and where uptake of advance care planning is known...... minority groups and the ethnic Dutch population in the NetherlandsMethods: Nationwide prospective cohorts of first hospitalized dementia patients (N = 55,827) from January 1, 2000 to December 31, 2010 were constructed. Differences in short-term and long-term mortality and readmission risk following...... and the Dutch attenuated and was no longer statistically significant after further adjustment for comorbidities. There were no ethnic differences in short-term and long-term risk of death, and risk of readmission among day clinic patients. CONCLUSION: Compared with Dutch patients with a comparable comorbidity...

  14. Prognosis Driven Rehabilitation After Rotator Cuff Repair Surgery.

    Science.gov (United States)

    Kokmeyer, Dirk; Dube, Eric; Millett, Peter J

    2016-01-01

    Rehabilitation after rotator cuff repair surgery has been the focus of several clinical trials in the past decade. Many illuminate new evidence with regard to the prognosis of structural and functional success after surgery. A selective literature search was performed and personal physiotherapeutic and surgical experiences are reported. Post-operative rehabilitation parameters, namely the decision to delay or allow early range of motion after surgery, play a large role in the overall success after surgery. Using a prognosis driven rehabilitation program offers clinicians a means of prescribing optimal rehabilitation parameters while ensuring structural and functional success. This commentary aims to synthesize the evidence in a spectrum of prognostic factors to guide post-operative rehabilitation. The optimal rehabilitation program after rotator cuff repair surgery is debatable; therefore, we suggest using a spectrum of prognostic factors to determine a rehabilitation program suited to ensure structural and functional success, quickly and safely.

  15. [Usefulness of biomarkers in the prognosis of severe head injuries].

    Science.gov (United States)

    Gordillo-Escobar, E; Egea-Guerrero, J J; Rodríguez-Rodríguez, A; Murillo-Cabezas, F

    2016-03-01

    Severe head injuries have a great socioeconomic and public health impact. Despite progress in diagnosis and treatment, no sufficiently reliable predictive models have been established for developing clinical trials and promoting effective therapeutic strategies capable of improving the prognosis. In the last decades, several brain damage biomarkers have been studied as potential diagnostic and prognostic tools in traumatic brain injury. However, all of them have limitations that preclude their universalized application. The properties of the known biomarkers -both those traditionally shown to correlate with severity and prognosis, and those recently announced as promising options- should be analyzed. New studies are needed to define their properties, both isolatedly and in combined use. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  16. Alcoholism: diagnosis, prognosis, epidemiology, and burden of the disease.

    Science.gov (United States)

    Beresford, Thomas P; Wongngamnit, Narin; Temple, Benjamin A

    2014-01-01

    To the clinician, alcoholism can appear as an amorphous entity that is confusing with respect to diagnosis, treatment prognosis, and the role of the health professional, despite its high incidence and associated morbidities and mortality when unrecognized or untreated. This chapter focuses on the clinical application of current knowledge, with the aim of being useful to the practitioner in working directly with patients for whom alcoholism may or may not be an already identified problem. It briefly reviews large-scale studies and then focuses on diagnosis and prognosis assessment and decision making. Also considered are current controversies in nomenclature and the chapter ends with an economic perspective with respect to healthcare and cost to society. As the introductory chapter, the goal is to provide a context of the scope of alcoholism and attendant problems for the rest of the chapters. © 2014 Elsevier B.V. All rights reserved.

  17. Management and prognosis of atrial fibrillation in the diabetic patient

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Olesen, Jonas Bjerring

    2015-01-01

    The global burden of atrial fibrillation and diabetes mellitus (diabetes) is considerable, and prevalence rates are increasing. Diabetes is associated with an increased risk of developing atrial fibrillation; however, diabetes also influences the management and prognosis of atrial fibrillation...... and outcomes of heart failure and the success rates of both ablation and cardioversion in atrial fibrillation patients with diabetes. Finally, this article describes the association of HbA1c levels with the management and prognosis of atrial fibrillation patients........ In the following article, the authors describe the association between diabetes and atrial fibrillation; specifically, the significance of diabetes on the risk of atrial fibrillation, ischemic stroke and bleeding complications associated with anticoagulation. In addition, the authors evaluate the risks...

  18. The role of metallothionein in oncogenesis and cancer prognosis

    DEFF Research Database (Denmark)

    Pedersen, Mie Ø; Larsen, Agnete; Stoltenberg, Meredin

    2009-01-01

    The antiapoptotic, antioxidant, proliferative, and angiogenic effects of metallothionein (MT)-I+II has resulted in increased focus on their role in oncogenesis, tumor progression, therapy response, and patient prognosis. Studies have reported increased expression of MT-I+II mRNA and protein...... in various human cancers; such as breast, kidney, lung, nasopharynx, ovary, prostate, salivary gland, testes, urinary bladder, cervical, endometrial, skin carcinoma, melanoma, acute lymphoblastic leukemia (ALL), and pancreatic cancers, where MT-I+II expression is sometimes correlated to higher tumor grade....../stage, chemotherapy/radiation resistance, and poor prognosis. However, MT-I+II are downregulated in other types of tumors (e.g. hepatocellular, gastric, colorectal, central nervous system (CNS), and thyroid cancers) where MT-I+II is either inversely correlated or unrelated to mortality. Large discrepancies exist...

  19. Compliance status

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford`s compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute.

  20. Prognosis of breast cancer during pregnancy: evidence for nursing care

    OpenAIRE

    Fernandes, Ana Fátima Carvalho; Santos, Míria Conceição Lavinas; Silva, Tiago Barreto de Castro e; Galvão, Cristina Maria

    2011-01-01

    This integrative review analyzed evidence available in the literature concerning the prognosis of breast cancer during pregnancy. The following databases were used for selecting studies: PubMed, CINAHL and LILACS. A total of 240 primary studies were identified; 13 papers were included in the integrative review’s sample after reading the titles and abstracts and according to the established inclusion and exclusion criteria. There is evidence indicating that pregnancy does not worsen the evolut...

  1. Risk factors and prognosis of hypoalbuminemia in surgical septic patients

    Directory of Open Access Journals (Sweden)

    Jia-Kui Sun

    2015-10-01

    Full Text Available The aim of this study was to investigate the risk factors of hypoalbuminemia and effects of different albumin levels on the prognosis of surgical septic patients. We preformed a retrospective clinical study including 135 adult patients from September 2011 to June 2014. The albumin levels and severity markers were recorded during the first 48 h after enrollment, and logistic regression analyses were used to determine the risk factors. The outcomes of patients with different albumin levels were also compared. The acute physiology and chronic health evaluation II (APACHE II score (OR 1.786, 95% CI [1.379–2.314], P < 0.001, C-reactive protein (CRP (OR 1.016, 95% CI [1.005–1.027], P = 0.005, and blood lactate (OR 1.764, 95% CI [1.141–2.726], P = 0.011 were established as the independent risk factors of hypoalbuminemia in patients with surgical sepsis. The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21–25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis. Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome. In conclusion, APACHE II score (≥14.5, CRP (≥34.25 mg/L, and blood lactate (≥.35 mmol/L were established as the independent risk factors of hypoalbuminemia in the early stage of surgical sepsis. Patients with baseline albumin level ≤20 g/L had worse prognosis than that of albumin level ≥21 g/L. Albumin levels were negatively correlated the prognosis of surgical sepsis when below about 23 g/L.

  2. An Integrated Cross-Platform Prognosis Study on Neuroblastoma Patients

    Science.gov (United States)

    Chen, Qing-Rong; Song, Young K.; Wei, Jun S.; Bilke, Sven; Asgharzadeh, Shahab; Seeger, Robert C.; Khan, Javed

    2008-01-01

    There have been several reports about the potential for predicting prognosis of neuroblastoma patients using microarray gene expression profiling of the tumors. However these studies have revealed an apparent diversity in the identity of the genes in their predictive signatures. In order to test the contribution of the platform to this discrepancy we applied z-scoring method to minimize the impact of platform and combine gene expression profiles of neuroblastoma (NB) tumors from two different platforms, cDNA and Affymetrix. A total of 12442 genes were common to both cDNA and Affymetrix arrays in our dataset. Two-way ANOVA analysis was applied to the combined dataset for assessing the relative effect of prognosis and platform on gene expression. We found 26.6% (3307) of the genes had significant impact on survival. There was no significant impact of microarray platform on expression after application of z-scoring standardization procedure. Artificial neural network (ANN) analysis of the combined data set in a leave-one-out prediction strategy correctly predicted the outcome for 90% of the samples. Hierarchical clustering analysis using the top-ranked 160 genes showed the great separation of two clusters, and the majority of matched samples from the different platforms were clustered next to each other. The ANN classifier trained with our combined cross-platform data for these 160 genes could predict the prognosis of 102 independent test samples with 71% accuracy. Furthermore it correctly predicted the outcome for 85/102 (83%) NB patients through the leave-one-out cross validation approach. Our study showed that gene expression studies performed in different platforms could be integrated for prognosis analysis after removing variation resulting from different platforms. PMID:18598751

  3. An integrated cross-platform prognosis study on neuroblastoma patients.

    Science.gov (United States)

    Chen, Qing-Rong; Song, Young K; Wei, Jun S; Bilke, Sven; Asgharzadeh, Shahab; Seeger, Robert C; Khan, Javed

    2008-10-01

    There have been several reports about the potential for predicting prognosis of neuroblastoma patients using microarray gene expression profiling of the tumors. However these studies have revealed an apparent diversity in the identity of the genes in their predictive signatures. To test the contribution of the platform to this discrepancy we applied the z-scoring method to minimize the impact of platform and combine gene expression profiles of neuroblastoma (NB) tumors from two different platforms, cDNA and Affymetrix. A total of 12442 genes were common to both cDNA and Affymetrix arrays in our data set. Two-way ANOVA analysis was applied to the combined data set for assessing the relative effect of prognosis and platform on gene expression. We found that 26.6% (3307) of the genes had significant impact on survival. There was no significant impact of microarray platform on expression after application of z-scoring standardization procedure. Artificial neural network (ANN) analysis of the combined data set in a leave-one-out prediction strategy correctly predicted the outcome for 90% of the samples. Hierarchical clustering analysis using the top-ranked 160 genes showed the great separation of two clusters, and the majority of matched samples from the different platforms were clustered next to each other. The ANN classifier trained with our combined cross-platform data for these 160 genes could predict the prognosis of 102 independent test samples with 71% accuracy. Furthermore it correctly predicted the outcome for 85/102 (83%) NB patients through the leave-one-out cross-validation approach. Our study showed that gene expression studies performed in different platforms could be integrated for prognosis analysis after removing variation resulting from different platforms.

  4. Sleep impairment and prognosis of acute myocardial infarction

    DEFF Research Database (Denmark)

    Clark, Alice; Lange, Theis; Hallqvist, Johan

    2014-01-01

    fatality and subsequent cardiovascular events following first-time acute myocardial infarction (AMI). DESIGN: Prospective cohort study. SETTING: The Stockholm Heart Epidemiology Program, Sweden. PARTICIPANTS: There were 2,246 first-time AMI cases. MEASUREMENTS AND RESULTS: SLEEP IMPAIRMENT WAS ASSESSED...... assessment that could benefit secondary cardiovascular prevention. CITATION: Clark A, Lange T, Hallqvist J, Jennum P, Rod NH. Sleep impairment and prognosis of acute myocardial infarction: a prospective cohort study. SLEEP 2014;37(5):851-858....

  5. 30 CFR 250.414 - What must my drilling prognosis include?

    Science.gov (United States)

    2010-07-01

    ... OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations Applying for A Permit to Drill § 250.414 What must my drilling prognosis include? Your drilling prognosis... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must my drilling prognosis include? 250...

  6. Predictors of vocational prognosis after herniated lumbar disc

    DEFF Research Database (Denmark)

    Jensen, Lone Donbæk; Frost, Poul; Schiøttz-Christensen, Berit

    2011-01-01

    Study Design. A register study with 2 years of follow up. Objective. To identify predictors of an unfavorable vocational prognosis after hospital contact for herniated lumbar disc (HLD). Summary of Background Data. There is sparse information about vocational prognosis among HLD patients diagnosed...... were lumbar fusion alone HR 1.4 (CI = 1.1–1.8) and in combination with discectomy HR 1.6 (CI = 1.2–2.2) as compared with nonsurgical treatment, ethnicity other than Danish HR 1.55 (CI = 1.2–1.8), and female gender HR 1.2 (CI = 1.1–1.4). Discectomy, age, and year of inclusion were not associated...... with the outcome. Conclusion. The risk of an unfavorable vocational prognosis after hospital contact for HLD was substantial. Nonacademic work and less than 40 weeks of employment within year two before hospital contact were the strongest prognostic factors, but also lumbar fusion alone and in combination...

  7. Starting hemoglobin value predicts early phase prognosis after liver transplantation.

    Science.gov (United States)

    Jiang, G-Q; Bai, D-S; Chen, P; Fan, J; Tan, J-W; Peng, M-H

    2011-06-01

    Few studies have addressed the relationship between starting hemoglobin (Hb) value and early phase prognosis after liver transplantation (OLT). The aim of our study was to determine the relationship between the starting Hb value and the early phase prognosis after OLT by retrospectively reviewing the medical records of 102 consecutive recipients. Within this cohort, 47 patients had pulmonary complications after OLT, including eight cases of pulmonary edema, 12 cases of acute lung injury, six cases of acute respiratory distress syndrome, and 21 cases of pneumonia. According to whether the patients had pulmonary complications or not, they were categorized into the "no" versus the pulmonary complication groups. Twenty-two perioperative variables were analyzed in both groups to screen for variables that affected early pulmonary complications. A starting Hb ≤ 100 g/L was an independent risk factor for postoperative pulmonary complications. The duration to initial passage of flatus and the intensive care unit length of stay were significantly prolonged in patients with starting Hb values ≤ 100 g/L; these patients had poorer arterial blood gas analyses. The starting Hb value predicted the early phase prognosis after OLT for cirrhosis-associated hepatocellular carcinoma. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Model Comparison for Breast Cancer Prognosis Based on Clinical Data.

    Directory of Open Access Journals (Sweden)

    Sabri Boughorbel

    Full Text Available We compared the performance of several prediction techniques for breast cancer prognosis, based on AU-ROC performance (Area Under ROC for different prognosis periods. The analyzed dataset contained 1,981 patients and from an initial 25 variables, the 11 most common clinical predictors were retained. We compared eight models from a wide spectrum of predictive models, namely; Generalized Linear Model (GLM, GLM-Net, Partial Least Square (PLS, Support Vector Machines (SVM, Random Forests (RF, Neural Networks, k-Nearest Neighbors (k-NN and Boosted Trees. In order to compare these models, paired t-test was applied on the model performance differences obtained from data resampling. Random Forests, Boosted Trees, Partial Least Square and GLMNet have superior overall performance, however they are only slightly higher than the other models. The comparative analysis also allowed us to define a relative variable importance as the average of variable importance from the different models. Two sets of variables are identified from this analysis. The first includes number of positive lymph nodes, tumor size, cancer grade and estrogen receptor, all has an important influence on model predictability. The second set incudes variables related to histological parameters and treatment types. The short term vs long term contribution of the clinical variables are also analyzed from the comparative models. From the various cancer treatment plans, the combination of Chemo/Radio therapy leads to the largest impact on cancer prognosis.

  9. Potential biomarkers for the clinical prognosis of severe dengue

    Directory of Open Access Journals (Sweden)

    Mayara Marques Carneiro da Silva

    2013-09-01

    Full Text Available Currently, several assays can confirm acute dengue infection at the point-of-care. However, none of these assays can predict the severity of the disease symptoms. A prognosis test that predicts the likelihood of a dengue patient to develop a severe form of the disease could permit more efficient patient triage and treatment. We hypothesise that mRNA expression of apoptosis and innate immune response-related genes will be differentially regulated during the early stages of dengue and might predict the clinical outcome. Aiming to identify biomarkers for dengue prognosis, we extracted mRNA from the peripheral blood mononuclear cells of mild and severe dengue patients during the febrile stage of the disease to measure the expression levels of selected genes by quantitative polymerase chain reaction. The selected candidate biomarkers were previously identified by our group as differentially expressed in microarray studies. We verified that the mRNA coding for CFD, MAGED1, PSMB9, PRDX4 and FCGR3B were differentially expressed between patients who developed clinical symptoms associated with the mild type of dengue and patients who showed clinical symptoms associated with severe dengue. We suggest that this gene expression panel could putatively serve as biomarkers for the clinical prognosis of dengue haemorrhagic fever.

  10. Expression of human papillomavirus and prognosis of juvenile laryngeal papilloma.

    Science.gov (United States)

    Li, Juan; Zhang, Tian-Yu; Tan, Le-Tian; Wang, Shu-Yi; Chen, Yu-Ying; Tian, Jie-Yan; Da, Wen-Ying; He, Ping; Zhao, Ya-Ming

    2015-01-01

    The aim of this study was to evaluate the correlation between clinical behavior and expression of human papillomavirus (HPV) in patients with juvenile laryngeal papillomatosis, in an attempt to develop an effective molecular biological method to predict prognosis. We included 37 patients with juvenile laryngeal papillomatosis in the study group and 10 cases each of juvenile vocal cord polyps and juvenile normal laryngeal mucosa as the control group. We detected HPV by immunocytochemistry and in situ hybridization, identified the virus type, and measured HPV-DNA content using a computer-assisted, color pathological image-analysis system. Additionally, we conducted a retrospective study with regard to the patients' clinical history to evaluate the prognosis. The data of the 2 groups were compared and statistically analyzed, including a correlation with prognosis. In the study group, 67.3% (25/37) were positive for HPV-Ag by immunocytochemistry; whereas 53.2%, 45.8%, and 25.4% were positive for HPV6b-DNA, HPV11-DNA, and HPV6b+11-DNA, respectively, by in situ hybridization. HPV was not detected in the control group. There was a significant difference between two groups (P laryngeal papilloma (JLP) and that HPV6b-positivity can be used as an index to predict the development and outcome of JLP.

  11. Does pregnancy influence melanoma prognosis? A meta-analysis.

    Science.gov (United States)

    Kyrgidis, Athanassios; Lallas, Aimilios; Moscarella, Elvira; Longo, Caterina; Alfano, Roberto; Argenziano, Giuseppe

    2017-08-01

    The literature has not been able to conclude whether pregnancy influences the prognosis of melanoma. The aim of this study was to explore the prognosis of melanoma diagnosed during pregnancy or post partum [pregnancy-associated melanoma (PAM)] compared with melanoma in female patients who were not pregnant. We systematically searched for studies of female patients with melanoma that reported outcomes related to survival. Fifteen eligible studies were found. Overall, PAM was associated with a 17% higher mortality compared with melanoma diagnosed in female patients who were not pregnant (hazard ratio=1.17, 95% confidence interval: 1.03-1.33, P=0.02). The heterogeneity associated with this test was moderate (P=0.07; I=38%). PAM was also associated with a 50% higher recurrence rate compared with melanoma not associated with pregnancy (hazard ratio=1.50, 95% confidence interval: 1.19-1.90, Pdefinition of PAM, which is not unanimous among the studies included. Our results indicate that PAM is associated with a worse prognosis than melanoma not related to pregnancy, both in terms of overall survival and disease-free survival. On the basis of our data, we anticipate that the survival difference we report here will be further amplified with the addition of future well-carried out studies. We suggest that detection of PAM requires particular awareness by healthcare professionals.

  12. The Geriatric Nutritional Risk Index is Independently Associated with Prognosis in Patients with Critical Limb Ischemia Following Endovascular Therapy.

    Science.gov (United States)

    Shiraki, T; Iida, O; Takahara, M; Masuda, M; Okamoto, S; Ishihara, T; Nanto, K; Kanda, T; Fujita, M; Uematsu, M

    2016-08-01

    Patients with critical limb ischemia (CLI) have poor overall and limb prognosis. Although nutritional status influences overall prognosis, and the Geriatric Nutritional Risk Index (GNRI) is a widely used, simple and well established nutritional status screening method, the association between the GNRI and the overall and limb prognosis of patients with CLI following endovascular therapy (EVT) has not been explored. Clinical outcomes were retrospectively evaluated in 473 consecutive patients (74 ± 10 years; 59% male) with CLI who underwent EVT. The GNRI on admission was calculated as follows: [14.89 × albumin (g/dL)] + [41.7 × (body weight/ideal body weight)]. Cox proportional hazard analysis was performed to explore the independent association between the GNRI and mortality and major amputation. Patients (53% ambulatory, 38% wheelchair bound, and 9% bedridden) were divided into two groups based on the median GNRI: the higher group (GNRI ≥ 91.2, n = 237) and the lower group (GNRI < 91.2, n = 236). Median follow up duration after EVT was 11.3 months. Three years after EVT, the survival rate (74% in the higher GNRI, and 48% in the lower GNRI, respectively), and limb salvage rate (92% in the higher GNRI, and 84% in the lower GNRI) were significantly lower in the lower GNRI group. GNRI (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.01-1.05), along with being wheelchair bound (HR, 1.87; 95% CI 1.17-2.97; vs. ambulatory status), being bedridden (HR, 3.10; 95% CI, 1.63-2.97; vs. ambulatory status), being on hemodialysis (HR, 2.33; 95% CI, 1.49-3.64), and having chronic heart failure (HR, 2.22; 95% CI, 1.44-3.43) were the independent predictors of mortality. The GNRI (HR, 1.04; 95% CI, 1.01-1.07), being bedridden (HR, 4.15; 95% CI, 1.67-10.3; vs. ambulatory status), isolated below knee disease (HR, 2.49; 95% CI, 1.30-4.77), and hemodialysis (HR, 2.44; 95% CI, 1.23-4.85) were independently associated with major amputation. The GNRI on admission

  13. Putative risk factors for postoperative pneumonia which affects poor prognosis in patients with gastric cancer.

    Science.gov (United States)

    Kiuchi, Jun; Komatsu, Shuhei; Ichikawa, Daisuke; Kosuga, Toshiyuki; Okamoto, Kazuma; Konishi, Hirotaka; Shiozaki, Atsushi; Fujiwara, Hitoshi; Yasuda, Tomoyo; Otsuji, Eigo

    2016-10-01

    Several recent studies identified that postoperative infectious complications contribute to recurrence and poor outcome in patients with gastric cancer. This study was designed to investigate the prognostic impact of postoperative pneumonia, and to identify the putative risk factors for its occurrence. We retrospectively analyzed 1,415 consecutive patients who underwent curative gastrectomy for gastric cancer between 1997 and 2013. A total of 31 (2.2 %) patients developed postoperative pneumonia (Clavien-Dindo classification ≥II). Patients with postoperative pneumonia showed a significantly poorer prognosis than patients without (P pneumonia, univariate and multivariate analyses identified older age (≥65 years; P = 0.010; odds ratio [OR] 3.59), lower nutritious status (albumin pneumonia was shown to be associated with long-term poor outcome in patients with gastric cancer. Care should be taken for patients with clinical factors such as older age, lower nutritional status, advanced stage, concurrent hypertension, and total gastrectomy.

  14. Acute toluene intoxication--clinical presentation, management and prognosis: a prospective observational study.

    Science.gov (United States)

    Camara-Lemarroy, Carlos Rodrigo; Rodríguez-Gutiérrez, René; Monreal-Robles, Roberto; González-González, José Gerardo

    2015-08-18

    Toluene is one of the most widely abused inhaled drugs due to its acute neurologic effects including euphoria and subsequent depression. However, dangerous metabolic abnormalities are associated to acute toluene intoxication. It has been previously reported that rhabdomyolysis and acute hepatorenal injury could be hallmarks of the condition, and could constitute risk factors for poor outcomes. The objective was to describe the clinical presentation, to characterize the renal and liver abnormalities, the management and prognosis associated to acute toluene intoxication. We prospectively assessed 20 patients that were admitted to a single center's emergency department from September 2012 to June 2014 with clinical and metabolic alterations due to acute toluene intoxication. The main clinical presentation consisted of weakness associated to severe hypokalemia and acidosis. Renal glomerular injury (proteinuria) is ubiquitous. Biliary tract injury (alkaline phosphatase and gamma-glutamyl transpeptidase elevations) disproportional to hepatocellular injury is common. Rhabdomyolysis occurred in 80% of patients, probably due to hypokalemia and hypophosphatemia. There were three deaths, all female, and all associated with altered mental status, severe acidosis, hypokalemia and acute oliguric renal failure. The cause of death was in all cases due to cardiac rhythm abnormalities. The hallmarks of acute toluene intoxication are hypokalemic paralysis and metabolic acidosis. Liver injury and rhabdomyolysis are common. On admission, altered mental status, renal failure, severe acidemia and female gender (not significant in our study, but present in all three deaths) could be associated with a poor outcome, and patients with these characteristics should be considered to be treated in an intensive care unit.

  15. The Danish Nephrology Registry

    Directory of Open Access Journals (Sweden)

    Heaf J

    2016-10-01

    Full Text Available James Heaf Department of Medicine, Roskilde Hospital, University of Copenhagen, Roskilde, Denmark Aim of database: The Danish Nephrology Registry's (DNR primary function is to support the Danish public health authorities' quality control program for patients with end-stage renal disease in order to improve patient care. DNR also supplies epidemiological data to several international organizations and supports epidemiological and clinical research. Study population: The study population included patients treated with dialysis or transplantation in Denmark from January 1, 1990 to January 1, 2016, with retrospective data since 1964. Main variables: DNR registers patient data (eg, age, sex, renal diagnosis, and comorbidity, predialysis specialist treatment, details of eight dialysis modalities (three hemodialysis and five peritoneal dialysis, all transplantation courses, dialysis access at first dialysis, treatment complications, and biochemical variables. The database is complete (<1% missing data. Patients are followed until death or emigration. Descriptive data: DNR now contains 18,120 patients, and an average of 678 is added annually. Data for each transplantation course include donor details, tissue type, time to onset of graft function, and cause of graft loss. Registered complications include peritonitis in peritoneal dialysis patients, causes of peritoneal dialysis technique failure, and transplant rejections. Fifteen biochemical variables are registered, mainly describing anemia control, mineral and bone disease, nutritional and uremia status. Date and cause of death are also included. Six quality indicators are published annually, and have been associated with improvements in patient results, eg, a reduction in dialysis patient mortality, improved graft survival, and earlier referral to specialist care. Approximately, ten articles, mainly epidemiological, are published each year. Conclusion: DNR contains a complete description of end

  16. Cancer Care Coordinators to Improve Tamoxifen Persistence in Breast Cancer: How Heterogeneity in Baseline Prognosis Impacts on Cost-Effectiveness.

    Science.gov (United States)

    Nair, Nisha; Kvizhinadze, Giorgi; Blakely, Tony

    2016-12-01

    To assess the cost-effectiveness of a cancer care coordinator (CCC) in helping women with estrogen receptor positive (ER+) early breast cancer persist with tamoxifen for 5 years. We investigated the cost-effectiveness of a CCC across eight breast cancer subtypes, defined by progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER2) status, and local/regional spread. These subtypes range from excellent to poorer prognoses. The CCC helped in improving tamoxifen persistence by providing information, checking-in by phone, and "troubleshooting" concerns. We constructed a Markov macrosimulation model to estimate health gain (in quality-adjusted life-years or QALYs) and health system costs in New Zealand, compared with no CCC. Participants were modeled until death or till the age of 110 years. Some input parameters (e.g., the impact of a CCC on tamoxifen persistence) had sparse evidence. Therefore, we used estimates with generous uncertainty and conducted sensitivity analyses. The cost-effectiveness of a CCC for regional ER+/PR-/HER2+ breast cancer (worst prognosis) was NZ $23,400 (US $15,800) per QALY gained, compared with NZ $368,500 (US $248,800) for local ER+/PR+/HER2- breast cancer (best prognosis). Using a cost-effectiveness threshold of NZ $45,000 (US $30,400) per QALY, a CCC would be cost-effective only in the four subtypes with the worst prognoses. There is value in investigating cost-effectiveness by different subtypes within a disease. In this example of breast cancer, the poorer the prognosis, the greater the health gains from a CCC and the better the cost-effectiveness. Incorporating heterogeneity in a cost-utility analysis is important and can inform resource allocation decisions. It is also feasible to undertake in practice. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Management and prognosis of malignant peripheral nerve sheath tumors: The experience of the French Sarcoma Group (GSF-GETO).

    Science.gov (United States)

    Valentin, T; Le Cesne, A; Ray-Coquard, I; Italiano, A; Decanter, G; Bompas, E; Isambert, N; Thariat, J; Linassier, C; Bertucci, F; Bay, J O; Bellesoeur, A; Penel, N; Le Guellec, S; Filleron, T; Chevreau, C

    2016-03-01

    Malignant peripheral nerve sheath tumors (MPNST) are a rare subtype of soft tissue sarcoma. They can arise in irradiated fields, in patients with type 1 neurofibromatosis (NF1), or sporadically. MPNST exhibit an aggressive behaviour, and their optimal management remains controversial. An unsolved issue is whether NF1-related and sporadic forms of MPNST have a different prognosis, and should be managed differently. Adult and paediatric patients with histologically confirmed MPNST treated between 1990 and 2013 in French cancer centres of the GSF/GETO network, were included in this retrospective study. A total of 353 patients (37% with NF1 and 59% with sporadic tumours) were analysed. Median age at diagnosis was 42 years (range 1-94). The majority of tumours developed in the limbs, were deep-seated and of high grade. Two hundreds and ninety four patients underwent a curative intent surgery. Among them, 60 patients (21%) had neoadjuvant treatment (mainly chemotherapy), and 173 (59%) had adjuvant treatment (mainly radiotherapy). For operated patients, median progression free and overall survival (OS) were 26.3 months and 95.8 months, respectively. In multivariate analysis, poor-prognosis factors for OS were high grade, deep location, locally advanced stage at diagnosis, and macroscopically incomplete resection (R2). NF1 status was not negatively prognostic, except in the recurrence or metastatic setting, where NF1-related MPNST patients treated with palliative chemotherapy showed worse survival than patients with sporadic forms. To our knowledge, our series is the largest study of patients with MPNST reported to date. For operated patients, we showed a worse prognosis for NF1-related MPNST, due to different clinical features at diagnosis, more than NF1 status itself. The French sarcoma group is now conducting correlative analyses on these patients, using the latest molecular tools. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  19. Human voltage-gated proton channel hv1: a new potential biomarker for diagnosis and prognosis of colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Yifan Wang

    Full Text Available Solid tumors exist in a hypoxic microenvironment, and possess high-glycolytic metabolites. To avoid the acidosis, tumor cells must exhibit a dynamic cytosolic pH regulation mechanism(s. The voltage-gated proton channel Hv1 mediates NADPH oxidase function by compensating cellular loss of electrons with protons. Here, we showed for the first time, that Hv1 expression is increased in colorectal tumor tissues and cell lines, associated with poor prognosis. Immunohistochemistry showed that Hv1 is strongly expressed in adenocarcinomas but not or lowly expressed in normal colorectal or hyperplastic polyps. Hv1 expression in colorectal cancer is significantly associated with the tumor size, tumor classification, lymph node status, clinical stage and p53 status. High Hv1 expression is associated significantly with shorter overall and recurrence-free survival. Furthermore, real-time RT-PCR and immunocytochemistry showed that Hv1 is highly expressed in colorectal cancer cell lines, SW620, HT29, LS174T and Colo205, but not in SW480. Inhibitions of Hv1 expression and activity in the highly metastatic SW620 cells by small interfering RNA (siRNA and Zn(2+ respectively, markedly decrease the cell invasion and migration, restraint proton extrusion and the intracellular pH recovery. Our results suggest that Hv1 may be used as a potential biomarker for diagnosis and prognosis of colorectal carcinoma, and a potential target for anticancer drugs in colorectal cancer therapy.

  20. Solid Waste Management Facilities with Permits by the Iowa DNR

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — All types of facilities that handle solid waste, including: sanitary landfills, appliance demanufacturing facilities, transfer stations, land application sites,...

  1. 2012 South Carolina DNR Lidar: McCormick County

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Towill Inc. collected LiDAR for over 3,300 square miles in Calhoun, Aiken, Barnwell, Edgefield, McCormick, and Abbeville counties in South Carolina. This metadata...

  2. Solid Waste Land Applications with Permits by the Iowa DNR

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — All types of facilities that handle solid waste, including: sanitary landfills, appliance demanufacturing facilities, transfer stations, land application sites,...

  3. Prognosis of schizophrenia in persons with and without a history of cannabis use.

    Science.gov (United States)

    Manrique-Garcia, E; Zammit, S; Dalman, C; Hemmingsson, T; Andreasson, S; Allebeck, P

    2014-09-01

    The aim of the study was to determinate whether schizophrenia patients with a history of cannabis use have a different prognosis, with regards to readmission and hospital duration, compared with those without a history of cannabis use. The present investigation was a cohort study of 50,087 Swedish men with data on cannabis use at the ages of 18-20 years. A total of 357 cases of schizophrenia were identified from in-patient care and followed up from 1973 to 2007. Schizophrenia patients with a history of cannabis use had a higher median duration of first hospital episode (59 days v. 30 days). Patients with a history of cannabis use had a higher median rate of readmission (10 times v. four times). Also, total number of hospital days was higher in patients with a history of cannabis use compared with those without (547 days v. 184 days). Patients with a history of cannabis use had an increased odds of having more than 20 hospital readmissions compared with non-users [3.1, 95% confidence interval (CI) 1.3-7.3] as well as an increased odds of hospital admission lasting more than 2 years (2.4, 95% CI 1.1-7.4) after controlling for diagnosis of personality disorders, family socio-economic position, IQ score, civil status, place of residence, risky use of alcohol and use of other drugs. Patients with a history of cannabis use were less likely to have paranoid schizophrenia compared with never users (8% v. 17%) in the first admission. Schizophrenia patients with a history of cannabis use had a significantly higher burden of lifetime in-patient care than non-cannabis users. Not only does cannabis increase the risk of schizophrenia, but also our findings indicate that the course and prognosis of schizophrenia may be more severe than schizophrenia cases in general.

  4. Diagnosis and Prognosis of Neuroendocrine Tumours of the Lung by Means of High Resolution Image Analysis

    Directory of Open Access Journals (Sweden)

    Uta Jütting

    1999-01-01

    Full Text Available Neuroendocrine tumours (NET of the lung are divided in subtypes with different malignant potential. The first is the benign or low‐grade malignant tumours, well‐differentiated, called typical carcinoids (TC and the second is the high‐grade malignant tumours, poorly differentiated of small (SCLC or large cell type (LCLC. Between these tumour types lies the well‐differentiated carcinoma with a lower grade of malignancy (WDNEC. In clinical routine it is very important with regard to prognosis to distinguish patients with low malignant potential from those with higher ones. In this study 32 cases of SCLC, 13 of WDNEC and 14 of TC with a follow‐up time up to 7 years were collected. Sections 4 μm thick from paraffin embedded tissue were Feulgen stained. By means of high resolution image analysis 100 nuclei per case were randomly gathered to extract morphometric, densitometric and textural quantitative features. To investigate the ploidy status of the tumour the corrected DNA distribution was calculated. Stepwise linear discriminant analysis to differentiate the classes and Cox regression analysis for the survival time analysis were applied. Using chromatin textural and morphometric features in two two‐class discriminations, 11 of the 14 TC cases and 8 of the 13 WDNEC cases were correctly classified and 11/13 WDNEC cases and 28/32 SCLC cases, respectively. The WDNEC cases are more similar in chromatin structure to TC than to SCLC. For the survival analysis, only chromatin features were selected to differentiate patients with better and worse prognosis independent of staging and tumour type.

  5. Predictive significance of HMGCS2 for prognosis in resected Chinese esophageal squamous cell carcinoma patients

    Directory of Open Access Journals (Sweden)

    Tang H

    2017-05-01

    Full Text Available Hong Tang,1,* Yufeng Wu,1,* Yanru Qin,2 Hongyan Wang,1 Yongxu Jia,2 Shujun Yang,1 Suxia Luo,1 Qiming Wang11Department of Internal Medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 2Department of Clinical Oncology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, Hong Kong, China*These authors contributed equally to this workAbstract: Despite a series of attempts during the last decades, the prognosis of esophageal squamous cell carcinoma (ESCC remains poor. Different responses of individual tumors encouraged us to look for valuable prognostic markers. As a key regulator controlling the anabolic ketogenic pathway, 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2 has been reported to play a crucial role in colorectal cancer and prostate cancer. However, its importance to ESCC has not been verified. Therefore, a large cohort retrospective study was planned, to investigate the relationship between HMGCS2 expression and ESCC prognosis. By adopting real-time polymerase chain reaction (PCR and immunohistochemical (IHC staining, HMGCS2 expression was examined in tissues of 300 ESCC patients with complete resection. Besides, the association between HMGCS2 protein expression and survival time was evaluated through chi-square test and Kaplan–Meier analysis. With the use of Cox-proportional hazards model, the prognostic impact of clinicopathologic variables and biomarker expression was evaluated. Compared with their non-tumor counterparts, HMGCS2 downregulation occurred in 65.5% and 37.6% of primary ESCCs on the mRNA and protein levels (P<0.001, respectively. On the protein level, HMGCS2 expression was associated with tumor cell differentiation (P=0.003, pT status (P=0.006, and TNM stage (P=0.010. In the down-HMGCS2 expression group, the 5-year overall survival (OS and relapse-free survival (RFS are poorer than those in the normal expression group (19 months vs 24 months, P=0.002; 13 months vs 17

  6. Effects of the reappearance of primitive reflexes on eating function and prognosis.

    Science.gov (United States)

    Hobo, Kimiko; Kawase, Junko; Tamura, Fumiyo; Groher, Michael; Kikutani, Takeshi; Sunakawa, Hajime

    2014-01-01

    Primitive reflexes can reappear with diseases of the brain, particularly those affecting the frontal lobes. Most studies on primitive reflexes have reported an association between such reflexes and brain damage, and the clinical symptoms of dementia. These reflexes can also be present during eating; however, their effects on eating function are difficult to evaluate. The purpose of the present study was to identify the frequency at which primitive reflexes reappear in elderly people, and to determine the effects that such reflexes have on eating function, nutritional status and prognosis. We followed 121 nursing home residents for 6 months. All patients required long-term care and were examined for the presence of a sucking reflex, snout reflex and phasic bite reflex for baseline measures. Demographic characteristics, physical and cognitive function, and nutritional status were obtained from chart reviews, interviews with nurses, and a brief physical examination at baseline and incidence of aspiration pneumonia during the study period. The sucking reflex was confirmed in 31 patients (25.6%), snout reflex in 15 patients (12.3%) and phasic bite reflex in 28 patients (23.1%). One or more of these reflexes was identified in 38 patients (31.4%). A relationship between the presence of a primitive reflex and nutritional status was shown. An association with the presence of these reflexes and the development of aspiration pneumonia during 6 months was also confirmed. The appearance of primitive reflexes appears to be associated with the risk of malnutrition and developing aspiration pneumonia. © 2013 Japan Geriatrics Society.

  7. Risk, characteristics, and prognosis of breast cancer after Hodgkin's lymphoma.

    Science.gov (United States)

    Veit-Rubin, Nikolaus; Rapiti, Elisabetta; Usel, Massimo; Benhamou, Simone; Vinh-Hung, Vincent; Vlastos, Georges; Bouchardy, Christine

    2012-01-01

    To assess breast cancer (BC) risk after Hodgkin's lymphoma (HL) and compare characteristics, risk of second BC, and prognosis of patients with these BCs with patients with first primary BC. We considered all 9,620 women with HL recorded in the Surveillance, Epidemiology and End Results dataset in 1973-2007. We calculated age-period standardized incidence ratios of BC. We compared patient, tumor, and treatment characteristics, risk of second BC, and prognosis between patients with BC after HL (n = 316) and patients with other BCs occurring during the same period (n = 450,413) using logistic regression and Cox models adjusted for confounders. HL patients had a 2.4-fold higher risk for developing BC (95% confidence interval [CI], 2.2-2.7) than the general population. Age at HL diagnosis and radiation therapy influenced this risk. Compared with first primary BCs, BCs after HL were diagnosed at a younger age, at an earlier stage, were less frequently hormone receptor positive, were located more frequently in external quadrants, and were less frequently treated using radiotherapy. These patients had a higher risk (adjusted hazard ratio [HR], 2.85; 95% CI, 1.79-4.53) for developing a second BC and had a higher BC mortality risk (adjusted HR, 1.36; 95% CI, 1.05-1.76). The higher mortality risk was only partly explained by the higher occurrence rate of a second BC. HL survivors have a higher risk for developing BC, their BCs are more aggressive, they have a higher risk for a second BC occurrence, and they have a poorer prognosis. Guidelines of care should be adapted to decrease the impact of BC in these high-risk patients.

  8. Number of tumor foci predicts prognosis in papillary thyroid cancer.

    Science.gov (United States)

    Qu, Ning; Zhang, Ling; Ji, Qing-hai; Zhu, Yong-xue; Wang, Zhuo-ying; Shen, Qiang; Wang, Yu; Li, Duan-shu

    2014-12-04

    Papillary thyroid cancer (PTC) often presents as multifocal. However, the association of multifocality with poor prognosis remains controversial. The aim of this retrospective study was to identify the characteristics of PTC with multiple foci and to evaluate the association between multifocality and prognosis. We reviewed the medical records of 496 patients who underwent total thyroidectomy for PTC. Patients were classified as G1 (1 tumor focus), G2 (2 foci), and G3 (3 or more foci). We analyzed the clinicopathological features and clinical outcomes in each classification. A Cox regression model was used to assess the relationship between multifocality and recurrence or cancer mortality. The G1, G2 and G3 groups included 287, 141 and 68 patients, respectively. The mean age was 47.1±16.1 yr in G1, 41.1±18.4 yr in G2, and 35.5±15.9 yr in G3 and differed significantly among the 3 groups (p=0.001). The proportion of extrathyroidal extension, central lymph node metastasis (CLNM), and lateral lymph node metastasis (LLNM) in the G1 to G3 groups increased with increasing number of tumor foci. The Kaplan-Meier curves revealed that G3 had the shortest recurrence-free survival, and differences were significant among the 3 groups (p=0.001, Log Rank test). Furthermore, cancer-specific survival rates decreased significantly with increasing number of tumor foci (p=0.041). Independent predictors of recurrence by multivariate Cox analysis included >3 tumor foci [HR 2.60, 95% confidence interval (CI) 1.53-4.39, p=0.001] and extrathyroidal extension (HR 1.95, CI 1.12-3.38, p=0.018). An increase in the number of tumors is associated with a tendency toward more aggressive features and predicts poor prognosis in PTC.

  9. [Hereditary vascular malformations: classification, symptoms, diagnostics and prognosis].

    Science.gov (United States)

    Wohlgemuth, W A; Wölfle, K; Schuster, T; Schlimok, G; Bohndorf, K

    2012-10-01

    The understanding of hereditary vascular anomalies was hampered for a long time by unclear und unspecific terminology. Today, the classification of the International Society for the Study of Vascular Anomalies (ISSVA) differentiates between vascular tumours (mostly infantile haemangioma) with active endothelial proliferation and regression and vascular malformations (VM), which are defects of the vascular morphogenesis and are distinguished in predominantly venous, arterial, capillary, lymphatic, arteriovenous or combined VM. Symptoms are pain, swelling and restricted movement, accompanied by skin signs like dys-plastic veins and capillary VM (naevus flammeus). Thrombophlebitis and chronic venous insufficiency are related to venous VM. Arteriovenous VM are progressive and can cause ischaemic necroses, in rare cases even a high-output cardiac fail-ure. Lymphatic VM lead to localised swelling, in the long run often to recurrent erysipelas and lymphorroea. Primary imaging is provided by -ul-trasound including flow measurements. Mor-phol-ogy and organ involvement is best delineated by magnetic resonance imaging. Phlebography is used to image deep venous system anomalies and is always accompanied by varicography of the dysplastic parts of the venous VM. Digital subtraction angiography is performed to demon-strate the flow pattern in feeding arteries, the nidus and the drainage veins of arteriovenous VM. Besides size and localisation the prognosis of the patients is determined by the pressure (the high-er the pressure, the poorer the prognosis) and the flow rate (the higher the flow rate, the poorer the prognosis) in the VM. Diagnosis and treatment of these rare diseases are best performed in special-ised, interdisciplinary centres. © Georg Thieme Verlag KG Stuttgart ˙ New York.

  10. IMP3 Predicts Invasion and Prognosis in Human Lung Adenocarcinoma.

    Science.gov (United States)

    Yan, Jinhai; Wei, Qingzhu; Jian, Wenjing; Qiu, Bo; Wen, Jing; Liu, Jianghuan; Fu, Bo; Zhou, Xinhua; Zhao, Tong

    2016-02-01

    Insulin-like growth factor II mRNA-binding protein 3 (IMP3) is an oncofetal protein associated with several aggressive and advanced cancers. Whether IMP3 can predict invasion, and prognosis in patients with human lung adenocarcinoma (LAC) remains unclear. Ninety-five LAC and 75 non-tumor lung tissue samples were included in a tissue microarray. IMP3 expression was assessed by immunohistochemical examination. Correlation between IMP3 expression levels, clinicopathological characteristics, and overall prognosis was evaluated. In a separate in vitro study, RNA interference method was applied for knockdown of IMP3 gene in human LAC cell lines. Invasive potential of LAC cells was then evaluated by transwell migration assay. IMP3 immunoreactivity was observed in 39 out of 95 (41.1 %) LAC patients, but not in non-tumor lung tissues. IMP3 expression levels were closely associated with histological grade (P = 0.037), TNM stage (P = 0.034), and lymph node metastasis (P = 0.011). Patients presenting with positive IMP3 expression (P = 0.000), an advanced TNM stage (P = 0.000), and lymph node metastasis (P = 0.001) had a worse overall survival, compared to those lacking these characteristics. Both IMP3 expression (hazard ratio [HR], 2.310; 95 % confidence interval [CI] 1.192-4.476; P = 0.013) and TNM stage (HR 2.338; 95 % CI 1.393-3.925; P = 0.001) were independent predictors of poor prognosis. The invasive potential of LAC cells was significantly inhibited by IMP3 knockdown. IMP3 appears to play an important role in tumor invasion in patients with LAC and may serve as a useful prognostic biomarker in these patients.

  11. Novelties in COPD prognosis: evolution of survival indexes.

    Science.gov (United States)

    Sferrazza Papa, G F; Battaglia, S; Solidoro, P

    2015-04-01

    Despite several techniques, such as non-invasive ventilation (NIV), have improved the outcome of the acute exacerbation, COPD remains affected by poor prognosis in the medium and long term. Moreover, the task of predicting prognosis remains a major challenge for respiratory physicians. In order to overcome this limitation, several indexes have been proposed to assess the COPD patient in his/her complexity. The rationale is that, by using numerical indexes physicians may improve their clinical judgment to tailor and share therapeutical choices, i.e. referring the patient for surgery or lung transplantation. On this ground, Almagro et al. recently proposed the CODEX index, as the latest evolution of the BODE through the BODEx (which takes into account exacerbations), by adding the evaluation of comorbidity to the severity of dyspnoea, airway obstruction and history of exacerbations. As afore mentioned, treatment of COPD with respiratory acidosis has been revolutionized by the use of NIV, by reducing the need for intubation and in-hospital mortality of patients with severe COPD exacerbations. Nowadays, new promising techniques, such as minimally invasive extracorporeal devices, may hasten the clearance of carbon dioxide and reduce the work of breathing and the need for ventilation of COPD patients. These techniques still lack of randomized controlled studies; however, the approach of extracorporeal CO2 removal has the potential to further improve the prognosis of severe exacerbation of COPD patients. In this paper we discuss the prognostic evaluation of patients affected by COPD through the evolution of dedicated indexes, which mirror the focus of current research on the disease.

  12. Osteoprotegerin concentrations and prognosis in acute ischaemic stroke

    DEFF Research Database (Denmark)

    Jensen, Jesper Khédri; Ueland, T; Gullestad, L

    2010-01-01

    Abstract. Jensen JK, Ueland T, Atar D, Gullestad L, Mickley H, Aukrust P, Januzzi JL (Odense University Hospital, Denmark; Rikshospitalet, Oslo, Norway; Massachusetts General Hospital, USA). Osteoprotegerin concentrations and prognosis in acute ischaemic stroke. J Intern Med 2009; doi: 10.1111/j.......1365-2796.2009.02163.x.Aim. Concentrations of osteoprotegerin (OPG) have been associated with the presence of vascular and cardiovascular diseases, but the knowledge of this marker in the setting of ischaemic stroke is limited. Methods and results. In 244 patients with acute ischaemic stroke (age: 69...

  13. Breast cancer prognosis by combinatorial analysis of gene expression data.

    Science.gov (United States)

    Alexe, Gabriela; Alexe, Sorin; Axelrod, David E; Bonates, Tibérius O; Lozina, Irina I; Reiss, Michael; Hammer, Peter L

    2006-01-01

    The potential of applying data analysis tools to microarray data for diagnosis and prognosis is illustrated on the recent breast cancer dataset of van 't Veer and coworkers. We re-examine that dataset using the novel technique of logical analysis of data (LAD), with the double objective of discovering patterns characteristic for cases with good or poor outcome, using them for accurate and justifiable predictions; and deriving novel information about the role of genes, the existence of special classes of cases, and other factors. Data were analyzed using the combinatorics and optimization-based method of LAD, recently shown to provide highly accurate diagnostic and prognostic systems in cardiology, cancer proteomics, hematology, pulmonology, and other disciplines. LAD identified a subset of 17 of the 25,000 genes, capable of fully distinguishing between patients with poor, respectively good prognoses. An extensive list of 'patterns' or 'combinatorial biomarkers' (that is, combinations of genes and limitations on their expression levels) was generated, and 40 patterns were used to create a prognostic system, shown to have 100% and 92.9% weighted accuracy on the training and test sets, respectively. The prognostic system uses fewer genes than other methods, and has similar or better accuracy than those reported in other studies. Out of the 17 genes identified by LAD, three (respectively, five) were shown to play a significant role in determining poor (respectively, good) prognosis. Two new classes of patients (described by similar sets of covering patterns, gene expression ranges, and clinical features) were discovered. As a by-product of the study, it is shown that the training and the test sets of van 't Veer have differing characteristics. The study shows that LAD provides an accurate and fully explanatory prognostic system for breast cancer using genomic data (that is, a system that, in addition to predicting good or poor prognosis, provides an individualized

  14. Parametric Modeling of Localized Melanoma Prognosis and Outcome

    Science.gov (United States)

    Ding, Shouluan; Soong, Seng-jaw; Lin, Hui-Yi; Desmond, Renee; Balch, Charles M.

    2010-01-01

    This investigation explored the most suitable parametric model for melanoma prognosis and compared it with the Cox model. Cox-Snell residuals and survival function plots were applied to assess the generalized gamma (GG) model was the best fit parametric model for the data. The GG model is a powerful alternative to the Cox model in prognostic modeling. The GG model offers an advantage of explicit and flexible individualized hazard functions over the Cox model, and provides a clinically useful risk assessment over time to aid clinicians in formulating patient treatment and follow-up plans and for clinical trial design and analysis. PMID:20183437

  15. Deregulated HOXB7 expression predicts poor prognosis of patients with malignancies of digestive system.

    Science.gov (United States)

    Liu, Fang-Teng; Chen, Han-Min; Xiong, Ying; Zhu, Zheng-Ming

    2017-07-26

    Numerous studies have investigated the relationship between deregulated HOXB7 expression with the clinical outcome in patients with digestive stem cancers, HOXB7 has showed negative impacts but with varying levels. We aimed to comprehensively evaluate the prediction and prognostic value of HOXB7 in digestive stem cancers. Electronic databases updated to December 1, 2016 were retrieved to collect relevant eligible studies to quantitatively explore the potential roles of HOXB7 as a prognostic indicator in digestive system cancers. A total of 9 studies (n = 1298 patients) was included in this synthetical meta-analysis. The pooled hazard ratios suggested that high expression of HOXB7 protein was associated with poor prognosis of OS in patients with digestive system cancers (HR = 1.97, 95% CI: 1.65-2.28, p= 0.000), and HOXB7 protein could act as an independent prognostic factor for predicting OS of patients with digestive system cancers (HR: 2.02, 95% CI: 1.69-2.36, p = 0.000). Statistical significance was also observed in subgroup meta-analysis based on the cancer type, histology type, country, sample size and publication date. Furthermore, we examined the correlations between HOXB7 protein and clinicopathological features. It showed that altered expression of HOXB7 protein was correlated with tumor invasion (p = 0.000), lymph node status (p = 0.000), distant metastasis (p = 0.001) and TNM stage (p = 0.000). However, the expression of HOXB7 protein was not associated with age (p = 0.64), gender (p = 0.40) or levels of differentiation (p = 0.19). High expression of HOXB7 protein was associated with poor prognosis of patients with digestive system cancers, as well as clinicopathologic characteristics, including the tumor invasion, lymph node status, distant metastasis and TNM stage. The expression of HOXB7 protein was not associated with age, gender or levels of differentiation. HOXB7 protein expression level in tumor tissue might serve as a novel prognostic marker for

  16. Clinical characteristics and vital and functional prognosis of out-of-hospital cardiac arrest survivors admitted to five cardiac intensive care units.

    Science.gov (United States)

    Loma-Osorio, Pablo; Aboal, Jaime; Sanz, Maria; Caballero, Ángel; Vila, Montserrat; Lorente, Victoria; Sánchez-Salado, José Carlos; Sionis, Alessandro; Curós, Antoni; Lidón, Rosa-Maria

    2013-08-01

    Survivors of out-of-hospital cardiac arrest constitute an increasing patient population in cardiac intensive care units. Our aim was to characterize these patients and determine their vital and functional prognosis in accordance with the latest evidence. A multicenter, prospective register was constructed with information from patients admitted to 5 cardiac intensive care units from January 2010 through January 2012 with a diagnosis of resuscitated out-of-hospital cardiac arrest. The information included clinical status, cardiac arrest characteristics, in-hospital course, and vital and neurologic status at discharge and at 6 months. A total of 204 patients were included. In 64% of cases, a first shockable rhythm was identified. The time to return of spontaneous circulation was 29 (18) min. An etiologic diagnosis was made in 86% of patients; 44% were discharged with no neurologic sequelae; 40% died in the hospital. At 6 months, 79% of survivors at discharge were still alive and neurologically intact with minimal sequelae. Short resuscitation time, first recorded rhythm, pH on admission >7.1, absence of shock, and use of hypothermia were the independent variables associated with a good neurologic prognosis. Half the patients who recovered from out-of-hospital cardiac arrest had good neurologic prognosis at discharge, and 79% of survivors were alive and neurologically intact after 6 months of follow-up. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  17. Patient and professional dissatisfaction: a literature review of prognosis communication related to hospital settings.

    Science.gov (United States)

    Bail, Kasia

    2008-06-01

    An essential element of health care decision making is related to 'what is going to happen next' (or prognosis). Patients are often dissatisfied with prognosis communication (Chan & Woodruff 1997; Kirk, Kirk & Kristjanson 2004). Yet there is a paucity of literature on the contributing factors and resulting consequences of prognosis communication. A thematic analysis on prognosis communication applicable to hospital wards was employed. The thematic analysis revealed that patients are dissatisfied with prognosis communication, and this dissatisfaction is related to information giving, understanding, and decision making. There is also evidence to suggest that health care professionals are also distressed and dissatisfied with the current use of prognosis in health care delivery, and this relates to hope, role discrepancies, and emotional labour. Factors identified in the literature as contributing to the current use of prognosis included difficulty with the definition, estimation and communication of prognosis. The contributing factor of the medical model upon prognosis communication is discussed. The suggestion is made that if both consumers and providers are dissatisfied with current prognosis communication, then there should be sufficient relevant research funded, undertaken and utilised to inform training, policy changes and individual clinical practice reflection in the movement towards more patient-focussed, sustainable health care.

  18. [Prognosis in pediatric traumatic brain injury. A dynamic cohort study].

    Science.gov (United States)

    Vázquez-Solís, María G; Villa-Manzano, Alberto I; Sánchez-Mosco, Dalia I; Vargas-Lares, José de Jesús; Plascencia-Fernández, Irma

    2013-01-01

    traumatic brain injury is a main cause of hospital admission and death in children. Our objective was to identify prognostic factors of pediatric traumatic brain injury. this was a dynamic cohort study of traumatic brain injury with 6 months follow-up. The exposition was: mild or moderate/severe traumatic brain injury, searching for prognosis (morbidity-mortality and decreased Glasgow scale). Relative risk and logistic regression was estimated for prognostic factors. we evaluated 440 patients with mild traumatic brain injury and 98 with moderate/severe traumatic brain injury. Morbidity for mild traumatic brain injury was 1 %; for moderate/severe traumatic brain injury, 5 %. There were no deaths. Prognostic factors for moderate/severe traumatic brain injury were associated injuries (RR = 133), fractures (RR = 60), street accidents (RR = 17), night time accidents (RR = 2.3) and weekend accidents (RR = 2). Decreased Glasgow scale was found in 9 %, having as prognostic factors: visible injuries (RR = 3), grown-up supervision (RR = 2.5) and time of progress (RR = 1.6). there should be a prognosis established based on kinetic energy of the injury and not only with Glasgow Scale.

  19. Inline quality prognosis of material condition induced process variations

    Science.gov (United States)

    Heinzler, Felix A.; Wortberg, Johannes

    2014-05-01

    The main variation in a good quality production are induced by material condition. Processing technical polymers like PA, ABS or PBT possible influences are residual moisture conditions of the material or minor variations of raw material charges. Small changes in the material properties are difficult to detect at first quality controls and can be within the property tolerances. But even these small differences cause defects. The effects range from viscosity variations to varied crystalline properties. The influence of material properties on the processing have to be detected inline and combined with material analysis to a quality prognosis. The equipped sensors at injection molding machines enable an adequate process performance. The recently available solutions for power consumption monitoring enhance the available process control opportunities. Because of the high process speed of injection molding machines, the required sampling rate has to be minimal 500 Hz. A setup of high bandwidth data processing linked to the machine control enables precise characterization of the production. Identified index numbers, energetic data and characteristic development of measured process figures enable a high resolution detection of material induced variations. This prognosis enables inline classification of the produced parts and a compensation by correlating quality requirements with adjusted filling and packing parameters.

  20. Multivariate Exponential Survival Trees And Their Application to Tooth Prognosis

    Science.gov (United States)

    Fan, Juanjuan; Nunn, Martha E.; Su, Xiaogang

    2009-01-01

    SUMMARY This paper is concerned with developing rules for assignment of tooth prognosis based on actual tooth loss in the VA Dental Longitudinal Study. It is also of interest to rank the relative importance of various clinical factors for tooth loss. A multivariate survival tree procedure is proposed. The procedure is built on a parametric exponential frailty model, which leads to greater computational efficiency. We adopted the goodness-of-split pruning algorithm of LeBlanc and Crowley (1993) to determine the best tree size. In addition, the variable importance method is extended to trees grown by goodness-of-fit using an algorithm similar to the random forest procedure in Breiman (2001). Simulation studies for assessing the proposed tree and variable importance methods are presented. To limit the final number of meaningful prognostic groups, an amalgamation algorithm is employed to merge terminal nodes that are homogenous in tooth survival. The resulting prognosis rules and variable importance rankings seem to offer simple yet clear and insightful interpretations. PMID:21709804

  1. Prognosis in adult patients with idiopathic pulmonary hemosiderosis.

    Science.gov (United States)

    Miwa, Seiichi; Imokawa, Shiro; Kato, Masato; Ide, Kyotaro; Uchiyama, Hiroshi; Yokomura, Koushi; Suda, Takafumi; Shirai, Masahiro; Hayakawa, Hiroshi; Chida, Kingo

    2011-01-01

    Diffuse alveolar hemorrhage (DAH) of unknown cause has been characterized as idiopathic pulmonary hemosiderosis (IPH). IPH is a rare disease, which has a high prevalence in children and shows a poor prognosis. However, in adults, since there are few reports about collective cases, the details remain to be determined. Between January 2003 and June 2008, consecutive adult patients strictly defined as unknown cause DAH by chest images, fiberoptic bronchoscopy, autoantibody testing, and exclusion of systemic disease were enrolled. We investigated the clinical characterization and course of the enrolled patients. Nine patients were included. All patients were middle-aged men (56.1 ± 4.2 year-old) with sudden onset. They did not present with anemia (the hemoglobin level was 13.9 ± 0.5 g/dL) despite the quantity of bleeding. In bronchoalveolar-lavage fluid analysis, the cell count was increased (7.6 ± 1.6×10(5) cells/mL) with neutorophilia (33.3 ± 13.3%). The illness resolved within 2 weeks with or without corticosteroid therapy. All of the patients were alive without recurrence during the follow-up period (45.2 ± 6.2 months) after diagnosis. Adult IPH patients showed good prognosis. However, the present patients are clinically slightly different from the previously characterized IPH.

  2. Temporal trends in the incidence and prognosis of aortic stenosis

    DEFF Research Database (Denmark)

    Martinsson, Andreas; Li, Xinjun; Andersson, Charlotte

    2015-01-01

    BACKGROUND: The aging of Western populations is expected to result in increasing occurrence of aortic stenosis (AS), but data are limited. Recent studies have reported declining incidence and mortality for other major heart diseases. We aimed to study temporal trends in the incidence and prognosi...... that improved risk factor control and cardiovascular therapy, combined with increased use of aortic valve replacement in the elderly and reduced perioperative mortality in aortic valve replacement, have translated into favorable effects for AS.......BACKGROUND: The aging of Western populations is expected to result in increasing occurrence of aortic stenosis (AS), but data are limited. Recent studies have reported declining incidence and mortality for other major heart diseases. We aimed to study temporal trends in the incidence and prognosis......-cause and cardiovascular-related mortality. The age-adjusted incidence of AS in Sweden declined from 15.0 to 11.4 in men and 9.8 to 7.1 in women per 100 000 between 1989 to 1991 and 2007 to 2009, and the median age at diagnosis increased by 4 years for both men and women. The age- and sex-adjusted relative risk of 1...

  3. Operative center of the geophysical prognosis in Izmiran

    Directory of Open Access Journals (Sweden)

    A. V. Belov

    2005-11-01

    Full Text Available IZMIRAN was founded about 65 years ago with one of the goals of carrying out geomagnetic prognoses. More or less, this activity has been developed during its entire history, but about 6 years ago this aim became sufficiently feasible due to the organization of the Forecasting Center of helio-geo-physical conditions. This Center appeared in response to new technologies, numerous new data available and new social demand. The Center uses the extended experimental basis of IZMIRAN and all available Internet sources. Its main tasks consist of continuous monitoring of the processes at the Sun and in the near-Earth environment, development of different kinds of prognoses and delivering them to users. The main product is a short-term (1-6 days prognosis of geomagnetic activity (mainly daily Ap-index and maximum Kp-index, a long-term (from weeks to years prognosis and detailed forecasting on the special fixed dates. Among its consumers it is worth mentioning the Russian Space Agency, the Russian Ministry of Civil Defense, Emergencies and Disaster Relief, railway departments, a number of medical institutions, and mass media. In this work we discuss some activities of the Center, along with presenting several examples of the real influence of geomagnetic disturbances on different sides of human activity. Our six years of experience show a growing interest in prognoses of this type and this tendency seems to be retained.

  4. Claudin-1 correlates with poor prognosis in lung adenocarcinoma.

    Science.gov (United States)

    Sun, Bing-Sheng; Yao, Yi-Qun; Pei, Bao-Xiang; Zhang, Zhen-Fa; Wang, Chang-Li

    2016-09-01

    This study was conducted to investigate the clinical significance of claudin-1 (CLDN1) expression in patients with lung adenocarcinoma. We examined CLDN1 protein expression by immunohistochemistry in a tissue microarray from 258 patients with lung adenocarcinoma. We investigated messenger ribonucleic acid (mRNA) expression in H358 (formerly bronchioloalveolar carcinoma) and lung adenocarcinoma cell lines (A549) by real-time reverse transcriptase-polymerase chain reaction. Multivariate analysis showed that prognostic factors for lung adenocarcinoma were histologic type, CLDN1, T stage and N stage. Patients with positive CLDN1 expression had a poorer prognosis than patients with negative CLDN1 expression. CLDN1 expression was correlated with Ras and epidermal growth factor receptor (EGFR) expression. Patients with positive expressions of both CLDN1 and Ras/EGFR had a poorer prognosis than patients with CLDN1 (+) Ras/EGFR(-) or CLDN1 (-) Ras/EGFR(+) and patients with negative expressions of both CLDN1 and Ras/EGFR. CLDN1 mRNA expression was lower in the H358 compared with the lung adenocarcinoma cell line (A549). The combination of CLDN1 and Ras/EGFR is a valuable independent prognostic predictor for lung adenocarcinoma. © 2016 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

  5. Operative center of the geophysical prognosis in Izmiran

    Science.gov (United States)

    Belov, A. V.; Gaidash, S. P.; Kanonidi, K. D.; Kanonidi, K. K.; Kuznetsov, V. D.; Eroshenko, E. A.

    2005-11-01

    IZMIRAN was founded about 65 years ago with one of the goals of carrying out geomagnetic prognoses. More or less, this activity has been developed during its entire history, but about 6 years ago this aim became sufficiently feasible due to the organization of the Forecasting Center of helio-geo-physical conditions. This Center appeared in response to new technologies, numerous new data available and new social demand. The Center uses the extended experimental basis of IZMIRAN and all available Internet sources. Its main tasks consist of continuous monitoring of the processes at the Sun and in the near-Earth environment, development of different kinds of prognoses and delivering them to users. The main product is a short-term (1-6 days) prognosis of geomagnetic activity (mainly daily Ap-index and maximum Kp-index), a long-term (from weeks to years) prognosis and detailed forecasting on the special fixed dates. Among its consumers it is worth mentioning the Russian Space Agency, the Russian Ministry of Civil Defense, Emergencies and Disaster Relief, railway departments, a number of medical institutions, and mass media. In this work we discuss some activities of the Center, along with presenting several examples of the real influence of geomagnetic disturbances on different sides of human activity. Our six years of experience show a growing interest in prognoses of this type and this tendency seems to be retained.

  6. 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.

  7. Correspondence: predictors of prognosis in neonates with congenital diaphragmatic hernia

    Directory of Open Access Journals (Sweden)

    Jogender Kumar

    2017-04-01

    Full Text Available Dear Editor,We read with great interest the article by Granjo Morais et al. published in the latest issue of your journal and found it very useful. First, we would like to commend the authors for their endeavor. We have the following comments regarding the methodological issues and unit practices in the management of congenital diaphragmatic hernia (CDH which require further clarification by the authors for the benefit of the readers of JPNIM. This corrispondence refers to the following article:Granjo Morais C, Rocha G, Flor-de-Lima F, Éden P, Fragoso AC, Guimarães H. Predictors of prognosis in neonates with congenital diaphragmatic hernia: experience of 12 years. J Pediatr Neonat Individual Med. 2017;6(1:e060126. doi: 10.7363/060126.Authors’ reply can be found in the following article:Granjo Morais C, Rocha G, Flor-de-Lima F, Éden P, Fragoso AC, Guimarães H. Correspondence: predictors of prognosis in neonates with congenital diaphragmatic hernia – Authors’ reply. J Pediatr Neonat Individual Med. 2017;6(1:e060140. doi: 10.7363/060140.

  8. Karyotype complexity and prognosis in acute myeloid leukemia.

    Science.gov (United States)

    Stölzel, F; Mohr, B; Kramer, M; Oelschlägel, U; Bochtler, T; Berdel, W E; Kaufmann, M; Baldus, C D; Schäfer-Eckart, K; Stuhlmann, R; Einsele, H; Krause, S W; Serve, H; Hänel, M; Herbst, R; Neubauer, A; Sohlbach, K; Mayer, J; Middeke, J M; Platzbecker, U; Schaich, M; Krämer, A; Röllig, C; Schetelig, J; Bornhäuser, M; Ehninger, G

    2016-01-15

    A complex aberrant karyotype consisting of multiple unrelated cytogenetic abnormalities is associated with poor prognosis in patients with acute myeloid leukemia (AML). The European Leukemia Net classification and the UK Medical Research Council recommendation provide prognostic categories that differ in the definition of unbalanced aberrations as well as the number of single aberrations. The aim of this study on 3526 AML patients was to redefine and validate a cutoff for karyotype complexity in AML with regard to adverse prognosis. Our study demonstrated that (1) patients with a pure hyperdiploid karyotype have an adverse risk irrespective of the number of chromosomal gains, (2) patients with translocation t(9;11)(p21∼22;q23) have an intermediate risk independent of the number of additional aberrations, (3) patients with ⩾4 abnormalities have an adverse risk per se and (4) patients with three aberrations in the absence of abnormalities of strong influence (hyperdiploid karyotype, t(9;11)(p21∼22;q23), CBF-AML, unique adverse-risk aberrations) have borderline intermediate/adverse risk with a reduced overall survival compared with patients with a normal karyotype.

  9. [Expository models relative to prognosis in the Corpus Hippocraticum. (Prorrhetic 2, Diseases 1-3, Internal disease, Prognosis)].

    Science.gov (United States)

    Fausti, Daniela

    2005-01-01

    In the Corpus Hippocraticum, prognosis and therapy are developed through observation of signs, as prescribed by Prognostic and Prorrhetic 2; the signs considered most significant are non-verbal signs, i.e. clues, because they cannot be voluntarily altered and the sign provides a hypothetical indication (semiotic abduction). In the examined texts the attention is devoted to the use of these signs with prognostic and therapeutic indication value and we can observe that the inferential scheme tends to aphoristic forms because the doctors need quick reference books, such as Coan Prognoses.

  10. Clinical features, tumor biology, and prognosis associated with MYC rearrangement and Myc overexpression in diffuse large B-cell lymphoma patients treated with rituximab-CHOP

    DEFF Research Database (Denmark)

    Xu-Monette, Zijun Y; Dabaja, Bouthaina S; Wang, Xiaoxiao

    2015-01-01

    the tumor biology associated with MYC dysregulation is important to understand the roles of MYC and MYC-associated biology in lymphomagenesis. In this study, we determined MYC rearrangement status (n=344) and Myc expression (n=535) in a well-characterized DLBCL cohort, individually assessed the clinical...... and pathobiological features of patients with MYC rearrangement and Myc protein overexpression, and analyzed the prognosis and gene expression profiling signatures associated with these MYC abnormalities in germinal center B-cell-like and activated B-cell-like DLBCL. Our results showed that the prognostic importance...... and prognostic effects associated with MYC dysregulation and suggest that detection of both MYC translocations and evaluation of Myc and Bcl-2 expression is necessary to predict the prognosis of DLBCL patients....

  11. Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection.

    Science.gov (United States)

    Tokunaga, Ryuma; Sakamoto, Yasuo; Nakagawa, Shigeki; Miyamoto, Yuji; Yoshida, Naoya; Oki, Eiji; Watanabe, Masayuki; Baba, Hideo

    2015-11-01

    The prognostic nutritional index is reportedly related to postoperative outcomes. The aim of this study was to elucidate the clinical importance of the prognostic nutritional index in patients with colorectal cancer who were undergoing primary tumor resection. This is a retrospective study from a single institution. This study was conducted at a colorectal surgery service in an academic teaching hospital. The 556 patients with colorectal cancer who were undergoing surgery between March 2005 and August 2014 were eligible for this study. The preoperative prognostic nutritional index was calculated. Classification and regression tree analysis was performed to determine the prognostic nutritional index cutoff value. The associations of the prognostic nutritional index status with clinicopathological factors and postoperative outcomes were examined using univariate and multivariate analyses. Classification and regression tree analysis demonstrated that 45.5 was the optimal cutoff value. The low status (≤45.5) was correlated with older age, low BMI, low estimated glomerular filtration rate, CEA positivity, carbohydrate antigen 19-9 positivity, preoperative chemotherapy, tumors invading muscular or deeper layers, distant metastasis, poor differentiation, severe postoperative complications, tumor recurrence, and poor survival. In multivariate analysis, the low status was an independent risk factor for severe postoperative complications (OR = 2.06 [95% CI, 1.22-3.50]; p = 0.007) and low overall survival (HR =3.98 [95% CI, 2.38-6.89]; p nutritional index status, not considering the postoperative host status. The preoperative prognostic nutritional index predicts severe complications, recurrence, and poor prognosis in patients with colorectal cancer who are undergoing primary tumor resection. Investigation of the nutritional and immunologic statuses using the prognostic nutritional index could be a useful clinical approach.

  12. Data-driven remaining useful life prognosis techniques stochastic models, methods and applications

    CERN Document Server

    Si, Xiao-Sheng; Hu, Chang-Hua

    2017-01-01

    This book introduces data-driven remaining useful life prognosis techniques, and shows how to utilize the condition monitoring data to predict the remaining useful life of stochastic degrading systems and to schedule maintenance and logistics plans. It is also the first book that describes the basic data-driven remaining useful life prognosis theory systematically and in detail. The emphasis of the book is on the stochastic models, methods and applications employed in remaining useful life prognosis. It includes a wealth of degradation monitoring experiment data, practical prognosis methods for remaining useful life in various cases, and a series of applications incorporated into prognostic information in decision-making, such as maintenance-related decisions and ordering spare parts. It also highlights the latest advances in data-driven remaining useful life prognosis techniques, especially in the contexts of adaptive prognosis for linear stochastic degrading systems, nonlinear degradation modeling based pro...

  13. Interleukin-10 Polymorphisms in Association with Prognosis in Patients with B-Cell Lymphoma Treated by R-CHOP

    Directory of Open Access Journals (Sweden)

    Min Kyeong Kim

    2016-12-01

    Full Text Available Interleukin-10 (IL10 plays an important role in initiating and maintaining an appropriate immune response to non-Hodgkin lymphoma (NHL. Previous studies have revealed that the transcription of IL10 mRNA and its protein expression may be infl uenced by several single-nucleotide polymorphisms in the promoter and intron regions, including rs1800896, rs1800871, and rs1800872. However, the impact of polymorphisms of the IL10 gene on NHL prognosis has not been fully elucidated. Here, we investigated the association between IL10 polymorphisms and NHL prognosis. This study involved 112 NHL patients treated at the National Cancer Center, Korea. The median age was 57 years, and 70 patients (62.5% were men. Clinical characteristics, including age, performance status, stage, and extra-nodal involvement, as well as cell lineage and International Prognostic Index (IPI, were evaluated. A total of four polymorphisms in IL10 with heterozygous alleles were analyzed for hazard ratios of overall survival (OS and progression-free survival (PFS using Cox proportional hazards regression analysis. Diffuse large B-cell lymphoma was the most common histologic type (n = 83, followed by T-cell lymphoma (n = 18, mantle cell lymphoma (n = 6, and others (n = 5. Cell lineage, IPI, and extra-nodal involvement were predictors of prognosis. In the additive genetic model results for each IL10 polymorphism, the rs1800871 and rs1800872 polymorphisms represented a marginal association with OS (p = 0.09 and p = 0.06 and PFS (p = 0.05 and p = 0.08 in B-cell lymphoma patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP. These findings suggest that IL10 polymorphisms might be prognostic indicators for patients with B-cell NHL treated with R-CHOP.

  14. Prognosis of the Newborns with Congenital Heart Diseases

    Directory of Open Access Journals (Sweden)

    Akbar Molaei

    2015-07-01

    Full Text Available Background: Congenital heart disease (CHD is defined as problems affecting the heart of the fetus. According to previous studies, the incidence rate varies from 4-12 in 1000 live births. This study aimed to evaluate the demographic characteristics, clinical presentations, and findings that have impact on the prognosis of newborns hospitalized in Tabriz children Hospital, northwest of Iran. Methods: This cross-sectional study was conducted on 82 neonates with CHD admitted in Tabriz children Hospital, northwest of Iran from December 2011 to December 2012. Demographic characteristics, main complaints, symptoms, clinical presentations, associated anomalies, diagnoses, and also the correlation between the treatment process and mortality were evaluated. All data were analyzed using SPSS™ version 16 statistical software. Results: A total of 82 neonates with CHD were enrolled. The mean age and birth weight were 8.54 days and 2828.17 grams, respectively. The most common chief complaint was respiratory distress (58 cases, 70.73%. The most common diagnosis was d-transposition of great arteries and the most frequent therapeutic procedure was medical therapy in combination with mechanical ventilation (31 cases, 37.8%. 10 neonates (12.1% had complications while seizure was the most common complication of the study (4 case, 4.87%. Of 82 newborns in this study, 30 patients (36.6% died of which 13 cases (43.33% had DTGA; the most common therapeutic procedure was mechanical ventilation plus medical therapy which was performed in 22 patients (73.33%. In our study, no significant correlation could be observed between age, sex or weight of neonates and final outcome. Conclusion: Mortality of neonates with critical CHD is high. Also, the neonates treated with more invasive methods have higher mortality rates. It is obvious that both early detection and timely management affect ultimate prognosis of these patients. Hence, prenatal (fetal echocardiography and

  15. Prognosis-a wearable health-monitoring system for people at risk: methodology and modeling.

    Science.gov (United States)

    Pantelopoulos, Alexandros; Bourbakis, Nikolaos G

    2010-05-01

    Wearable health-monitoring systems (WHMSs) represent the new generation of healthcare by providing real-time unobtrusive monitoring of patients' physiological parameters through the deployment of several on-body and even intrabody biosensors. Although several technological issues regarding WHMS still need to be resolved in order to become more applicable in real-life scenarios, it is expected that continuous ambulatory monitoring of vital signs will enable proactive personal health management and better treatment of patients suffering from chronic diseases, of the elderly population, and of emergency situations. In this paper, we present a physiological data fusion model for multisensor WHMS called Prognosis. The proposed methodology is based on a fuzzy regular language for the generation of the prognoses of the health conditions of the patient, whereby the current state of the corresponding fuzzy finite-state machine signifies the current estimated health state and context of the patient. The operation of the proposed scheme is explained via detailed examples in hypothetical scenarios. Finally, a stochastic Petri net model of the human-device interaction is presented, which illustrates how additional health status feedback can be obtained from the WHMS' user.

  16. Endosomal gene expression: a new indicator for prostate cancer patient prognosis?

    LENUS (Irish Health Repository)

    Johnson, Ian R D

    2015-11-10

    Prostate cancer continues to be a major cause of morbidity and mortality in men, but a method for accurate prognosis in these patients is yet to be developed. The recent discovery of altered endosomal biogenesis in prostate cancer has identified a fundamental change in the cell biology of this cancer, which holds great promise for the identification of novel biomarkers that can predict disease outcomes. Here we have identified significantly altered expression of endosomal genes in prostate cancer compared to non-malignant tissue in mRNA microarrays and confirmed these findings by qRT-PCR on fresh-frozen tissue. Importantly, we identified endosomal gene expression patterns that were predictive of patient outcomes. Two endosomal tri-gene signatures were identified from a previously published microarray cohort and had a significant capacity to stratify patient outcomes. The expression of APPL1, RAB5A, EEA1, PDCD6IP, NOX4 and SORT1 were altered in malignant patient tissue, when compared to indolent and normal prostate tissue. These findings support the initiation of a case-control study using larger cohorts of prostate tissue, with documented patient outcomes, to determine if different combinations of these new biomarkers can accurately predict disease status and clinical progression in prostate cancer patients.

  17. The CD4(+) T-lymphocyte count is an important predictor for the prognosis of cryptococcosis.

    Science.gov (United States)

    Ding, Y; Li, P; He, Q; Wei, H; Wu, T; Xia, D; Tan, M; Shi, Y; Su, X

    2017-05-01

    There is great heterogeneity of immunity among patients with cryptococcosis, and severe immunodeficiency can lead to negative clinical outcomes. Underlying disease is a poor surrogate for immune status and inferior in predicting an individual's prognosis. This study was intended to determine whether T-lymphocyte subgroups would be more suitable indicators regarding the severity of infection and clinical outcomes of such patients. We retrieved clinical data on 101 patients with cryptococcosis and compared the validity of multiple parameters (underlying disease and T-lymphocyte subgroups) in predicting the severity of infection and clinical outcome in these patients. For patients with CD4(+) T-lymphocyte counts lower than 400/μL, the odds ratio of disseminated cryptococcosis was 23.3 (P = 0.005). There was a moderate negative correlation between CD4(+) T-cell count and Apache II score (-0.609, P lymphocytes was significantly higher than among those with normal levels (23.8% vs 5.3%, P = 0.016). However, the difference was not significant if the patients were grouped by underlying disease (P = 0.067). The CD4(+) T-lymphocyte count in peripheral blood is a simple and more accurate biomarker for predicting severity of infection and clinical outcome in patients with cryptococcosis.

  18. Independent validation of the modified prognosis palliative care study predictor models in three palliative care settings.

    Science.gov (United States)

    Baba, Mika; Maeda, Isseki; Morita, Tatsuya; Hisanaga, Takayuki; Ishihara, Tatsuhiko; Iwashita, Tomoyuki; Kaneishi, Keisuke; Kawagoe, Shohei; Kuriyama, Toshiyuki; Maeda, Takashi; Mori, Ichiro; Nakajima, Nobuhisa; Nishi, Tomohiro; Sakurai, Hiroki; Shimoyama, Satofumi; Shinjo, Takuya; Shirayama, Hiroto; Yamada, Takeshi; Ono, Shigeki; Ozawa, Taketoshi; Yamamoto, Ryo; Tsuneto, Satoru

    2015-05-01

    Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams. The primary aim of this study is to examine the accuracy and to validate the modified PiPS (using physician-proxy ratings of mental status instead of patient interviews) in three palliative care settings, namely palliative care units, hospital-based palliative care teams, and home-based palliative care services. This multicenter prospective cohort study was conducted in 58 palliative care services including 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services in Japan from September 2012 through April 2014. A total of 2426 subjects were recruited. For reasons including lack of followup and missing variables (primarily blood examination data), we obtained analyzable data from 2212 and 1257 patients for the modified PiPS-A and PiPS-B, respectively. In all palliative care settings, both the modified PiPS-A and PiPS-B identified three risk groups with different survival rates (Ppalliative care units, hospital-based palliative care teams, and home-based palliative care services. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  19. Protein Z efficiently depletes thrombin generation in disseminated intravascular coagulation with poor prognosis.

    Science.gov (United States)

    Lee, Nuri; Kim, Ji-Eun; Gu, Ja-Yoon; Yoo, Hyun Ju; Kim, Inho; Yoon, Sung-Soo; Park, Seonyang; Han, Kyou-Sup; Kim, Hyun Kyung

    2016-01-01

    Disseminated intravascular coagulation (DIC) is characterized by consumption of coagulation factors and anticoagulants. Thrombin generation assay (TGA) gives useful information about global hemostatic status. We developed a new TGA system that anticoagulant addition can deplete thrombin generation in plasma, which may reflect defective anticoagulant system in DIC. TGAs were measured on the calibrated automated thrombogram with and without thrombomodulin or protein Z in 152 patients who were suspected of having DIC, yielding four parameters including lag time, endogenous thrombin potential, peak thrombin and time-to-peak in each experiment. Nonsurvivors showed significantly prolonged lag time and time-to-peak in TGA-protein Z system, which was performed with added protein Z. In multivariate Cox regression analysis, lag time and time-to-peak in TGA system were significant independent prognostic factors. In TGA-protein Z system, lag time and time-to-peak were revealed as independent prognostic factors of DIC. Protein Z addition could potentiate its anticoagulant effect in DIC with poor prognosis, suggesting the presence of defective protein Z system. The prolonged lag time and time-to-peak in both TGA and TGA-protein Z systems are expected to be used as independent prognostic factors of DIC.

  20. Evaluation of clinical, laboratory and electrophoretic profile to determine of the prognosis of hospitalized dogs

    Directory of Open Access Journals (Sweden)

    Andrei Kelliton Fabretti

    2014-12-01

    Full Text Available There are several diseases that can affect pets. Recognize the infirm at risk of death would allow early medical interventions and the establishment of different monitoring protocols, increasing survival. The objective of this work was to analyze the potential for prognostic markers of clinical and laboratory accessible variables in 185 hospitalized dogs. The animals were divided into two groups: those who had hospital outcome and those who have died, being the clinical nutritional status (NS defined by the interpretation of body condition score (BCS, muscle mass score (MMS and body mass index (BMI. The following laboratory variables were assessed: blood cell count, total leukocyte count, fibrinogen concentration, glucose, calcium, phosphorus, magnesium, cholesterol, total protein, albumin and serum protein profile defined by electrophoresis. In the present study, were indicative of poor prognosis: low values of BCS, low values of MMS, decreased total number of lymphocytes, hyperphosphatemia, reduced concentrations of albumin and total protein and betaglobunin fraction, in electrophoresis. Good prognostic indicators were: normal or high BSC, appropriate MMS and discreet lift of alpha2-globulin fraction on electrophoresis. The authors did not consider blood glucose, cholesterol and calcium as prognostic indicators.

  1. Clinical Prognosis in Neonatal Bacterial Meningitis: The Role of Cerebrospinal Fluid Protein.

    Science.gov (United States)

    Tan, Jintong; Kan, Juan; Qiu, Gang; Zhao, Dongying; Ren, Fang; Luo, Zhongcheng; Zhang, Yongjun

    2015-01-01

    Neonates are at high risk of meningitis and of resulting neurologic complications. Early recognition of neonates at risk of poor prognosis would be helpful in providing timely management. From January 2008 to June 2014, we enrolled 232 term neonates with bacterial meningitis admitted to 3 neonatology departments in Shanghai, China. The clinical status on the day of discharge from these hospitals or at a postnatal age of 2.5 to 3 months was evaluated using the Glasgow Outcome Scale (GOS). Patients were classified into two outcome groups: good (167 cases, 72.0%, GOS = 5) or poor (65 cases, 28.0%, GOS = 1-4). Neonates with good outcome had less frequent apnea, drowsiness, poor feeding, bulging fontanelle, irritability and more severe jaundice compared to neonates with poor outcome. The good outcome group also had less pneumonia than the poor outcome group. Besides, there were statistically significant differences in hemoglobin, mean platelet volume, platelet distribution width, C-reaction protein, procalcitonin, cerebrospinal fluid (CSF) glucose and CSF protein. Multivariate logistic regression analyses suggested that poor feeding, pneumonia and CSF protein were the predictors of poor outcome. CSF protein content was significantly higher in patients with poor outcome. The best cut-offs for predicting poor outcome were 1,880 mg/L in CSF protein concentration (sensitivity 70.8%, specificity 86.2%). After 2 weeks of treatment, CSF protein remained higher in the poor outcome group. High CSF protein concentration may prognosticate poor outcome in neonates with bacterial meningitis.

  2. Clinical Prognosis in Neonatal Bacterial Meningitis: The Role of Cerebrospinal Fluid Protein

    Science.gov (United States)

    Zhao, Dongying; Ren, Fang; Luo, Zhongcheng; Zhang, Yongjun

    2015-01-01

    Neonates are at high risk of meningitis and of resulting neurologic complications. Early recognition of neonates at risk of poor prognosis would be helpful in providing timely management. From January 2008 to June 2014, we enrolled 232 term neonates with bacterial meningitis admitted to 3 neonatology departments in Shanghai, China. The clinical status on the day of discharge from these hospitals or at a postnatal age of 2.5 to 3 months was evaluated using the Glasgow Outcome Scale (GOS). Patients were classified into two outcome groups: good (167 cases, 72.0%, GOS = 5) or poor (65 cases, 28.0%, GOS = 1–4). Neonates with good outcome had less frequent apnea, drowsiness, poor feeding, bulging fontanelle, irritability and more severe jaundice compared to neonates with poor outcome. The good outcome group also had less pneumonia than the poor outcome group. Besides, there were statistically significant differences in hemoglobin, mean platelet volume, platelet distribution width, C-reaction protein, procalcitonin, cerebrospinal fluid (CSF) glucose and CSF protein. Multivariate logistic regression analyses suggested that poor feeding, pneumonia and CSF protein were the predictors of poor outcome. CSF protein content was significantly higher in patients with poor outcome. The best cut-offs for predicting poor outcome were 1,880 mg/L in CSF protein concentration (sensitivity 70.8%, specificity 86.2%). After 2 weeks of treatment, CSF protein remained higher in the poor outcome group. High CSF protein concentration may prognosticate poor outcome in neonates with bacterial meningitis. PMID:26509880

  3. Prognosis Prediction for Postoperative Esophageal Cancer Patients Using Onodera's Prognostic Nutritional Index.

    Science.gov (United States)

    Matsumoto, Hideo; Okamoto, Yuko; Kawai, Akimasa; Ueno, Daisuke; Kubota, Hisako; Murakami, Haruaki; Higashida, Masaharu; Hirai, Toshihiro

    2017-01-01

    Preoperative nutritional status may impact surgical outcome and prognosis. We evaluated the predictive value of Onodera's prognostic nutritional index (O's-PNI) of surgical outcome following esophagectomy in esophageal cancer patients. In total, 144 patients undergoing esophagectomy for esophageal cancer from April 2010 to May 2015 were evaluated, retrospectively. Eighty-four patients were enrolled in this study. O's-PNIs were calculated before surgery, discharge, and 1, 2, and 6 mo after discharge. The relationship between O's-PNI and occurrence of complications as classified by the Clavien-Dindo (C-D) classification, length of hospital stay, and survival time was investigated. The mean O's-PNI for patients with complications of more than Grade 2 by the C-D classification was 37.4, which was significantly lower than that for Grades 0 or 1 (40.5, P = 0.0094). A negative correlation was obtained between O's-PNI and hospital stay length (P = 0.0006), whereas a positive correlation was obtained for O's-PNI at 6 mo postsurgery and overall survival (P = 0.0171, P = 0.0201). O's-PNI may represent a useful indicator of the occurrence of complications and length of hospital stay, and may influence overall survival at 6 mo postsurgery. Nutritional management during the perioperative period could therefore contribute to satisfactory outcomes following esophagectomy in esophageal cancer patients.

  4. Nomograms for preoperative prediction of prognosis in patients with oral cavity squamous cell carcinoma.

    Science.gov (United States)

    Montero, Pablo H; Yu, Changhong; Palmer, Frank L; Patel, Purvi D; Ganly, Ian; Shah, Jatin P; Shaha, Ashok R; Boyle, Jay O; Kraus, Dennis H; Singh, Bhuvanesh; Wong, Richard J; Morris, Luc G; Kattan, Michael W; Patel, Snehal G

    2014-01-15

    This study sought to develop prognostic tools that will accurately predict overall and cancer-related mortality and risk of recurrence in individual patients with oral cancer based on host and tumor characteristics. These tools would take into account numerous prognosticators beyond those covered by the traditional TNM (tumor-node-metastasis) staging system. Demographic, host, and tumor characteristics of 1617 patients with cancer of the oral cavity, who were treated primarily with surgery at a single-institution tertiary care cancer center between 1985 and 2009, were reviewed from a preexisting database. Recurrent disease was recorded in 509 patients (456 locoregional and 116 distant); 328 patients died of cancer-related causes, and 542 died of other causes. The median follow-up was 42 months (range, 1-300 months). The following variables were analyzed as predictors of prognosis: age, sex, race, alcohol and tobacco use, oral cavity subsite, invasion of other structures, comorbidity, tumor size, and clinical nodal status. The stepdown method was used to select the statistically most influential predictors for inclusion in the final nomogram for each outcome of interest. The most influential predictors of both recurrence and cancer-specific mortality probability (CSMP) were tumor size, nodal status, subsite, and bone invasion. Nomograms were generated for prediction of overall survival (OS), CSMP, and locoregional recurrence-free probability (LRRFP). The nomograms were internally validated with an overfit-corrected predictive discrimination metric (concordance index) for OS of 67%, CSMP of 66%, and LRRFP of 60%. Nomograms have been developed that can reasonably estimate OS, CSMP, and LRRFP based on specific tumor and host characteristics in patients with oral cancer. © 2013 American Cancer Society.

  5. In-situ fatigue life prognosis for composite laminates based on stiffness degradation

    Data.gov (United States)

    National Aeronautics and Space Administration — In this paper, a real-time composite fatigue life prognosis framework is proposed. The proposed methodology combines Bayesian inference, piezoelectric sensor...

  6. Association between Perception of Prognosis and Spiritual Well-being among Cancer Patients

    Directory of Open Access Journals (Sweden)

    Alehe Seyedrasooly

    2014-02-01

    Full Text Available Introduction: Disclosure of cancer prognosis is one of the most difficult challenges in caring of cancer patients. An exact effect of prognosis disclosure on spiritual well-being of cancer patient was not completely investigated. Therefore, the present study aimed to investigate the relationship between perception of prognosis and spiritual well-being among cancer patients. Methods: In this descriptive-correlational study, which conducted in 2013, two hundred cancer patients referred to Shahid Ghazi Hospital and private offices of two oncologists in Tabriz participated with convenience sampling method. Perception of prognosis was investigated by Perception of Prognosis Inventory and spiritual well-being of cancer patients was investigated by Paloutzian and Ellison Inventory. Data were analyzed using descriptive statistics and Pearson correlation test. Results: Participants reported positive perception about the prognosis of their disease (score 11 from 15 and rated their spiritual well-being as high (score 99 from 120. There was a positive correlation between the perception of prognosis and spiritual health among cancer patients.Conclusion: Disclosure of cancer prognosis has negative effects on cancer patients. This result highlights the importance of considering cultural factors in disclosure of cancer prognosis. According to limitations of the present study approving these results need more studies.

  7. A Fresh Look at the Process of Arriving at a Clinical Prognosis Part 2: Colic

    National Research Council Canada - National Science Library

    Orsini, James A

    2011-01-01

    Generating an accurate prognosis in a horse with colic involves identifying and determining the severity of homeostatic derangements, particularly aberrations in cardiorespiratory, metabolic, and hemostatic functions...

  8. Increased expression of CD147 and MMP-9 is correlated with poor prognosis of salivary duct carcinoma.

    Science.gov (United States)

    Piao, Songlin; Zhao, Shu; Guo, Fulin; Xue, Jie; Yao, Guodong; Wei, Zhili; Huang, Qi; Sun, Yao; Zhang, Bin

    2012-04-01

    The aim of this study was to investigate expression of CD147 and MMP-9 in salivary duct carcinoma (SDC) so as to determine whether these two genes may be correlated with poor prognosis of SDC. We examined the significance of the CD147 and MMP-9 expression in SDC (n = 35), non-cancerous salivary tissue (n = 20) in previously untreated patients using immunohistochemical staining. Furthermore, we analyzed the correlation between the expression of these two genes and various clinicopathologic factors including survival status of patients with SDC. Positive stain of CD147 and MMP-9 was seen in all 35 cases of tumor samples. A statistical correlation was observed between CD147 and MMP-9 expression in SDC tissues. The incidences of high expression were 45.71% for CD147 and 51.43% for MMP-9 in 35 SDC tissues, respectively. High expression of CD147 and MMP-9 was significantly correlated with clinical feature and shorter progression-free survival (PFS) (P (CD147) = 0.031; P (MMP-9) = 0.020) and overall survival (OS) (P (CD147) = 0.044; P (MMP-9) = 0.013). CD147 and MMP-9 expression is correlated with invasion, metastasis and shorter PFS/OS of SDC. Patients with high expression of CD147 and MMP-9 had poor prognosis than SDC patients with low expression.

  9. Improved prognosis of diabetic nephropathy in type 1 diabetes

    DEFF Research Database (Denmark)

    Andrésdóttir, Gudbjörg; Jensen, Majken L; Carstensen, Bendix

    2015-01-01

    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......-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...... previously 4.0 to 3.3 ml/min per 1.73 m2/year. During a median follow-up of 9.1 years, 29% of participants doubled their plasma creatinine or developed end-stage renal disease. Mortality risk was similar to our prior study (hazard ratio 1.05 (0.76-1.43). However, after age adjustment, as both diabetes...

  10. Improved prognosis in type 1 diabetic patients with nephropathy

    DEFF Research Database (Denmark)

    Astrup, Anne Sofie; Tarnow, Lise; Rossing, Peter

    2005-01-01

    BACKGROUND: In early studies, a median survival time of 5 to 7 years from onset of diabetic nephropathy was observed. Furthermore, end-stage renal disease (ESRD) was the main cause of death. We prospectively assessed the impact of reno- and cardiovascular protective treatment on prognosis in type 1...... diabetic patients with diabetic nephropathy. METHODS: We prospectively followed 199 type 1 diabetic patients with diabetic nephropathy and 192 patients with normoalbuminuria for 10 years. Aggressive antihypertensive treatment was initiated in patients with diabetic nephropathy in mid 1980s, whereas statins......%) died; hereof, 25 deaths (42%) were ascribed to cardiovascular causes while 30 patients (50%) with nephropathy died with ESRD. The estimate of median survival time from onset of diabetic nephropathy was 21.7 years, SE 3.3 years. CONCLUSION: The survival of patients with diabetic nephropathy has improved...

  11. Concurrent new drug prescriptions and prognosis of early breast cancer

    DEFF Research Database (Denmark)

    Cronin-Fenton, Deirdre; Lash, Timothy L; Ahern, Thomas P

    2018-01-01

    BACKGROUND: Myriad reports suggest that frequently used prescription drugs alter the viability of breast cancer cells in pre-clinical studies. Routine use of these drugs, therefore, may impact breast cancer prognosis, and could have important implications for public health. METHODS: The Danish...... the Danish National Prescription Registry, has facilitated large population-based pharmacoepidemiology studies. A unique advantage of using DBCG data for such studies is the ability to investigate the association of drugs with breast cancer recurrence rather than breast cancer mortality - which may...... be misclassified - or all-cause mortality. Here we summarize findings from pharmacoepidemiological studies, based on DBCG data, on the association between routinely used prescription drugs and risk of breast cancer recurrence. RESULTS: Our findings suggest that concurrent use of glucocorticoids, ACE inhibitors...

  12. [PROGNOSIS OF DEEP INFECTIOUS COMPLICATIONS IN HIP ARTHROPLASTY].

    Science.gov (United States)

    Dorofeev, Yu L; Ptashnikov, D A; Tkachenko, A N; Bakhtin, M Yu; Kalimullina, A F

    2015-01-01

    The retrospective research analyzed the data of 893 patients undergoing total hip arthroplasty. There were used the data about patients undergoing hip arthroplasty without complications (the first group--808 cases) and patients with developed deep surgical site infection following total joint arthroplasty after 12 months (the second group--85 patients). It was applied as the training matrix in creation of mathematical prognosis and algorithm of prophylaxis of deep infection in patients undergoing the primary total hip arthroplasty. There were revealed 21 prognostic significant criteria of deep infection development in surgical site. The program was tested in prospective investigation (293 clinical cases) with follow-up term of 12 months after operation. The rate of development of postoperative deep infection in surgical wound reduced as compared with the rate in group of retrospective research from 1.7% to 0.7%. The efficacy of proposed program was 80%.

  13. Markers of early disease and prognosis in COPD

    DEFF Research Database (Denmark)

    Dahl, Morten; Nordestgaard, Børge G

    2009-01-01

    vary substantially over time. This review explores potential markers of early disease and prognosis in COPD by examining genetic markers in the alpha(1)-antitrypsin, cystic fibrosis transmembrane conductance regulator (CFTR), and MBL-2 genes, and by examining the biochemical markers fibrinogen and C......COPD is a complex disease with multiple pathological components, which we unfortunately tend to ignore when spirometry is used as the only method to evaluate the disorder. Additional measures are needed to allow a more complete and clinically relevant assessment of COPD. The earliest potential risk...... factors of disease in COPD are variations in the genetic background. Genetic variations are present from conception and can determine lifelong changes in enzyme activities and protein concentrations. In contrast, measurements in blood, sputum, exhaled breath, broncho-alveolar lavage, and lung biopsies may...

  14. Differentiation of Diabetes by Pathophysiology, Natural History, and Prognosis.

    Science.gov (United States)

    Skyler, Jay S; Bakris, George L; Bonifacio, Ezio; Darsow, Tamara; Eckel, Robert H; Groop, Leif; Groop, Per-Henrik; Handelsman, Yehuda; Insel, Richard A; Mathieu, Chantal; McElvaine, Allison T; Palmer, Jerry P; Pugliese, Alberto; Schatz, Desmond A; Sosenko, Jay M; Wilding, John P H; Ratner, Robert E

    2017-02-01

    The American Diabetes Association, JDRF, the European Association for the Study of Diabetes, and the American Association of Clinical Endocrinologists convened a research symposium, "The Differentiation of Diabetes by Pathophysiology, Natural History and Prognosis" on 10-12 October 2015. International experts in genetics, immunology, metabolism, endocrinology, and systems biology discussed genetic and environmental determinants of type 1 and type 2 diabetes risk and progression, as well as complications. The participants debated how to determine appropriate therapeutic approaches based on disease pathophysiology and stage and defined remaining research gaps hindering a personalized medical approach for diabetes to drive the field to address these gaps. The authors recommend a structure for data stratification to define the phenotypes and genotypes of subtypes of diabetes that will facilitate individualized treatment. © 2017 by the American Diabetes Association.

  15. Genetic imprecision: Diagnosis of possible defects often cannot predict prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, R.

    1991-05-01

    The author discusses the difficulties in using current genetic information for the detection of hereditary diseases. Although there have been many advances in cytogenetic and molecular testing, the diagnosis of defects does not necessarily predict prognosis. Detection of mutant alleles, mosaicism, familial chromosomal rearrangements and de novo chromosomal rearrangements lends uncertainties to genetic counselling. The problems have been compounded by a lack of follow-up to determine if a defect actually exists in a fetus aborted as a result of counselling; nor has there been long-term follow-up of fetuses carried to term that appear healthy at birth. Disappointments after the discovery of the cystic fibrosis gene were due to discovery of many mutations of the gene, making screening for the disease difficult. Some genetic counselors question the benefits of screening for this disease since with advances in treatment, life span has been lengthened and quality of life has been improved.

  16. Heterotopic cesarean scar pregnancy: diagnosis, treatment, and prognosis.

    Science.gov (United States)

    OuYang, Zhenbo; Yin, Qian; Xu, Yujing; Ma, Yunyan; Zhang, Qiushi; Yu, Yanhong

    2014-09-01

    Heterotopic cesarean scar pregnancy is a rare, life-threatening form of ectopic pregnancy. To provide information regarding the clinical manifestations, diagnosis, management, and prognosis of this condition, we reviewed all cases reported in the English literature. All literature on heterotopic cesarean scar pregnancy was retrieved by searching the PubMed database and tracking references of the relevant literature. Full texts were reviewed, and clinical manifestations, diagnostic methods, and the relationship between the treatment and prognosis were summarized. A total of 14 patients with heterotopic cesarean scar pregnancies were identified, including 6 spontaneous pregnancies and 8 following in vitro fertilization-embryo transfer. Gestational ages at diagnosis ranged from 5 weeks to 8 weeks 4 days. Only 5 cases presented with vaginal bleeding, and the others were asymptomatic. All 14 cases were diagnosed by transvaginal sonography. One patient with no future fertility requirements underwent pregnancy termination by methotrexate. Of the remaining 13 patients who desired to preserve their intrauterine gestations, 10 were treated by sonographically guided selective embryo reduction in situ (by embryo aspiration, drug injection, or both); 2 underwent laparoscopic and hysteroscopic excision of the ectopic pregnancy masses; and 1 was treated by expectant management. All operations were successful and maintained a living intrauterine gestation. Twelve cases resulted in live births by cesarean delivery (3 at term and 9 preterm). One patient underwent pregnancy termination at 12 weeks because of a fetal malformation confirmed by sonography. The possibility of heterotopic cesarean scar pregnancy after cesarean delivery should be considered, especially when pregnancy follows assisted reproductive technology. Transvaginal sonography is an important tool for diagnosis and management. Despite the many options, the best treatment for this condition remains unclear. Selective

  17. Long-term prognosis of childhood absence epilepsy.

    Science.gov (United States)

    Martínez-Ferrández, C; Martínez-Salcedo, E; Casas-Fernández, C; Alarcón-Martínez, H; Ibáñez-Micó, S; Domingo-Jiménez, R

    2017-03-18

    Childhood absence epilepsy (CAE) is considered easily manageable with medication provided that a strict patient classification system is employed. It accounts for 10% of all childhood epilepsy cases starting before the age of 15 and it is most frequent in school-aged girls. The aim of this study is to analyse long-term outcomes of patients diagnosed with CAE according to the Loiseau and Panayiotopoulos criteria and treated during childhood. We conducted a retrospective study including 69 patients with CAE who are currently older than 11; data were gathered from medical histories, EEG records, and telephone questionnaires. 52 patients met the Loiseau and Panayiotopoulos criteria. Mean age is now 17.16 years. Female-to-male ratio was 1.65:1; mean age at onset was 6 years and 2 months; mean duration of treatment was 3 years and 9 months. A family history of epilepsy was present in 30.8% of the patients and 7.7% had a personal history of febrile convulsions. Absence seizures were simple in 73.5% of the patients and complex in 26.5%. Response rates to first-line treatment were as follows: valproic acid, 46.3%; and valproic acid plus ethosuximide, 90.9%. The rate of response to second-line therapy (ethosuximide or lamotrigine) was 84.2%; 4% of the patients experienced further seizures after treatment discontinuation, 78.8% achieved seizure remission, and 25% needed psychological and academic support. Our data show that epileptic patients should be classified according to strict diagnostic criteria since patients with true CAE have an excellent prognosis. The relapse rate was very low in our sample. Despite the favourable prognosis, psychological and academic support is usually necessary. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Applications of Machine Learning in Cancer Prediction and Prognosis

    Directory of Open Access Journals (Sweden)

    Joseph A. Cruz

    2006-01-01

    Full Text Available Machine learning is a branch of artificial intelligence that employs a variety of statistical, probabilistic and optimization techniques that allows computers to “learn” from past examples and to detect hard-to-discern patterns from large, noisy or complex data sets. This capability is particularly well-suited to medical applications, especially those that depend on complex proteomic and genomic measurements. As a result, machine learning is frequently used in cancer diagnosis and detection. More recently machine learning has been applied to cancer prognosis and prediction. This latter approach is particularly interesting as it is part of a growing trend towards personalized, predictive medicine. In assembling this review we conducted a broad survey of the different types of machine learning methods being used, the types of data being integrated and the performance of these methods in cancer prediction and prognosis. A number of trends are noted, including a growing dependence on protein biomarkers and microarray data, a strong bias towards applications in prostate and breast cancer, and a heavy reliance on “older” technologies such artificial neural networks (ANNs instead of more recently developed or more easily interpretable machine learning methods. A number of published studies also appear to lack an appropriate level of validation or testing. Among the better designed and validated studies it is clear that machine learning methods can be used to substantially (15-25% improve the accuracy of predicting cancer susceptibility, recurrence and mortality. At a more fundamental level, it is also evident that machine learning is also helping to improve our basic understanding of cancer development and progression.

  19. Influence of gender on prognosis of acute coronary syndromes.

    Science.gov (United States)

    Cabrerizo-García, José Luis; Pérez-Calvo, Juan I; Zalba-Etayo, Begoña

    2015-01-01

    Ischemic heart disease presents different features in men and women. We analyzed the relation between gender and prognosis in patients who had suffered a high-risk acute coronary syndrome (ACS). This was a prospective analytical cohort study performed at Lozano Blesa University Hospital, Zaragoza, Spain, of 559 patients diagnosed with high-risk ACS with and without ST-segment elevation according to the American College of Cardiology/American Heart Association guidelines. The sample was divided into two groups by gender and differences in epidemiologic, laboratory, electrocardiographic and echocardiographic variables and treatment were recorded. A Cox's proportional hazard model was applied and 6-month mortality was analyzed as the main variable. The median age was 65.2±12.7 years, and 21.8% were women. Baseline characteristics in women were more unfavorable, with higher GRACE scores, older age, higher prevalence of hypertension, diabetes and heart failure, lower ejection fraction and more renal dysfunction at admission. Women suffered more adverse cardiovascular events (27.9% vs. 15.8%, p=0.002). Sixty-four patients died, 18.9% of the women vs. 9.4% of the men (p=0.004). After multivariate analysis, female gender did not present an independent relation with mortality. Hemoglobin level, renal function, ejection fraction and Killip class >1 presented significant differences. Acute syndrome coronary in women has a worse prognosis than in men. Their adverse course is due to their baseline characteristics and not to their gender. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  20. Yin Yang gene expression ratio signature for lung cancer prognosis.

    Directory of Open Access Journals (Sweden)

    Wayne Xu

    Full Text Available Many studies have established gene expression-based prognostic signatures for lung cancer. All of these signatures were built from training data sets by learning the correlation of gene expression with the patients' survival time. They require all new sample data to be normalized to the training data, ultimately resulting in common problems of low reproducibility and impracticality. To overcome these problems, we propose a new signature model which does not involve data training. We hypothesize that the imbalance of two opposing effects in lung cancer cells, represented by Yin and Yang genes, determines a patient's prognosis. We selected the Yin and Yang genes by comparing expression data from normal lung and lung cancer tissue samples using both unsupervised clustering and pathways analyses. We calculated the Yin and Yang gene expression mean ratio (YMR as patient risk scores. Thirty-one Yin and thirty-two Yang genes were identified and selected for the signature development. In normal lung tissues, the YMR is less than 1.0; in lung cancer cases, the YMR is greater than 1.0. The YMR was tested for lung cancer prognosis prediction in four independent data sets and it significantly stratified patients into high- and low-risk survival groups (p = 0.02, HR = 2.72; p = 0.01, HR = 2.70; p = 0.007, HR = 2.73; p = 0.005, HR = 2.63. It also showed prediction of the chemotherapy outcomes for stage II & III. In multivariate analysis, the YMR risk factor was more successful at predicting clinical outcomes than other commonly used clinical factors, with the exception of tumor stage. The YMR can be measured in an individual patient in the clinic independent of gene expression platform. This study provided a novel insight into the biology of lung cancer and shed light on the clinical applicability.

  1. Revisiting 'Respiratory Function in Emphysema in Relation to Prognosis'

    Directory of Open Access Journals (Sweden)

    David V Bates

    2000-01-01

    Full Text Available BACKGROUND: The 1956 paper by DV Bates, JMS Knott and RV Christie, "Respiratory function in emphysema in relation to prognosis" Quart J Med 1956;97:137-157 is largely reprinted with a commentary by the first author, Dr David Bates. Although the pathology of emphysema was well recognized at the time, the clinical diagnosis and assessment of its severity were known to be imprecise; physiological measurements assessing and following the clinical course had not been established. The study aimed to follow systematically a group of patients, selected by clinical criteria using standardized clinical and physiological techniques, over four years and correlate physiological and clinical changes in relation to prognosis and eventually to postmortem findings. Fifty-nine patients were recruited to an emphysema clinic at St Bartholomew's Hospital, London, England. Inclusion criteria were dyspnea without other causes and no cor pulmonale present. Patients' symptoms were assessed by a standardized questionnaire, and measurements were taken of lung volumes, maximal ventilatory volume, carbon monoxide diffusing capacity at rest, exercise and oxygen saturation by oximetry.  During the four years of the study, 17 patients died (actuarial expected - four and 13 presented with signs of pulmonary heart failure. All postmortem examinations (n=9 showed advanced emphysema. A seasonal variation in dyspnea was established (the period included the infamous 1952 London smog. Four patients improved, and the remainder were unchanged or deteriorated. Close relationships were shown between dyspnea and function results, particularly for the diffusing capacity of lungs for carbon monoxide (DLCO. A comparison among a group of patients with chronic bronchitis without dyspnea showed that the DLCO discriminated between them. A loss of the normal increase in DLCO during exercise was shown in emphysema.

  2. Use of Wilms Tumor 1 Gene Expression as a Reliable Marker for Prognosis and Minimal Residual Disease Monitoring in Acute Myeloid Leukemia With Normal Karyotype Patients.

    Science.gov (United States)

    Marjanovic, Irena; Karan-Djurasevic, Teodora; Ugrin, Milena; Virijevic, Marijana; Vidovic, Ana; Tomin, Dragica; Suvajdzic Vukovic, Nada; Pavlovic, Sonja; Tosic, Natasa

    2017-05-01

    Acute myeloid leukemia with normal karyotype (AML-NK) represents the largest group of AML patients classified with an intermediate prognosis. A constant need exists to introduce new molecular markers for more precise risk stratification and for minimal residual disease (MRD) monitoring. Quantitative assessment of Wilms tumor 1 (WT1) gene transcripts was performed using real-time polymerase chain reaction. The bone marrow samples were collected at the diagnosis from 104 AML-NK patients and from 34 of these patients during follow-up or disease relapse. We found that overexpression of the WT1 gene (WT1 high status), present in 25.5% of patients, was an independent unfavorable factor for achieving complete remission. WT1 high status was also associated with resistance to therapy and shorter disease-free survival and overall survival. Assessment of the log reduction value of WT1 expression, measured in paired diagnosis/complete remission samples, revealed that patients with a log reduction of < 2 had a tendency toward shorter disease-free survival and overall survival and a greater incidence of disease relapse. Combining WT1 gene expression status with NPM1 and FLT3-ITD mutational status, we found that the tumor behavior of intermediate patients (FLT3-ITD - /NPM1 - double negative) with WT1 high status is almost the same as the tumor behavior of the adverse risk group. WT1 expression status represents a good molecular marker of prognosis, response to treatment, and MRD monitoring. Above all, the usage of the WT1 expression level as an additional marker for more precise risk stratification of AML-NK patients could lead to more adapted, personalized treatment protocols. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. 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.

  4. Decreased expression of the GATA3 gene is associated with poor prognosis in primary gastric adenocarcinoma.

    Directory of Open Access Journals (Sweden)

    Rajiv Prasad Keshari

    Full Text Available BACKGROUND: GATA binding protein 3 (GATA3 was recently proposed to function as a tumor suppressor gene in some types of human cancer. This study aims to investigate GATA3 expression and its prognostic significance in primary gastric adenocarcinoma. METHODOLOGY/PRINCIPAL FINDINGS: Using real-time quantitative PCR (RT-qPCR and immunohistochemical staining methods, GATA3 expression was analyzed in tissue samples from a consecutive series of 402 gastric adenocarcinoma patients who underwent resections between 2003 and 2006. The relationship between GATA3 expression, clinicopathological factors, and patient survival was investigated. The expression status of GATA3 was shown to be clearly reduced in the tumor tissue samples compared with that in the matched adjacent non-tumor tissue samples by RT-qPCR (P = 0.0014. Immunohistochemistry analysis indicated that GATA3 expression was significantly decreased in 225 of the 402 (56% gastric adenocarcinoma cases. Reduced GATA3 expression was also observed in patients with large tumors (P = 0.017, signet ring cell carcinoma or mucinous carcinoma (P = 0.005 and tumors with lymphatic or venous invasion (P = 0.040. Additionally, reduced expression of GATA3 was more commonly observed in tumors that were staged as T4a/b (P<0.001, N3 (P<0.001, or M1 (P<0.001. Kaplan-Meier survival curves revealed that reduced expression of GATA3 was associated with poor prognosis in gastric adenocarcinoma patients (P<0.001. Multivariate Cox analysis identified GATA3 expression as an independent prognostic factor for overall survival (HR = 5.375, 95% CI = 3.647-7.921, P<0.001. To investigate the predictive ability of the models with and without containing GATA3 gene expression, Harrell's c-index was calculated as a measure of predictive accuracy of survival outcome. The c-index values revealed that model containing GATA3 expression (c-index = 0.897 had superior discrimination ability to the model without containg it (c-index = 0

  5. ASPM is a novel marker for vascular invasion, early recurrence, and poor prognosis of hepatocellular carcinoma.

    Science.gov (United States)

    Lin, Shih-Yeh; Pan, Hung-Wei; Liu, Shu-Hsiang; Jeng, Yung-Ming; Hu, Fu-Chang; Peng, Shian-Yang; Lai, Po-Lin; Hsu, Hey-Chi

    2008-08-01

    Abnormal spindle-like microcephaly associated (ASPM) plays an important role in neurogenesis and cell proliferation. This study is to elucidate its role in hepatocellular carcinoma (HCC), particularly early tumor recurrence (ETR) and prognosis. We used reverse transcription-PCR assays to measure the ASPM mRNA levels in 247 HCC and correlated with clinicopathologic and molecular features. ASPM mRNA levels were high in fetal tissues but very low in most adult tissues. ASPM mRNA was overexpressed in 162 HCC (66%) but not in benign liver tumors. ASPM overexpression correlated with high alpha-fetoprotein (P = 1 x 10(-8)), high-grade (grade II-IV) HCC (P = 2 x 10(-6)), high-stage (stage IIIA-IV) HCC (P = 1 x 10(-8)), and importantly ETR (P = 1 x 10(-8)). ETR is the most critical unfavorable clinical prognostic factor. Among the various independent histopathologic (tumor size, tumor grade and tumor stage) and molecular factors (p53 mutation, high alpha-fetoprotein, and ASPM overexpression), tumor stage was the most crucial histologic factor (odds ratio, 14.7; 95% confidence interval, 6.65-33.0; P = 1 x 10(-8)), whereas ASPM overexpression (odds ratio, 6.49; P = 1 x 10(-8)) is the most important molecular factor associated with ETR. ASPM overexpression was associated with vascular invasion and ETR in both p53-mutated (all P values = 1 x 10(-8)) and non-p53-mutated HCC (P = 1 x 10(-8) and 0.00088, respectively). Hence, patients with APSM-overexpressing HCC had lower 5-year survival (P = 0.000001) in both p53-mutated (P = 0.00008) and non-p53-mutated HCC (P = 0.0027). In low-stage (stage II) HCC, ASPM overexpression also correlated with higher ETR (P = 0.008). ASPM overexpression is a molecular marker predicting enhanced invasive/metastatic potential of HCC, higher risk of ETR regardless of p53 mutation status and tumor stage, and hence poor prognosis.

  6. Overexpression of cannabinoid receptor 1 in esophageal squamous cell carcinoma is correlated with metastasis to lymph nodes and distant organs, and poor prognosis.

    Science.gov (United States)

    Hijiya, Naoki; Shibata, Tomotaka; Daa, Tsutomu; Hamanaka, Ryoji; Uchida, Tomohisa; Matsuura, Keiko; Tsukamoto, Yoshiyuki; Nakada, Chisato; Iha, Hidekatsu; Inomata, Masafumi; Moriyama, Masatsugu

    2017-02-01

    In patients with esophageal squamous cell carcinoma (ESCC), the status of metastasis to lymph nodes is strongly associated with prognosis. Consequently, development of a biomarker to detect the presence of metastasis would be clinically valuable. In this study, we found that overexpression of cannabinoid receptor 1 (CB1R) was applicable as a marker for prediction of metastasis in ESCC. CB1R overexpression was detected immunohistochemically in 54 of 88 cases (61.4%). The intensity of CB1R expression was uniform in both intraepithelial and invasive regions in each case, and was significantly correlated with the status of metastasis to lymph nodes (P = 0.046) and distant organs (P = 0.047). Furthermore, multivariate analysis revealed that CB1R overexpression was independently associated with poor prognosis (P = 0.019). Biological analysis of CB1R overexpression using ESCC cell lines revealed that CB1R activation appeared to promote cell proliferation and invasion. On the basis of these findings, we propose that evaluation of CB1R expression status in biopsy specimens of ESCC using immunohistochemistry might be clinically useful for prediction of metastasis to lymph nodes and distant organs. © 2016 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

  7. 21 CFR 866.6040 - Gene expression profiling test system for breast cancer prognosis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gene expression profiling test system for breast... Associated Antigen immunological Test Systems § 866.6040 Gene expression profiling test system for breast cancer prognosis. (a) Identification. A gene expression profiling test system for breast cancer prognosis...

  8. Prognosis of the comorbid heart failure and Anemia: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    M. Kyriakou

    2016-04-01

    Conclusion: The meta-analysis gives an outline profile of patients with the co-morbidity HF and anemia in terms of clinical outcomes. The results point out worse prognosis in HF patients with anemia. Nevertheless, the available data did not allow the extraction of a conclusion in which exact Hb levels anemia becomes a negative predictor of prognosis.

  9. Prognosis in Acute Cerebrovascular Accidents in Relation to Respiratory Pattern and Blood—gas Tensions

    Science.gov (United States)

    Rout, M. W.; Lane, D. J.; Wollner, L.

    1971-01-01

    Respiratory pattern and arterial blood gas tensions were assessed in patients with acute cerebrovascular accidents. Hyperventilation, low Pco2, and high arterial pH were associated with a poor prognosis, whereas patients with normal respiratory pattern and blood gas tensions survived. Periodic and Cheyne-Stokes breathing carried an intermediate prognosis. PMID:5091916

  10. Delayed breast reconstruction with implants after invasive breast cancer does not impair prognosis

    DEFF Research Database (Denmark)

    Holmich, L.R.; During, M.; Henriksen, T.F.

    2008-01-01

    We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women......We investigated if delayed breast implant reconstruction after breast cancer impairs prognosis. Using data from the Danish Breast Cancer Cooperative Group register, we identified all women...

  11. 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.

  12. CpG island methylator phenotype in plasma is associated with hepatocellular carcinoma prognosis

    Science.gov (United States)

    Liu, Ji-Bin; Zhang, Yi-Xin; Zhou, Shu-Hui; Shi, Min-Xin; Cai, Jin; Liu, Yan; Chen, Ke-Ping; Qiang, Fu-Lin

    2011-01-01

    AIM: To evaluate the clinical significance of CpG island methylator phenotype (CIMP) in plasma and its association with hepatocellular carcinoma (HCC) progress. METHODS: CIMP status of 108 HCC patients was analyzed using a methylation marker panel in tumor tissues and plasma with methylation-specific polymerase chain reaction. Fifteen samples of non-neoplastic liver tissues and 60 of plasma from healthy persons were examined simultaneously. Examined genes included APC, WIF-1, RUNX-3, DLC-1, SFRP-1, DKK and E-cad. RESULTS: The frequencies of high-level methylation in HCC tissue and plasma were at least 15% for the seven genes: APC, 48/108, 44.44% in tissue and 26/108, 24.07% in plasma; WIF-1, 53/108, 49.07% in tissue and 35/108, 32.41% in plasma; RUNX-3, 52/108, 48.14% in tissue and 42/108, 38.89% in plasma; DLC-1, 38/108, 35.18% in tissue and 23/108, 21.30% in plasma; SFRP-1, 40/108, 37.04% in tissue and 31/108, 28.7% in plasma; DKK, 39/108, 36.1% in tissue and 25/108, 23.14% in plasma; and E-cad, 37/108, 34.3% in tissue and 18/108, 16.67% in plasma. CIMP+ (≥ 3 methylated genes) was detected in 68 (60.2%) tumor tissue samples and 62 (57.4%) plasma samples. CIMP was not detected in non-neoplastic liver tissues or plasma of healthy persons. CIMP status in tumor tissues differed significantly in gender, hepatitis B surface antigen, alpha-fetoprotein, and tumor-node-metastasis stage (P < 0.05). Similar results were obtained with plasma samples (P < 0.05). There was no difference in CIMP status in age, presence of hepatitis C virus antibody, cirrhosis, number of nodes, number of tumors, tumor size, or Edmondson-Steiner stage. A one-year follow-up found that the metastatic rate and recurrence rate in the CIMP+ group were significantly higher than in the CIMP- group as assessed with plasma samples (P < 0.05). CONCLUSION: Plasma DNA can be a reliable sample source for CIMP analysis. CIMP in plasma may serve as a molecular marker of late-stage and poor-prognosis HCC. PMID

  13. Chronic intraoral pain--assessment of diagnostic methods and prognosis.

    Science.gov (United States)

    Pigg, Maria

    2011-01-01

    The overall goal of this thesis was to broaden our knowledge of chronic intraoral pain. The research questions were: What methods can be used to differentiate inflammatory, odontogenic tooth pain from pain that presents as toothache but is non-odontogenic in origin? What is the prognosis of chronic tooth pain of non-odontogenic origin, and which factors affect the prognosis? Atypical odontalgia (AO) is a relatively rare but severe and chronic pain condition affecting the dentoalveolar region. Recent research indicates that the origin is peripheral nerve damage: neuropathic pain. The condition presents as tooth pain and is challenging to dentists because it is difficult to distinguish from ordinary toothache due to inflammation or infection. AO is of interest to the pain community because it shares many characteristics with other chronic pain conditions, and pain perpetuation mechanisms are likely to be similar. An AO diagnosis is made after a comprehensive examination and assessment of patients' self-reported characteristics: the pain history. Traditional dental diagnostic methods do not appear to suffice, since many patients report repeated care-seeking and numerous treatment efforts with little or no pain relief. Developing methods that are useful in the clinical setting is a prerequisite for a correct diagnosis and adequate treatment decisions. Quantitative sensory testing (QST) is used to assess sensory function on skin when nerve damage or disease is suspected. A variety of stimuli has been used to examine the perception of, for example, touch, temperature (painful and non-painful), vibration, pinprick pain, and pressure pain. To detect sensory abnormalities and nerve damage in the oral cavity, the same methods may be possible to use. Study I examined properties of thermal thresholds in and around the mouth in 30 pain-free subjects: the influence of measurement location and stimulation area size on threshold levels, and time variability of thresholds

  14. Clinical course and seizure outcome of idiopathic childhood epilepsy: determinants of early and long-term prognosis

    Science.gov (United States)

    2013-01-01

    Background Idiopathic epilepsies and epileptic syndromes predominate childhood and adolescence epilepsy. The aim of the present study was to investigate the clinical course and outcome of idiopathic childhood epilepsy and identify variables determining both early and long-term prognosis. Methods We followed 303 children with newly diagnosed idiopathic epilepsy aged 1–14 years old, both prospectively and retrospectively. Outcome was defined at one, 2 and 4 years of follow-up, as well as at the end of the study period for all patients. Based on the data collected, patients were classified in four patterns of clinical course: “excellent”, “improving”, “relapsing” and “poor”. Variables defined at intake and after the initial year of treatment were analyzed for their prognostic relevance towards the clinical course and outcome of the patients. Results The mean age at seizure onset was 6,7 years and the mean duration of follow-up was 8,3 years (range 2,0-22,0,SD 4,24). During the initial year of treatment, 70,3% of patients were seizure-free. The course of epilepsy was “excellent” in 53,1% of the subjects, “improving” in 22,8%, “relapsing” in 22,1% whereas only 6 children with idiopathic epilepsy (2%) had a “poor” clinical course exhibiting drug-resistance. After multivariate analysis, variables predictive of a poor initial response to therapy were early seizure onset, multiple seizure types and history of status epilepticus. At the end of follow-up, early response to treatment was of significant positive predictive value, while the presence of multiple seizure types and the history of migraine had a negative impact on prognosis. Conclusions In the vast majority of children, the long-term prognosis of idiopathic epilepsy is favorable. More than half of the patients attain seizure freedom immediately and their clinical course is considered “excellent”. About one fifth exhibit either an improving or a fluctuating course. Early

  15. Prognosis and Clinicopathologic Features of Patients With Advanced Stage Isocitrate Dehydrogenase (IDH) Mutant and IDH Wild-Type Intrahepatic Cholangiocarcinoma.

    Science.gov (United States)

    Goyal, Lipika; Govindan, Aparna; Sheth, Rahul A; Nardi, Valentina; Blaszkowsky, Lawrence S; Faris, Jason E; Clark, Jeffrey W; Ryan, David P; Kwak, Eunice L; Allen, Jill N; Murphy, Janet E; Saha, Supriya K; Hong, Theodore S; Wo, Jennifer Y; Ferrone, Cristina R; Tanabe, Kenneth K; Chong, Dawn Q; Deshpande, Vikram; Borger, Darrell R; Iafrate, A John; Bardeesy, Nabeel; Zheng, Hui; Zhu, Andrew X

    2015-09-01

    Conflicting data exist regarding the prognostic impact of the isocitrate dehydrogenase (IDH) mutation in intrahepatic cholangiocarcinoma (ICC), and limited data exist in patients with advanced-stage disease. Similarly, the clinical phenotype of patients with advanced IDH mutant (IDHm) ICC has not been characterized. In this study, we report the correlation of IDH mutation status with prognosis and clinicopathologic features in patients with advanced ICC. Patients with histologically confirmed advanced ICC who underwent tumor mutational profiling as a routine part of their care between 2009 and 2014 were evaluated. Clinical and pathological data were collected by retrospective chart review for patients with IDHm versus IDH wild-type (IDHwt) ICC. Pretreatment tumor volume was calculated on computed tomography or magnetic resonance imaging. Of the 104 patients with ICC who were evaluated, 30 (28.8%) had an IDH mutation (25.0% IDH1, 3.8% IDH2). The median overall survival did not differ significantly between IDHm and IDHwt patients (15.0 vs. 20.1 months, respectively; p = .17). The pretreatment serum carbohydrate antigen 19-9 (CA19-9) level in IDHm and IDHwt patients was 34.5 and 118.0 U/mL, respectively (p = .04). Age at diagnosis, sex, histologic grade, and pattern of metastasis did not differ significantly by IDH mutation status. The IDH mutation was not associated with prognosis in patients with advanced ICC. The clinical phenotypes of advanced IDHm and IDHwt ICC were similar, but patients with IDHm ICC had a lower median serum CA19-9 level at presentation. Previous studies assessing the prognostic impact of the isocitrate dehydrogenase (IDH) gene mutation in intrahepatic cholangiocarcinoma (ICC) mainly focused on patients with early-stage disease who have undergone resection. These studies offer conflicting results. The target population for clinical trials of IDH inhibitors is patients with unresectable or metastatic disease, and the current study is the first to

  16. Clinical course and seizure outcome of idiopathic childhood epilepsy: determinants of early and long-term prognosis.

    Science.gov (United States)

    Dragoumi, Pinelopi; Tzetzi, Olga; Vargiami, Efthimia; Pavlou, Evangelos; Krikonis, Konstantinos; Kontopoulos, Eleftherios; Zafeiriou, Dimitrios I

    2013-12-18

    Idiopathic epilepsies and epileptic syndromes predominate childhood and adolescence epilepsy. The aim of the present study was to investigate the clinical course and outcome of idiopathic childhood epilepsy and identify variables determining both early and long-term prognosis. We followed 303 children with newly diagnosed idiopathic epilepsy aged 1-14 years old, both prospectively and retrospectively. Outcome was defined at one, 2 and 4 years of follow-up, as well as at the end of the study period for all patients. Based on the data collected, patients were classified in four patterns of clinical course: "excellent", "improving", "relapsing" and "poor". Variables defined at intake and after the initial year of treatment were analyzed for their prognostic relevance towards the clinical course and outcome of the patients. The mean age at seizure onset was 6.7 years and the mean duration of follow-up was 8.3 years (range 2,0-22,0,SD 4,24). During the initial year of treatment, 70,3% of patients were seizure-free. The course of epilepsy was "excellent" in 53,1% of the subjects, "improving" in 22,8%, "relapsing" in 22,1% whereas only 6 children with idiopathic epilepsy (2%) had a "poor" clinical course exhibiting drug-resistance. After multivariate analysis, variables predictive of a poor initial response to therapy were early seizure onset, multiple seizure types and history of status epilepticus. At the end of follow-up, early response to treatment was of significant positive predictive value, while the presence of multiple seizure types and the history of migraine had a negative impact on prognosis. In the vast majority of children, the long-term prognosis of idiopathic epilepsy is favorable. More than half of the patients attain seizure freedom immediately and their clinical course is considered "excellent". About one fifth exhibit either an improving or a fluctuating course. Early seizure onset, multiple seizure types and status epilepticus are predictive of an

  17. Accuracy of prognosis estimates by four palliative care teams: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Costantini Massimo

    2002-03-01

    Full Text Available Abstract Background Prognosis estimates are used to access services, but are often inaccurate. This study aimed to determine the accuracy of giving a prognosis range. Methods and measurements A prospective cohort study in four multi-professional palliative care teams in England collected data on 275 consecutive cancer referrals who died. Prognosis estimates (minimum – maximum at referral, patient characteristics, were recorded by staff, and later compared with actual survival. Results Minimum survival estimates ranged Conclusions Offering a prognosis range has higher levels of accuracy (about double than traditional estimates, but is still very often inaccurate, except very close to death. Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.

  18. [Diagnosis and prognosis of preterm labor: physical examination and ultrasonography].

    Science.gov (United States)

    Goffinet, F; Kayem, G

    2002-11-01

    Diagnosis. Preterm labor is defined by cervical changes associated with regular painful uterine contractions (UC) between 22 and 36 weeks + 6 days. Tocometry does not improve diagnosis or prognosis, despite the identification of more UC (NP 4). Electromyography and cervical distensibility (cervicotonometer) are promising techniques but are still in the research field. Clinical markers for prognosis. Clinical markers associated with clinical cervical examination tested in scoring systems are not validated and can't be recommended in clinical practise (NP 4). Ultrasonographic examination of the cervix. Technical evaluation of ultrasonographic examination of the cervix is satisfactory (NP 3); the transvaginal technical have to be used (NP 3). This method has a better accuracy and reproducibility than clinical examination provided a good apprenticeship (NP 3). Three ultrasound abnormal criteria are defined: a short length, a large internal cervical os and the presence of a funnel in the cervical canal. The best cut-off of cervical length to predict preterm delivery lies between 18 and 30 mm (NP 3). The choice of the cutt-off level depends on the prectitioner: high sensitivity but with many false-positives (cut-off close to 30 mm) or lower sensitivity with few false-positives (close to 20 mm). Cervical length seems to be more accurate that internal os or presence of a funnel which should be used with caution in clinical decisions (NP 3). There is no comparative study about the use of ultrasonographic examination of the cervix in women with preterm labor to evaluate benefits and adverse effects in clinical practice. However, ultrasonographic examination of the cervix supply a progress identifying women at risk of preterm delivery and this technique has a better predictive value than clinical cervical examination (NP 3). It seems reasonable to recommend utilisation of ultrasonographic examination of the cervic in preterm labor. It would not seem reasonable to replace the

  19. Diagnosis and prognosis of fetal cardiomyopathies: a review.

    Science.gov (United States)

    Mongiovì, Maurizio; Fesslova, Vlasta; Fazio, Giovanni; Barbaro, Giuseppe; Pipitone, Salvatore

    2010-01-01

    is associated with systolic dysfunction. Etiologically primary fetal HCM is a heterogeneous condition that can be the result of intrinsic fetal pathology as well as of extrinsic factors. It can be concentric or asymmetric. Prognosis of infants with HCM associated with maternal diabetes is good while a bad prognosis has been reported in fetuses without diabetic mother. HCM may be evolutive, mainly after birth; otherwise there are also cases that improve or regress completely. Unfortunately, a poor outcome is observed in most, particularly in DCM, with only a few therapeutic options available. Detailed evaluation of fetal and maternal condition provide prognostic information for prenatal counselling and may lead to improved outcome of at least some affected pregnancies.

  20. [Severe pulmonary embolism revealed by status epilepticus].

    Science.gov (United States)

    Allou, N; Coolen-Allou, N; Delmas, B; Cordier, C; Allyn, J

    2016-12-01

    High-risk pulmonary embolism (PE) is associated with high mortality rate (>50%). In some cases, diagnosis of PE remains a challenge with atypical presentations like in this case report with a PE revealed by status epilepticus. We report the case of a 40-year-old man without prior disease, hospitalized in ICU for status epilepticus. All paraclinical examinations at admission did not show any significant abnormalities (laboratory tests, cardiologic and neurological investigations). On day 1, he presented a sudden circulatory collapse and echocardiography showed right intra-auricular thrombus. He was treated by thrombolysis and arteriovenous extracorporeal membrane oxygenation. After stabilization, computed tomography showed severe bilateral PE. He developed multi-organ failure and died 4days after admission. Pulmonary embolism revealed by status epilepticus has rarely been reported and is associated with poor prognosis. Physicians should be aware and think of the possibility of PE in patients with status epilepticus without any history or risk factors of seizure and normal neurological investigations. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Obesity and Breast Cancer Prognosis: Evidence, Challenges, and Opportunities.

    Science.gov (United States)

    Jiralerspong, Sao; Goodwin, Pamela J

    2016-12-10

    Purpose To summarize the evidence of an association between obesity and breast cancer prognosis. Methods We reviewed the literature regarding overweight and obesity and breast cancer survival outcomes, overall and with regard to breast cancer subtypes, breast cancer therapies, biologic mechanisms, and possible interventions. We summarize our findings and provide clinical management recommendations. Results Obesity is associated with a 35% to 40% increased risk of breast cancer recurrence and death and therefore poorer survival outcomes. This is most clearly established for estrogen receptor-positive breast cancer, with the relationship in triple-negative and human epidermal growth factor receptor 2-positive subtypes less well established. A range of biologic mechanisms that may underlie this association has been identified. Weight loss and lifestyle interventions, as well as metformin and other obesity-targeted therapies, are promising avenues that require further study. Conclusion Obesity is associated with inferior survival in breast cancer. Understanding the nature and mechanisms of this effect provides an important opportunity for interventions to improve the diagnosis, treatment, and outcomes of obese patients with breast cancer.

  2. Acute Kidney Injury: Epidemiology, Diagnosis, Prognosis, and Future Directions

    Directory of Open Access Journals (Sweden)

    Joana Briosa Neves

    2015-07-01

    Full Text Available Acute kidney injury (AKI is a common problem highly associated with hospitalisation. AKI is the cause of harmful short-term consequences: longer hospital stays, greater disability after discharge, and greater risk of in-hospital mortality, as well as adverse long-term outcomes, such as progression to chronic kidney disease, development of cardiovascular disease, and increased risk of long-term mortality. The concept of AKI has changed since the introduction of the ‘Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease’ (RIFLE classification. More recently, the ‘Kidney Disease Improving Global Outcomes’ (KDIGO classification appears to have provided increased diagnostic sensitivity and outcome-prediction capability. Novel biomarkers and further research on the role of the immune system in AKI may help improve the diagnosis, severity, outcome evaluation, and treatment of the condition. In this review we describe the epidemiology, diagnosis, and prognosis of AKI, as well as possible future directions for its clinical management.

  3. Immunophenotypes and Immune Markers Associated with Acute Promyelocytic Leukemia Prognosis

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    Fang Xu

    2014-01-01

    Full Text Available CD2+, CD34+, and CD56+ immunophenotypes are associated with poor prognoses of acute promyelocytic leukemia (APL. The present study aimed to explore the role of APL immunophenotypes and immune markers as prognostic predictors on clinical outcomes. A total of 132 patients with de novo APL were retrospectively analyzed. Immunophenotypes were determined by flow cytometry. Clinical features, complete remission (CR, relapse, and five-year overall survival (OS rate were assessed and subjected to multivariate analyses. The CD13+CD33+HLA-DR-CD34− immunophenotype was commonly observed in patients with APL. Positive rates for other APL immune markers including cMPO, CD117, CD64, and CD9 were 68.7%, 26%, 78.4%, and 96.6%, respectively. When compared with patients with CD2− APL, patients with CD2+ APL had a significantly higher incidence of early death (50% versus 15.7%; P=0.016, lower CR rate (50% versus 91.1%; P=0.042, and lower five-year OS rate (41.7% versus 74.2%; P=0.018. White blood cell (WBC count before treatment was found to be the only independent risk factor of early death, CR failure, and five-year mortality rate. Flow cytometric immunophenotype analysis can facilitate prompt APL diagnosis. Multivariate analysis has demonstrated that WBC count before treatment is the only known independent risk factor that predicts prognosis for APL in this study population.

  4. Apathy is associated with poor prognosis in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Caga, J; Turner, M R; Hsieh, S; Ahmed, R M; Devenney, E; Ramsey, E; Zoing, M C; Mioshi, E; Kiernan, M C

    2016-05-01

    Apathy is the most commonly reported behavioural change in amyotrophic lateral sclerosis (ALS). However, the degree to which it affects prognosis and overlaps with depression in this population is unknown. The present study examined the relationship between level of apathy, mortality and survival time and whether apathy was linked to specific symptom clusters of depression. A cohort of 76 consecutive ALS patients attending specialized multidisciplinary clinics were classified according to level of apathy. The effects of clinical factors and apathy on survival time were analysed using univariate and multivariate methods. The majority of patients with moderate to severe apathy died during the study (P = 0.003) and had a median survival time of 21.7 months, considerably shorter than patients with mild apathy (46.9 months) and no apathy (51.9 months) (P = 0.0001). Apathy remained a significant predictor of survival even after controlling for clinical factors and symptom duration at the time of study entry (hazard ratio 3.8, 95% confidence interval 1.9-7.5, P = 0.0001). Depression with demoralization was not associated with level of apathy (P = 0.172) whereas depression with anhedonia was more common in patients with apathy than in those without apathy (P = 0.006). The presence of severe apathy is an independent, negative prognostic factor in ALS. © 2016 EAN.

  5. Canine mast cell tumors: diagnosis, treatment, and prognosis

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    Garrett LD

    2014-08-01

    Full Text Available Laura D Garrett Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana, IL, USA Abstract: Mast cell tumors (MCTs are the most common malignant skin cancer in dogs, and significant variability exists in their biological behavior. Most MCTs are cured with appropriate local therapy, but a subset shows malignant behavior with the potential to spread to lymph nodes, liver, spleen, and other areas and to thus become a systemic cancer. Because of this variable behavior, it is difficult to predict how any individual tumor is going to behave. The variability thus creates uncertainty in deciding what a particular dog's prognosis is, whether staging tests to assess for metastasis are needed, and even what treatments will be necessary for best outcome. In addition to controversies over the potential for development of systemic disease, or diffuse metastasis, controversies also exist over what treatment is needed to best attain local control of these tumors. This article will briefly discuss the diagnosis of MCTs in dogs and will summarize the literature in regards to the controversial topics surrounding the more aggressive form of this disease, with recommendations made based on published studies. Keywords: mitotic index, mastocytosis, tyrosine kinase inhibitor, histologic grade

  6. Prognosis of Carotid Endarterectomy in High Risk Patients

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    MH Modaghegh

    2016-04-01

    Full Text Available Introduction: Carotid Endarterectomy (CE can be mentioned as a valuable theraputic method for primary and secondary prevention of stroke, provided it can be performed in vascular surgery centers with a low surgical risk. Thus, the present study aimed to assess prognosis of CE in high risk patients of an Iranian vascular surgery center. Methods: This prospective observational study consisted of 50 high risk CE patients during 2011-14 in Mashhad University of Medical Sciences. All the high risk CE were performed by a vascular surgeon and a surgical carotid shunt was placed in each CE. Neurologic evaluation was performed before CE and serial neurologic axamination was done after CE by a neurologist. Surgical complications including stroke, death and lower cranial nerve palsy were recorded for 30 days after operation. Results: The study results revealed that 80% of high risk CE patients had symptomatic carotid stenosis on the operation side and 80% had carotid stenosis contralateral to the operation side. Thirteen high risk CE were performed simultaneously with coronary artery by pass graft and 24 patients were demonstrated to have diabetes. Post surgical death and stroke in the high risk CE patients were reported 2% and 4%, respectively. Lower cranial nerve palsy appeared in 2% of patients. Conclusion: The 6% post operative stroke and death rate in the high risk CE patients are comparable to best vascular surgery centers in Europe and North America.

  7. Gene expression profiling for prognosis using Cox regression.

    Science.gov (United States)

    Pawitan, Y; Bjöhle, J; Wedren, S; Humphreys, K; Skoog, L; Huang, F; Amler, L; Shaw, P; Hall, P; Bergh, J

    2004-06-15

    Given the promise of rich biological information in microarray data we will expect an increasing demand for a robust, practical and well-tested methodology to provide patient prognosis based on gene expression data. In standard settings, with few clinical predictors, such a methodology has been provided by the Cox proportional hazard model, but no corresponding methodology is available to deal with the full set of genes in microarray data. Furthermore, we want the procedure to be able to deal with the general survival data that include censored information. Conceptually such a procedure can be constructed quite easily, but its implementation will never be straightforward due to computational problems. We have developed an approach that relies on an extension of the Cox proportional likelihood that allows random effects parameters. In this approach, we use the full set of genes in the analysis and deal with survival data in the most general way. We describe the development of the model and the steps in the implementation, including a fast computational formula based on a subsampling of the risk set and the singular value decomposition. Finally, we illustrate the methodology using a data set obtained from a cohort of breast cancer patients. Copyright 2004 John Wiley & Sons, Ltd.

  8. [Immunoregulants improves the prognosis of infants with wheezing].

    Science.gov (United States)

    Chen, Zhuang-Gui; Ji, Jing-Zhi; Li, Ming; Chen, Yan-Feng; Chen, Fen-Hua; Chen, Hong

    2007-10-01

    To assess the value of immunoregulants in improving the prognosis of infants with wheezing. Forty-three infants with wheezing with given oxygen support, injection or inhalation of glucocorticosteroids or bronchodilatator to relieve the symptoms. Of these infants, 24 received immunoregulant treatment with bronchovaxom at the daily dose of 3.5 mg for 10 days every a month for a treatment course of 3 months. The other 19 infants were managed with budesonide aerosol at 200 microg once or twice daily for 3 months (basic treatment group). All the infants were followed up for 1 year to record the number of wheezing episode and infections. Ten healthy infants were also included in this study as the control group. In infants with bronchovaxom treatment, 25% reported more than 3 wheezing episodes within the 1-year follow-up, a rate significantly lower than that in the control group (63.2%, Chi(2)=6.344, Pbronchovaxom group and the healthy control group (t=0.72, P>0.05), but significantly higher in the basic treatment group than in bronchovaxom and the healthy control group (t=3.11 and 3.92, respectively. PBronchovaxom can effectively reduce the recurrence of wheezing and respiratory infections in the infants with wheezing attack to reduce the risks of asthma development.

  9. Poor Prognosis in Acute Myeloid Leukemia Patients with Monosomal Karyotype

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    Junqing Xu

    2017-06-01

    Full Text Available Objective: This study aimed to investigate the clinical characteristics and prognostic significance of monosomal karyotypes (MKs in patients with acute myeloid leukemia (AML. Materials and Methods: We retrospectively analyzed the clinical data for 498 patients with AML, of whom 233 (46.8% had an abnormal karyotype, including 42 with MKs (8.4% and 70 with a complex karyotype (CK (14.1%. Results: Patients with MKs were older (median age 62.5 vs. 52 years, p=0.003 and had lower median hemoglobin levels (62.5 vs. 77 g/L, p=0.009 and lower white blood cell counts (7.0×109/L vs. 11.7×109/L, p=0.008. Univariate analysis showed that patients with MKs or CKs had shorter overall survival than patients without these karyotypes (median survival time 7.3 vs. 26.3 months for MK, p<0.001, and 14.8 vs. 26.3 months for CK, p<0.001. In multivariable analysis for overall survival, MK and National Comprehensive Cancer Network prognostic group were the only significant factors. Conclusion: MK is an independent risk factor for poor prognosis in AML patients.

  10. Complications and visual prognosis in children with aniridia.

    Science.gov (United States)

    Lee, Helena; Meyers, Katrina; Lanigan, Bernadette; O'Keefe, Michael

    2010-01-01

    To characterize the ophthalmological findings, assess surgical outcomes, and review visual outcomes in aniridia. A retrospective case review was performed and data were collected, including patient demographics, incidence of aniridia-associated keratopathy, glaucoma, cataract, retinal breaks or detachments, optic nerve hypoplasia, macular hypoplasia, poor vision, and nystagmus. All outcomes from surgery, including penetrating keratoplasty, trabeculectomy, Ahmed valve insertion, and cataract extraction, were recorded. Six children (12 eyes) had corneal abnormalities, 4 had optic nerve hypoplasia, 9 had nystagmus, and 2 had retinal detachments. Four patients (7 eyes) required penetrating keratoplasty. Five patients (9 eyes) developed glaucoma and only 1 of the 4 trabeculectomies performed succeeded. Of the 6 Ahmed valve procedures performed, all succeeded in maintaining a satisfactory intraocular pressure but some required needling and 5-fluorouracil. Eight patients developed cataract and 7 required surgery. Visual outcomes were poor despite treatment. Nine patients had Snellen acuity of 6/60 or less and required low visual aids to function. Aniridia is a disorder that requires multiple surgeries. It has a poor visual prognosis despite early diagnosis and aggressive management. Newer techniques such as Ahmed valves and Boston keratoprostheses offer hope, but its proliferative nature makes treatment difficult.

  11. MicroRNA-429 Modulates Hepatocellular Carcinoma Prognosis and Tumorigenesis

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    Xiao-Ying Huang

    2013-01-01

    Full Text Available MicroRNA-429 (miR-429 may modify the development and progression of cancers; however, the role of this microRNA in the hepatocellular carcinoma (HCC has not been well elaborated. Here, we tested miR-429 expression in 138 pathology-diagnosed HCC cases and SMMC-7721 cells. We found that miR-429 was upregulated in HCC tumor tissues and that the high expression of miR-429 was significantly correlated with larger tumor size (odd ratio (OR, 2.70; 95% confidence interval (CI, 1.28–5.56 and higher aflatoxin B1-DNA adducts (OR = 3.13, 95% CI = 1.47–6.67. Furthermore, this microRNA overexpression modified the recurrence-free survival and overall survival of HCC patients. Functionally, miR-429 overexpression progressed tumor cells proliferation and inhibited cell apoptosis. These results indicate for the first time that miR-429 may modify HCC prognosis and tumorigenesis and may be a potential tumor therapeutic target.

  12. Diagnosis and prognosis of acute hamstring injuries in athletes.

    Science.gov (United States)

    Kerkhoffs, Gino M M J; van Es, Nick; Wieldraaijer, Thijs; Sierevelt, Inger N; Ekstrand, Jan; van Dijk, C Niek

    2013-02-01

    Identification of the most relevant diagnostic and prognostic factors of physical examination and imaging of hamstring injuries in (elite) athletes. A literature search was conducted in MEDLINE and EMBASE for articles between 1950 and April 2011. A survey was distributed among the members of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy, which focused on physical examination, prognosis, imaging and laboratory tests of hamstring injuries in (elite) athletes. Medical history, inspection and palpation of the muscle bellies and imaging are most valuable at the initial assessment according to the literature. Experts considered medical history, posture and gait inspection, inspection and palpation of muscle bellies, range of motion tests, manual muscle testing, referred pain tests and imaging to be most important in the initial assessment of hamstring injuries. Magnetic resonance imaging (MRI) is preferred over ultrasonography and should take place within 3 days post-trauma. Important prognostic factors are injury grade, length of the muscle tear on MR images, MRI-negative injuries and trauma mechanism. Posture and gait inspection, inspection and palpation of muscle bellies, range of motion tests, manual muscle testing and referred pain tests within 2 days post-trauma were identified as the most relevant diagnostic factors. Literature review and expert opinion, Level V.

  13. Prognosis of CKD Patients Receiving Outpatient Nephrology Care in Italy

    Science.gov (United States)

    Chiodini, Paolo; Zoccali, Carmine; Borrelli, Silvio; Cianciaruso, Bruno; Di Iorio, Biagio; Santoro, Domenico; Giancaspro, Vincenzo; Abaterusso, Cataldo; Gallo, Ciro; Conte, Giuseppe; Minutolo, Roberto

    2011-01-01

    Summary Background and objectives Prognosis in nondialysis chronic kidney disease (CKD) patients under regular nephrology care is rarely investigated. Design, setting, participants, & measurements We prospectively followed from 2003 to death or June 2010 a cohort of 1248 patients with CKD stages 3 to 5 and previous nephrology care ≥1 year in 25 Italian outpatient nephrology clinics. Cumulative incidence of ESRD or death before ESRD were estimated using the competing-risk approach. Results Estimated rates (per 100 patient-years) of ESRD and death 8.3 (95% confidence interval [CI], 7.4 to 9.2) and 5.9 (95% CI 5.2 to 6.6), respectively. Risk of ESRD and death increased progressively from stages 3 to 5. ESRD was more frequent than death in stage 4 and 5 CKD, whereas the opposite was true in stage 3 CKD. Younger age, lower body mass index, proteinuria, and high phosphate predicted ESRD, whereas older age, diabetes, previous cardiovascular disease, ESRD, proteinuria, high uric acid, and anemia predicted death (P nephrology clinics, ESRD was a more frequent outcome than death in stage 4 and 5 CKD, but the opposite was true in stage 3. Outcomes were predicted by modifiable risk factors specific to CKD. Proteinuria used in conjunction with estimated GFR refined risk stratification. These findings provide information, specific to CKD patients under regular outpatient nephrology care, for risk stratification that complement recent observations in the general population. PMID:21817127

  14. ALCAPA: the role of myocardial viability studies in determining prognosis

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    Browne, Lorna P.; Krishnamurthy, Rajesh [Texas Children' s Hospital, Department of Diagnostic Imaging, Houston, TX (United States); Kearney, Debra [Texas Children' s Hospital, Department of Pathology, Houston, TX (United States); Taylor, Michael D.; Slesnick, Timothy C.; Nutting, Arni C. [Texas Children' s Hospital, Department of Cardiology, Houston, TX (United States); Chung, Taylor [Children' s Hospital and Research Center, Department of Diagnostic Imaging, Oakland, CA (United States)

    2010-02-15

    ALCAPA is optimally treated by coronary artery reimplantation early in neonatal life. Delayed diagnosis, however, is not infrequent, because symptoms often do not manifest until about 3 months of age, coinciding with the physiological nadir in pulmonary vascular resistance. With delayed diagnosis, there is potential for coronary steal and irreversible myocardial injury, which worsens outcome. To assess the utility of MRI in determining prognosis in children with surgically corrected ALCAPA. A retrospective chart review was performed in two children with ALCAPA who underwent coronary reimplantation and postoperative cardiac MRI. Both children subsequently underwent cardiac transplantation. The imaging findings and pathological findings at explant are presented. In both children, there was severe, globally depressed left ventricular systolic function and abnormal delayed enhancement in a predominantly subendocardial distribution. Pathological examination of the cardiac explants showed extensive fibrotic tissue, which correlated with areas of abnormal delayed enhancement on MRI. Severe reduction in systolic function and presence of delayed enhancement indicate extensive myocardial injury and pathologically correlate with irreversible fibrotic changes, which may help identify a subgroup of children who will not recover ventricular function and ultimately require heart transplantation. (orig.)

  15. GP discussion of prognosis with patients with severe chronic obstructive pulmonary disease: a qualitative study

    Science.gov (United States)

    Halliwell, Joan; Mulcahy, Patrick; Buetow, Stephen; Bray, Yvonne; Coster, Gregor; Osman, Liesl M

    2004-01-01

    Background: Recent research shows that health professionals do not communicate about prognosis with patients with chronic obstructive pulmonary disease (COPD) as openly as with patients who have cancer. Aim: To identify strategies that general practitioners (GPs) can use to facilitate discussion of prognosis with patients who have COPD. Design of study: Telephone interviews of 15 GPs and five respiratory consultants on the topic of discussing prognosis with patients who have severe COPD. Setting: Participating doctors worked in the Auckland region of New Zealand. Method: GPs and consultants were selected purposively to detect unique and shared patterns from diversity in how prognosis is discussed with patients with severe COPD. An interview guide was developed from a literature review and results of our earlier postal survey of GPs. Transcripts of audiotaped interviews were analysed independently and then together by three authors, using a general inductive approach. Results: Seven strategies were identified that GPs had used or could use to facilitate discussion of prognosis with patients with COPD. These were: be aware of implications of diagnosis; use uncertainty to ease discussion; build relationship with patients; be caring and respectful; begin discussion early in disease course; identify and use opportunities to discuss prognosis; and work as a team. Conclusion: A number of suggested strategies can be used to facilitate discussion of prognosis with patients who have severe COPD. PMID:15588534

  16. Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study.

    Science.gov (United States)

    Moreira, Wagner Brant; Brandão, Eduardo Carvalho; Soares, Aleida Nazareth; Lucena, Clécio Enio Murta de; Antunes, Carlos Maurício Figueiredo

    2010-05-01

    Previous studies have suggested that the occurrence of pregnancy concomitantly with a diagnosis of breast cancer may affect the evolution of the neoplasia. The present study aimed to compare pregnancy-associated breast cancer (PABC) patients with non-pregnant cancer patients (controls) in relation to the time taken to diagnose the disease, tumor characteristics and mortality. A retrospective, paired case-control study was conducted at the Hospital da Santa Casa de Misericórdia and Centro de Quimioterapia Antiblástica e Imunoterapia in Belo Horizonte, Brazil. The study involved 87 PABC and 252 control patients. The influence of covariables (interval between first symptoms and diagnosis, tumor histology, size of primary tumor, distant metastasis, grade of malignancy, hormone receptor status and axillary lymph node involvement) and the pregnancy variable on overall survival was investigated using univariate and multivariate analyses. The median overall survival for PABC patients of 30.1 months (95% confidence interval, CI: 19.4-40.9 months) was significantly different (P = 0.005) from that of the control group (53.1 months; 95% CI: 35.1-71.0 months). The cumulative overall survivals after five and ten years were, respectively, 29.7 and 19.2% for PABC patients, and 47.3 and 34.8% for control patients (P = 0.005). Tumor size, grade of malignancy, distant metastasis and pregnancy were independent factors that significantly modified disease prognosis. Pregnancy was an independent prognostic factor. The overall survival of PABC patients was shorter than that of non-pregnant patients.

  17. Analysis of four scoring systems for the prognosis of patients with metastasis of the vertebral column.

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    Pollner, Péter; Horváth, Anna; Mezei, Tamás; Banczerowski, Péter; Czigléczki, Gábor

    2018-01-31

    The metastatic spinal diseases are common health problems and there is no consensus on the appropriate treatment of metastases in several conditions. Using clinical measures (e.g. survival time, functional status), the prognosis prediction systems advise on the appropriate interventions. The aim of this article is to assess and compare four widely used scoring systems (revised Tokuhashi, Tomita, Van der Linden and modified Bauer scores) on a single center cohort. A retrospective study of 329 patients was designed who were subjected to surgeries because of metastatic spinal diseases. Subpopulations according to the classifications of four scoring systems were identified. The overall survival was calculated with the Kaplan-Meier formula. The difference between the survival curves of subpopulations was analyzed with the log-rank tests. The consistency rates for the four scoring systems are calculated as well. The follow up period was 8 years. The median survival time was 222 days. The overall survival of prognostic categories in three scoring systems was significantly differing from each other, but we found no differences between the categories of the van der Linden system. In this cohort the revised Tokuhashi system gave the best approximation for the survival time with a mean predictive capability 60.5%. The evaluation of four standard scoring systems showed that three of them were self-consistent although, none of systems was able to predict the survival rates in our cohort. Based on the predictive capability, the revised Tokuhashi system may provide the best predictions with careful examination of individual cases. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Heterogeneity of Patients With Intermediate-Prognosis Metastatic Renal Cell Carcinoma Treated With Sunitinib.

    Science.gov (United States)

    Sella, Avishay; Michaelson, M Dror; Matczak, Ewa; Simantov, Ronit; Lin, Xun; Figlin, Robert A

    2017-04-01

    The Memorial Sloan Kettering Cancer Center (MSKCC) and International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) models categorize patients with 1 or 2 risk factors as intermediate prognosis (INTMP). This category encompasses 15 and 19 permutations of the MSKCC and IMDC risk factors, respectively. The purpose of the present retrospective analysis of data from INTMP patients in 6 clinical trials was to determine whether this heterogeneity influences the response to sunitinib. Patients with INTMP metastatic renal cell carcinoma (mRCC) were identified using the MSKCC and IMDC classifications. The statistical data were analyzed using Cox regression analysis, Kaplan-Meier methods, and Pearson χ(2) tests. The patient characteristics and risk factors were similar in the MSKCC (n = 548) and IMDC (n = 517) groups. Overall, 59% had 1 risk factor and 41% had 2 risk factors. The most common was low hemoglobin alone or with an interval of < 1 year since diagnosis. In both groups, patients with 1 risk factor had longer overall survival (OS) and progression-free survival (PFS) than did those with 2 risk factors (P < .001 for both outcomes). Patients in the IMDC group with 1 risk factor had a greater objective response rate (ORR; P = .023). In both groups, OS was longer for patients with Eastern Cooperative Oncology Group performance status (ECOG PS) 0 than for those with ECOG PS 1 or 2 (P < .001). An ECOG PS of 0 was also associated with superior PFS and ORR in the MSKCC group (P < .05). INTMP comprises a heterogeneous group of mRCC patients in whom the number of risk factors and ECOG PS might predict the outcome with sunitinib. Copyright © 2016 Elsevier Inc. All rights reserved.

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

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    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

  20. Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study

    Directory of Open Access Journals (Sweden)

    Wagner Brant Moreira

    Full Text Available CONTEXT AND OBJECTIVE: Previous studies have suggested that the occurrence of pregnancy concomitantly with a diagnosis of breast cancer may affect the evolution of the neoplasia. The present study aimed to compare pregnancy-associated breast cancer (PABC patients with non-pregnant cancer patients (controls in relation to the time taken to diagnose the disease, tumor characteristics and mortality. DESIGN AND SETTING: A retrospective, paired case-control study was conducted at the Hospital da Santa Casa de Misericórdia and Centro de Quimioterapia Antiblástica e Imunoterapia in Belo Horizonte, Brazil. METHODS: The study involved 87 PABC and 252 control patients. The influence of covariables (interval between first symptoms and diagnosis, tumor histology, size of primary tumor, distant metastasis, grade of malignancy, hormone receptor status and axillary lymph node involvement and the pregnancy variable on overall survival was investigated using univariate and multivariate analyses. RESULTS: The median overall survival for PABC patients of 30.1 months (95% confidence interval, CI: 19.4-40.9 months was significantly different (P = 0.005 from that of the control group (53.1 months; 95% CI: 35.1-71.0 months. The cumulative overall survivals after five and ten years were, respectively, 29.7 and 19.2% for PABC patients, and 47.3 and 34.8% for control patients (P = 0.005. Tumor size, grade of malignancy, distant metastasis and pregnancy were independent factors that significantly modified disease prognosis. CONCLUSIONS: Pregnancy was an independent prognostic factor. The overall survival of PABC patients was shorter than that of non-pregnant patients.

  1. Long-term ocular prognosis in 327 children with congenital toxoplasmosis.

    Science.gov (United States)

    Wallon, Martine; Kodjikian, Laurent; Binquet, Christine; Garweg, Justus; Fleury, Jacques; Quantin, Catherine; Peyron, François

    2004-06-01

    Retinochoroiditis is the most frequent consequence of congenital toxoplasmosis. Early diagnosis and treatment are believed to reduce the risk of visual impairment. We report on the clinical evolution of ocular lesions and final visual function in a prospective cohort of congenitally infected children who were identified during monthly maternal prenatal screening. The study included 327 congenitally infected children who were monitored for up to 14 years at the Croix Rousse Hospital in Lyon, France. Data on date of maternal infection; time and type of therapy; antenatal, neonatal, and postnatal work-ups; and ocular status were analyzed. All mothers but 52 had been treated. Pyrimethamine and sulfadiazine was given in utero to 38% of children and after birth to 72% of newborns. Fansidar was given for an average duration of 337 days in all but 2 children. After a median follow-up of 6 years, 79 (24%) children had at least 1 retinochoroidal lesion. In 23 (29%) of them, at least 1 new event had been diagnosed up to 10 years after detection of the first lesions: reactivation of an existing lesion (1 case), new lesion in a previously healthy location (19 cases), or both (3 cases). Fifty-five children had lesions in 1 eye; of the 45 children for whom final visual acuity data were available, 31 (69%) had normal vision. Twenty-four children had lesions in both eyes; of the 21 for whom final visual acuity data were available, 11 had normal vision in both eyes. None had bilateral visual impairment. Clinicians, parents, and elder children with congenital infection should be informed that late-onset retinal lesions and relapse can occur many years after birth but that the overall ocular prognosis of congenital toxoplasmosis is satisfactory when infection is identified early and treated accordingly.

  2. Fasting blood glucose level and prognosis in non-small cell lung cancer (NSCLC) patients.

    Science.gov (United States)

    Luo, Juhua; Chen, Yea-Jyh; Chang, Li-Jung

    2012-05-01

    Diabetes has been consistently linked to many forms of cancers, such as liver, colorectal, pancreatic, and breast cancer, however, the role of diabetes in outcome among cancer patients remains unclear. In this study, we retrospectively reviewed electronic medical records of 342 inpatients newly diagnosed with NSCLC referred by a teaching hospital cancer center in southern Taiwan between 2005 and 2007 to examine the effects of fasting glucose levels at time of cancer diagnosis on overall survival in patients with non-small cell lung cancer (NSCLC). All patients were followed up until the end of 2010. The Kaplan-Meier method was used to compare survival curves for patients with and without diabetes. The Cox proportional hazards model was used to estimate hazard ratios for the association between diabetes, other prognostic factors and patient survival. We observed that significant prognostic factors for poor overall survival in patients with NSCLC included older age, smoking, poor performance status, advanced stage (stage IIIB or IV), and no cancer-directed surgery treatment. Particularly, we identified that diabetic state defined by fasting blood glucose level ≥126 mg/dl was another independent prognostic factor for these patients. Compared with those who had normal range of fasting glucose level (70-99 mg/dl), patients with high fasting glucose level (≥126 mg/dl) had 69% excess risk of all-cause mortality in patients with NSCLC. Diabetes as indicated by elevated fasting blood glucose was independently associated with a significantly higher risk of all-cause mortality in patients with NSCLC, indicating that diabetes or hyperglycemia effectively controlled may present an opportunity for improving prognosis in NSCLS patients with abnormal glucose level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Neural network cascade optimizes microRNA biomarker selection for nasopharyngeal cancer prognosis.

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    Wenliang Zhu

    Full Text Available MicroRNAs (miRNAs have been shown to be promising biomarkers in predicting cancer prognosis. However, inappropriate or poorly optimized processing and modeling of miRNA expression data can negatively affect prediction performance. Here, we propose a holistic solution for miRNA biomarker selection and prediction model building. This work introduces the use of a neural network cascade, a cascaded constitution of small artificial neural network units, for evaluating miRNA expression and patient outcome. A miRNA microarray dataset of nasopharyngeal carcinoma was retrieved from Gene Expression Omnibus to illustrate the methodology. Results indicated a nonlinear relationship between miRNA expression and patient death risk, implying that direct comparison of expression values is inappropriate. However, this method performs transformation of miRNA expression values into a miRNA score, which linearly measures death risk. Spearman correlation was calculated between miRNA scores and survival status for each miRNA. Finally, a nine-miRNA signature was optimized to predict death risk after nasopharyngeal carcinoma by establishing a neural network cascade consisting of 13 artificial neural network units. Area under the ROC was 0.951 for the internal validation set and had a prediction accuracy of 83% for the external validation set. In particular, the established neural network cascade was found to have strong immunity against noise interference that disturbs miRNA expression values. This study provides an efficient and easy-to-use method that aims to maximize clinical application of miRNAs in prognostic risk assessment of patients with cancer.

  4. Nonendemic HPV-Positive Nasopharyngeal Carcinoma: Association With Poor Prognosis

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    Stenmark, Matthew H., E-mail: stenmark@med.umich.edu [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); McHugh, Jonathan B. [Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Schipper, Matthew [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Department of Biostatistics, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Walline, Heather M.; Komarck, Christine [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Worden, Francis P. [Department of Medical Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Wolf, Gregory T.; Chepeha, Douglas B.; Prince, Mark E.; Bradford, Carol R. [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Mukherji, Suresh K. [Department of Radiology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Eisbruch, Avraham [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Carey, Thomas E. [Department of Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan (United States)

    2014-03-01

    Purpose: To investigate the relationship between human papillomavirus (HPV) and Epstein-Barr virus (EBV) in nonendemic nasopharyngeal carcinoma (NPC) and assess the prognostic implications of viral status. Methods and Materials: Paraffin-embedded tumor specimens from 62 patients with primary NPC diagnosed between 1985 and 2011 were analyzed for EBV and high-risk HPV. EBV status was determined by the use of in situ hybridization for EBV encoded RNA. HPV status was assessed with p16 immunohistochemistry and multiplex polymerase chain reaction MassArray for determination of HPV type. Proportional hazards models were used to compare the risk of death among patients as stratified by viral status. Results: Of 61 evaluable tumors, 26 (43%) were EBV-positive/HPV-negative, 18 (30%) were HPV-positive/EBV-negative, and 17 (28%) were EBV/HPV-negative. EBV and HPV infection was mutually exclusive. HPV positivity was significantly correlated with World Health Organization grade 2 tumors, older age, and smoking (all P<.001). The racial distribution of the study population was 74% white, 15% African American, and 11% Asian/Middle Eastern. Among HPV-positive patients, 94% were white. At a median follow-up time of 7 years, HPV-positive and EBV/HPV-negative tumors exhibited worse outcomes than did EBV-positive tumors, including decreased overall survival (hazard ratio [HR] 2.98, P=.01; and HR 3.89, P=.002), progression-free survival (HR 2.55, P=.02; and HR 4.04, P<.001), and locoregional control (HR 4.01, P=.03; and HR 6.87, P=.001). Conclusion: In our Midwestern population, high-risk HPV infection may play an etiologic role in the development of nonendemic, EBV-negative NPC. Compared with EBV-positive NPC, HPV-positive and EBV/HPV-negative NPC are associated with worse outcomes. A larger confirmatory study is needed to validate these findings.

  5. Risk Factors of Poor Prognosis after Whiplash Injury

    Directory of Open Access Journals (Sweden)

    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

  6. [Tumor size and prognosis in patients with Wilms tumor].

    Science.gov (United States)

    Provenzi, Valentina Oliveira; Rosa, Rafael Fabiano Machado; Rosa, Rosana Cardoso Manique; Roehe, Adriana Vial; dos Santos, Pedro Paulo Albino; Faulhaber, Fabrízia Rennó Sodero; de Oliveira, Ceres Andréia Vieira; Zen, Paulo Ricardo Gazzola

    2015-01-01

    Investigate the relationship of the tumor volume after preoperative chemotherapy (TVAPQ) and before preoperative chemotherapy (TVBPQ) with overall survival at two and at five years, and lifetime. Our sample consisted of consecutive patients evaluated in the period from 1989 to 2009 in an Onco-Hematology Service. Clinical, histological and volumetric data were collected from the medical records. For analysis, chi-square, Kaplan-Meier, log-rank and Cox regression tests were used. The sample consisted of 32 patients, 53.1% were male with a median age at diagnosis of 43 months. There was a significant association between TVAPQ >500 mL and the difference between the TVBPQ and TVAPQ (p=0.015) and histologic types of risk (p=0.008). It was also verified an association between the difference between the TVBPQ and TVAPQ and the predominant stromal tumor (p=0.037). When assessing the TVAPQ of all patients, without a cutoff, there was an association of the variable with lifetime (p=0.013), i.e., for each increase of 10 mL in TVAPQ there was an average increase of 2% in the risk of death. Although our results indicate that the TVAPQ could be considered alone as a predictor of poor prognosis regardless of the cutoff suggested in the literature, more studies are needed to replace the histology and staging by tumor size as best prognostic variable. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Seizure prognosis of patients with low-grade tumors.

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    Kahlenberg, Cynthia A; Fadul, Camilo E; Roberts, David W; Thadani, Vijay M; Bujarski, Krzysztof A; Scott, Rod C; Jobst, Barbara C

    2012-09-01

    Seizures frequently impact the quality of life of patients with low grade tumors. Management is often based on best clinical judgment. We examined factors that correlate with seizure outcome to optimize seizure management. Patients with supratentorial low-grade tumors evaluated at a single institution were retrospectively reviewed. Using multiple regression analysis the patient characteristics and treatments were correlated with seizure outcome using Engel's classification. Of the 73 patients with low grade tumors and median follow up of 3.8 years (range 1-20 years), 54 (74%) patients had a seizure ever and 46 (63%) had at least one seizure before tumor surgery. The only factor significantly associated with pre-surgical seizures was tumor histology. Of the 54 patients with seizures ever, 25 (46.3%) had a class I outcome at last follow up. There was no difference in seizure outcome between grade II gliomas (astrocytoma grade II, oligodendroglioma grade II, mixed oligo-astrocytoma grade II) and other pathologies (pilocytic astrocytoma, ependymomas, DNET, gangliocytoma and ganglioglioma). Once seizures were established seizure prognosis was similar between different pathologies. Chemotherapy (p=0.03) and radiation therapy (p=0.02) had a positive effect on seizure outcome. No other parameter including significant tumor growth during the follow up period predicted seizure outcome. Only three patients developed new-onset seizures after tumor surgery that were non-perioperative. Anticonvulsant medication was tapered in 14 patients with seizures and 10 had no further seizures. Five patients underwent additional epilepsy surgery with a class I outcome in four. Two patients received a vagal nerve stimulator with >50% seizure reduction. Seizures at presentation are the most important factor associated with continued seizures after tumor surgery. Pathology does not influence seizure outcome. Use of long term prophylactic anticonvulsants is unwarranted. Chemotherapy and

  8. Machine learning applications in cancer prognosis and prediction

    Directory of Open Access Journals (Sweden)

    Konstantina Kourou

    2015-01-01

    Full Text Available Cancer has been characterized as a heterogeneous disease consisting of many different subtypes. The early diagnosis and prognosis of a cancer type have become a necessity in cancer research, as it can facilitate the subsequent clinical management of patients. The importance of classifying cancer patients into high or low risk groups has led many research teams, from the biomedical and the bioinformatics field, to study the application of machine learning (ML methods. Therefore, these techniques have been utilized as an aim to model the progression and treatment of cancerous conditions. In addition, the ability of ML tools to detect key features from complex datasets reveals their importance. A variety of these techniques, including Artificial Neural Networks (ANNs, Bayesian Networks (BNs, Support Vector Machines (SVMs and Decision Trees (DTs have been widely applied in cancer research for the development of predictive models, resulting in effective and accurate decision making. Even though it is evident that the use of ML methods can improve our understanding of cancer progression, an appropriate level of validation is needed in order for these methods to be considered in the everyday clinical practice. In this work, we present a review of recent ML approaches employed in the modeling of cancer progression. The predictive models discussed here are based on various supervised ML techniques as well as on different input features and data samples. Given the growing trend on the application of ML methods in cancer research, we present here the most recent publications that employ these techniques as an aim to model cancer risk or patient outcomes.

  9. Pars planitis: Epidemiology, clinical characteristics, management and visual prognosis

    Directory of Open Access Journals (Sweden)

    Pinar Cakar Ozdal

    2015-01-01

    Full Text Available Pars planitis is an idiopathic chronic intermediate uveitis which predominantly affects children and adolescents, and accounts for 5-26.7% of pediatric uveitis. Although an autoimmune process with a genetic predisposition has been suggested, its etiology still remains unknown. The most common presenting symptoms are floaters and blurred vision. Diffuse vitreous cells, haze, snowballs and snowbanks are typical findings of pars planitis. Peripheral retinal vasculitis, optic disc edema and anterior segment inflammation are other well-known findings. Although pars planitis is known to be a benign form of uveitis in most cases, it may become a potentially blinding disease due to complications including cataract, cystoid macular edema, vitreous opacities and optic disc edema. Cystoid macular edema is the most common cause of visual morbidity. Band keratopathy, epiretinal membrane formation, vitreous condensation, neovascularizations, vitreous hemorrhage, retinal detachment, cyclitic membranes, glaucoma and amblyopia may develop as a consequence of the chronic course of the disease. Exclusion of infectious and non-infectious causes which may present with intermediate uveitis is of utmost importance before starting treatment. Treatment of pars planitis has been a controversial issue. There is no consensus specifically for treatment of cases with minimal inflammation and relatively good visual acuity. However, current experience shows that pars planitis may cause severe inflammation and needs an aggressive treatment. A stepladder approach including corticosteroids, immunosupressive agents, anti-tumor necrosis factor-alpha and pars plana vitrectomy and/or laser photocoagulation is the most commonly used method for treatment of pars planitis. Adequate control of inflammation and prompt detection of associated complications are crucial in order to improve the overall prognosis of the disease.

  10. ST2 and patient prognosis in chronic heart failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Zhang, Yuhui; Ky, Bonnie

    2015-04-02

    Biomarkers of cardiovascular diseases are indispensable tools for diagnosis and prognosis, and the use of several biomarkers is now considered the standard of care. New markers continue to be developed, but few prove to be substantially better than established markers. Suppression of tumorigenicity 2 (ST2) is a marker of cardiomyocyte stress and fibrosis that provides incremental value to natriuretic peptides for risk stratification of patients with a wide spectrum of cardiovascular diseases. On the basis of all available data, the 2013 American College of Cardiology and American Heart Association guidelines now recommend measurement of ST2 for additive risk stratification in patients with acute or chronic ambulatory heart failure (HF). This report provides an up-to-date overview of the clinical studies that led to the endorsement of ST2 as a cardiovascular prognostic marker in chronic HF. The presented data suggest that the addition of ST2 to a model that includes established mortality risk factors, including natriuretic peptides, substantially improves the risk stratification for death and HF hospitalization in patients with HF. ST2's prognostic value remains strong even in the subset of patients with renal insufficiency and is superior to other remodeling-fibrosis biomarkers currently being evaluated. In conclusion, these results have been repeatedly validated; thus, ST2 could be rapidly incorporated into clinical practice for risk prediction. Indeed, the body of evidence supporting the use of ST2 in chronic HF stratification continues to grow, with consistent data from cohorts around the world in single-center (Barcelona, Brussels, and San Diego cohorts) and multicenter (Penn Heart Failure Study [PHFS] and Muerte Subita en Insuficiencia Cardiac [MUSIC]) studies and in post hoc studies from clinical trials (Prospective Randomized Amlodipine Survival Evaluation 2 [PRAISE-2], Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training [HF

  11. Akt expression may predict favorable prognosis in cholangiocarcinoma.

    Science.gov (United States)

    Javle, Milind M; Yu, Jihnhee; Khoury, Thaer; Chadha, Krishdeep S; Chadha, Krishdeep C; Iyer, Renuka V; Foster, Jason; Kuvshinoff, Boris W; Gibbs, John F; Geradts, Joseph; Black, Jennifer D; Brattain, Michael G

    2006-11-01

    Overexpression of signaling proteins including epidermal growth factor receptor (EGFR), Akt, mitogen activated protein kinase (MAPK) and cyclooxygenase-2 (COX-2) occurs in cholangiocarcinoma cell lines. However, the prognostic value of these markers is unknown. No prior study correlated the expression of these signaling proteins with clinical outcome. Further, co-expression of these proteins has not been reported. Co-expression may reflect cross-talk between signaling pathways. The aim of this clinicopathological study was to investigate the overexpression and co-expression of EGFR and related signaling proteins in cholangiocarcinoma and explore their relationship to clinical outcome. Twenty-four consecutive cases of cholangiocarcinoma treated from 1996 to 2002 at Roswell Park Cancer Institute were included. Immunohistochemical staining of paraffin-embedded tissue sections was performed using antibodies against Akt, p-Akt, MAPK, p-MAPK, COX-2, EGFR and p-EGFR. Two pathologists independently scored the protein expression. Cyclooxygenase-2, Akt, and p-MAPK were commonly expressed in biliary cancers (100%, 96% and 87% of malignant cells, respectively). EGFR (60%) and p-EGFR (22%) overexpression was also detected. There was a significant association between EGFR and p-EGFR (P = 0.027) and between Akt and p-Akt (P = 0.017) expression in tumor tissue. A noteworthy association was shown between MAPK and p-Akt (P = 0.054). Multivariate analysis using the Cox proportional hazard model identified the use of chemotherapy (hazard ratio [HR] = 0.039, P = 0.0002), radiation (HR = 0.176, P = 0.0441) and Akt expression (HR = 0.139, P = 0.006) as the best predictors of overall prognosis. Epidermal growth factor receptor signaling intermediates are commonly expressed in cholangiocarcinoma. Expression of Akt and use of systemic chemotherapy or radiation may correlate with improved survival.

  12. HER family receptor expression and prognosis in pancreatic cancer.

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    Bittoni, Alessandro; Mandolesi, Alessandra; Andrikou, Kalliopi; Santoni, Matteo; Alfonsi, Simona; Lanese, Andrea; Loretelli, Cristian; Pellei, Chiara; Piva, Francesco; Scarpelli, Marina; Cascinu, Stefano

    2015-07-22

    HER family receptors play a key role in tumor progression in several malignancies, such as colorectal, lung or breast cancer. The aims of this study were to investigate expression of HER-1, HER-2 and HER-3 in pancreatic cancer (PC) samples and evaluate the association between HER-family receptor expression and patients' clinical outcomes. Tissue samples from 91 PC patients were subjected to immunohistochemical staining to assess the expression of HER-1, HER-2 and HER-3. Semiquantitative scores of zero (no staining or staining in less than 10% of cancer cells), 1+, 2+ or 3+ were assigned to each sample based on the intensity of staining for HER receptors. Scores of 2+ or 3+ were defined as positive staining. HER-1 overexpression was observed in 41 out of 91 samples (45.1%), while HER-2 was not overexpressed in any of the analyzed samples. HER-3 was overexpressed in 37 samples (40.7%) and was found to be associated with advanced TNM stage. In particular, HER-3 was overexpressed in 12 out of 16 stage IV patients (75%) compared with only 33.3% of stage I-III patients (p = 0.02). Among 79 patients with available survival data, the 6 patients with strong HER-3 expression (score 3+) had a shorter survival compared with remaining patients (median overall survival 6.9 months vs. 12.3 months, respectively). HER-1 and HER-3 were found to be expressed in a significant proportion of PC patients. Strong HER-3 expression represents an indicator of poor prognosis in PC patients, being associated with advanced stage and shorter survival.

  13. Prognosis of Primary and Recurrent Chondrosarcoma of the Rib.

    Science.gov (United States)

    Roos, Eva; van Coevorden, Frits; Verhoef, Cornelis; Wouters, Michel W; Kroon, Herman M; Hogendoorn, Pancras C W; van Houdt, Winan J

    2016-03-01

    Chondrosarcoma of the rib is a rare disease. Although surgery is the only curative treatment option, rib resection with an adequate margin can be challenging and local recurrence is a frequent problem. In this study, the prognosis of primary and recurrent chondrosarcoma of the rib is reported. Retrospective analysis was performed of patients treated for chondrosarcoma of the rib between 1984 and 2014 in three major tertiary referral centers in The Netherlands. Clinical and histopathological features were analyzed for their prognostic value using Kaplan-Meier and Cox proportional hazard analysis. Endpoints were set at local recurrent disease, metastasis rate, or death. Overall, 76 patients underwent a resection for a primary chondrosarcoma, and 26 patients underwent a resection for a recurrent chondrosarcoma. Five-year overall survival in the primary group was 90%, local recurrence rate was 17%, and metastasis rate was 12%. The 5-year outcome after recurrent chondrosarcoma was lower, with an overall survival of 65%, local recurrence rate of 27%, and metastasis rate of 27%. For primary chondrosarcoma, tumor size >5 cm and a positive resection margin were correlated with worse overall survival [hazard ratio (HR) 3.28, 95% confidence interval (CI) 1.03-10.44; HR 2.92, 95% CI 1.03-8.25). A higher histological grade was correlated with a higher local recurrence and metastasis rate (HR 5.92, 95% CI 1.11-31.65; HR 6.96, 95% CI 1.15-42.60). Surgical resection of both primary and recurrent chondrosarcoma of the rib is an effective treatment strategy. The oncological outcome after surgery is worse in tumors >5 cm, in tumors with positive resection margins and grade 3 chondrosarcoma.

  14. [Prognosis for motor deficits after strokes in Burkina Faso].

    Science.gov (United States)

    Napon, C; Tougma, L; Kaboré, R; Kaboré, J

    2013-01-01

    Stroke is a common, severe, and disabling condition that is recognized as a major public health problem. Our goal was to study the clinical features and prognosis of motor deficits in stroke patients hospitalized in the neurology department of the Yalgado-Oeudraogo University Hospital in Burkina Faso. This cross-sectional study took place from March 1 through September 30, 2012. The study included all patients with motor disabilities following a CT-confirmed stroke that had occurred within the previous month. Patients were reviewed at one month (M1) and three months (M3) to assess their current treatment and their autonomy, by the Barthel Index. During the study period, 59 patients were hospitalized for stroke, 56 with motor disabilities for a 95% prevalence of stroke with motor deficit. Their mean age was 57.8 ± 17.7 years (range: 20 to 84 years), and the sex-ratio of 1.6 (male/female). Overall, 61% of the strokes were ischemic and 39% hemorrhagic, with an equal distribution of right and left hemiplegia (46.4% each) and 7% of the patients showing bilateral involvement. The mortality rate before M1 was 29% and before M3, 40%. On admission, 4% of patients had a Barthel Index greater than 60, at M1 35%, and at M3, 60%. Only 51% of patients received physical therapy. Characteristics significantly associated with functional recovery were age younger than 65 years (p = 0.0026), sphincter disorders at M1 (p = 0.002), hemorrhagic stroke (compared to ischemic) (p = 0.0038), functional rehabilitation (p = 0.0012), and right (versus left) hemisphere damage (p = 0.010).

  15. Pars Planitis: Epidemiology, Clinical Characteristics, Management and Visual Prognosis.

    Science.gov (United States)

    Ozdal, Pinar Cakar; Berker, Nilufer; Tugal-Tutkun, Ilknur

    2015-01-01

    Pars planitis is an idiopathic chronic intermediate uveitis which predominantly affects children and adolescents, and accounts for 5-26.7% of pediatric uveitis. Although an autoimmune process with a genetic predisposition has been suggested, its etiology still remains unknown. The most common presenting symptoms are floaters and blurred vision. Diffuse vitreous cells, haze, snowballs and snowbanks are typical findings of pars planitis. Peripheral retinal vasculitis, optic disc edema and anterior segment inflammation are other well-known findings. Although pars planitis is known to be a benign form of uveitis in most cases, it may become a potentially blinding disease due to complications including cataract, cystoid macular edema, vitreous opacities and optic disc edema. Cystoid macular edema is the most common cause of visual morbidity. Band keratopathy, epiretinal membrane formation, vitreous condensation, neovascularizations, vitreous hemorrhage, retinal detachment, cyclitic membranes, glaucoma and amblyopia may develop as a consequence of the chronic course of the disease. Exclusion of infectious and non-infectious causes which may present with intermediate uveitis is of utmost importance before starting treatment. Treatment of pars planitis has been a controversial issue. There is no consensus specifically for treatment of cases with minimal inflammation and relatively good visual acuity. However, current experience shows that pars planitis may cause severe inflammation and needs an aggressive treatment. A stepladder approach including corticosteroids, immunosupressive agents, anti-tumor necrosis factor-alpha and pars plana vitrectomy and/or laser photocoagulation is the most commonly used method for treatment of pars planitis. Adequate control of inflammation and prompt detection of associated complications are crucial in order to improve the overall prognosis of the disease.

  16. ACUTE CORONARY SINDROMES SECOND PART: PROGNOSIS, TREATMENTAND SECONDARY PREVENTION

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    Stevan Ilić

    2004-07-01

    Full Text Available The prognosis of patients with acute coronary syndromes is directly depends on risk, so it is necessary for the risk stratification to be carried out both at the admittance and during the treatment phase, as well as after the dismissal from hospital. There are many variables that influence the risk, being categorized as either high or low. It is important to emphasise that low risk doesn’t mean that there is no risk at all. The sort of therapic approach that would be applied depends on electrocardiogramic presentation of acute isochemical syndrome. If the patient with persistant elevation of ST segments is in question, then the first step is aimed at achieving reperfusion by the trombolitical therapy application or primary percutanae coronary intervention. Trombolisis is not applied in case of a patient who doesn’t have a persistant ST elevation, but expresses ST segments depression, change of T waves or has a normal electrocardiograme (acute coronary syndrome without persistant ST evaluation. If there is a high risk, the inhibitors of receptors Gp llb/lla and higher coronary angiography are applied. However, if there is a low risk, troponines are determined again. If troponines are positive, the procedure is the same as in patient with high risk; if troponines are negative two times, further procedure depens on the stress test results. A long-term treatment of patients with acute coronary syndrome is necessary in order to prevent new cardic events to come into being. It presuposes life style change, modification of risk factors as well a medications for second prevention.

  17. [Congenital anomalies of poor prognosis. Genetics Consensus Committee].

    Science.gov (United States)

    Pardo Vargas, Rosa A; Aracena, Mariana; Aravena, Teresa; Cares, Carolina; Cortés, Fanny; Faundes, Víctor; Mellado, Cecilia; Passalacqua, Cristóbal; Sanz, Patricia; Castillo Taucher, Silvia

    The Genetic Branch of the Chilean Society of Paediatrics, given the draft Law governing the decriminalisation of abortion on three grounds, focusing on the second ground, which considers the "embryo or foetus suffering from a congenital structural anomaly or a genetic disorder incompatible with life outside the womb", met to discuss the scientific evidence according to which congenital anomalies (CA) may be included in this draft law. Experts in clinical genetics focused on 10 CA, reviewed the literature evidence, and met to discuss it. It was agreed not to use the term "incompatible with life outside the womb", as there are exceptions and longer survivals, and change to "congenital anomaly of poor prognosis (CAPP)". Ten CA were evaluated: serious defects of neural tube closure: anencephaly, iniencephaly and craniorachischisis, pulmonary hypoplasia, acardiac foetus, ectopia cordis, non-mosaic triploidy, "limb body wall" complex, "body stalk" anomaly, trisomy 13, trisomy 18, and bilateral renal agenesis. Findings on the prevalence, natural history, prenatal diagnostic methods, survival, and reported cases of prolonged survival were analysed. Post-natal survival, existence of treatments, and outcomes, as well as natural history without intervention, were taken into account in classifying a CA as a CAPP. A CAPP would be: anencephaly, severe pulmonary hypoplasia, acardiac foetus, cervical ectopia cordis, non-mosaic triploidy, limb body wall complex, body stalk anomaly, non-mosaic trisomy 13, non-mosaic trisomy 18, and bilateral renal agenesis. For their diagnosis, it is required that all pregnant women have access to assessments by foetal anatomy ultrasound and occasionally MRI, and cytogenetic and molecular testing. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Blunt abdominal trauma and organ damage and its prognosis

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    Babk Abri

    2016-12-01

    Full Text Available Introduction: Trauma is the first cause of death in the young population and imposes large costs on the health system. Due to high rates of trauma and its associated mortality in developing countries, it seems to be necessary to study epidemiological and demographic characteristics of the damage caused by blunt abdominal trauma and common organs involved and the prognosis. Methods: All patients with blunt trauma of the abdomen who referred to Imam Reza Hospital, Tabriz, Iran, from March 2012 up to March 2014 were enrolled, the data were collected by a questionnaire for each patient separately; then all data was analyzed by SPSS. Results: From March 2012 to March 2014, 332 patients with blunt abdominal trauma came to the emergency department, mean age was 34.15 ± 1.6 years and 63.9% of them were men. In 290 cases (83.3% there was not any damage to any organ. The most common injured organs were spleen and liver, equally 10 cases (3.0%. Kidney (2.4% bladder (1.8% and intestine (1.2% were also involved. In this study, the most common cause of blunt abdominal trauma was a car crash. Conclusion: According to this study, men consisted 63.9% cases of blunt abdominal trauma and the mean age of patients was 34.15 ± 1.6 years. The most common cause of blunt abdominal trauma was car crash. In this study, 87.3% cases did not have any intra-abdominal organ damage. Among patients with intra-abdominal organ damage, spleen and liver were most commonly involved with equal incidence. About 79.5% of all patients with blunt abdominal trauma were discharged without complication and morbidity.

  19. Genomic Classification and Prognosis in Acute Myeloid Leukemia.

    Science.gov (United States)

    Papaemmanuil, Elli; Gerstung, Moritz; Bullinger, Lars; Gaidzik, Verena I; Paschka, Peter; Roberts, Nicola D; Potter, Nicola E; Heuser, Michael; Thol, Felicitas; Bolli, Niccolo; Gundem, Gunes; Van Loo, Peter; Martincorena, Inigo; Ganly, Peter; Mudie, Laura; McLaren, Stuart; O'Meara, Sarah; Raine, Keiran; Jones, David R; Teague, Jon W; Butler, Adam P; Greaves, Mel F; Ganser, Arnold; Döhner, Konstanze; Schlenk, Richard F; Döhner, Hartmut; Campbell, Peter J

    2016-06-09

    Recent studies have provided a detailed census of genes that are mutated in acute myeloid leukemia (AML). Our next challenge is to understand how this genetic diversity defines the pathophysiology of AML and informs clinical practice. We enrolled a total of 1540 patients in three prospective trials of intensive therapy. Combining driver mutations in 111 cancer genes with cytogenetic and clinical data, we defined AML genomic subgroups and their relevance to clinical outcomes. We identified 5234 driver mutations across 76 genes or genomic regions, with 2 or more drivers identified in 86% of the patients. Patterns of co-mutation compartmentalized the cohort into 11 classes, each with distinct diagnostic features and clinical outcomes. In addition to currently defined AML subgroups, three heterogeneous genomic categories emerged: AML with mutations in genes encoding chromatin, RNA-splicing regulators, or both (in 18% of patients); AML with TP53 mutations, chromosomal aneuploidies, or both (in 13%); and, provisionally, AML with IDH2(R172) mutations (in 1%). Patients with chromatin-spliceosome and TP53-aneuploidy AML had poor outcomes, with the various class-defining mutations contributing independently and additively to the outcome. In addition to class-defining lesions, other co-occurring driver mutations also had a substantial effect on overall survival. The prognostic effects of individual mutations were often significantly altered by the presence or absence of other driver mutations. Such gene-gene interactions were especially pronounced for NPM1-mutated AML, in which patterns of co-mutation identified groups with a favorable or adverse prognosis. These predictions require validation in prospective clinical trials. The driver landscape in AML reveals distinct molecular subgroups that reflect discrete paths in the evolution of AML, informing disease classification and prognostic stratification. (Funded by the Wellcome Trust and others; ClinicalTrials.gov number, NCT

  20. PROGNOSIS OF RESULTS IN CRITERIA VARIABLE BASIC SWINGING BASIS ON VARIABLES OF MOTOR ABILITIES

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    Edin Mujanović

    2008-08-01

    Full Text Available Main goal of this research is identification prognosis of results in criteria variable basic swinging basis on variables of motor abilities. Research has been conducted on sample of 81 students the 3rd year of Faculty of physical education and sport at University of Tuzla. Measuring was accomplished with 24 variables of motor abilities and criteria variable, basic swinging. Results of regressive analyze have shown that success in performing of criteria variable is conditioned with all applied variables of motor abilities, and prognosis of results is exceeds, basis on the entire system of prediction variables in regard to help of individual influence prognosis variables on criteria system.

  1. Loss of constitutive ABCB1 expression in breast cancer associated with worse prognosis

    Science.gov (United States)

    Delou, João Marcos de Azevedo; Vignal, Giselle Maria; Índio-do-Brasil, Vanessa; Accioly, Maria Theresa de Souza; da Silva, Taiana Sousa Lopes; Piranda, Diogo Nascimento; Sobral-Leite, Marcelo; de Carvalho, Marcelo Alex; Capella, Márcia Alves Marques; Vianna-Jorge, Rosane

    2017-01-01

    ABCB1 gene encodes an adenosine 5′-triphosphate–binding cassette transporter, which not only confers multidrug resistance phenotype in malignant cells, but is also present in several nonmalignant tissues. For the last thirty years, ABCB1 expression in breast cancer has been described by many authors, but the extent of expression differs among the studies, and there is no consensus regarding its potential role in carcinogenesis or in the tumor response to antineoplastic drugs. This study aimed to characterize the expression of ABCB1 in breast tumors as a function of genetic, clinical, and histopathological variables. The ABCB1 expression was also evaluated in nonmalignant mammary tissues adjacent to tumors and in benign lesions. The detection of ABCB1 protein was performed by immunohistochemistry in tissue specimens of excised breasts obtained from a prospective cohort of Brazilian women with breast cancer. The association of ABCB1 protein levels with ABCB1 mRNA, gene polymorphisms, and clinical and histopathological variables was also evaluated. The Kaplan–Meier curves and multivariate Cox regression analyses were conducted to identify independent predictors of disease-free survival of patients with breast cancer. ABCB1 was detected in 86.3% (656) of breast tumors, 98.8% (606) of nonmalignant mammary tissue adjacent to tumors, and 100% (28) of benign lesions. Reduced ABCB1 protein levels in breast tumors was associated with triple-negative subtype (adjusted odds ratio [ORadj] =0.24; 95% confidence interval [CI] =0.13–0.45), lymph node status 2 cm (ORadj =0.55; 95% CI =0.32–0.93), and hypertensive status (ORadj =0.42; 95% CI =0.24–0.73), and it was significantly associated with shorter disease-free survival, either for all breast cancer patients (p log-rank =0.012; hazard ratio [HR] =3.46; 95% CI =1.21–9.91) or for those with triple-negative tumors (p log-rank =0.007; HR =11.41; 95% CI =1.29–100.67). The loss of constitutive ABCB1 expression in

  2. The significance of combining VEGFA, FLT1, and KDR expressions in colon cancer patient prognosis and predicting response to bevacizumab

    Directory of Open Access Journals (Sweden)

    Zhang SD

    2015-04-01

    Full Text Available Shu-Dong Zhang,1,2,* Cian M McCrudden,3,* Chen Meng,4 Yao Lin,4 Hang Fai Kwok1,31Faculty of Health Sciences, University of Macau, Avenida de Universidade, Macau, Special Administrative Region of the People’s Republic of China; 2Center for Cancer Research and Cell Biology, Queen’s University Belfast, United Kingdom; 3School of Pharmacy, Queen’s University Belfast, United Kingdom; 4College of Life Sciences, Fujian Normal University, Fujian, People’s Republic of China*These authors contributed equally to this workAbstract: Targeting angiogenesis through inhibition of the vascular endothelial growth factor (VEGF pathway has been successful in the treatment of late stage colorectal cancer. However, not all patients benefit from inhibition of VEGF. Ras status is a powerful biomarker for response to anti-epidermal growth factor receptor therapy; however, an appropriate biomarker for response to anti-VEGF therapy is yet to be identified. VEGF and its receptors, FLT1 and KDR, play a crucial role in colon cancer progression; individually, these factors have been shown to be prognostic in colon cancer; however, expression of none of these factors alone was predictive of tumor response to anti-VEGF therapy. In the present study, we analyzed the expression levels of VEGFA, FLT1, and KDR in two independent colon cancer datasets and found that high expression levels of all three factors afforded a very poor prognosis. The observation was further confirmed in another independent colon cancer dataset, wherein high levels of expression of this three-gene signature was predictive of poor prognosis in patients with proficient mismatch repair a wild-type KRas status, or mutant p53 status. Most importantly, this signature also predicted tumor response to bevacizumab, an antibody targeting VEGFA, in a cohort of bevacizumab-treated patients. Since bevacizumab has been proven to be an important drug in the treatment of advanced stage colon cancer, our results

  3. Protocadherin-17 promoter methylation in serum-derived DNA is associated with poor prognosis of bladder cancer.

    Science.gov (United States)

    Luo, Zhen-Guo; Li, Zhi-Gang; Gui, Shi-Liang; Chi, Bao-Jin; Ma, Jian-Guo

    2014-02-01

    To investigate the prognostic value of protocadherin 17 (PCDH17) promoter methylation in serum-derived DNA of patients with bladder cancer. DNA was isolated from serum of patients with bladder cancer and from age- and sex-matched controls. Methylation-specific polymerase chain reaction was used to examine the methylation status of the PCDH17 promoter. The correlations between methylation status and clinicopathological characteristics and overall survival were examined. PCDH17 promoter methylation was detected in 79/151 (52.3%) of patients with bladder cancer, and none of the 43 control subjects. Methylation was significantly associated with larger tumour diameter (>3 cm), high grade (G3) and advanced stage (T2-T4). Patients with PCDH17 promoter methylation had significantly shorter overall survival than those with unmethylated PCDH17 promoter. Methylation was an independent predictor of overall survival. PCDH17 promoter methylation was significantly associated with malignant behaviour and poor prognosis of bladder cancer. The detection of PCDH17 promoter methylation in serum-derived DNA may be a convenient and noninvasive predictive biomarker in routine clinical practice.

  4. NR2F6 Expression Correlates with Pelvic Lymph Node Metastasis and Poor Prognosis in Early-Stage Cervical Cancer

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    Chunhao Niu

    2016-10-01

    Full Text Available Background: There is an abnormal expression of nuclear receptor subfamily 2 group F member 6 (NR2F6 in human cancers such as breast cancer, colon cancer, and acute myelogenous leukemia. However, its clinical significance in cervical cancer has not been established. We explored NR2F6 expression and its clinicopathological significance in early-stage cervical cancer. Methods: NR2F6 expression in cervical cancer cell lines and cervical cancer tissues was determined by Western blotting, real-time PCR, and immunochemistry (IHC. NR2F6 expression in 189 human early-stage cervical cancer tissue samples was evaluated using IHC. The relevance between NR2F6 expression and early-stage cervical cancer prognosis and clinicopathological features was determined. Results: There was marked NR2F6 mRNA and protein overexpression in the cervical cancer cells and clinical tissues compared with an immortalized squamous cell line and adjacent noncancerous cervical tissues, respectively. In the 189 cervical cancer samples, NR2F6 expression was positively related to International Federation of Gynecology and Obstetrics (FIGO stage (p = 0.006, squamous cell carcinoma antigen (p = 0.006, vital status (p < 0.001, tumor recurrence (p = 0.001, chemotherapy (p = 0.039, and lymph node metastasis (p < 0.001. Overall and disease-free survival was shorter in patients with early-stage cervical cancer and higher NR2F6 levels than in patients with lower levels of NR2F6. Univariate and multivariate analysis determined that NR2F6 was an independent prognostic factor of survival in early-stage cervical cancer. Conclusions: Taken together, our findings suggest that high NR2F6 expression predicts pelvic lymph node metastasis, tumor recurrence and poor prognosis in early-stage cervical cancer. NR2F6 might be a novel prognostic biomarker and potential therapeutic target of cervical cancer.

  5. Refining prognostic stratification of human papillomavirus-related oropharyngeal squamous cell carcinoma: different prognosis between T1 and T2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Su Min; Lee, Sang Wook; Park, Sun Min [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2017-09-15

    To validate the 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and investigate whether a modified classification better reflects the prognosis. Medical records of patients diagnosed with non-metastatic HPV-related OPSCC between 2010 and 2016 at a single institution were retrospectively reviewed. HPV status was determined by immunohistochemical analysis of p16 and/or HPV DNA polymerase chain reaction (PCR). We reclassified TNM stage T0-1 and N0-1 as group A, T2-3 or N2 as B, and T4 or N3 as C. Survival analysis according to 8th AJCC/UICC TNM staging and the modified classification was performed. Of 383 OPSCC patients, 211 were positive for HPV DNA PCR or p16. After exclusion, 184 patients were included in this analysis. Median age was 56 years (range, 31 to 81 years). Most primary tumors were in the palatine tonsil (148 tumors, 80%). The eighth AJCC/UICC TNM classification could not differentiate between stage I and II (p = 0.470) or II and III (p = 0.209). Applying modified grouping, the 3-year overall survival rate of group A was significantly higher than that of group B and C (98% vs. 91%, p = 0.039 and 98% vs. 78%, p < 0.001, respectively). Differentiation between group B and C was marginally significant (p = 0.053). The 8th AJCC/UICC TNM staging system did not clearly distinguish the prognosis of stage II from that of other stages. Including the T2N0-1 group in stage II may improve prognostic stratification.

  6. The GADD45A (1506T>C) Polymorphism Is Associated with Ovarian Cancer Susceptibility and Prognosis.

    Science.gov (United States)

    Yuan, Cunzhong; Liu, Xiaoyan; Liu, Xiaolin; Yang, Ning; Liu, Zhenping; Yan, Shi; Shen, Keng; Kong, Beihua

    2015-01-01

    GADD45A (growth arrest and DNA damage 45 A) is the first stress-inducible gene identified to be a target of p53. However, no studies to date have assessed variants of the GADD45 gene and their potential relationship to tumor susceptibility. We investigated the association of the GADD45A (1506T>C) polymorphism with ovarian cancer development in 258 ovarian cancer patients and 332 age-matched healthy women as controls using sequence analysis. We found a statistically significant difference in the GADD45A (1506T>C) genotype distributions between the case and control groups (TT vs. TC vs. CC, P = 0.0021) and found that variant 1506T>C was significantly associated with an increased risk of ovarian cancer (Phistology (P = 0.032) and CA125 status (P = 0.021). Carrying the C allele (TC+CC) was associated with an increased risk of positive CA125 (OR = 3.20, 95% CI [1.15-8.71). Carrying the T allele (TT+TC) showed a significant correlation with both higher GADD45A mRNA expression and longer ovarian cancer RFS (relapse-free survival) and OS (overall survival). We are the first group to demonstrate that the GADD45A (1506T>C) polymorphism is associated with ovarian cancer susceptibility and prognosis. These data suggest that GADD45A (1506T>C) is a new tumor susceptibility gene and could be a useful molecular marker for assessing ovarian cancer risk and for predicting ovarian cancer patient prognosis.

  7. A Genetic Polymorphism (rs17251221 in the Calcium-Sensing Receptor is Associated with Breast Cancer Susceptibility and Prognosis

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    Xiaoyan Li

    2014-01-01

    Full Text Available Background: Calcium-sensing receptor (CaSR is a typical G protein coupled receptor. The rs17251221 SNP is located in an intron of the CaSR gene, and the G allele is considered a gain of function mutation. Previous studies revealed that rs17251221 polymorphisms contribute to the risk of developing certain types of cancers. This study investigated the rs17251221 SNP in breast cancer by analyzing the correlation of the rs17251221 genotype with breast cancer susceptibility, clinicopathological features and prognosis. Methods: A TaqMan assay was used to genotype the rs17251221 SNP in a case-control study. The expression levels of CaSR in breast cancer tissues were determined using quantitative reverse-transcription PCR (qRT-PCR and western blot analysis. The association of the rs17251221 genotype and the clinicopathological characteristics, as well as the prognosis of the breast cancer patient, was assessed statistically. Results: We found that the AG and GG genotypes were associated with lower mRNA and protein levels of CaSR compared to the AA genotype in breast cancer tissues. We also found that the AG and GG genotypes were associated with breast cancer susceptibility, the patient's age at diagnosis, tumor size, lymph node metastasis and estrogen receptor status of breast cancer tissue. More importantly, we found that the genotypes were prognostic markers for both disease-free survival and overall survival of breast cancer. Conclusion: The rs17251221 SNP is a risk factor associated with breast cancer susceptibility, as well as a prognostic indicator. Our data suggest that rs17251221 may be a potential therapeutic target in breast cancer.

  8. Pilot study for early prognosis of Azoospermia in relation to Y-STR Profiling

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    Ahmed M. Refaat

    2016-01-01

    Conclusion: There was a significant correlation of Y-STR Profiling results and the prevalence of Azoospermia condition, which supports the idea of using Y-STR Profiling in early prognosis of Azoospermia.

  9. An Integrated Framework for Model-Based Distributed Diagnosis and Prognosis

    Data.gov (United States)

    National Aeronautics and Space Administration — Diagnosis and prognosis are necessary tasks for system re- configuration and fault-adaptive control in complex systems. Diagnosis consists of detection, isolation...

  10. Early treatment improves urodynamic prognosis in neurogenic voiding dysfunction: 20 years of experience

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    Lucia M. Costa Monteiro

    2017-07-01

    Conclusion: Treatment onset within the first year of life improves urodynamic prognosis in patients with neurogenic bladder and triplicates the probability of urodynamic improvement in two years. The role of neonatologists and pediatricians in early referral is extremely important.

  11. Age at diagnosis in women with non-metastatic breast cancer: Is it related to prognosis?

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    Nelly H. Alieldin

    2014-03-01

    Conclusion: Young women were not found to have poorer prognosis, yet they presented with more ER negative tumors. Most of women presented with advanced stage and young women had higher recurrence rates.

  12. Entropy-based probabilistic fatigue damage prognosis and algorithmic performance comparison

    Data.gov (United States)

    National Aeronautics and Space Administration — In this paper, a maximum entropy-based general framework for probabilistic fatigue damage prognosis is investigated. The proposed methodology is based on an...

  13. Association of C-reactive protein (CRP) gene polymorphisms, serum CRP levels and cervical cancer prognosis

    National Research Council Canada - National Science Library

    Polterauer, Stephan; Grimm, Christoph; Zeillinger, Robert; Heinze, Georg; Tempfer, Clemens; Reinthaller, Alexander; Hefler, Lukas

    2011-01-01

    C-reactive protein (CRP) is the prototypical biomarker of inflammation. Genetic variations within the CRP gene have been shown to be associated with alterations of CRP expression and prognosis in cancer patients...

  14. Entropy-based Probabilistic Fatigue Damage Prognosis and Algorithmic Performance Comparison

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    National Aeronautics and Space Administration — In this paper, a maximum entropy-based general framework for probabilistic fatigue damage prognosis is investigated. The proposed methodology is based on an...

  15. 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.

    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

  16. Progression of urinary protein excretion after kidney transplantation: A marker for poor long-term prognosis

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    Josefa Borrego Hinojosa

    2015-07-01

    Conclusions: Proteinuria after transplantation, essentially when it progresses, is a marker of a poor prognosis and a predictor for graft survival. Progression of proteinuria is associated with poorer renal function and lower graft survival rates.

  17. Congenital Aortic Stenosis in Children: Diagnosis, Clinical Presentation, Treatment and Prognosis

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    Ye.A. Kalashnikova

    2014-05-01

    Full Text Available This article considered the literature data on the incidence, main clinical manifestations, modern methods of early neonatal and postnatal diagnosis, treatment and prognosis of aortic stenosis — congenital cardiovascular system malformation.

  18. RSPF-based Prognosis Framework for Estimation of Remaining Useful Life in Energy Storage Devices

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper presents a case study where a RSPF-based prognosis framework is applied to estimate the remaining useful life of an energy storage device (Li-Ion...

  19. Recovery patterns and long term prognosis for axonal Guillain–Barré syndrome

    OpenAIRE

    Hiraga, A; Mori, M; Ogawara, K.; Kojima, S.; Kanesaka, T; Misawa, S.; Hattori, T.; Kuwabara, S

    2005-01-01

    Background: Little is known about the long term prognosis for patients the severe acute motor axonal neuropathy (AMAN) form of Guillain–Barré syndrome (GBS), unlike those with acute inflammatory demyelinating neuropathy (AIDP).

  20. Incidence, Development, and Prognosis of Diabetic Kidney Disease in China: Design and Methods

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    Yao-Zheng Yang

    2017-01-01

    Conclusions: INDEED study will provide essential information regarding the clinical phenotype and prognosis of patients with DKD in China and will be valuable to identify factors and biomarkers associated with patients with DKD in China.

  1. [Clinical value of angiogenin in predicting the prognosis of patients with idiopathic pulmonary fibrosis].

    Science.gov (United States)

    Bai, Yanling; Zhu, Haiyan; Sun, Qiyu; Gu, Guozhong; Zhang, Lingyu; Li, Ying; Yang, Baofeng

    2017-09-01

    To explore the relationship between angiogenin-1/2 (Ang-1/2) and clinical parameters of idiopathic pulmonary fibrosis (IPF), and to assess the value of Ang-1/2 in predicting the prognosis of patients with IPF. A retrospective analysis was conducted. Ninety-one patients diagnosed as IPF by high resolution CT (HRCT) and lung biopsy admitted to Daqing Oil Field General Hospital from March 2014 to January 2015 were enrolled. The general data, serum parameters and pulmonary function parameters of all patients were collected. After treatment, all of the 91 patients were followed-up to 2 years. The patients were divided into favorable prognosis group and unfavorable prognosis group according to follow-up results. The differences in all parameters between the two groups were compared. The relationship between Ang-1, Ang-2 and lung function parameters was analyzed by Pearson correlation analysis. Cox proportional hazard regression model was used to evaluate the effect of clinical parameters on the prognosis of patients with IPF. The effect of Ang-2 in predicting prognosis of patients with IPF was analyzed by receiver operating characteristic (ROC) curve. During the 2-year follow-up period, 30 of 91 patients showed a favorable prognosis, and 55 showed an unfavorable prognosis with a poor prognosis rate of 64.71%, and 6 patients withdrew from the study due to loss of follow-up and death. Compared with the favorable prognosis group, Ang-2 level in the unfavorable prognosis group was significantly increased (μg/L: 2.88±1.63 vs. 1.89±1.22, t = 2.909, P = 0.005), but Ang-1 only showed a slight increase (μg/L: 28.70±14.26 vs. 25.62±11.95, t = 1.005, P = 0.318). The results of Pearson correlation analysis showed that Ang-2 level was negatively correlated with forced expiratory volume in 1 second (FVC1) and the percentage of carbon monoxide diffusing capacity accounting for the expected value (DLCO%: r value was -0.227 and -0.206, and P value was 0.147 and 0.253, respectively

  2. Role of interleukin-10 in prognosis of hepatitis B virus infection

    Directory of Open Access Journals (Sweden)

    WU Changhui

    2015-04-01

    Full Text Available Multiple etiological factors are integrally involved in the development of hepatitis B virus (HBV infection. Interleukin-10 (IL-10 is an essential cytokine of immune regulation, and IL-10 gene promoter polymorphism affects its mRNA transcription and serum level. IL-10 is related to the prognosis of HBV infection. This review briefly discusses the association of IL-10 gene polymorphism and its serum level with the prognosis of HBV infection, and summarizes the role of IL-10, as an anti-inflammatory cytokine, in host immune function, the prognosis and progression of HBV infection, and HBV-related complications. IL-10 gene polymorphism and its serum level are closely associated with inflammatory response after HBV infection, influence HBV clearance, and are related to the severity of HBV-related liver injury, liver cirrhosis, and hepatocellular carcinoma. The determination of IL-10 gene and serum levels may provide a predictive marker for the prognosis of HBV infection.

  3. Non convulsive status epilepticus masquerading as stroke.

    Science.gov (United States)

    Kennel, Christopher; Michas-Martin, Andreas; Berman, Brian D; Poisson, Sharon

    2015-03-01

    This case describes a patient with multiple stroke risk factors—including prior stroke—who presented to the emergency department with symptoms suggestive of stroke and who received a rapid stroke work up but was later found to be in non convulsive status epilepticus (NCSE). This case report highlights the challenge and importance of making an accurate diagnosis in NCSE, and we have included teaching points to help clinicians understand the clinical manifestations and diagnosis of NCSE as well as how it may impact a patient's prognosis. Given the growing attention to rapid stroke protocols in emergency departments across the country, it is important to remember that not all that appears as stroke is stroke, even in people who are at high risk for stroke or in whom stroke is the most likely cause of their neurologic deficits.

  4. [Research advances in indices and methods for nutritional status evaluation in patients with liver cirrhosis].

    Science.gov (United States)

    Li, H; Zhang, L

    2017-03-20

    In recent years, malnutrition in patients with liver cirrhosis has been taken more and more seriously in clinical physicians, and patients' nutritional status is closely associated with prognosis. At present, there are many methods for the evaluation of nutritional status in patients with liver cirrhosis, but there are still no unified standards. This article reviews the common evaluation indices and methods used in clinical practice in China and foreign countries, in order to provide a basis for accurately evaluating nutritional status and guiding nutritional therapy in patients with liver cirrhosis.

  5. Expectations for recovery important in the prognosis of whiplash injuries.

    Directory of Open Access Journals (Sweden)

    Lena W Holm

    2008-05-01

    .2 to 3.2. Associations between expectations and disability were also found among individuals with moderate disability. CONCLUSIONS: Individuals' expectations for recovery are important in prognosis, even after controlling for symptom severity. Interventions designed to increase patients' expectations may be beneficial and should be examined further in controlled studies.

  6. Application of exercise testing in the diagnosis, prognosis, and treatment of patients with Pulmonary Hypertension

    OpenAIRE

    Fuentes Sánchez, Darío

    2016-01-01

    Background Recent developments have added exercise testing and training as part of the clinical practice in the diagnosis, treatment, and prognosis of diseased populations. Exercise testing has been used widely in cardiovascular disease and in some circumstances in pulmonary disease. Cardiopulmonary Exercise Testing has been used in the diagnosis and prognosis of pulmonary hypertension patients. However, no many studies have tried to evaluate functional capacity, explore prediction of cardio...

  7. INTERRELATION BETWEEN PERSISTENT NECROSIS OF CARDIOMYOCYTES AND PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE

    OpenAIRE

    E. N. Golovenko; D. A. Napalkov; V. A. Sulimov

    2010-01-01

    Background. Chronic heart failure (CHF) progression is accompanied by remodeling of muscular, collagen and vascular elements of myocardium. This can lead to increase in serum concentrations of myocardial lesion markers (cardiac troponin I (TrI) and myoglobin) which seem to correlate with poor prognosis in patients with CHF.Aim. To estimate correlations between cardiac TrI, myoglobin, creatine phosphokinase MB-fraction (MB-CPK) serum concentrations and disease severity and prognosis in CHF pat...

  8. Disparities in prognosis communication among parents of children with cancer: The impact of race and ethnicity.

    Science.gov (United States)

    Ilowite, Maya F; Cronin, Angel M; Kang, Tammy I; Mack, Jennifer W

    2017-10-15

    Most parents of children with cancer say they want detailed information about their child's prognosis. However, prior work has been conducted in populations of limited diversity. The authors sought to evaluate the impact of parental race/ethnicity on prognosis communication experiences among parents of children with cancer. In total, 357 parents of children with cancer and the children's physicians were surveyed at Dana-Farber Cancer Institute/Boston Children's Hospital and Children's Hospital of Philadelphia. Outcome measures were parental preferences for prognostic information, physician beliefs about parental preferences, prognosis communication processes, and communication outcomes. Associations were assessed by logistic regression with generalized estimating equations to correct for physician clustering. Two hundred eighty-one parents (79%) were white, 23 (6%) were black, 29 (8%) were Hispanic, and 24 (7%) were Asian/other. Eighty-seven percent of parents wanted as much detail as possible about their child's prognosis, with no significant differences by race/ethnicity (P = .75). However, physician beliefs about parental preferences for prognosis communication varied based on parent race/ethnicity, with physicians considering black and Hispanic parents less interested in details about prognosis than whites (P = .003). Accurate understanding of a less favorable prognosis was greater among white (49%) versus nonwhite parents (range, 20%-29%), although this difference was not statistically significant (P = .14). Most parents, regardless of racial and ethnic background, want detailed prognostic information about their child's cancer. However, physicians underestimate the information needs of black and Hispanic parents. To meet parents' information needs, physicians should ask about parents' information preferences before prognosis discussions. Cancer 2017;123:3995-4003. © 2017 American Cancer Society. © 2017 American Cancer Society.

  9. Real-time monitoring, prognosis, and resilient control for wind turbine systems

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Zhiwei; Sheng, Shuangwen

    2018-02-01

    This special issue aims to provide a platform for academic and industrial communities to report recent results and emerging research in real-time monitoring, fault diagnosis, prognosis, and resilient control and design of wind turbine systems. After a strict peer-review process, 20 papers were selected, which represent the most recent progress of the real-time monitoring, diagnosis, prognosis, and resilient control methods/techniques in wind turbine systems.

  10. A Diagnosis-Prognosis Feedback Loop for Improved Performance Under Uncertainties

    Science.gov (United States)

    Leser, Patrick E.; Warner, James E.

    2017-01-01

    The feed-forward relationship between diagnosis and prognosis is the foundation of both aircraft structural health management and the digital twin concept. Measurements of structural response are obtained either in-situ with mounted sensor networks or offline using more traditional techniques (e.g., nondestructive evaluation). Diagnosis algorithms process this information to detect and quantify damage and then feed this data forward to a prognostic framework. A prognosis of the structure's future operational readiness (e.g., remaining useful life or residual strength) is then made and is used to inform mission- critical decision-making. Years of research have been devoted to improving the elements of this process, but the process itself has not changed significantly. Here, a new approach is proposed in which prognosis information is not only fed forward for decision-making, but it is also fed back to the forthcoming diagnosis. In this way, diagnosis algorithms can take advantage of a priori information about the expected state of health, rather than operating in an uninformed condition. As a feasibility test, a diagnosis-prognosis feedback loop of this manner is demonstrated. The approach is applied to a numerical example in which fatigue crack growth is simulated in a simple aluminum alloy test specimen. A prognosis was derived from a set of diagnoses which provided feedback to a subsequent set of diagnoses. Improvements in accuracy and a reduction in uncertainty in the prognosis- informed diagnoses were observed when compared with an uninformed diagnostic approach.

  11. The relationship between polymorphisms of XRCC5 genes with astrocytoma prognosis in the Han Chinese population

    Science.gov (United States)

    Li, Lei; Zhang, Jiayi; Wu, Ruipeng; Zhang, Yuan; Kang, Longli; Yuan, Dongya; Jin, Tianbo

    2016-01-01

    Background Gliomas are highly malignant with a poor prognosis. Studies have reported that DNA repair genes influence risk for glioma, but its relationship with prognosis is unclear. In this study, we want to explore the relationship between DNA repair genes (XRCC3, XRCC4 and XRCC5) and prognosis of astrocytoma in the Chinese Han population. Materials and Methods 160 astrocytoma cases were recruited in our study. Survival probabilities were estimated by using Kaplan–Meier analysis, and significant differences were analyzed by using the log-rank test. Cox proportional hazards models were used to analyze the associations between genotypes with astrocytoma survival. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable models. All tests were two-sided and p astrocytoma prognosis. Further, the “A/A” genotype of rs9288516 in XRCC5 (HR: 1.67, 95%CI: 1.02 - 2.72, p = 0.042) had significantly outcomes after adjusting for potential confounders, patients with poor tumor differentiation and the coexistence of the unfavorable genotypes. Conclusion These results suggest that polymorphisms of XRCC5 play an important role in astrocytoma prognosis in the Chinese Han population which could be used in the determination of astrocytoma prognosis in clinical researches. PMID:27852033

  12. A Damage Prognosis Method of Girder Structures Based on Wavelet Neural Networks

    Directory of Open Access Journals (Sweden)

    Rumian Zhong

    2014-01-01

    Full Text Available Based on the basic theory of wavelet neural networks and finite element model updating method, a basic framework of damage prognosis method is proposed in this paper. Firstly, a damaged I-steel beam model testing is used to verify the feasibility and effectiveness of the proposed damage prognosis method. The results show that the predicted results of the damage prognosis method and the measured results are very well consistent, and the maximum error is less than 5%. Furthermore, Xinyihe Bridge in the Beijing-Shanghai Highway is selected as the engineering background, and the damage prognosis is conducted based on the data from the structural health monitoring system. The results show that the traffic volume will increase and seasonal differences will decrease in the next year and a half. The displacement has a slight increase and seasonal characters in the critical section of mid span, but the strain will increase distinctly. The analysis results indicate that the proposed method can be applied to the damage prognosis of girder bridge structures and has the potential for the bridge health monitoring and safety prognosis.

  13. Integrative analysis of cancer prognosis data with multiple subtypes using regularized gradient descent.

    Science.gov (United States)

    Ma, Shuangge; Zhang, Yawei; Huang, Jian; Huang, Yuan; Lan, Qing; Rothman, Nathaniel; Zheng, Tongzhang

    2012-12-01

    In cancer research, high-throughput profiling studies have been extensively conducted, searching for genes/single nucleotide polymorphisms (SNPs) associated with prognosis. Despite seemingly significant differences, different subtypes of the same cancer (or different types of cancers) may share common susceptibility genes. In this study, we analyze prognosis data on multiple subtypes of the same cancer but note that the proposed approach is directly applicable to the analysis of data on multiple types of cancers. We describe the genetic basis of multiple subtypes using the heterogeneity model that allows overlapping but different sets of susceptibility genes/SNPs for different subtypes. An accelerated failure time (AFT) model is adopted to describe prognosis. We develop a regularized gradient descent approach that conducts gene-level analysis and identifies genes that contain important SNPs associated with prognosis. The proposed approach belongs to the family of gradient descent approaches, is intuitively reasonable, and has affordable computational cost. Simulation study shows that when prognosis-associated SNPs are clustered in a small number of genes, the proposed approach outperforms alternatives with significantly more true positives and fewer false positives. We analyze an NHL (non-Hodgkin lymphoma) prognosis study with SNP measurements and identify genes associated with the three major subtypes of NHL, namely, DLBCL, FL, and CLL/SLL. The proposed approach identifies genes different from using alternative approaches and has the best prediction performance. © 2012 Wiley Periodicals, Inc.

  14. Impact of Neoadjuvant Chemoradiation on Lymph Node Status in Esophageal Cancer Post hoc Analysis of a Randomized Controlled Trial

    NARCIS (Netherlands)

    Talsma, Koen; Wijnhoven, Bas; van Lanschot, Jan; van Berge Henegouwen, Mark

    2015-01-01

    Objective: The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. Background: Pathological LN status is a major disease

  15. P53 mutation analysis of colorectal liver metastases : Relation to actual survival, angiogenic status, and p53 overexpression

    NARCIS (Netherlands)

    de Jong, KP; Gouw, ASH; Peeters, PMJG; Bulthuis, M; Menkema, L; Porte, RJ; Slooff, MJH; van Goor, H; van den Berg, Anke

    2005-01-01

    Purpose: To correlate TP53 mutations with angiogenic status of the tumor and prognosis after liver surgery in patients with colorectal liver metastases and to correlate immunohistochemical staining of p53 protein with TP53 gene mutations. Experimental Design: Tumors of 44 patients with surgically

  16. USCIS My Case Status

    Data.gov (United States)

    Department of Homeland Security — USCIS provide a way for the public who applied for U.S. citizenship to check the status of their application online. To view the status of a case, the application...

  17. Visceral Obesity is Associated with Poor Prognosis in Pancreatic Adenocarcinoma.

    Science.gov (United States)

    Kim, Bun; Chung, Moon Jae; Park, Se Woo; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Song, Si Young; Chung, Jae Bock

    2016-01-01

    An association between obesity and unfavorable outcomes for various types of malignancy has been established. Nevertheless, the impact of visceral obesity (VO) on outcomes in pancreatic cancer is still unknown and controversial. The aim of this study was to uncover an association between VO and pancreatic cancer outcomes. We retrospectively reviewed 499 patients with pancreatic cancer who were diagnosed and treated in Severance Hospital from January 2006 to December 2011. Compared to the low-VO group (n = 260), the high-VO group (n = 239) was mostly male (68.2% vs. 31.8%, P alcohol intake status (52.3% vs. 26.4%, P pancreatic cancer, VO at the time of diagnosis is associated with negative outcomes, such as shorter PFS and OS.

  18. Epidemiology and prognosis of coma in daytime television dramas.

    Science.gov (United States)

    Casarett, David; Fishman, Jessica M; MacMoran, Holly Jo; Pickard, Amy; Asch, David A

    2005-12-24

    To determine how soap operas portray, and possibly misrepresent, the likelihood of recovery for patients in coma. Retrospective cohort study. Nine soap operas in the United States reviewed between 1 January 1995 and 15 May 2005. 64 characters who experienced a period of unconsciousness lasting at least 24 hours. Their final status at the end of the follow-up period was compared with pooled data from a meta-analysis. Comas lasted a median of 13 days (interquartile range 7-25 days). Fifty seven (89%) patients recovered fully, five (8%) died, and two (3%) remained in a vegetative state. Mortality for non-traumatic and traumatic coma was significantly lower than would be predicted from the meta-analysis data (non-traumatic 4% v 53%; traumatic 6% v 67%; Fisher's exact test both P expected chance of returning to normal function (non-traumatic 91% v 1%; traumatic 89% v 7%; both P expectations of recovery.

  19. High nevus counts confer a favorable prognosis in melanoma patients.

    Science.gov (United States)

    Ribero, Simone; Davies, John R; Requena, Celia; Carrera, Cristina; Glass, Daniel; Rull, Ramon; Vidal-Sicart, Sergi; Vilalta, Antonio; Alos, Lucia; Soriano, Virtudes; Quaglino, Pietro; Traves, Victor; Newton-Bishop, Julia A; Nagore, Eduardo; Malvehy, Josep; Puig, Susana; Bataille, Veronique

    2015-10-01

    A high number of nevi is the most significant phenotypic risk factor for melanoma and is in part genetically determined. The number of nevi decreases from middle age onward but this senescence can be delayed in patients with melanoma. We investigated the effects of nevus number count on sentinel node status and melanoma survival in a large cohort of melanoma cases. Out of 2,184 melanoma cases, 684 (31.3%) had a high nevus count (>50). High nevus counts were associated with favorable prognostic factors such as lower Breslow thickness, less ulceration and lower mitotic rate, despite adjustment for age. Nevus count was not predictive of sentinel node status. The crude 5- and 10-year melanoma-specific survival rate was higher in melanomas cases with a high nevus count compared to those with a low nevus count (91.2 vs. 86.4% and 87.2 vs. 79%, respectively). The difference in survival remained significant after adjusting for all known melanoma prognostic factors (hazard ratio [HR] = 0.43, confidence interval [CI] = 0.21-0.89). The favorable prognostic value of a high nevus count was also seen within the positive sentinel node subgroup of patients (HR = 0.22, CI = 0.08-0.60). High nevus count is associated with a better melanoma survival, even in the subgroup of patients with positive sentinel lymph node. This suggests a different biological behavior of melanoma tumors in patients with an excess of nevi. © 2015 The Authors. Published by Wiley Periodicals, Inc. on behalf of UICC.

  20. Subtypes and Prognosis of Guillain-Barré Syndrome in Southwest China.

    Directory of Open Access Journals (Sweden)

    Gang Zhang

    Full Text Available The proportion of different subtypes of Guillain-Barré syndrome (GBS and their prognosis varied significantly among different regions. This study attempts to investigate the clinical subtypes and outcome of GBS in southwest China. Patients with GBS admitted to The First Affiliated Hospital of Chongqing Medical University from January 2006 to March 2013 were included in our study. Patients were classified into acute inflammatory demyelinating polyneuropathy (AIDP group, acute motor axonal neuropathy (AMAN group, Miller-Fisher syndrome (MFS group, cranial nerve variants(CNV, Bickerstaff's brainstem encephalitis overlaps with GBS (BBE-GBS group and unclassifiable group based on clinical features and electrophysiological findings. Hughes function grade score (HFGS was used to assess the prognosis at 3 and 6 months. The prognosis of different subtypes and outcome predictors were analyzed. The most common subtype of GBS was AIDP (57%, followed by AMAN (22% and MFS (7%. The prognosis of AMAN and BBE-GBS is similar at 3 month(P = 0.0704and 6 month (P = 0.1614 follow-up. The prognosis of AMAN group was poorer than that of AIDP group at 3 month and 6 month follow-up (P<0.001. Outcome of MFS group and that of CNV group at 6 months were both good(Hughes≤1. Hughes≥3(P<0.0001,OR = 6.650,95%CI = 2.865 to 15.023and dysautonomia (P = 0.043,OR = 2.820,95%CI = 1.031 to 7.715 were associated with poor outcome at 6 month follow-up. AIDP is the most common subtype of GBS. Prognosis of AMAN group and BBE-GBS group is poorer than that of AIDP group at 3 month and 6 month follow-up. Hughes≥3 at nadir and dysautonomia are predictors of poor prognosis at 6 month follow-up.

  1. Heuristic status polling

    Science.gov (United States)

    Archer, Charles J [Rochester, MN; Blocksome, Michael A [Rochester, MN; Heidelberger, Philip [Cortlandt Manor, NY; Kumar, Sameer [White Plains, NY; Parker, Jeffrey J [Rochester, MN; Ratterman, Joseph D [Rochester, MN

    2011-06-07

    Methods, compute nodes, and computer program products are provided for heuristic status polling of a component in a computing system. Embodiments include receiving, by a polling module from a requesting application, a status request requesting status of a component; determining, by the polling module, whether an activity history for the component satisfies heuristic polling criteria; polling, by the polling module, the component for status if the activity history for the component satisfies the heuristic polling criteria; and not polling, by the polling module, the component for status if the activity history for the component does not satisfy the heuristic criteria.

  2. Prognosis of Significant Intraoperative Neurophysiologic Monitoring Events in Severe Spinal Deformity Surgery.

    Science.gov (United States)

    Bjerke, Benjamin T; Zuchelli, Daniel M; Nemani, Venu M; Emerson, Ronald G; Kim, Han Jo; Boachie-Adjei, Oheneba

    2017-03-01

    Intraoperative neurophysiologic monitoring has become a standard tool for mitigating neurologic injury during spinal deformity surgery. Significant monitoring changes during deformity correction are relatively uncommon. This study characterizes precipitating factors for neurologic injury and relates significant events and postoperative neurologic prognosis. All spinal deformity surgeries at a West African hospital over a 12-month period were reviewed. Patients were included if complete operative reports, monitoring data, and postoperative neurologic examinations were available for review. Surgical and systemic triggers of monitoring events were recorded and neurologic status was followed for 6 weeks postoperatively. Eighty-eight patients met inclusion criteria. The average age was 14 years (3-28). The average kyphosis was 108° (54°-176°) and average scoliosis was 100° (48°-177°). There were 44 separate neurologic events in 34 patients (39%). The most common triggers were traction or positioning (16), posterior column osteotomies/vertebral column resections (9/1), and distraction, corrective maneuvers, or implant placement (12). On surgery completion, 100% (12/12) of events from non-osteotomy-related surgical procedures, 75% (12/16) of events from traction or positioning resolved; however, 0% (0/10) of events from osteotomies resolved completely. Eight percent (7/88) had new neurologic deficits postoperatively, all with intraoperative monitoring changes. In 6 of these 7 patients, the event was attributed to an osteotomy; in 1 patient the cause was not determined. At 6-week follow-up, all patients had some preserved motor function bilaterally with the ability to walk (ASIA D/E) or recovered completely. Intraoperative signal changes were most frequently from traction or positioning. However, the most common cause of persistent neurologic deterioration and the only cause of postoperative neurologic deficit was the performance of osteotomies. Unlike traction- or

  3. STAT3 signaling drives EZH2 transcriptional activation and mediates poor prognosis in gastric cancer.

    Science.gov (United States)

    Pan, Yuan-Ming; Wang, Cheng-Gang; Zhu, Min; Xing, Rui; Cui, Jian-Tao; Li, Wen-Mei; Yu, De-Dong; Wang, Shu-Bin; Zhu, Wei; Ye, Ying-Jiang; Wu, Yun; Wang, Shan; Lu, You-Yong

    2016-12-09

    STAT3 signaling plays the pivotal role in tumorigenesis through EZH2 epigenetic modification, which enhanced STAT3 activity by increased tyrosine phosphorylation of STAT3. Here, another possible feedback mechanism and clinical significance of EZH2 and STAT3 were investigated in gastric cancer (GC). STAT3, p-STAT3 (Tyr 705) and EZH2 expression were examined in 63 GC specimens with matched normal tissues by IHC staining. EZH2 and STAT3 were also identified in five GC cell lines using RT-PCR and western blot analyses. p-STAT3 protein was detected by western blotting. In order to investigate whether EZH2 expression was directly regulated by STAT3, EZH2 expression was further detected using siRNA for STAT3 or IL-6 stimulation, with dual luciferase reporter analyses, electrophoretic mobility shift assay (EMSA) and chromatin immunoprecipitation (ChIP) assays. The clinical significance of STAT3, p-STAT3 and EZH2 expression was evaluated by multi-factor COX regression and Kaplan-Meier analyses. Hyper-activation of STAT3, p-STAT3 and EZH2 expression were observed in GC cells and tissues. STAT3 signaling was correlated with EZH2 expression in GC (R = 0.373, P = 0.003), which was consistent with our data showing that STAT3 as the transcriptional factor enhanced EZH2 transcriptional activity by binding the relative promoter region (-214 ~ -206). STAT3 was an independent signature for poor survival (P = 0.002). Patients with STAT3(+)/EZH2(+) or p-STAT3(+)/EZH2(+) had a worse outcome than others (P EZH2 was associated with advanced TNM staging (P = 0.017). Moreover, treatment with a combination of siSTAT3 and EZH2-specific inhibitor, 3-deazaneplanocin A (DZNEP), increased the apoptotic ratio of cells. It is benefit for targeting STAT3-EZH2 interplay in GC treatment. Our results indicate that STAT3 status mediated EZH2 upregulation, associated with advanced TNM stage and poor prognosis, suggesting that combination with knockdown of STAT3 and EZH2 inhibitor

  4. Clinical and Laboratory Features, Treatment and Prognosis in Children with Guillian-Barre Syndrome

    Directory of Open Access Journals (Sweden)

    N. A. Suponeva

    2015-01-01

    Full Text Available A retrospective study of 42 cases of acute flaccid paralysis (AFP in children aged between 7 months and 15 years, registered at the Municipal Clinical Hospital №1 throughout a 7 year period (2007—2014, was performed to investigate the features of pediatric Guillian-Barre Syndrome (GBS. GBS has shown to be the most common cause of AFP in children, with prevalence of 74% of all 31 cases. Clinical manifestations, functional status, laboratory and electrodiagnostic data were evaluated in group of 31 children in order to highlight particular features of childhood GBS in Russia. The highest frequency of GBS was observed in children aged between 1 to 3 with the median 6 [3; 11] years. Boys with GBS outnumbered girls by a 2,1:1 ratio. No seasonal dependence has been observed, with children equally suffering from this disease without a seasonal pattern throughout the year. According to the electrophysiological and clinical data, 24 children were diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (AIDP (77%, 5 with acute motor axonal neuropathy (AMAN (16% and 2 with аcute motor-sensory axonal neuropathy (AMSAN in a total of cases (7%. Several exclusive features of GBS in children for Russia were discovered. The most common initial symptom was limb pain, with the impartial sensory disturbance found only in 13% of the patients observed, 10% of which were paresthesias and the remaining 3% belonging to hypostesias. Children reached the nadir state rapidly, the median time from onset to nadir was 9.5 [6,25; 12,5] days. Cranial nerve dysfunction at nadir was observed in a greater percentage of patients (51% compared to that of 23% cases at the onset, with the facial palsy increasing from 10 to 32% and the bulbar palsy from 12 to 19%. The patients were given intravenous immunoglobulin in various doses: from 0.2 to 1.75 mg/kg per course (0.5 [0.5; 0.8] g/kg and/or plasmapheresis with a median volume of 93 [81; 100] ml/kg per

  5. Prognosis of sentinel node staged patients with primary cutaneous melanoma.

    Directory of Open Access Journals (Sweden)

    Otmar Elsaesser

    Full Text Available BACKGROUND: This study investigated survival probabilities and prognostic factors in sentinel lymph node biopsy (SLNB staged patients with cutaneous melanoma (CM with the aim of defining subgroups of patients who are at higher risk for recurrences and who should be considered for adjuvant clinical trials. METHODS: Patients with primary CM who underwent SLNB in the Department of Dermatology, University of Tuebingen, Germany, between 1996 and 2009 were included into this study. Survival probabilities and prognostic factors were evaluated by Kaplan-Meier and multivariate Cox proportional hazard models. RESULTS: 1909 SLNB staged patients were evaluated. Median follow-up time was 44 months. Median tumor thickness was 1.8 mm, ulceration was present in 31.8% of cases. The 5-year Overall Survival (OS was 90.3% in SLNB negative patients (IB 96.2%, IIA 87.0%, IIB 78.1%, IIC 72.6%. Patients with micrometastases (stage IIIA/B had a 5-year OS rate of 70.9% which was clearly less favorable than for stages I-II. Multivariate analysis revealed tumor thickness, ulceration, body site, histopathologic subtype and SLNB status as independent significant prognostic factors. CONCLUSION: Survival rates of patients with primary CM in stages I-II were shown to be much more favorable than previously reported from non sentinel node staged collectives. For future clinical trials, sample size calculations should be adapted using survival probabilities based on sentinel node staging.

  6. Vocal fold motion outcome based on excellent prognosis with laryngeal electromyography.

    Science.gov (United States)

    Smith, Libby J; Rosen, Clark A; Munin, Michael C

    2016-10-01

    As laryngeal electromyography (LEMG) becomes more refined, accurate predictions of vocal fold motion recovery are possible. Focus has been on outcomes for patients with poor prognosis for vocal fold motion recovery. Limited information is available regarding the expected rate of purposeful vocal fold motion recovery when there is good to normal motor recruitment, no signs of denervation, and no signs of synkinetic activity with LEMG, termed excellent prognosis. The objective of this study is to determine the rate of vocal fold motion recovery with excellent prognosis findings on LEMG after acute recurrent laryngeal nerve injury. Retrospective review. Patients undergoing a standardized LEMG protocol, consisting of qualitative (evaluation of motor recruitment, motor unit configuration, detection of fibrillations, presence of synkinesis) and quantitative (turns analysis) measurements were evaluated for purposeful vocal-fold motion recovery, calculated after at least 6 months since onset of injury. Twenty-three patients who underwent LEMG for acute vocal fold paralysis met the inclusion criteria of excellent prognosis. Eighteen patients (78.3%) recovered vocal fold motion, as determined by flexible laryngoscopy. Nearly 80% of patients determined to have excellent prognosis for vocal fold motion recovery experienced return of vocal fold motion. This information will help clinicians not only counsel their patients on expectations but will also help guide treatment. 4. Laryngoscope, 126:2310-2314, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Long-term prognosis of Guillain-Barré syndrome not determined by treatment options?

    Science.gov (United States)

    Wang, Ying; Lang, Wenjuan; Zhang, Yaqian; Ma, Xiaoyi; Zhou, Chunkui; Zhang, Hong-Liang

    2017-01-01

    Background The long-term follow-up system for Guillain-Barré syndrome (GBS) is not well established worldwide. In our study, the preliminary data of the long-term prognosis of GBS are collected to explore the prognosis of GBS and the effect of intravenous immunoglobulin (IVIg) treatment. Methods The follow-up data of 186 patients with GBS admitted from 2003 to 2013 were collected in 2015 via phone interview. The GBS disability scale score was ranked by clinician to evaluate the long-term prognosis. The clinical data during the acute phase were also collected. Results The mortality rates were 2.15%, 5.45% and 7.89% at discharge, 2-5 years and 6-10 years after disease, respectively. The GBS disability scale score improved dramatically from discharge to 2-12 years after the acute phase. The self-limitation, the spontaneous recovery of disease, occurred both at acute phase and 2-5 years after discharge. Comparisons between IVIg-treated patients and GBS patients who only received supportive care revealed no significant difference of long-term prognosis. Conclusion The long-term prognosis of GBS appears not to be influenced by treatment options. The long-term improvement of IVIg treated-patients might be due to the self-limitation of GBS per se instead of the IVIg treatment.

  8. A web-based decision support tool for prognosis simulation in multiple sclerosis.

    Science.gov (United States)

    Veloso, Mário

    2014-09-01

    A multiplicity of natural history studies of multiple sclerosis provides valuable knowledge of the disease progression but individualized prognosis remains elusive. A few decision support tools that assist the clinician in such task have emerged but have not received proper attention from clinicians and patients. The objective of the current work is to implement a web-based tool, conveying decision relevant prognostic scientific evidence, which will help clinicians discuss prognosis with individual patients. Data were extracted from a set of reference studies, especially those dealing with the natural history of multiple sclerosis. The web-based decision support tool for individualized prognosis simulation was implemented with NetLogo, a program environment suited for the development of complex adaptive systems. Its prototype has been launched online; it enables clinicians to predict both the likelihood of CIS to CDMS conversion, and the long-term prognosis of disability level and SPMS conversion, as well as assess and monitor the effects of treatment. More robust decision support tools, which convey scientific evidence and satisfy the needs of clinical practice by helping clinicians discuss prognosis expectations with individual patients, are required. The web-based simulation model herein introduced proposes to be a step forward toward this purpose. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Ceratocone: fatores prognósticos Keratoconus: prognosis factors

    Directory of Open Access Journals (Sweden)

    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.

  10. Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF. One Year of Clinical Follow-up.

    Directory of Open Access Journals (Sweden)

    Fabiana G Marcondes-Braga

    Full Text Available The identification of new biomarkers of heart failure (HF could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis.To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF.After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year. Study physicians, blind to the results of cardiac biomarker testing, ascertained vital status of each study participant at 12 months.The composite endpoint death and heart transplantation (HT were observed in 35 patients (39.3%: 29 patients (32.6% died and 6 (6.7% were submitted to HT within 12 months after study enrollment. High levels of EBA (≥3.7μg/L, 50th percentile were associated with a progressively worse prognosis in 12-month follow-up (log-rank = 11.06, p = 0.001. Concentrations of EBA above 3.7μg/L increased the risk of death or HT in 3.26 times (HR = 3.26, 95%CI = 1.56-6.80, p = 0.002 within 12 months. In a multivariable cox regression model, the independent predictors of all-cause mortality were systolic blood pressure, respiratory rate and EBA levels.High EBA levels could be associated to poor prognosis in HFrEF patients.

  11. Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF). One Year of Clinical Follow-up

    Science.gov (United States)

    Saldiva, Paulo H. N.; Mangini, Sandrigo; Issa, Victor S.; Ayub-Ferreira, Silvia M.; Bocchi, Edimar A.

    2016-01-01

    Background The identification of new biomarkers of heart failure (HF) could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA) is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis. Objectives To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF). Methods After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year. Study physicians, blind to the results of cardiac biomarker testing, ascertained vital status of each study participant at 12 months. Results The composite endpoint death and heart transplantation (HT) were observed in 35 patients (39.3%): 29 patients (32.6%) died and 6 (6.7%) were submitted to HT within 12 months after study enrollment. High levels of EBA (≥3.7μg/L, 50th percentile) were associated with a progressively worse prognosis in 12-month follow-up (log-rank = 11.06, p = 0.001). Concentrations of EBA above 3.7μg/L increased the risk of death or HT in 3.26 times (HR = 3.26, 95%CI = 1.56–6.80, p = 0.002) within 12 months. In a multivariable cox regression model, the independent predictors of all-cause mortality were systolic blood pressure, respiratory rate and EBA levels. Conclusions High EBA levels could be associated to poor prognosis in HFrEF patients. PMID:28030609

  12. Sex-based differences in clinical features, management, and 28-day and 7-year prognosis of first acute myocardial infarction. RESCATE II study.

    Science.gov (United States)

    García-García, Cosme; Molina, Lluís; Subirana, Isaac; Sala, Joan; Bruguera, Jordi; Arós, Fernando; Fiol, Miquel; Serra, Jordi; Marrugat, Jaume; Elosua, Roberto

    2014-01-01

    To analyze sex-based differences in clinical characteristics, management, and 28-day and 7-year prognosis after a first myocardial infarction. Between 2001 and 2003, 2042 first myocardial infarction patients were consecutively registered in 6 Spanish hospitals. Clinical characteristics, management, and 28-day case-fatality were prospectively recorded. Seven-year vital status was also ascertained by data linkage with the National Mortality Index. The registry included 449 women and 1593 men with a first myocardial infarction. Compared with men, women were older, had a higher prevalence of hypertension and diabetes, and were more likely to receive angiotensin-converting enzyme (ACE) inhibitors but were less likely to receive beta-blockers or thrombolysis. No differences were observed in use of invasive procedures. More women had non-ST-segment elevation and unclassified myocardial infarction than men (37.9% vs 31.3% and 9.8% vs 6.1%, respectively; both P<.001). Case-fatality at 28 days was similar in women and men (5.57% vs 4.46%; P=.39). After multivariate adjustment, the odds ratio of 28-day mortality for men was 1.06 (95% confidence interval: 0.49-2.27; P=.883) compared with women. After multivariate adjustment, men had higher 7-year mortality than women, hazard ratio 1.93 (95% confidence interval: 1.46-2.56; P<.001). There are demographic and clinical differences between men and women with a first myocardial infarction. The short-term prognosis of a first myocardial infarction in this century is similar in both sexes. However, the long-term vital prognosis after a first myocardial infarction is worse in men than in women. These results are observed in both ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction events. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  13. A systematic review of prognosis after mild traumatic brain injury in the military. Results of the International Collaboration on MTBI Prognosis (ICoMP)

    DEFF Research Database (Denmark)

    Boyle, Eleanor; Cancelliere, Carol; Hartvigsen, Jan

    2014-01-01

    : The evidence was synthesized qualitatively and presented in evidence tables. Results: The findings are based on three studies of US military personnel who were deployed in Iraq or Afghanistan. It was found that military personnel with MTBI report PTSD and post-concussive symptoms. In addition, reporting...... of post-concussive symptoms differed based on the levels of combat stress the individuals experienced. The evidence suggests a slight decline in neurocognitive function post-MTBI, but this decline was in the normal range of brain functioning. Conclusions: This study found limited evidence that combat...... stress, PTSD and post-concussive symptoms affect recovery and prognosis of MTBI in military personnel. Additional high quality research is needed to fully assess the prognosis of MTBI in military personnel....

  14. Prognostic effect of estrogen receptor status across age in primary breast cancer

    DEFF Research Database (Denmark)

    Bentzon, Niels; Düring, Maria; Rasmussen, Birgitte Bruun

    2008-01-01

    Estrogen receptor (ER) status is considered as an important prognostic factor as well as a predictive factor for endocrine responsiveness in breast cancer. We analyzed the distribution of ER status across age and estimated variations in the prognostic impact of ER status related to patients' age...... and time since diagnosis. Overall, 26,944 patients with primary breast cancer diagnosed from 1989 to 2004 were included. The proportion of ER positive tumors increased over age from 51 to 82%. In multivariate analysis of overall survival, ER positive status was found to be a significantly positive...... unchanged in patients who did not receive adjuvant systemic therapy (n = 6,272). Thus, positive ER status does not confer a negative impact on survival in young women as has been previously reported. The inferior prognosis for ER negative patients during the first 5 years after diagnosis changes...

  15. Estradiol metabolites as biomarkers of endometrial cancer prognosis after surgery.

    Science.gov (United States)

    Audet-Delage, Yannick; Grégoire, Jean; Caron, Patrick; Turcotte, Véronique; Plante, Marie; Ayotte, Pierre; Simonyan, David; Villeneuve, Lyne; Guillemette, Chantal

    2017-10-29

    Endometrial cancer (EC) is the most common gynecologic malignancy prevailing after menopause. Defining steroid profiles may help predict the risk of recurrence after hysterectomy, which remains limited due to the lack of reliable markers. Adrenal precursors, androgens, parent estrogens and catechol estrogen metabolites were measured by mass spectrometry (MS) in preoperative serums and those collected one month after hysterectomy from 246 newly diagnosed postmenopausal EC cases. We also examined the associations between steroid hormones and EC status by including 110 healthy postmenopausal women. Steroid concentrations were analyzed in relation to clinicopathological features, recurrence and overall survival (OS). The mean follow-up time was 65.5 months and 26 patients experienced relapse after surgery for a recurrence incidence of 10.6% (6.4% Type I and 29.5% Type II). Recurrence and OS were related to a more aggressive disease but not linked to body mass index. Preoperative levels of estriol (E3) and estrone-sulfate (E1-S) were inversely associated with recurrence in a multivariate logistic regression analysis (Hazard ratios (HRs) of 0.31, P=0.039 and 3.01, P=0.024; respectively). All circulating steroids declined considerably after surgery almost reaching those of healthy women, except 4-methoxy-E2 (4MeO-E2) for which postoperative levels increased by 35% and were associated to a 68% decreased risk of recurrence (HR=0.32, P=0.015). Women diagnosed with both histological types of EC present significantly higher levels of steroids, in support of their mitogenic effects. The estrogen precursor E1-S, the anticancer metabolite 4MeO-E2, and E3 that exert mixed antagonist and agonist estrogenic activities and immunological effects, are potential independent prognostic factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Prognosis moderates the engagement-outcome relationship in unguided cCBT for depression: A proof of concept for the prognosis moderation hypothesis.

    Science.gov (United States)

    Forand, Nicholas R; Huibers, Marcus J H; DeRubeis, Robert J

    2017-05-01

    Understanding how treatments work is a goal of psychotherapy research, however the strength of relationships between therapy processes and outcomes is inconsistent. DeRubeis, Cohen, et al. (2014) proposed that process-outcome relationships are moderated by patient characteristics. These "patient response patterns" (PRPs) indicate individuals' responsiveness to the active ingredients of treatment. Given the same quality of therapy, one individual may receive more benefit than another depending on their PRP. The "prognosis moderation hypothesis" states that PRPs can be defined by pretreatment prognostic indicators. Medium prognosis groups ("pliant-like") will have stronger process-outcome relationships than good ("easy-like") or poor ("challenging-like") groups. N = 190 individuals received unguided computerized CBT. They were 58% women, aged 44.7 years. Engagement with the cCBT program was the process variable. PRPs were defined by predicted scores from a prognostic regression model. Outcomes were BDI scores at 3, 6, and 12 months. "Easy-like," "pliant-like" and "challenging-like" groups were created and the engagement-outcome relationship was assessed as a function of group. Engagement-outcome correlations by PRP were: easy-like, r = -.27 (p moderator of the engagement-outcome relationship. Results were similar at 6 months but faded at 12. The engagement-outcome relationship varied as a function of prognosis, providing support for the prognosis moderation hypothesis. The "pliant-like" group appeared most sensitive to treatment procedures. Future research is needed to refine the methods for identifying PRPs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  17. Autonomous health management for PMSM rail vehicles through demagnetization monitoring and prognosis control.

    Science.gov (United States)

    Niu, Gang; Jiang, Junjie; Youn, Byeng D; Pecht, Michael

    2017-10-10

    Autonomous vehicles are playing an increasingly importance in support of a wide variety of critical events. This paper presents a novel autonomous health management scheme on rail vehicles driven by permanent magnet synchronous motors (PMSMs). Firstly, the PMSMs are modeled based on first principle to deduce the initial profile of pneumatic braking (p-braking) force, then which is utilized for real-time demagnetization monitoring and degradation prognosis through similarity-based theory and generate prognosis-enhanced p-braking force strategy for final optimal control. A case study is conducted to demonstrate the feasibility and benefit of using the real-time prognostics and health management (PHM) information in vehicle 'drive-brake' control automatically. The results show that accurate demagnetization monitoring, degradation prognosis, and real-time capability for control optimization can be obtained, which can effectively relieve brake shoe wear. Copyright © 2017. Published by Elsevier Ltd.

  18. HER-2 positive and p53 negative breast cancers are associated with poor prognosis.

    LENUS (Irish Health Repository)

    2012-02-01

    p53 and HER-2 coexpression in breast cancer has been controversial. These markers were tested using immunohistochemistry and HercepTest. HER-2 expression is related to reduced breast cancer survival (p = .02) . p53 expression relates to HER-2 expression (p = .029). Coexpression between p53 and HER-2 has no relation to prognosis. On univariate and multivariate analysis, combination of HER-2 positive and p53 negative expression was associated with a poor prognosis (p = .018 and p = .027, respectively), while the combination of HER-2 negative and p53 positive expression was associated with a favorable prognosis (p = .022 and p = .010, respectively). Therefore the expression of these markers should be considered collectively.

  19. HER-2 positive and p53 negative breast cancers are associated with poor prognosis.

    LENUS (Irish Health Repository)

    2011-06-01

    p53 and HER-2 coexpression in breast cancer has been controversial. These markers were tested using immunohistochemistry and HercepTest. HER-2 expression is related to reduced breast cancer survival (p = .02) . p53 expression relates to HER-2 expression (p = .029). Coexpression between p53 and HER-2 has no relation to prognosis. On univariate and multivariate analysis, combination of HER-2 positive and p53 negative expression was associated with a poor prognosis (p = .018 and p = .027, respectively), while the combination of HER-2 negative and p53 positive expression was associated with a favorable prognosis (p = .022 and p = .010, respectively). Therefore the expression of these markers should be considered collectively.

  20. Computer-aided prognosis on breast cancer with hematoxylin and eosin histopathology images: A review.

    Science.gov (United States)

    Chen, Jia-Mei; Li, Yan; Xu, Jun; Gong, Lei; Wang, Lin-Wei; Liu, Wen-Lou; Liu, Juan

    2017-03-01

    With the advance of digital pathology, image analysis has begun to show its advantages in information analysis of hematoxylin and eosin histopathology images. Generally, histological features in hematoxylin and eosin images are measured to evaluate tumor grade and prognosis for breast cancer. This review summarized recent works in image analysis of hematoxylin and eosin histopathology images for breast cancer prognosis. First, prognostic factors for breast cancer based on hematoxylin and eosin histopathology images were summarized. Then, usual procedures of image analysis for breast cancer prognosis were systematically reviewed, including image acquisition, image preprocessing, image detection and segmentation, and feature extraction. Finally, the prognostic value of image features and image feature-based prognostic models was evaluated. Moreover, we discussed the issues of current analysis, and some directions for future research.

  1. Allergens associated with severe symptoms of hand eczema and a poor prognosis

    DEFF Research Database (Denmark)

    Hald, Marianne; Agner, Tove; Blands, Jette

    2009-01-01

    BACKGROUND: Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis. OBJECTIVES: To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months. METHODS......: The study population comprised 799 consecutive hand eczema patients enrolled during January 2006-February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system...... (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens. RESULTS: At baseline, greater severity of hand eczema was associated with a positive patch...

  2. Obesity and Prevalence of Cardiovascular Diseases and Prognosis-The Obesity Paradox Updated.

    Science.gov (United States)

    Lavie, Carl J; De Schutter, Alban; Parto, Parham; Jahangir, Eiman; Kokkinos, Peter; Ortega, Francisco B; Arena, Ross; Milani, Richard V

    2016-01-01

    The prevalence and severity of obesity have increased in the United States and most of the Westernized World over recent decades, reaching worldwide epidemics. Since obesity worsens most of the cardiovascular disease (CVD) risk factors, not surprisingly, most CVDs, including hypertension, coronary heart disease, heart failure, and atrial fibrillation, are all increased in the setting of obesity. However, many studies and meta-analyses have demonstrated an obesity paradox with regards to prognosis in CVD patients, with often the overweight and mildly obese having a better prognosis than do their leaner counterparts with the same CVD. The implication for fitness to markedly alter the relationship between adiposity and prognosis and the potential impact of weight loss, in light of the obesity paradox, are all reviewed. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Formalisation of a new prognosis model for supporting proactive maintenance implementation on industrial system

    Energy Technology Data Exchange (ETDEWEB)

    Muller, Alexandre; Suhner, Marie-Christine [Centre de Recherche en Automatique de Nancy (CRAN), Nancy Universite, UMR 7039 CNRS-UHP-INPL, Faculte des Sciences-1er Cycle-BP239, 54506 Vandoeuvre-Les-Nancy Cedex (France); Iung, Benoit [Centre de Recherche en Automatique de Nancy (CRAN), Nancy Universite, UMR 7039 CNRS-UHP-INPL, Faculte des Sciences-1er Cycle-BP239, 54506 Vandoeuvre-Les-Nancy Cedex (France)], E-mail: Benoit.iung@cran.uhp-nancy.fr

    2008-02-15

    The importance of the maintenance function has increased because of its role in keeping and improving system availability and safety, as well as product quality. To support this role, the maintenance concept has undergone several major developments that have led to proactive considerations mainly based on a prognosis process, which normally allows selection of the best maintenance action to be carried out. This paper proposes the deployment and experimentation of a prognosis process within an e-maintenance architecture. The deployment follows a methodology based on the combination of both a probabilistic approach for modelling the degradation mechanism and of an event one for dynamical degradation monitoring. The feasibility and benefits of this new prognosis process is investigated with an experiment using a manufacturing TELMA (TELe-MAintenance) platform supporting the unwinding of metal bobbins.

  4. Long-term prognosis of acute back pain in patients seen in general practice

    DEFF Research Database (Denmark)

    Schiøttz-Christensen, Berit; Nielsen, Gunnar Lauge; Hansen, Vivian Kjær

    1999-01-01

    practice in Denmark. The patients were those aged 18-60 years consulting their GP due to an episode of LBP lasting less than 2 weeks. The GPs collected data regarding 34 exposure variables, including their global assessment of the likelihood of chronic LBP. Outcome variables were collected from......OBJECTIVES: We aimed to examine the prognosis of acute low back pain (LBP) in patients in general practice and to identify prognostic factors associated with the long-term prognosis based on information immediately available to the GP. METHOD: We conducted a prospective cohort study in general...... to develop chronic LBP and (iii) a history of LBP having caused previous sick leave. CONCLUSIONS: LBP in general practice has a good prognosis with regard to sick leave, but a high proportion of patients continue to complain of LBP. We were not able to identify objective measures that strongly predict...

  5. Tumor-infiltrating immune cells and prognosis: the potential link between conventional cancer therapy and immunity

    Science.gov (United States)

    Jochems, Caroline; Schlom, Jeffrey

    2011-01-01

    Numerous studies have now documented a link between the immune infiltrate in several human carcinoma types and prognosis and response to therapy. The most comprehensive of these studies were in colorectal cancer with similar conclusions by numerous groups. Analyses of immune infiltrate of several other carcinoma types also showed general correlations between immune infiltrate and prognosis, but with some conflicting results. This review will attempt to summarize the current state of this field and point out what factors may be responsible for some of the conflicting findings. Nonetheless, the breadth of reports drawing similar conclusions for some cancer cell types leads one to more seriously consider the link between immune cell infiltrate and tumor prognosis and/or response to therapy, and the potential for combining conventional cancer therapy with active immunotherapy employing therapeutic cancer vaccines. PMID:21486861

  6. [Status epilepticus in the elderly patients. A retrospective study of 63 in-patients].

    Science.gov (United States)

    Darcel, G; Verstichel, P; Herbaud, S; Taillandier-Heriche, E; Paillaud, E

    2008-11-01

    Status epilepticus is quite frequent in the elderly but rarely studied despite the poor functional prognosis and significant mortality. We retrospectively evaluated the clinical manifestations and electroencephalogram findings observed over a two-year period in 63 consecutive inpatients aged over 70 years presenting status epilepticus. The variables studied included age, sex, the number of concomitant chronic active diseases, previous neurological disorders, brain lesions on CT or MRI, the use and withdrawal of medications and outcome. The incidence of status epilepticus was 1%; two-thirds in women and one-third in men. The mean age was 83 years. Complex partial status epilepticus was noted in 91% with predominant features of confusion (89%), impairment of consciousness (75%) or psychiatric symptoms (46%). Etiologies were often multifactorial and acute symptomatic. Etiology was metabolic in 60%, drug-induced in 51%, demential in 44%, cerebrovascular in 37%, infectious in 30% and other neurological disorders in 28% of the cases. Antiepileptic drugs used to treat status epilepticus were benzodiazepine (60%), often in association with lamotrigine (51%), valproate (46%) or phenytoin (25%). Maintenance of an antiepileptic drug was found in 70% of cases. Complications were loss of autonomy (86%), malnutrition (67%), infections (51%), dementia (30%), pressure sores (14%), and recurrent epilepsy (13%). Mortality was 32% of cases and it was higher in men. These findings have shown some special features of status epilepticus among the elderly but other prospective studies are needed to confirm these results and to identify optimal management to decrease mortality, and improve the poor functional prognosis.

  7. Comparison of 5 Ki-67 antibodies regarding reproducibility and capacity to predict prognosis in breast cancer: does the antibody matter?

    Science.gov (United States)

    Ács, Balázs; Kulka, Janina; Kovács, Kristóf Attila; Teleki, Ivett; Tőkés, Anna-Mária; Meczker, Ágnes; Győrffy, Balázs; Madaras, Lilla; Krenács, Tibor; Szász, Attila Marcell

    2017-07-01

    Although several antibodies are available for immunohistochemical detection of Ki-67, even the most commonly used MIB-1 has not been validated yet. Our aim was to compare 5 commercially available antibodies for detection of Ki-67 in terms of agreement and their ability in predicting prognosis of breast cancer. Tissue microarrays were constructed from 378 breast cancer patients' representative formalin-fixed, paraffin-embedded tumor blocks. Five antibodies were used to detect Ki-67 expression: MIB-1 using chromogenic detection and immunofluorescent-labeled MIB-1, SP-6, 30-9, poly, and B56. Semiquantitative assessment was performed by 2 pathologists independently on digitized slides. To compare the 5 antibodies, intraclass correlation and concordance correlation coefficient were used. All the antibodies but immunofluorescent-labeled MIB-1 (at 20% and 30% thresholds, P=.993 and P=.342, respectively) and B56 (at 30% threshold, P=.288) separated high- and low-risk patient groups. However, there were a significant difference (P values for all comparisons≤.005) and a moderate concordance (intraclass correlation, 0.645) between their Ki-67 labeling index scores. The highest concordance was found between MIB-1 and poly (concordance correlation coefficient=0.785) antibodies. None of the antibodies except Ki-67 labeling index as detected by poly (P=.031) at 20% threshold and lymph node status (Pantibodies in their capacity to detect proliferating tumor cells and to separate low- and high-risk breast cancer patient groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Inhibition of STAT3 reduces astrocytoma cell invasion and constitutive activation of STAT3 predicts poor prognosis in human astrocytoma.

    Directory of Open Access Journals (Sweden)

    Qinchuan Liang

    Full Text Available Astrocytoma cells characteristically possess high invasion potentials. Recent studies have revealed that knockdown of signal transducers and activators of transcription 3 (STAT3 expression by RNAi induces apoptosis in astrocytoma cell. Nevertheless, the distinct roles of STAT3 in astrocytoma's invasion and recurrence have not been elucidated. In this study, we silenced STAT3 using Small interfering RNAs in two human glioblastoma multiforme (GBM cell lines (U251 and U87, and investigated the effect on GBM cell adhesion and invasion. Our results demonstrate that disruption of STAT3 inhibits GBM cell's adhesion and invasion. Knockdown of STAT3 significantly increased E-cadherin but decreased N-cadherin, vascular endothelial growth factor, matrix metalloproteinase 2 and matrix metalloproteinase 9. Additionally, expression of pSTAT3(Tyr705 correlates with astrocytoma WHO classification, Karnofsky performance status scale score, tumor recurrence and survival. Furthermore, pSTAT3(Tyr705 is a significant prognostic factor in astrocytoma. In conclusion, STAT3 may affect astrocytoma invasion, expression of pSTAT3(Tyr705 is a significant prognostic factor in tumor recurrence and overall survival in astrocytoma patients. Therefore, STAT3 may provide a potential target for molecular therapy in human astrocytoma, and pSTAT3(Tyr705could be an important biomarker for astrocytoma prognosis.

  9. Expressions of c-Cbl, Cbl-b and EGFR and Its Role of Prognosis in NSCLC

    Directory of Open Access Journals (Sweden)

    Xin JIAO

    2011-06-01

    Full Text Available Background and objective Epidermal growth factor receptor (EGFR is closely correlated with the progression of lung cancer. Its activity is modulated by Casitas B-lineage lymphoma (Cbl family. The aim of this study is to investigate the expression and clinical relevance of c-Cbl, Cbl-b and EGFR in non-small cell lung cancer (NSCLC. Methods Expressions of c-Cbl, Cbl-b and EGFR protein were detected with tissue microarrays and immunohistochemistry technique in 94 cases of NSCLC. The correlations between the expression of the three proteins and clinicopathological parameters were analyzed. Results The positive expression rates of EGFR, c-Cbl and Cbl-b were 60.6% (57/94, 30.9% (29/94 and 84.0% (79/94, respectively. The expression of EGFR, c-Cbl and Cbl-b was not associated with age, pathological type, TNM stage, lymph node metastasis, and smoking history. c-Cbl and Cbl-b status was not significantly correlated with overall survival. Subgroup analyses showed that c-Cbl-positive patients had longer survival than c-Cbl-negative patients in EGFR-positive group (P=0.014. Conclusion Detection of c-Cbl protein levels might contribute to the prognosis evaluation of EGFR-positive NSCLC.

  10. Associations of clinical features and prognosis with age at disease onset in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Feng, X; Zou, Y; Pan, W; Wang, X; Wu, M; Zhang, M; Tao, J; Zhang, Y; Tan, K; Li, J; Chen, Z; Ding, X; Qian, X; Da, Z; Wang, M; Sun, L

    2014-03-01

    The objective of this study is to evaluate the association of clinical features and prognosis with age at disease onset in patients with systemic lupus erythematosus (SLE) in a large, multicenter Chinese cohort. Medical records of 1898 SLE inpatients from 15 hospitals were reviewed and classified into three groups according to their ages at disease presentation. Categorical data were analyzed by chi-square test and potentially associated factors were tested by multinomial logistic regression. Among the patients studied, 259 (13.6%) were juvenile onset (≤18 years), 1444 (76.1%) were early onset (>18 and ≤45 years) and 195 (10.3%) were late onset (>45 years). Whenever manifestations occurred, most patients (>80%) were diagnosed within two years. Juvenile-onset patients were more likely to be untreated before admission (p lupus. Interestingly, our data showed that more patients with late-onset disease had a SLEDAI score change of >7 at discharge. In conclusion, age at onset has an impact on SLE disease status, and infection is the main cause of death in those with late-onset lupus. Considering that the late-onset patients had simultaneously easily controllable diseases and high incidence of comorbidities, a different treatment strategy from younger patients should be considered.

  11. Prognosis of Pregnancy-Associated Gastric Cancer: An Age-, Sex-, and Stage-Matched Case-Control Study.

    Science.gov (United States)

    Song, Min Jeong; Park, Young Soo; Song, Ho June; Park, Se Jeong; Ahn, Ji Yong; Choi, Kee Don; Lee, Gin Hyug; Jung, Hwoon-Yong; Yook, Jeong Hwan; Kim, Byung Sik

    2016-09-15

    Pregnancy-associated gastric cancer is a rare condition. This case-control study was performed to identify the clinicopathological features and prognostic factors of pregnancy-associated gastric cancer. All consecutive patients who presented to our tertiary referral hospital with pregnancy-associated gastric cancer from 1991 to 2012 were identified. Two age-, sex-, and stagematched controls for each case were also identified from the records. Clinicopathological, gynecological, and oncological outcomes were recorded. Immunohistochemical staining was performed for estrogen receptor, progesterone receptor, epidermal growth factor receptor, human epidermal growth factor receptor, and E-cadherin. Fluorescence in situ hybridization was performed for fibroblast growth factor receptor 2. The median overall survival rates of the pregnancyassociated gastric cancer and control groups were 7.0 months and 15.0 months, respectively (p=0.189). Poor prognostic factors included advanced stage and tumor location in the corpus or the entire stomach but not pregnancy status or loss of E-cadherin. Pregnancy-associated gastric cancer was associated with a longer time from diagnosis to treatment (21 days vs 7 days, p=0.021). The two groups did not differ in the expression of the receptors or E-cadherin. The dismal prognosis of pregnancy-associated gastric cancer may related to the tumor stage and location rather than to pregnancy itself.

  12. CALIPSO Mission Status Update: Payload Status

    Science.gov (United States)

    Verhappen, Ron; Borchardt, Robert; MacDonnell, David; Cisewski, Mike

    2007-01-01

    The CALIPSO mission payload status update is presented. The contents include: 1) Wide Field Camera Overview; 2) WFC Temperatures; 3) WFC Voltages; 4) Imaging Infrared Radiometer (IIR) Health; 5) IIR Voltages; 6) Payload Control (PLC) Voltages; 7) PLC Temperatures; 8) Low Voltage Power Supply (LVPS) (CALOPS0025N); 9) PLC Radiation Effects; 10) SDS Status (CALOPS0020N); 11) CALIOP LIDAR; 12) Laser Energy Trends; 13) Laser Energy Zoom; 14) Laser Management Approach; 15) Green / Red Ratio; 16) Pedestal @ SHG Temperature Trends; 17) LOM Heater Duty Cycle Trends; 18) LOM Pressure Trends; 19) Boresight Trend; 20) 1064 Dark Noise Trend; 21) 532 SNR Trend; 22) Spike Trends; 23) LIDAR Highlights; 24) Backup Laser Status; and 25) Future Plans.

  13. Stratification of Prognosis of Triple-Negative Breast Cancer Patients Using Combinatorial Biomarkers.

    Directory of Open Access Journals (Sweden)

    Yong Yue

    Full Text Available Triple-negative breast cancer (TNBC is highly diverse group of cancers, and generally considered an aggressive disease associated with poor survival. Stratification of TNBC is highly desired for both prognosis and treatment decisions to identify patients who may benefit from less aggressive therapy.This study retrieved 192 consecutive non-metastasis TNBC patients who had undergone a resection of a primary tumor from 2008 to 2012. All samples were negative for ER, PR, and HER2/neu. Disease-free-survival (DFS and overall-survival (OS were evaluated for expression of immunohistochemical biomarkers (P53, Ki-67, CK5/6 and EGFR, as well as clinicopathological variables including age, tumor size, grade, lymph node status, pathologic tumor and nodal stages. The cutoff values of the basal biomarkers, EGFR and CK5/6, were estimated by time-dependent ROC curves. The prognostic values of combinatorial variables were identified by univariate and multivariate Cox analysis. Patients were stratified into different risk groups based on expression status of identified prognostic variables.Median age was 57 years (range, 28-92 years. Patients' tumor stage and nodal stage were significantly associated with OS and DFS. EGFR and CK5/6 were significant prognostic variables at cutoff points of 15% (p = 0.001, AUC = 0.723, and 50% (p = 0.006, AUC = 0.675, respectively. Multivariate Cox analysis identified five significant variables: EGFR (p = 0.016, CK5/6 (p = 0.018, Ki-67 (p = 0.048, tumor stage (p = 0.010, and nodal stage (p = 0.003. Patients were stratified into low basal (EGFR≤15% and CK5/6≤50% and high basal (EGFR>15% and/or CK5/6>50% expression groups. In the low basal expression group, patients with low expressions of Ki-67, low tumor and nodal stage had significantly better survival than those with high expressions/stages of three variables, log-rank p = 0.015 (100% vs 68% at 50 months. In the high basal expression group, patient with high basal expression

  14. Loss of constitutive ABCB1 expression in breast cancer associated with worse prognosis

    Directory of Open Access Journals (Sweden)

    Delou JM

    2017-06-01

    histopathological variables was also evaluated. The Kaplan–Meier curves and multivariate Cox regression analyses were conducted to identify independent predictors of disease-free survival of patients with breast cancer. ABCB1 was detected in 86.3% (656 of breast tumors, 98.8% (606 of nonmalignant mammary tissue adjacent to tumors, and 100% (28 of benign lesions. Reduced ABCB1 protein levels in breast tumors was associated with triple-negative subtype (adjusted odds ratio [ORadj] =0.24; 95% confidence interval [CI] =0.13–0.45, lymph node status < pN2 (ORadj =0.27; 95% CI =0.10–0.71, tumor size >2 cm (ORadj =0.55; 95% CI =0.32–0.93, and hypertensive status (ORadj =0.42; 95% CI =0.24–0.73, and it was significantly associated with shorter disease-free survival, either for all breast cancer patients (p log-rank =0.012; hazard ratio [HR] =3.46; 95% CI =1.21–9.91 or for those with triple-negative tumors (p log-rank =0.007; HR =11.41; 95% CI =1.29–100.67. The loss of constitutive ABCB1 expression in breast cancer, especially in triple-negative tumors, seems to indicate a subgroup of worse prognosis. Keywords: multidrug resistance, single-nucleotide polymorphisms, immunohistochemistry, disease-free survival, triple-negative breast cancer, hypertension

  15. Phosphorylation of signal transducer and activator of transcription 3 in soft tissue leiomyosarcoma is associated with a better prognosis.

    Science.gov (United States)

    Setsu, Nokitaka; Kohashi, Kenichi; Endo, Makoto; Yamamoto, Hidetaka; Tamiya, Sadafumi; Takahashi, Yusuke; Yamada, Yuichi; Ishii, Takeaki; Matsuda, Shuichi; Yokoyama, Ryohei; Iwamoto, Yukihide; Oda, Yoshinao

    2013-01-01

    Signal transducer and activator of transcription (STAT) 3 mediates a broad range of biological processes, including cell survival and proliferation, and STAT3 has generally been regarded as a pro-oncogenic transcription factor. We investigated the phosphorylation status of STAT3 and the protein expression of the suppressor of cytokine signaling 3 (SOCS3) by immunohistochemistry in 145 formalin-fixed, paraffin-embedded samples of soft tissue leiomyosarcoma (LMS), including 129 primary tumors. Eight benign soft tissue smooth muscle tumors were also examined. Thirteen frozen LMS samples, which were paired with normal tissue samples, were assessed by Western blot analysis for the phosphorylation of STAT3 and SOCS3 expression. Immunohistochemical study showed that the phosphorylation of STAT3 was not a major event in LMS (37%). Moreover, phosphorylated STAT3 (pSTAT3) expression was significantly correlated with a better prognosis. Overexpression of SOCS3 was recognized in 52% of the cases and negatively correlated with pSTAT3 expression. Among the benign tumors, 63 and 25% were positive for pSTAT3 and SOCS3, respectively. Immunoblotting detected pSTAT3 in all tumor samples, but at lower levels than in non-neoplastic tissue. SOCS3 was detected in 92% (12 out of 13) of tumor tissues, but in none of the normal tissues. Contrary to the previous investigations of many other malignant tumors, STAT3 was inactivated in most LMS cases, likely owing to SOCS3 overexpression. STAT3 might not contribute to the progression of soft tissue LMS, and the phosphorylation status of STAT3 has the potential to be a favorable prognostic marker of LMS. Copyright © 2012 UICC.

  16. Aberrant GSTP1 promoter methylation predicts poor prognosis of acute-on-chronic hepatitis B pre-liver failure.

    Science.gov (United States)

    Qiao, Chen-Yang; Li, Feng; Teng, Yue; Zhao, Jing; Hu, Na; Fan, Yu-Chen; Wang, Kai

    2017-07-04

    It has been demonstrated that glutathione-S-transferase P1 (GSTP1) could protect cells from DNA damage mediated by oxidizing agents or electrophiles in hepatic inflammatory response. Our study evaluated the methylation status and the predictive value for prognosis of GSTP1 promoter region in patients with acute-on-chronic hepatitis B pre-liver failure (pre-ACHBLF). Methylation status of GSTP1 promoter in peripheral blood mononuclear cells (PBMCs) and plasma was measured in 103 patients with pre-ACHBLF, 80 patients with chronic hepatitis B (CHB) and 30 healthy controls (HCs) by methylation-specific polymerase chain reaction. The mRNA level of GSTP1 was detected by quantitative real-time polymerase chain reaction. The methylation frequency of GSTP1 promoter region in patients with pre-ACHBLF (35/103 in PBMCs and 33/103 in plasma) was significantly higher than CHB (2/80) and HCs (0/30), respectively. The mRNA level of GSTP1 in patients with pre-ACHBLF was significantly lower than CHB and HCs. Additionally, pre-ACHBLF patients with methylated GSTP1 presented strikingly higher incidence of ACHBLF than those without. Of note, GSTP1 methylation presented distinctly better performance than model for end-stage liver disease score [area under the receiver operating characteristic curves (AUCs) 0.825 in PBMCs and 0.798 in plasma VS 0.589; AUC 0.804 in PBMCs and 0.779 in plasma VS 0.622; AUC 0.767 in PBMCs and 0.744 in plasma VS 0.602, respectively] when used to predict the 1-, 2- or 3-month incidence of ACHBLF in patients with pre-ACHBLF. Aberrant methylation of GSTP1 has potential to be a prognostic biomarker for pre-ACHBLF.

  17. Copy Number Profiling of MammaPrint™ Genes Reveals Association with the Prognosis of Breast Cancer Patients

    Science.gov (United States)

    Fatima, Areej; Tariq, Fomaz; Malik, Muhammad Faraz Arshad; Qasim, Muhammad

    2017-01-01

    Purpose The MammaPrint™ gene signature, currently used in clinical practice, provides prognostic information regarding the recurrence and potential metastasis in breast cancer patients. However, the prognostic information of the 70 genes included can only be estimated at the RNA expression level. In this study, we investigated whether copy number information of MammaPrint™ genes at the DNA level can be used as a prognostic tool for breast cancer, as copy number variations (CNVs) are major contributors to cancer progression. Methods We performed CNV profiling of MammaPrint™ genes in 59 breast cancer cell lines and 650 breast cancer patients, using publicly available data in The Cancer Genome Atlas (TCGA) database. Statistical analyses including Fisher exact test, chi-square test, and Kaplan-Meier survival analyses were performed. Results All MammaPrint™ genes showed recurrent CNVs, particularly in TCGA cohort. CNVs of 32 and 36 genes showed significant associations with progesterone receptor and estrogen rector, respectively. No genes showed a significant association with human epidermal growth factor receptor 2 status and lymph node status. In addition, only six genes were associated with tumor stages. RFC4, HRASLS, NMU, GPR126, SCUBE2, C20orf46, and EBF4 were associated with reduced survival and RASSF7 and ESM1 were associated with reduced disease-free survival. Conclusion Based on these findings, a concordance of CNV-based genomic rearrangement with expression profiling of these genes and their putative roles in disease tumorigenesis was established. The results suggested that the CNV profiles of the MammaPrint™ genes can be used to predict the prognosis of breast cancer patients. In addition, this approach may lead to the development of new cancer biomarkers at the DNA level. PMID:28970850

  18. Copy Number Profiling of MammaPrint™ Genes Reveals Association with the Prognosis of Breast Cancer Patients.

    Science.gov (United States)

    Fatima, Areej; Tariq, Fomaz; Malik, Muhammad Faraz Arshad; Qasim, Muhammad; Haq, Farhan

    2017-09-01

    The MammaPrint™ gene signature, currently used in clinical practice, provides prognostic information regarding the recurrence and potential metastasis in breast cancer patients. However, the prognostic information of the 70 genes included can only be estimated at the RNA expression level. In this study, we investigated whether copy number information of MammaPrint™ genes at the DNA level can be used as a prognostic tool for breast cancer, as copy number variations (CNVs) are major contributors to cancer progression. We performed CNV profiling of MammaPrint™ genes in 59 breast cancer cell lines and 650 breast cancer patients, using publicly available data in The Cancer Genome Atlas (TCGA) database. Statistical analyses including Fisher exact test, chi-square test, and Kaplan-Meier survival analyses were performed. All MammaPrint™ genes showed recurrent CNVs, particularly in TCGA cohort. CNVs of 32 and 36 genes showed significant associations with progesterone receptor and estrogen rector, respectively. No genes showed a significant association with human epidermal growth factor receptor 2 status and lymph node status. In addition, only six genes were associated with tumor stages. RFC4 , HRASLS , NMU , GPR126 , SCUBE2 , C20orf46 , and EBF4 were associated with reduced survival and RASSF7 and ESM1 were associated with reduced disease-free survival. Based on these findings, a concordance of CNV-based genomic rearrangement with expression profiling of these genes and their putative roles in disease tumorigenesis was established. The results suggested that the CNV profiles of the MammaPrint™ genes can be used to predict the prognosis of breast cancer patients. In addition, this approach may lead to the development of new cancer biomarkers at the DNA level.

  19. Service Level Status

    CERN Multimedia

    Lopienski, S

    2007-01-01

    Nowadays, IT departments provide, and people use, computing services of an increasingly heterogeneous nature. There is thus a growing need for a status display that groups these different services and reports status and availability in a uniform way. The Service Level Status (SLS) system addresses these needs by providing a web-based display that dynamically shows availability, basic information and statistics about various IT services, as well as the dependencies between them.

  20. SIS - Status Determination

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Status Determination dataset within the Species Information System (SIS) contains information related to overfishing, overfished, and approaching overfished...