Articoli di riviste: "346.7303 har"

1

Roa, Silvia, Ana López-Alfonso, Inmaculada Toboso del Amo, Sandra Falagan, Francisco Zambrana, Miriam Lopez-Gomez, Ana M. Jimenez-Gordo et al. "Prospective analysis of antinuclear antibodies prevalence in a pan-tumor sample." Journal of Clinical Oncology 38, n. 15_suppl (20 maggio 2020): e15012-e15012. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e15012.

Testo completo

Abstract (sommario):

e15012 Background: Antinuclear antibodies (ANAs) constitute a spectrum of autoantibodies targeted to nuclear and cytoplasmic components of the cells considered serological markers for different autoimmune disease. However, ANAs are also presented in different types of cancers. Here, we present an exploratory analysis of ANAs patterns detected in patients with a recent cancer diagnosis. Methods: We carried out a prospective analysis of patients recently diagnosed of cancer in two centers. All were tested for ANAs from January to December 2019. Clinical-pathological features were collected from clinical reports. Results: 190 patients were included with different tumors: Lung(56.3%); colon/rectum(16.3%); head-neck(10.5%); pancreas(3.6%); stomach(3.1%); sarcoma(3.1%); urothelial(2.6%) and others( 3.6%). Most of the patients (pts) had stage IV (65.7%) and III (26.8%). Several histologies were included: adenocarcinoma(55.7%); squamous (32.6%) and others (transitional, clear cells, small cell and mesotelial/sarcoma). Chemotherapy was the main treatment (73.6%pts) followed by immunotherapy (11.5%pts), targeted therapy (6.8%pts) and chemo-inmunotherapy (3.1%pts). Among all pts included, only 13 had autoimmune disease: polymyalgia rheumatica (1pt); psoriasis (4pts), bronchial hyperreactivity (2pts) and hypotiroidism (6pts). In this cohort, we found that 60/190, 31.5%pts, showed positive ANAs (+) titers by immunofluorescence analysis. Different patterns were described according to First International Consensus on Standardized Nomenclature of ANAs. The predominant was a speckled pattern presented in 26% pts; secondly, a nucleolar pattern in 16.6% pts and CENP-F AC14 was presented in 8.3%pts. More minoritary patterns were also described. Patients with advanced lung cancer included 56.6% of ANAs (+) cases followed by colorectal cancer (11.6%). Adenocarcinoma (73,3 % pts) and squamous carcinoma (16,6% pts) were the most common histologies among ANAs (+) cases but none of the small cell carcinoma were ANA(+). The majority of ANAs (+) patients were on chemotherapy (73.3 % pts) followed by immunotherapy (16.6% pts). On the other hand, 4/13 of patients with autoimmune diseases presented ANAs(+) titers (CENT-F, scl70 and AC3 patterns). The only patient who developed a severe inmune-related toxicity was ANA negative. Conclusions: In this study, we describe the prevalence of ANAs and their patterns in a cohort of cancer patients. A complementary description of relevant clinical-pathological features in ANAs(+) subgroup is also reported.

Gli stili APA, Harvard, Vancouver, ISO e altri

2

Soria Curi, Y., L. Gonzalez Lucero, F. J. Hüttmann, M. L. Leguizamón, S. M. Mazza, G. V. Espasa, A. L. Barbaglia et al. "FRI0603-HPR COMORBIDITIES IN RHEUMATOID ARTHRITIS: UTILITY OF RACI SCORE (RHEUMATOID ARTHRITIS COMORBIDITY INDEX)". Annals of the Rheumatic Diseases 79, Suppl 1 (giugno 2020): 907.3–908. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5648.

Testo completo

Abstract (sommario):

Background:One third of patients with rheumatoid arthritis have some comorbidity at the time of diagnosis and 80% during the evolution. The presence of each additional comorbidity reduces the chances of remission by 28%.Objectives:To determine the prevalence of comorbidities in Rheumatoid Arthritis (RA) and to evaluate associated variables.Methods:A descriptive cross-sectional study was conducted. It were included patients over 18 years of age, who attended the Rheumatology office between May and August 2018 with a diagnosis of RA according to the ACR 1987 and ACR/EULAR 2010 criteria. Demographic variables were studied along with disease-related variables (time of evolution, disease activity by DAS-28 and CDAI, treatment and functional capacity (HAQ-A)). The presence of comorbidities was evaluated using two indexes: Rheumatoid Arthritis Comorbidity Index (RACI) and Disease Comorbidity Index (RDCI). RACI consists of 31 comorbidities grouped into 11 categories: DAS 28 >3.6, local inflammation, smoking, tumors, systemic involvement, infection, vascular disease, bone health, mood, metabolic and cardiovascular disorders (score range 0-36). RDCI consists of 11 comorbidities (categories according to ICD-10) and a formula to calculate it (range 0-9). For both indexes; higher score, greater comorbidity.Results:In this cross-sectional study, 345 patients were evaluated, of which 176 were included, 85.8% of the patients were female and the mean age was 52.7 ± 10.9 years; 31.2% of the cases finished primary school, the median of disease duration was 9 years (1-40), the mean DAS28 3.8 ± 1.4, and the mean CDAI 12.4 ± 11.3. 52.3% of the patients received treatment with glucocorticoids, 60.8% with NSAID, 60.2% with methotrexate, 39.2% with leflunomide, 17.6% with biologic DMARds and 5.6% with tofacitinib. 90.3% of the patients (95% CI 84.8, 94.3) presented some comorbidity measured by RACI. The average score was 4.7 ± 3.4 and the most frequent comorbidity were: elevated DAS28 (40.9%), dyslipidemia (38.1%), AHT (36.4%), prednisone >5 mg/d in 31.8%, endocrinopathies 19.3%. 73.3% of the patients had more than one comorbidity. Regarding RDCI, 47.2% of the cases presented some comorbidity with an average score of 0.95 ± 1.3; the most frequent were: AHT 36.4%, lung disease 12.5% and diabetes 8%. The oldest patients had more than one comorbidity (RACI), and also presented a higher HAQ score than those with only one (p<0.0001). Higher RACI score was associated with higher CDAI (p<0.001) and the use of glucocorticoids (p=0.008).Conclusion:The prevalence of comorbidities in RA by RACI was elevated (90.3%) and 73.3% of the patients presented more than one comorbidity. The patients with the highest RACI score had higher disease activity and used glucocorticoids more frequently.Disclosure of Interests:None declared

Gli stili APA, Harvard, Vancouver, ISO e altri

3

Toan, Nguyen Duc, Thomas C. Darton, Nguyen Hoang Thien Huong, Le Thanh Hoang Nhat, To Nguyen Thi Nguyen, Ha Thanh Tuyen, Le Quoc Thinh et al. "Clinical and laboratory factors associated with neonatal sepsis mortality at a major Vietnamese children’s hospital". PLOS Global Public Health 2, n. 9 (2 settembre 2022): e0000875. http://dx.doi.org/10.1371/journal.pgph.0000875.

Testo completo

Abstract (sommario):

Sepsis is a major cause of neonatal mortality and children born in low- and middle-income countries (LMICs) are at greater risk of severe neonatal infections than those in higher-income countries. Despite this disparity, there are limited contemporaneous data linking the clinical features of neonatal sepsis with outcome in LMICs. Here, we aimed to identify factors associated with mortality from neonatal sepsis in Vietnam. We conducted a prospective, observational study to describe the clinical features, laboratory characteristics, and mortality rate of neonatal sepsis at a major children’s hospital in Ho Chi Minh City. All in-patient neonates clinically diagnosed with probable or culture-confirmed sepsis meeting inclusion criteria from January 2017 to June 2018 were enrolled. We performed univariable analysis and logistic regression to identify factors independently associated with mortality. 524 neonates were recruited. Most cases were defined as late-onset neonatal sepsis and were hospital-acquired (91.4% and 73.3%, respectively). The median (IQR) duration of hospital stay was 23 (13–41) days, 344/524 (65.6%) had a positive blood culture (of which 393 non-contaminant organisms were isolated), and 69/524 (13.2%) patients died. Coagulase-negative staphylococci (232/405; 57.3%), Klebsiella spp. (28/405; 6.9%), and Escherichia coli (27/405; 6.7%) were the most isolated organisms. Sclerema (OR = 11.4), leukopenia <4,000/mm3 (OR = 7.8), thrombocytopenia <100,000/mm3 (OR = 3.7), base excess < –20 mEq/L (OR = 3.6), serum lactate >4 mmol/L (OR = 3.4), extremely low birth weight (OR = 3.2), and hyperglycaemia >180 mg/dL (OR = 2.6) were all significantly (p<0.05) associated with mortality. The identified risk factors can be adopted as prognostic factors for the diagnosis and treatment of neonatal sepsis and enable early risk stratification and interventions appropriate to reduce neonatal sepsis in LMIC settings.

Gli stili APA, Harvard, Vancouver, ISO e altri

4

Yeo, Kevin, Daniel Gordon, Lori Perry, Ilfra Raymond-Loher, Nita Tati, Kevin Yeo, Grace Lin, Gina DiPietro, Alex Selmani e Michael Decker. "SG-APSIC1035: Prospective safety surveillance study of ACAM2000 smallpox vaccine in deployed military personnel". Antimicrobial Stewardship & Healthcare Epidemiology 3, S1 (febbraio 2023): s10. http://dx.doi.org/10.1017/ash.2023.31.

Testo completo

Abstract (sommario):

Objectives: We compared rates of myopericarditis adverse events and evaluated potential risk factors of development. We compared rates of dermatological–neurological adverse events (severe and serious) with other adverse events in a specific population of deployed US military personnel who received or did not receive ACAM2000 vaccine (ie, Vaccinia smallpox live vaccine). Methods: Up to 20,000 military personnel recipients were enrolled in a prospective observational cohort study: up to 15,000 ACAM2000 recipients in cohort 1 and up to 5,000 military personnel who were eligible for ACAM2000 vaccination but were not vaccinated due to recent vaccination or characteristics of their contacts in cohort 2. Enrollment was at a 3:1 ratio, respectively. Serum specimens and data were collected at the initial visit and 10 days later (cf, window of 6–17 days). Study participants with evidence, either clinical or laboratory, of possible myopericarditis were referred to a blinded independent review committee for further evaluation and adjudication. The primary analysis was logistic regression with adjudicated myopericarditis as the dependent variable and age, sex, race, and exercise regimen as the independent variables. Results: Initial data and serum specimens were obtained from 14,667 participants (cohort 1, N = 10,825; cohort 2, N = 3,842). According to protocol, 2 visits were completed by 12,110 participants (cohort 1, N = 8,945; cohort 2, N = 3,165), and 125 participants (cohort 1, N = 111; cohort 2, N = 14) were referred for myopericarditis adjudication, of whom 1 had confirmed myocarditis, 5 had suspected myocarditis, 1 had suspected pericarditis, and 54 (cohort 1, N = 44; cohort 2, N = 10) had subclinical myopericarditis. The unadjusted myopericarditis rates were 5.7 per 1,000 (95% CI, 4.3–7.5) for cohort 1 and 3.2 per 1,000 (95% CI, 1.7–5.8) for cohort 2. The unadjusted and adjusted odds ratios for myopericarditis for cohort 1 and cohort 2 were 1.8 (95% CI, 0.9–3.6) and 1.3 (95% CI, 0.6–2.6), respectively. At least 1 serious adverse event was experienced by 117 participants (1.1%) in cohort 1 and 13 (0.3%) in cohort 2. No serious and severe neurological or dermatological adverse events were reported. Conclusions: ACAM2000 vaccination was associated with a modest but nonsignificant increase in the risk of myopericarditis in this prudently screened, young and healthy service-member population. The adjusted OR was 1.3 and the unadjusted OR was 1.8. Overall, all but 7 cases were subclinical. Citation: Faix DJ, Gordon DM, Perry LN, et al. Prospective safety surveillance study of ACAM2000 smallpox vaccine in deploying military personnel. Vaccine 2020;38:7323–7330.

Gli stili APA, Harvard, Vancouver, ISO e altri

5

Pasechnik, O. A., V. L. Stasenko e A. I. Bloh. "Epidemic Manifestations of Tuberculosis in Regions of Siberia with Various Prevalence of HIV Infection". Epidemiology and Vaccine Prevention 14, n. 5 (20 ottobre 2015): 31–35. http://dx.doi.org/10.31631/2073-3046-2015-14-5-31-35.

Testo completo

Abstract (sommario):

On the territory of the Siberian Federal District 2005 - 2014 period was characterized by a moderate tendency to reduce the incidence of tuberculosis and marked increase in the incidence of HIV infection. The subjects of the Siberian Federal District, the prevalence of HIV infection in which exceeded the level of 705.0 per 100 thousand people, had significant differences in the incidence rates of tuberculosis (115.4), the prevalence of tuberculosis (278.6 per 100 thousand), disability (73.3 per 100 thousand) and deaths from TB infection (25.5 per 100 thousand). The unfavorable short-term outlook for the morbidity of HIV-associated tuberculosis requires a change in approaches to epidemiological surveillance system for HIV and TB.

Gli stili APA, Harvard, Vancouver, ISO e altri

6

Samoylov, A. N., G. A. Fazleeva, T. R. Khaybrakhmanov, P. A. Samoylova e M. A. Fazleeva. "A retrospective analysis of the results of surgical treatment of large macular holes". Kazan medical journal 99, n. 2 (15 aprile 2018): 341–44. http://dx.doi.org/10.17816/kmj2018-341.

Testo completo

Abstract (sommario):

Aim. A retrospective analysis of the results of surgical treatment of large idiopathic macular holes depending on the technique of surgical intervention. Methods. The results of surgical treatment of 60 patients (60 eyes) with idiopathic macular holes with a diameter of more than 800 μm were studied in the Republican clinical ophthalmology hospital of Kazan. The average age of the patients was 66.2±5.37 (61-74) years. The patients underwent complex ophthalmological examination before the surgery and 10 days and 1 month after the surgery, including visometry, tonometry and optical coherence tomography. Patients were divided into two groups (30 subjects each), comparable in clinical and epidemiological parameters: group 1 - standard surgical tactics, group 2 - surgical treatment according to the method proposed by professor A.N. Samoylov. Visual acuity with correction before surgery in group 1 was 0.11±0.05, in group 2 - 0.12±0.06. Results. Ten days after the surgery, group 1 had anatomical closure in 23 (76.7%) patients, anatomical result was not achieved in 7 (23.3%) patients. In group 2, complete closure of the rupture was achieved in 27 (90.0%) patients, incomplete - in 3 (10.0%) patients. In 1 month in group 1, complete closure of the macular rupture was observed in 22 (73.3%) patients, in 8 (26.7%) patients the result was not achieved. In group 2, complete closure of the rupture was determined in 28 (93.3%) patients, incomplete closure - in 2 (6.7%) patients. Visual acuity 1 month after the surgery in group 1 was 0.15±0.08, and in group 2 - 0.32±0.11 (p <0.05). Conclusion. Surgical treatment of large idiopathic macular holes according to the modified technique of the inverted internal limiting membrane flap proposed by professor A.N. Samoylov, provides better anatomical and functional results in comparison with the standard technique (p <0.05).

Gli stili APA, Harvard, Vancouver, ISO e altri

7

Naaseh, Ariana, Hannah Rice, Isabel Temosihue, Natasha Zimmermann e Erin Linnenbringer. "Abstract 7333: From provider discussion to test completion: Evaluating cancer genetic services in a diverse academic comprehensive cancer care population". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 7333. http://dx.doi.org/10.1158/1538-7445.am2024-7333.

Testo completo

Abstract (sommario):

Abstract Objective: Genetic testing (GT) and counseling (GC) are important aspects of comprehensive cancer care, yet persistent equity challenges exist. We aim to characterize the evolving utilization of GT and GC services for potential hereditary breast, ovarian, pancreatic, and prostate cancers (HBOPP). Methods: We performed a retrospective single-institution chart review of a balanced racial subset of HBOPP patients who met National Comprehensive Cancer Network (NCCN) criteria diagnosed from 2019-2013. Data were analyzed using chi-squared test and multivariable logistic regression. Results: 503 HBOPP patients were studied. GT was discussed with 50.5% (n=254) of patients, 42.3% (n=213) completed GT, but only 8.7% had GC (n=44) (Table 1). Patients who were younger, had managed care, or had a family history of cancer were significantly more likely to have a GT discussion and complete GT (all p<0.01). Pancreatic cancer (RR 0.11; 95% CI 0.05-0.21) and prostate cancer patients (RR 0.05; 95% CI 0.02-0.10) were less likely to have a GT discussion with their provider than breast cancer patients. HBOPP patients had a lower likelihood of having a GT discussion with each additional year of age at diagnosis (RR 0.95; 95% CI 0.93-0.98). Among patients who had a GT discussion, prostate cancer patients (RR 0.14; 95% CI 0.04-0.47) and Black patients (RR 0.25; 95% CI 0.09-0.71) were less likely to complete GT. Ovarian cancer patients (RR 12.1; 95% CI 5.19-28.5) and patients with a family history of cancer (RR 2.26; 95% CI 1.05-4.86) were more likely to have GC. Conclusions: Inequities persist in GT and GC. NCCN-eligible patients who were older or had prostate or pancreatic cancer were less likely to have GT discussion. We found that Black patients were less likely than White patients to complete GT. GC rates were low across all groups except patients with ovarian cancer. Multilevel and systemic interventions are needed to improve equity in cancer genetic services. Access to, completion, and outcomes of genetic testing and counseling, by cancer type. Breast (n=212) Ovarian (n=48) Pancreatic (n=105) Prostate (n=138) Total (n=503) Test (p) Was there evidence a provider discussed and/or offered genetic testing? Yes 172 (81.1%) 36 (75.0%) 26 (24.8%) 20 (14.5%) 254 (50.5%) <0.001 No 40 (18.9%) 12 (25.0%) 79 (75.2%) 118 (85.5%) 249 (49.5%) Is there any evidence that the patient received genetic testing? Yes 155 (90.1%) 32 (88.9%) 18 (69.2%) 8 (42.1%) 213 (84.2%) <0.001 No 17 (9.9%) 4 (11.1%) 8 (30.8%) 11 (57.9%) 40 (15.8%) What were the patients results? Mutation positive 25 (16.3%) 5 (15.6%) 2 (11.1%) 0 (0.0%) 32 (15.2%) 0.095 Mutation negative 83 (54.2) 12 (37.5%) 13 (72.2%) 3 (37.5%) 111 (52.6%) Variant of unknown significance 43 (28.1%) 13 (40.6%) 3 (16.7%) 4 (50.0%) 63 (29.9%) No info available/cannot find 2 (1.3%) 2 (6.2%) 0 (0.0%) 1 (12.5%) 5 (2.4%) Was there evidence of any genetic counseling encounter? No 195 (92.4%) 27 (57.4%) 102 (97.1%) 133 (96.4%) 457 (91.2%) <0.001 Yes 16 (7.6%) 20 (42.6%) 3 (2.9%) 5 (3.6%) 44 (8.8%) Citation Format: Ariana Naaseh, Hannah Rice, Isabel Temosihue, Natasha Zimmermann, Erin Linnenbringer. From provider discussion to test completion: Evaluating cancer genetic services in a diverse academic comprehensive cancer care population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7333.

Gli stili APA, Harvard, Vancouver, ISO e altri

8

Gupta, Sapna, Sharminder Kaur, Shamiya Sadiq e Vijay Khajuria. "Primary dysmenorrhea: evaluation and treatment pattern among female medical students". International Journal of Basic & Clinical Pharmacology 7, n. 10 (24 settembre 2018): 1873. http://dx.doi.org/10.18203/2319-2003.ijbcp20183883.

Testo completo

Abstract (sommario):

Background: Dysmenorrhea is a very common condition in females in fertile age group and its affective and somatic features often limit female mobility which results in loss of work hours. The aim of the study was to evaluate prevalence, severity, drug usage and loss of work days among young female medical students.Methods: The current questionnaire based study was done in Department of pharmacology, GMC Jammu over a period of 3 months. Female students aged between 17-24 years who consented for participation were included. The demographic profile and detailed history of dysmenorrhea was recorded.Results: Out of 342 participants, 218 females (63.7%) had history of dysmenorrhea. Most of the dysmenorrhic females had menarche between 13-14 yrs of age (73.3%) and menstrual cycle of 21-34 days (82.5%), duration of bleeding less than 6 days (91.6%) and had a positive family history of dysmenorrhea (58.7%). Majority of females had mild to moderate features of dysmenorrhea (93.4%). Most common medication was Mefenemic acid alone and in combination (90.5%). Most of the females took self-medication (69.8%) and only 30.2% took medicines on advice of doctor. 71.5% students missed their classes due to symptoms of dysmennorhea.Conclusions: Dysmenorrhea is quite prevalent among college going medical students. Most of them had positive family history. Mefenemic acid and its combination was frequently used to treat symptoms. On an average 1-2days were lost due to dysmenorrhea.

Gli stili APA, Harvard, Vancouver, ISO e altri

9

Olisova, Olga Yu, Jessika R. Amshinskaya e Vladimir V. Demkin. "Micro-RNAs in the Diagnosis of Cutaneous T-Cell Lymphomas". Annals of the Russian academy of medical sciences 78, n. 6 (29 febbraio 2024): 530–40. http://dx.doi.org/10.15690/vramn11612.

Testo completo

Abstract (sommario):

Rationale. Early diagnosis of mycosis fungoides (MF), as the most common form of T-cell lymphoma, presents significant challenges. The diagnosis of MF is based on the following criteria: comprehensive assessment of the clinical picture of the disease, histological and immunohistochemical examination of the skin, and determination of rearrangement of the T-cell receptor gene, but even this does not always aid in diagnosis. The aim of the study is to investigate the expression of micro-RNAs (miR-223, -423, -663, -16, -326, -711) in the blood plasma and leukocytes of patients with a presumptive diagnosis of MF to improve the disease diagnosis. Methods. This study included 50 patients aged 24 to 79 years, of whom 30 patients had a preliminary diagnosis of MF and 20 patients with small plaque parapsoriasis, who formed the comparison group. All patients underwent histological, immunohistochemical examination of skin biopsies, and determination of micro-RNA (miR-223, -423, -663, -16, -326, -711) expression in blood plasma and leukocytes by real-time PCR. Results. Analyzing the results of clinical-anamnestic, histological, and immunohistochemical research methods, the diagnosis of MF was established in 22 of 30 (73.3%) patients, of which 9 of 14 (64.3%) were in the early stages of the disease. small plaque parapsoriasis. Conclusion. During our study, it was found that the studied micro-RNAs (miR-326, -663, -711, -223, -423, -16) in the blood plasma and leukocytes of patients with MF have statistically significant levels of expression compared to the low level of expression of these micro-RNAs in patients with small plaque parapsoriasis. The expression of micro-RNAs we studied in the skin contributes to the improvement of MF diagnosis with an accuracy of up to 90%.

Gli stili APA, Harvard, Vancouver, ISO e altri

10

Oestreich, W. K., N. K. Ganju, J. W. Pohlman e S. E. Suttles. "Colored dissolved organic matter in shallow estuaries: the effect of source on quantification". Biogeosciences Discussions 12, n. 10 (18 maggio 2015): 7301–33. http://dx.doi.org/10.5194/bgd-12-7301-2015.

Testo completo

Abstract (sommario):

Abstract. Light availability is of primary importance to the ecological function of shallow estuaries. For example, benthic primary production by submerged aquatic vegetation is contingent upon light penetration to the seabed. A major component that attenuates light in estuaries is colored dissolved organic matter (CDOM). CDOM is often measured via a proxy, fluorescing dissolved organic matter (fDOM), due to the ease of in situ fDOM measurements. Fluorescence must be converted to CDOM absorbance for use in light attenuation calculations and models. However, this fDOM-CDOM relationship varies among and within estuaries. We quantified the variability in this relationship within three estuaries: West Falmouth Harbor (MA), Barnegat Bay (NJ), and Chincoteague Bay (MD, VA). Land use surrounding these estuaries ranges from urban to developed, with varying sources of nutrients and organic matter. Measurements of fDOM and CDOM absorbance were taken along a terrestrial-to-marine gradient in all three estuaries. The ratio of the absorption coefficient at 340 nm (m−1) to fDOM (QSU) was higher in West Falmouth Harbor (1.22) than in Barnegat Bay (0.22) and Chincoteague Bay (0.17). The fDOM-CDOM absorption ratio was variable between sites within West Falmouth Harbor and Barnegat Bay, but consistent between sites within Chincoteague Bay. Stable carbon isotope analysis for constraining the source of dissolved organic matter in West Falmouth Harbor and Barnegat Bay yielded δ13C values ranging from −19.7 to −26.1‰ and −20.8 to −26.7‰, respectively. Stable carbon isotope mixing models of DOC in the estuaries indicate contributions from marine plankton, terrestrial plants, and Spartina cordgrass. Comparison of DOC source to fDOM-CDOM absorption ratio at each site demonstrates the influence of source on optical properties. Samples with a greater contribution from marsh (Spartina) organic material had higher fDOM-CDOM absorption ratios than samples with greater contribution from terrestrial organic material. Applying a uniform fDOM-CDOM absorption ratio and spectral slope within a given estuary yields errors in modeled light attenuation ranging from 11–33% depending on estuary. The application of a uniform absorption ratio across all estuaries doubles this error. These results demonstrate that continuous monitoring of light attenuation in estuaries requires some quantification of CDOM absorption and source to refine light models.

Gli stili APA, Harvard, Vancouver, ISO e altri

11

S., Purushotama T., Sathish K., Santhosh K., Ravindranath K. S. e Manjunath C. N. "Efficacy and safety of thrombolytic therapy in prosthetic valve thrombosis". International Journal of Research in Medical Sciences 8, n. 2 (27 gennaio 2020): 575. http://dx.doi.org/10.18203/2320-6012.ijrms20200238.

Testo completo

Abstract (sommario):

Background: There is limited data available about the effectiveness of thrombolysis in prosthetic valve thrombosis (PVT). Therefore, this study aimed to evaluate the efficacy and safety of thrombolytic treatment in PVT patients.Methods: This was an observational study conducted at a tertiary-care centre in India between March 2013 and April 2014. Total of 56 patients with either recurrent PVT or with confirmed left-sided PVT was included in the study. Thrombolytic therapy was administered as an intravenous infusion of streptokinase or urokinase, initially at a loading dose of 2.5L IU/hour over 30 minutes, followed by 1L IU/hour for 48–78 hours depending upon the clinical and 2D-Echo observation. Primary endpoint was considered as the occurrence of a complete clinical response. Secondary endpoint was considered as a composite of death, major bleeding or embolic stroke.Results: Mean age of the patients was 37±13 years. Most of the patients presented with NYHA-II (51.7%), III (39.2%), and IV (8.9%) symptoms. Mitral and aortic valve thrombosis were observed in 40(71.4%) and 11(28.6%) patients. Forty-nine (73.3%) patients were treated with streptokinase. Whereas, rethrombosis patients were treated with urokinase [6(16%)] and tenecteplase [1(1.3%)]. Two (3.6%) patients died, 1(1.8%), 1(1.8%), 2(3.6%), and 1(1.8%) patient had peripheral embolism, central nervous system bleeding, stroke, and embolic complications.Conclusions: Thrombolytic therapy can be used as the first-line treatment for thrombolysis in PVT patients. All PVT patients can be treated with streptokinase unless specific contraindications exist. Urokinase or tenecteplase is an alternative thrombolytic agent in rethrombosis patients.

Gli stili APA, Harvard, Vancouver, ISO e altri

12

Adhikari, Prava, Aurawamon Sriyuktasuth e Warunee Phligbua. "Social determinants of health and glycemic control in persons with type 2 diabetes mellitus attending a tertiary hospital in Nepal: A cross-sectional study". Belitung Nursing Journal 9, n. 5 (26 ottobre 2023): 489–97. http://dx.doi.org/10.33546/bnj.2753.

Testo completo

Abstract (sommario):

Background: Diabetes mellitus (DM) is an emerging global public health challenge worldwide, including Nepal. Social determinants of health (SDOH) play a major role in glycemic control among persons with type 2 DM (T2DM). However, little is known about the association between SDOH and glycemic control among individuals with T2DM in Nepal. Objective: This study aimed to identify the level of glycemic control and SDOH associated with glycemic control among Nepalese with T2DM. Methods: This cross-sectional study was conducted at a tertiary hospital in Kathmandu, Nepal, among 135 Nepalese diagnosed with T2DM who attended follow-up appointments. Convenience sampling and inclusion criteria were utilized for participant selection. Data were collected from April to June 2021 using validated scales. Descriptive statistics, Chi-square test, and binary logistic regression were employed to analyze the data. Results: The mean age of the participants in this study was 53.84 (SD = 11.78) years, and the average monthly household income was 567.64 (SD = 362.30) USD. The majority of the participants (77.8%) were literate and had no health insurance coverage (73.3%). Approximately 64.4% of the participants showed suboptimal glycemic control indicated by glycated hemoglobin (HbA1c) ≥7%. The significant determinants of good glycemic control included monthly household income of >850 USD (odds ratio [OR] = 12.20, 95% confident interval [CI] = 1.76–84.61, p = 0.011) and 341–600 USD (OR = 7.64, 95% CI 1.35–42.98, p = 0.021), being literate (OR = 6.37, 95% CI = 1.65–24.49, p = 0.007), having health insurance (OR = 5.82, 95% CI = 1.49–22.65, p = 0.011), sufficient health literacy (OR = 3.46, 95% CI = 1.10–10.83, p = 0.03), and high (OR = 16.17, 95% CI = 2.36–110.67, p = 0.005) and moderate (OR = 7.02, 95% CI = 1.26–39.07, p = 0.026) food availability, respectively. Conclusion: The study revealed suboptimal glycemic control in Nepalese with T2DM. This study presents essential social determinants of glycemic control in this population. Therefore, healthcare providers, particularly nurses, should pay more attention to assessing social determinants and provide targeted interventions to patients with T2DM who have low income, are illiterate, have no health insurance coverage, have insufficient health literacy, and have low resources for food availability.

Gli stili APA, Harvard, Vancouver, ISO e altri

13

Hoskin, Peter, Vivek Misra, Kirsten Hopkins, Tanya Holt, Gillian Brown, Seonaid Arnott, Sharon Shibu Thomas et al. "SCORAD III: Randomized noninferiority phase III trial of single-dose radiotherapy (RT) compared to multifraction RT in patients (pts) with metastatic spinal canal compression (SCC)." Journal of Clinical Oncology 35, n. 18_suppl (20 giugno 2017): LBA10004. http://dx.doi.org/10.1200/jco.2017.35.18_suppl.lba10004.

Testo completo

Abstract (sommario):

LBA10004 Background: SCC is a common complication of metastatic cancer. Most pts receive RT to improve neurological function and mobility and to relieve pain. There is no standard schedule (RT ranges from single dose 8Gy to 40Gy in 20 fractions). SCORAD III was conducted to show whether a single fraction is as effective as multifraction RT without compromising patient outcomes. Methods: Pts from 43 UK and 4 Australian sites were randomized (1:1) to receive external beam spinal canal RT as a single dose of 8Gy or 20Gy in 5 fractions; stratified by RT center, ambulatory status (AS), site of primary, and presence or absence of nonskeletal metastases. Eligible pts had spinal cord or cauda equina (C1-S2) compression confirmed by MRI/CT scan, treatable within a single radiation field, life expectancy >8 weeks (wks), no previous RT to the same area. Primary endpoint was AS at wk 8: graded 1 (full function) to 4 (no/flicker motor power). The noninferiority margin was 11% for comparing the proportion of patients with AS 1 or 2 at wk 8 (whether maintained from baseline or improved from AS 3-4). Results: 688 pts were randomized Feb 2008 to Apr 2016 (n=345 single dose, n=343 multifraction). 73% were male; median age 70 years; ambulatory with/without walking aids 66%; 44% prostate, 18% lung, 11% breast, 11% gastrointestinal. Baseline characteristics were balanced. 69.5% (114/164 pts evaluable at wk 8) single dose vs. 73.3% (129/176) multifraction had AS 1-2 at wk 8 (risk difference: -3.78%, 90%CI -11.85 to 4.28). Importantly, overall survival (OS) was very similar: median OS 12.4 wks single dose vs. 13.7 multifraction, (hazard ratio 1.02 [95%CI 0.86-1.21], p=0.81). Proportion of pts with adverse events was similar for grade 3-4 (20.6% single dose vs. 20.4% multifraction), but grade 1-2 events were lower with single dose (51.0% vs. 56.9%). Conclusions: Using a single dose of 8Gy in pts with metastatic SCC was as effective as multiple fractions for AS at 8 wks and OS. We now recommend using single dose RT in this setting, with the major benefit of requiring only a single instead of multiple hospital visits, important when considering the short survival in these pts. Clinical trial information: 97108008.

Gli stili APA, Harvard, Vancouver, ISO e altri

14

Pengpid, Supa, e Karl Peltzer. "Ethnic and Gender Disparities in Healthy Ageing among People 50 Years and Older in South Africa". Geriatrics 6, n. 3 (12 agosto 2021): 79. http://dx.doi.org/10.3390/geriatrics6030079.

Testo completo

Abstract (sommario):

Objective: this study aimed to determine the prevalence and correlates of healthy ageing in older adults living in the community in South Africa. Methods: the cross-sectional sample consisted of 3734 individuals (≥50 years) from the cross-sectional South African National Health and Nutrition Survey (SANHANES-1) in 2011–2012. Healthy ageing was assessed using a multidimensional concept, which includes five components: (1) absence of major illness, (2) absence of disability, (3) good mental health, (4) social engagement and (5) well-being or good health. Results: in general, 36.6% had a healthy ageing, including 73.3% had no major diseases, 87.1% were free of disability, 62.3% had good mental health, 73.0% were socially engaged and 64.0% had a high well-being. In the adjusted logistic regression analysis, male sex (Adjusted Odds Ratio-AOR: 1.33, 95% confidence interval-CI: 1.03–1.72), white population group (AOR: 3.46, 95% CI: 2.29–5.22) and coloured population group (AOR: 1.82, 95% CI: 1.34–2.47), were positively associated with healthy ageing, while increasing age (AOR: 0.96, 95% CI: 0.94–0.97), daily tobacco use (AOR: 0.56, 95% CI: 0.42–0.74), perceived underweight (AOR: 0.48, 95% CI: 0.34–0.66) and perceived overweight (AOR: 0.53, 95% CI: 0.34–0.81) were negatively associated with associated with healthy ageing. Conclusion: almost two in five older adults in South Africa were successfully ageing. Factors associated with healthy ageing included, younger age, male sex, population group (Whites, Coloureds), not daily tobacco users, not having underweight and overweight.

Gli stili APA, Harvard, Vancouver, ISO e altri

15

Magambo, Juma Morigo John, Nuria Majaliwa e Jamal B. Kussaga. "A Cross-sectional Study to Assess Bacteriological Quality of Fresh Vegetable Salads and Associated Risk Factors in Food Service Establishments in Mwanza City". Asian Food Science Journal 23, n. 1 (6 febbraio 2024): 34–48. http://dx.doi.org/10.9734/afsj/2024/v23i1693.

Testo completo

Abstract (sommario):

This study examined the bacteriological quality of fresh vegetable salads and associated risk factors in restaurants and street food vendors in Nyamagana and Ilemela municipalities, Mwanza City, Tanzania. Thirty samples of vegetable salads (i.e., Kachumbari), along with 30 swabs from hands and chopping boards, were collected and analyzed. High contamination levels exceeding acceptable limits were observed with total bacterial counts, S. aureus, and E. coli ranging from 3.6 to 6.7 log CFU/g. All Kachumbari samples (100%) were unsatisfactory, and 17 (56.7%) had unsatisfactory E. coli levels. Moreover, 22 samples (73.3%) had unsatisfactory S. aureus levels, and 10 samples (33.3%) showed unsatisfactory Salmonella spp. contamination. Further, Kachumbari from street food vending sites had a significantly (p < 0.05) higher TBC mean value (6.5 ± 0.3 log CFU/g) than the one from restaurants (5.2 ± 0.6 log CFU/g). On the other hand, chopping boards and hands had high total counts ranging from 3.5 to 4.7 log CFU.cm-2. Also, the type of chopping board was significantly related to the S. aureus contamination levels in the Kachumbari salads (p < 0.05). The presence of both hygiene indicator microorganisms and pathogens indicates a potential public health risk associated with the consumption of Kachumbari. Urgent intervention measures are required to enhance handling practices, personal hygiene, and overall safety throughout the food value chain, thus ensuring the quality and safety of vegetable salads in food service establishments.

Gli stili APA, Harvard, Vancouver, ISO e altri

16

Hossain, Md Suman, Ruhul Amin Tuhin, Md Wahiduzzaman, Hosne Ara Begum e Anam Ahmed. "Fast Food Consumption and Dental Caries among Teenagers". Asian Journal of Medicine and Health 21, n. 10 (18 agosto 2023): 204–9. http://dx.doi.org/10.9734/ajmah/2023/v21i10894.

Testo completo

Abstract (sommario):

Background: Dental caries in teenagers is a significant public health concern. Fast food consumption among teenagers in Bangladesh is steadily increasing. The objectives of the study were to determine the association between fast food consumption and dental caries among teenagers. Methods: This cross-sectional study was conducted from January to December 2022. The calculated sample size was 345 teenagers from two secondary schools in Dhaka city. The convenience sampling technique was used to collect data through face-to-face interviews with a pretested, semi-structured questionnaire. A checklist was also used to collect data through clinical examination of the oral cavity. By double-checking, data were altered for quality control. Statistical software was used to analyze the data. Results: Among 345 teenagers, the mean ± SD age was 14.88±1.17 years. The majority of the teenagers (53.6%) were female and Muslim (95%). Around 59.4% of the teenagers' fathers were business owners, while 37.4% were government employees. The majority of respondents (73.3%) ate breakfast before going to school and 52.2% took food from the school canteen. The majority (93.3%) ate at outside restaurants, with 90.4% eating fast food. 59.7% of people ate fast food at least once a week. Dental caries affected 36.8% of the teenager who ate fast food (p<0.05). A significant association was found between dental caries and the frequency of fast-food consumption. Among the respondents, 4.8% had dental caries who ate fast food daily (p<0.05). Conclusion: To prevent dental caries, teenagers should avoid eating fast food and snacks between meals and brush their teeth on a regular basis.

Gli stili APA, Harvard, Vancouver, ISO e altri

17

Liu, James K., Nicole A. Silva, Ilesha A. Sevak e Jean Anderson Eloy. "Transbasal versus endoscopic endonasal versus combined approaches for olfactory groove meningiomas: importance of approach selection". Neurosurgical Focus 44, n. 4 (aprile 2018): E8. http://dx.doi.org/10.3171/2018.1.focus17722.

Testo completo

Abstract (sommario):

OBJECTIVEThere has been much debate regarding the optimal surgical approach for resecting olfactory groove meningiomas (OGMs). In this paper, the authors analyzed the factors involved in approach selection and reviewed the surgical outcomes in a series of OGMs.METHODSA retrospective review of 28 consecutive OGMs from a prospective database was conducted. Each tumor was treated via one of 3 approaches: transbasal approach (n = 15), pure endoscopic endonasal approach (EEA; n = 5), and combined (endoscope-assisted) transbasal-EEA (n = 8).RESULTSThe mean tumor volume was greatest in the transbasal (92.02 cm3) and combined (101.15 cm3) groups. Both groups had significant lateral dural extension over the orbits (transbasal 73.3%, p < 0.001; combined 100%), while the transbasal group had the most cerebral edema (73.3%, p < 0.001) and vascular involvement (66.7%, p < 0.001), and the least presence of a cortical cuff (33.3%, p = 0.019). All tumors in the combined group were recurrent tumors that invaded into the sinonasal cavity. The purely EEA group had the smallest mean tumor volume (33.33 cm3), all with a cortical cuff and no lateral dural extension. Gross-total resection was achieved in 80% of transbasal, 100% of EEA, and 62.5% of combined cases. Near-total resection (> 95%) was achieved in 20% of transbasal and 37.5% of combined cases, all due to tumor adherence to the critical neurovascular structures. The rate of CSF leakage was 0% in the transbasal and combined groups, and there was 1 leak in the EEA group (20%), resulting in an overall CSF leakage rate of 3.6%. Olfaction was preserved in 66.7% in the transbasal group. There was no significant difference in length of stay or 30-day readmission rate between the 3 groups. The mean modified Rankin Scale score was 0.79 after the transbasal approach, 2.0 after EEA, and 2.4 after the combined approach (p = 0.0604). The mean follow-up was 14.5 months (range 1–76 months).CONCLUSIONSThe transbasal approach provided the best clinical outcomes with the lowest rate of complications for large tumors (> 40 mm) and for smaller tumors (< 40 mm) with intact olfaction. The role of EEA appears to be limited to smaller, appropriately selected tumors in which olfaction is already absent. EEA also plays an important adjunctive role when combined with the transbasal approach for recurrent OGMs invading the sinonasal cavity. Careful patient selection using an individualized, tailored strategy is important to optimize surgical outcomes.

Gli stili APA, Harvard, Vancouver, ISO e altri

18

Alsaber, A., A. Al-Herz, J. Pan, K. Saleh, A. Al-Awadhi, W. Al-Kandari, E. Hasan et al. "THU0556 MISSING DATA AND MULTIPLE IMPUTATION IN RHEUMATOID ARTHRITIS REGISTRIES USING SEQUENTIAL RANDOM FOREST METHOD". Annals of the Rheumatic Diseases 79, Suppl 1 (giugno 2020): 519.1–519. http://dx.doi.org/10.1136/annrheumdis-2020-eular.4838.

Testo completo

Abstract (sommario):

Background:Missing data in clinical epidemiological researches violate the intention to treat principle,reduce statistical power and can induce bias if they are related to patient’s response to treatment. In multiple imputation (MI), covariates are included in the imputation equation to predict the values of missing data.Objectives:To find the best approach to estimate and impute the missing values in Kuwait Registry for Rheumatic Diseases (KRRD) patients data.Methods:A number of methods were implemented for dealing with missing data. These includedMultivariate imputation by chained equations(MICE),K-Nearest Neighbors(KNN),Bayesian Principal Component Analysis(BPCA),EM with Bootstrapping(Amelia II),Sequential Random Forest(MissForest) and mean imputation. Choosing the best imputation method wasjudged by the minimum scores ofRoot Mean Square Error(RMSE),Mean Absolute Error(MAE) andKolmogorov–Smirnov D test statistic(KS) between the imputed datapoints and the original datapoints that were subsequently sat to missing.Results:A total of 1,685 rheumatoid arthritis (RA) patients and 10,613 hospital visits were included in the registry. Among them, we found a number of variables that had missing values exceeding 5% of the total values. These included duration of RA (13.0%), smoking history (26.3%), rheumatoid factor (7.93%), anti-citrullinated peptide antibodies (20.5%), anti-nuclear antibodies (20.4%), sicca symptoms (19.2%), family history of a rheumatic disease (28.5%), steroid therapy (5.94%), ESR (5.16%), CRP (22.9%) and SDAI (38.0%), The results showed that among the methods used, MissForest gave the highest level of accuracy to estimate the missing values. It had the least imputation errors for both continuous and categorical variables at each frequency of missingness and it had the smallest prediction differences when the models used imputed laboratory values. In both data sets, MICE had the second least imputation errors and prediction differences, followed by KNN and mean imputation.Conclusion:MissForest is a highly accurate method of imputation for missing data in KRRD and outperforms other common imputation techniques in terms of imputation error and maintenance of predictive ability with imputed values in clinical predictive models. This approach can be used in registries to improve the accuracy of data, including the ones for rheumatoid arthritis patients.References:[1]Junninen, H.; Niska, H.; Tuppurainen, K.; Ruuskanen, J.; Kolehmainen, M. Methods for imputation ofmissing values in air quality data sets.Atmospheric Environment2004,38, 2895–2907.[2]Norazian, M.N.; Shukri, Y.A.; Azam, R.N.; Al Bakri, A.M.M. Estimation of missing values in air pollutiondata using single imputation techniques.ScienceAsia2008,34, 341–345.[3]Plaia, A.; Bondi, A. Single imputation method of missing values in environmental pollution data sets.Atmospheric Environment2006,40, 7316–7330.[4]Kabir, G.; Tesfamariam, S.; Hemsing, J.; Sadiq, R. Handling incomplete and missing data in water networkdatabase using imputation methods.Sustainable and Resilient Infrastructure2019, pp. 1–13.[5]Di Zio, M.; Guarnera, U.; Luzi, O. Imputation through finite Gaussian mixture models.ComputationalStatistics & Data Analysis2007,51, 5305–5316.Disclosure of Interests:None declared

Gli stili APA, Harvard, Vancouver, ISO e altri

19

White, Martha M., Elizabeth A. Gilpin, Sherry L. Emery e John P. Pierce. "Facilitating Adolescent Smoking: Who Provides the Cigarettes?" American Journal of Health Promotion 19, n. 5 (maggio 2005): 355–60. http://dx.doi.org/10.4278/0890-1171-19.5.355.

Testo completo

Abstract (sommario):

Purpose. Most adolescent smokers obtain cigarettes through social sources. We examine the extent to which cigarettes are provided by facilitators of legal age to purchase cigarettes. Design. Analyses of data from the 1999 California Tobacco Survey, a large population-based, random-digit–dialed telephone survey, are reported. Setting. California. Subjects. Data were from a subset of 1239 adolescent (12–17 years) respondents who reported ever having smoked a cigarette. The response rate for all adolescents selected for interview was 75.5%. Measures. We describe cigarette providers to adolescents in social (cigarettes given to the adolescent) and economic (someone else buys cigarettes for the adolescent) transactions by the reported facilitator's age. Results. Of the 82.2% ± 2.6% of adolescents who had ever smoked who usually obtained cigarettes from others, 21.6% ± 2.5% used economic transactions; most (60.6% ± 3.4%) were given cigarettes. The majority (73.3% ± 3.6%) of those relying on social sources were given cigarettes by someone <18 years of age; very few were given cigarettes by someone 21+ years old. Most (90.4% ± 2.0%) usually given cigarettes reported friends as facilitators. Of those who relied on economic transactions, 56.1% ± 6.6% reported facilitators who were 18- to 20-year-olds, another 24.7% ±6.3% had suppliers ≥21 years of age. Altogether, 80.8% ± 5.8% of facilitators in economic transactions were ≥18 years of age. Conclusions. Until peer approval of smoking and sharing cigarettes and adult facilitation of adolescent smoking is reduced, it will be difficult to significantly reduce adolescents' access to cigarettes.

Gli stili APA, Harvard, Vancouver, ISO e altri

20

Sridhar, Arthi, Binoy Yohannan, Harmanpreet Kaur e Neha Maithel. "De novo prostate cancer in renal transplant recipients: A single-center study." Journal of Clinical Oncology 41, n. 6_suppl (20 febbraio 2023): 326. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.326.

Testo completo

Abstract (sommario):

326 Background: Renal transplant recipients (RTRs) are at an increased risk of developing solid organ malignancies. Given improved allograft survival and life expectancy, the incidence of prostate cancer (PC) in RTRs appears to be increasing. Previous studies have reported the incidence of PC among RTRs to be between 0.3% and 3.24%. Limited data is available on the clinical characteristics, treatment, predictive markers, and outcomes of PC in RTRs. Methods: We performed a single-center retrospective study of male RTRs who developed PC. We collected the following data on RTRs who underwent transplantation between January 1, 1999, and December 31, 2019: baseline demographics, cause of end-stage renal disease (ESRD), duration of dialysis prior to RT, type of RT (cadaveric vs. living donor), immunosuppressive regimen, interval from RT to diagnosis of PC, stage of PC, type of treatment received, allograft survival, and overall survival (OS) were collected. Results: Among 1093 male RTRs, 15 (1.37%) developed PC. The median age at diagnosis of PC was 60 (range, 49-75) years. Subject races were African American (n=7), Hispanic (n=3), White (n=3), and other (n=2). The median duration from transplant to diagnosis of PC was 72 (range, 12-156) months. PC was diagnosed at stage I in 13 patients, stage II in 1 patient, and stage IV in 1 patient. The management of these patients consisted of local radiation (LR) alone in 6 patients, LR with leuprolide therapy in 6 patients, and radical prostatectomy alone in 1 patient. The patient with stage IV PC was treated with leuprolide and abiraterone acetate and remains progression free at follow-up of 41 months. The 5-year OS for this cohort of patients was 73.3%. Allograft function was preserved in 13 patients 12 months after diagnosis of PC. No PC-related mortality was noted. Conclusions: The incidence of PC in our analysis appears to be consistent with prior published studies. Most of our RTRs with PC had early-stage disease with excellent 5-year survival. The current standard-of-care treatment modalities for PC appear to be effective in the management of these patients. Allograft function was preserved in the majority of RTRs with PC in this study. Further research is required to evaluate the predictive factors for developing PC in RTR.

Gli stili APA, Harvard, Vancouver, ISO e altri

21

Souweidane, Mark M., Peter F. Morgenstern, Paul J. Christos, Mark A. Edgar, Yasmin Khakoo, James T. Rutka e Ira J. Dunkel. "INTRAOPERATIVE ARACHNOID AND CEREBROSPINAL FLUID SAMPLING IN CHILDREN WITH POSTERIOR FOSSA BRAIN TUMORS". Neurosurgery 65, n. 1 (1 luglio 2009): 72–78. http://dx.doi.org/10.1227/01.neu.0000348011.98625.43.

Testo completo

Abstract (sommario):

ABSTRACT OBJECTIVE This study was conducted to determine whether arachnoid tissue or cerebrospinal fluid (CSF) sampling is valuable for risk stratification in children with posterior fossa brain tumors. METHODS Arachnoid tissue and CSF from the cisterna magna (CSFCM) was sampled at the time of primary tumor resection. Results were compared with conventional staging methods (M stage) and correlated with patient outcome. RESULTS Eighty-three patients were enrolled in the study. Arachnoid infiltration was identified in 11 of 80 (13.8%) and CSFCM was positive in 20 of 77 (26.0%) specimens. Arachnoid infiltration and CSF cytology were found in 20.0% and 44.8%, respectively, for medulloblastoma/pineoblastoma (primitive neuroectodermal tumor), 6.9% and 3.6% for pilocytic astrocytoma, and 0.0% and 33.3% for ependymoma. The 3-year event-free survival (EFS) was negatively influenced by either arachnoid infiltration (40.9% arachnoid positive versus 65.4% arachnoid negative; P = 0.23) or CSFCM positivity (52.6% CSFCM positive versus 67.1% CSFCM negative; P = 0.03). The 3-year EFS for patients with primitive neuroectodermal tumor who had positive arachnoid sampling was 33.3%, compared with 67.3% in patients who had no evidence of arachnoid infiltration (P = 0.26). The 3-year EFS for patients with primitive neuroectodermal tumor who had positive CSFCM was 50.0% compared with 67.5% in patients who had negative cytological analysis of CSFCM (P = 0.07). Arachnoid infiltration and CSF sampling were congruous with M stage in 73.3% and 86.2% of patients, respectively. CONCLUSION Intraoperative evidence of arachnoid infiltration or CSFCM dissemination in patients with posterior fossa brain tumors occurs at a variable frequency that is dependent on tumor type, correlates with conventional M stage, and may be predictive of outcome.

Gli stili APA, Harvard, Vancouver, ISO e altri

22

Erofeeva, M. K., M. A. Stukova, E. V. Shakhlanskaya, Zh V. Buzitskaya, V. L. Maksakova, T. I. Krainova, T. M. Chirkina, M. M. Pisareva e D. A. Lioznov. "Evaluation of the preventive effectiveness of influenza vaccines in St. Petersburg". Epidemiology and Vaccinal Prevention 19, n. 5 (11 novembre 2020): 76–83. http://dx.doi.org/10.31631/2073-3046-2020-19-5-76-83.

Testo completo

Abstract (sommario):

Background. The influenza vaccination coverage has steadily increased in the Russian Federation. The introduction of new domestic influenza vaccines into practice and the study of their effectiveness are of great importance for public health. However, a systematic analysis of the effectiveness of vaccines manufactured and used in Russia in recent years has not been performed. The aim ofthe study was to assess the epidemiological effectiveness of three domestic influenza vaccines in St. Petersburg during the 2018–2019 epidemic season.Material and methods. The organized community of 1892 young students aged 18 to 23 years has been under supervision during the period of time from October 2018 to March 2019. Influenza vaccines Grippol Plus, Sovigripp, and Ultrix were used for vaccination.Results and discussion. Prophylactic vaccination with influenza vaccines Sovigripp, Grippol Plus and Ultrix in the fall of 2018 led to a decrease in the incidence of influenza and other acute respiratory infections (ARI) by a total of 1.6–3.8 times; a decrease in the incidence of influenza by 2.7–7.1 times; the total protective efficacy of vaccines against influenza and ARI was 52.4%, and against influenza, taking into account laboratory correction, 73.3%.Conclusions. Under the conditions of the viruses circulating in Russia and in St. Petersburg in the 2018–2019 epidemic season the strains introduced into the composition of influenza vaccines, domestic influenza vaccines were characterized by good tolerance, were safe, areactogenic and had a pronounced protective effect. If the viruses circulating in Russia and in St. Petersburg in the 2018–2019 epidemic season corresponded to the strains introduced into the composition of influenza vaccines, domestic influenza vaccines, showing good tolerance, safety and low reactogenicity, had a pronounced protective effect.

Gli stili APA, Harvard, Vancouver, ISO e altri

23

Ainan, S., F. F. Furia, F. Mhimbira, N. P. Mnyambwa, N. Mgina, A. Zumla, S. G. Mfinanga e E. Ngadaya. "Xpert® MTB/RIF assay testing on stool for the diagnosis of paediatric pulmonary TB in Tanzania". Public Health Action 11, n. 2 (21 giugno 2021): 75–79. http://dx.doi.org/10.5588/pha.20.0062.

Testo completo

Abstract (sommario):

SETTING: Six health facilities in Dar es Salaam, Tanzania.OBJECTIVE: To evaluate the use of stool specimens in the diagnostic workup of paediatric TB using the Xpert® MTB/RIF assay.DESIGN: Between December 2018 and May 2019, we performed a cross-sectional diagnostic study of children aged between 1 month and 14 years with presumptive TB. A single stool specimen was tested using Xpert. The result was compared with the reference microbiological standard for respiratory or gastric specimens tested using Xpert and/or solid culture. The sensitivity, specificity and predictive values of stool Xpert assay were assessed.RESULTS: A total of 225 children with a median age of 2.17 years (IQR 1.16–5.19) were enrolled; 165/225 (73.3%) were aged <5 years. Of 225 children, 8 (3.6%) were diagnosed with TB as they were culture- or Xpert-positive on sputum/gastric aspirate. The stool Xpert assay showed a sensitivity of 62.5% (95% CI 25–92) and specificity of 100% (95% CI 98–100) against the reference standard.CONCLUSION: Use of the Xpert assay on stool specimens had a moderate sensitivity and high specificity in the diagnosis of pulmonary TB in children. Our data adds to the body of evidence for the use of Xpert assay on stool as a non-respiratory specimen to complement conventional methods used to diagnose the disease.

Gli stili APA, Harvard, Vancouver, ISO e altri

24

Marmamula, Srinivas, Satya Brahmanandam Modepalli, Thirupathi Reddy Kumbham, Rajesh Challa e Jill E. Keeffe. "Prevalence of disabilities and non-communicable diseases in an elderly population in the Telangana state, India: a population-based cross-sectional study". BMJ Open 11, n. 2 (febbraio 2021): e041755. http://dx.doi.org/10.1136/bmjopen-2020-041755.

Testo completo

Abstract (sommario):

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.

Gli stili APA, Harvard, Vancouver, ISO e altri

25

Zeiler, F. A., P. J. McDonald, A. M. Kaufmann, D. Fewer, J. Butler, G. Schroeder e M. West. "Gamma Knife Radiosurgery of Cavernous Sinus Meningiomas: An Institutional Review". Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 39, n. 6 (novembre 2012): 757–62. http://dx.doi.org/10.1017/s0317167100015572.

Testo completo

Abstract (sommario):

Introduction:Stereotactic radiosurgery offers a unique and effective means of controlling cavernous sinus meningiomas with a low rate of complications.Methods:We retrospectively reviewed all cavernous sinus meningiomas treated with Gamma Knife (GK) radiosurgery between November 2003 and April 2011 at our institution.Results:Thirty patients were treated, four were lost to follow- up. Presenting symptoms included: headache (9), trigeminal nerve dysesthesias/paresthesias (13), abducens nerve palsy (11), oculomotor nerve palsy (8), Horner's syndrome (2), blurred vision (9), and relative afferent pupillary defect (1). One patient was asymptomatic with documented tumor growth. Treatment planning consisted of MRI and CT in 17 of 30 patients (56.7%), the remainder were planned with MRI alone (44.3%). There were 8 males (26.7%) and 22 females (73.3%). Twelve patients had previous surgical debulking prior to radiosurgery. Average diameter and volume at time of radiosurgery was 3.4 cm and 7.9 cm3 respectively. Average dose at the 50% isodose line was 13.5 Gy. Follow-up was available in 26 patients. Average follow-up was 36.1 months. Mean age 55.1 years. Tumor size post GK decreased in 9 patients (34.6%), remained stable in 15 patients (57.7%), and continued to grow in 2 (7.7%). Minor transient complications occurred in 12 patients, all resolving. Serious permanent complications occurred in 5 patients: new onset trigeminal neuropathic pain (2), frame related occipital neuralgia (1), worsening of pre-GK seizures (1), and panhypopituitarism (1).Conclusion:GK offers an effective treatment method for halting meningioma progression in the cavernous sinus, with an acceptable permanent complication rate.

Gli stili APA, Harvard, Vancouver, ISO e altri

26

Xu, Tianyun, Fei Sun e Yanfang Li. "Long-Term Outcomes and Factors Related to the Prognosis of Pure Ovarian Dysgerminoma: A Retrospective Study of 107 Cases". Gynecologic and Obstetric Investigation 86, n. 6 (2021): 494–501. http://dx.doi.org/10.1159/000519515.

Testo completo

Abstract (sommario):

Objective: The aim of this study was to evaluate the long-term outcomes and the factors related to patient prognosis. Materials and Methods: We retrospectively analyzed patients treated at the Department of Gynecology, Sun Yat-sen University Cancer Center, between January 1, 1968, and December 12, 2018. Results: A total of 107 patients were identified. Of all patients, 79 (73.8%) presented with stage I disease, 14 (13.1%) stage II, 13 (12.2%) stage III, and 1 (0.9%) stage IV. All patients received surgery, with 70 (65.4%) undergoing fertility-sparing surgery (FS) and 37 (34.6%) nonfertility-sparing surgery (NFS). Ninety patients received postoperative chemotherapy. Nine of the 43 cases with a lymphadenectomy had metastasis (20.9%). The median follow-up time was 132 months (range, 1–536 months). The overall 5-year and 10-year survival was 95.1% and 91.7%, respectively. The 10-year survival rate for stage I and II–IV patients was 96.1% and 79.1%, respectively (p = 0.008). For the patients undergoing FS and NFS, the 10-year disease-free survival rate was 82.3% and 88.0%, respectively (p = 0.403). The 10-year disease-free survival rate for patients with or without lymphadenectomy was 95.1% and 78.4%, respectively (p = 0.040), and it was 92.5% and 76.0%, respectively (p = 0.041), for those with or without omentectomy. Fifteen patients relapsed, and 4 of them (26.7%) had recurrence in the lymph nodes. Eleven of the 15 relapsed patients (73.3%) had been successfully salvaged. Limitations: As a study of a rare disease, our analysis was limited by its small sample size and the deemed disadvantage of a retrospective study. Conclusion: Excellent treatment results can be achieved in dysgerminoma patients who received proper treatment. Lymphadenectomy may improve patient survival. Relapsed patients can also be successfully salvaged.

Gli stili APA, Harvard, Vancouver, ISO e altri

27

Amin, MR, A. Chakma, MZ Alam, MM Hossain e F. Ge. "Screening of tomato varieties against tomato fruit borer and associated plant characters". SAARC Journal of Agriculture 14, n. 2 (23 gennaio 2017): 150–61. http://dx.doi.org/10.3329/sja.v14i2.31255.

Testo completo

Abstract (sommario):

Ten tomato varieties were evaluated to find out their level of resistance against tomato fruit borer Helicoverpa armigera Hubner (Lepidoptera: Noctuidae) under field conditions. The abundance of fruit borer larvae and their infestation, plant morphological characters, nitrogen content, yield and seed germination of the varieties were studied. The varieties differed in their leaf thickness, trichome density, rind thickness and nitrogen content. The fruit borer larval abundance and fruit infestation among the varieties varied significantly. Five varieties namely BARI Tomato-1, BARI Tomato-4, BARI Tomato-10, BARI Tomato-11 and BARI Tomato-15 were least infested by fruit borer (3.6 to 10.0%) and had significantly lower abundance of larvae (0.3 to 0.7 plant-1), and the varieties were classified as resistant. The yield reduction and seed germination of these varieties ranged from 3.9 to 7.9% and 76.7 to 90.7%, respectively. Four varieties namely BARI Tomato-2, BARI Tomato-5, BARI Tomato-12 and BARI Tomato-14 were graded as moderately resistant as the varieties showed 12.4 to 16.2% fruit infestation and revealed 1.0 to 1.3 larvae plant-1. The yield reduction and seed germination of these varieties ranged from 9.6 to13.2% and 66.7 to 73.3%, respectively. Only the variety BARI Tomato-7 was categorized as moderately susceptible which had significantly the highest abundance of fruit borer larva (1.7plant-1), fruit infestation (22.2%) and yield loss (15.9%), and lowest germination performance (62.7%). The study indicated that the varieties differed in their levels of resistance and this promising source of resistance may be incorporated in the integrated management of tomato fruit borer.SAARC J. Agri., 14(2): 150-161 (2016)

Gli stili APA, Harvard, Vancouver, ISO e altri

28

Nair, Abhilash, Devasenathipathy Kandasamy, Raju Sharma, HL Nag, Upiderpal Singh, Himani Bhatia, Soma Saha, Nikhil Tandon e R. Goswami. "Shoulder Periarthritis and its Imaging Features in Patients with Type 1 Diabetes Mellitus". Annals of the National Academy of Medical Sciences (India) 53, n. 04 (ottobre 2017): 222–29. http://dx.doi.org/10.1055/s-0040-1712810.

Testo completo

Abstract (sommario):

ABSTRACT Aim: There is limited information on periarthritis/adhesive capsulitis of the shoulder (ACS) in patients with type-1-diabetes mellitus (T1D). We assessed the prevalence and characteristics of ACS in patients with type-1-diabetes mellitus. Methods: Consecutive 267 patients attending 'Diabetes of Young Clinic' were screened for ACS. Those with clinical features of ACS were further assessed by 'shoulder pain and disability index' (SPADI), radiograph and MRI of the shoulder. The average glycemic status (HbA1c) during preceding 2 years was assessed in patients with and without ACS. Controls were age and sex matched healthy subjects (1:1 ratio). Results: Sixteen of 267 patients (6.0%) with type-1-diabetes had clinical features of ACS, unlike none of the healthy controls (P < 0.001). Internal and external rotation of the shoulders was the most frequently restricted movements in ACS. Thickened coracohumeral ligament and axillary pouch obliteration was characteristic MRI feature, present in 80.0% in 73.3% cases, respectively. Though 14/16 type-1-diabetes patients with ACS were symptomatic, they never reported these complaints in diabetic clinic with the treating physicians. On regression analysis (odds ratio; 95% CI), duration of diabetes (1.1; 1.03-1.17, P < 0.01), retinopathy (3.6; 1.05-12.52, P = 0.04), and limited joint mobility (6.4; 1.88-21.95, P < 0.01) were independent predictors for presence of ACS in type-1-diabetes. The mean HbA1c and lipid levels were comparable in patients with or without ACS. Conclusions: Six percent of patients with type-1-diabetes had ACS, which can be detected on clinical screening and conﬁrmed by imaging to help initiate early treatment.

Gli stili APA, Harvard, Vancouver, ISO e altri

29

Hung, C. C., C. W. Tseng, G. C. Gong, K. S. Chen, M. H. Chen e S. C. Hsu. "Behavior and fluxes of particulate organic carbon in the East China Sea". Biogeosciences Discussions 10, n. 3 (5 marzo 2013): 4271–302. http://dx.doi.org/10.5194/bgd-10-4271-2013.

Testo completo

Abstract (sommario):

Abstract. To better understand carbon cycling in marginal seas, particulate organic carbon (POC) concentrations, POC fluxes and primary production (PP) were measured in the East China Sea (ECS) in summer 2007. Higher concentrations of POC were observed in the inner shelf and lower POC values were found in the outer shelf. Similar to POC concentrations, elevated uncorrected POC fluxes (720–7300 mg C m−2 d−1) were found in the inner shelf and lower POC fluxes (80–150 mg C m−2 d−1) were in the outer shelf, respectively. PP values (~340–3380 mg C m−2 d−1) had analogous distribution patterns to POC fluxes, while some of PP values were significantly lower than POC fluxes, suggesting that contributions of resuspended particles to POC fluxes need to be appropriately corrected. A vertical mixing model was used to correct effects of bottom sediment resuspension and the corrected POC fluxes ranging from 41 ± 20 to 956 ± 443 mg C m−2 d−1, which were indeed lower than PP values. The results suggest that 49–93% of the POC flux in the ECS might be from the contribution of resuspension of bottom sediments rather than from the actual biogenic carbon sinking flux. While the vertical mixing model is not a perfect model to solve sediment resuspension because it ignores biological degradation of sinking particles, Changjinag plume (or terrestrial) inputs and lateral transport, it makes significant progress in both correcting resuspension problem and in assessing a reasonable quantitative estimate in a marginal sea.

Gli stili APA, Harvard, Vancouver, ISO e altri

30

Batailler, C., J. Weidner, M. Wyatt, F. Dalmay e M. Beck. "Position of the greater trochanter and functional femoral antetorsion". Bone & Joint Journal 100-B, n. 6 (giugno 2018): 712–19. http://dx.doi.org/10.1302/0301-620x.100b6.bjj-2017-1068.r1.

Testo completo

Abstract (sommario):

Aims The primary aim of this study was to define and quantify three new measurements to indicate the position of the greater trochanter. Secondary aims were to define ‘functional antetorsion’ as it relates to abductor function in populations both with and without torsional abnormality. Patients and Methods Three new measurements, functional antetorsion, posterior tilt, and posterior translation of the greater trochanter, were assessed from 61 CT scans of cadaveric femurs, and their reliability determined. These measurements and their relationships were also evaluated in three groups of patients: a control group (n = 22), a ‘high-antetorsion’ group (n = 22) and a ‘low-antetorsion’ group (n = 10). Results In the cadaver group, the mean anatomical antetorsion was 14.7° (sd 8.5; 0 to 36.5) and the functional antetorsion 21.5° (sd 8.1; 3.6 to 44.3): the posterior tilt was 73.3° (sd 10.8; 46.9 to 88.7) and the posterior translation 0.59 (sd 0.2; 0.2 to 0.9). These measurements had excellent intra and interobserver agreement with a range from 0.93 to 0.99. When the anatomical antetorsion decreased, the greater trochanter was more tilted and translated posteriorly in relation to the axis of the femoral neck, and the difference between functional and anatomical antetorsion increased. The results the three patient groups were similar to those of the cadaver group. Conclusion The position of the greater trochanter and functional antetorsion varied with anatomical antetorsion. In the surgical management of femoral retrotorsion, subtrochanteric osteotomy can result in an excessively posterior position of the greater trochanter and an increase in functional antetorsion. Cite this article: Bone Joint J 2018;100-B:712–19.

Gli stili APA, Harvard, Vancouver, ISO e altri

31

Schramm, Sara H., Susanne Moebus, Nils Lehmann, Ursula Galli, Mark Obermann, Eva Bock, Min-Suk Yoon, Hans-Christoph Diener e Zaza Katsarava. "The association between stress and headache: A longitudinal population-based study". Cephalalgia 35, n. 10 (5 dicembre 2014): 853–63. http://dx.doi.org/10.1177/0333102414563087.

Testo completo

Abstract (sommario):

Introduction We studied the association between stress intensity and headache frequency for tension-type headache (TTH), migraine and migraine with coexisting TTH (MigTTH). Method We studied a population-based sample of 5159 participants (21–71 years) who were asked quarterly between March 2010 and April 2012 about headache and stress. Log-linear regression in the framework of generalized estimating equations was used to estimate regression coefficients presented as percent changes to describe the association between stress intensity (modified visual analog scale (VAS) from 0 to 100) and headache frequency (days/month) stratified by headache subtypes and age groups and adjusted for sex, age, frequent intake of acute pain drugs, drinking, smoking, BMI and education. Results TTH was reported in 31% participants (48.1 ± 12.5years, 51.5% women, 2.2 ± 3.9 mean headache days/month, 52.3 ± 26.7 mean stress), migraine in 14% (44.8 ± 11.3years, 73.3%, 4.5 ± 5.2 days/month, 62.4 ± 23.3), MigTTH in 10.6% (43.5 ± 11.5 years, 61.0%, 3.6 ± 4.8 days/month, 58.6 ± 24.1), 23.6% were unclassifiable, and 20.8% had no headache. In participants with TTH an increase of 10 points on VAS was associated with an increase of headaches days/month of 6.0% (adjusted). Higher effects were observed in younger age groups (21–30/31–40/41–50/51–60/61–71 years: 9.8/10.2/7.0/6.5/3.5%). Slightly lower effects were observed for migraine (4.3%, 8.1/5.1/3.4/6.3/0.3%) and MigTTH (4.2%, 5.5/6.8/6.9/5.8/–0.7%). Conclusion Our study provides evidence for an association between stress intensity and headache frequency.

Gli stili APA, Harvard, Vancouver, ISO e altri

32

Song, Meong Gun, Hyun Suk Yang, Jong Bum Choi, Je Kyoun Shin, Hyun Keun Chee e Jun Seok Kim. "Aortic Valve Reconstruction with Use of Pericardial Leaflets in Adults with Bicuspid Aortic Valve Disease: Early and Midterm Outcomes". Texas Heart Institute Journal 41, n. 6 (1 dicembre 2014): 585–91. http://dx.doi.org/10.14503/thij-13-3619.

Testo completo

Abstract (sommario):

In this study, we retrospectively analyzed the outcomes of adults with bicuspid aortic valve (BAV) disease who underwent aortic valve reconstructive surgery (AVRS), consisting of replacement of the diseased BAV with 2 or 3 pericardial leaflets plus fixation of the sinotubular junction for accurate and constant leaflet coaptation. From December 2007 through April 2013, 135 consecutive patients (mean age, 49.2 ± 13.1 yr; 73.3% men) with symptomatic BAV disease underwent AVRS. Raphe was observed in 84 patients (62.2%), and the remaining 51 patients had pure BAV without raphe. A total of 122 patients (90.4%) underwent 3-leaflet reconstruction, and 13 (9.6%) underwent 2-leaflet reconstruction. Concomitant aortic wrapping with an artificial graft was performed in 63 patients (46.7%). There were no in-hospital deaths and 2 late deaths (1.5%); 6 patients (4.4%) needed valve-related reoperation. The 5-year cumulative survival rate was 98% ± 1.5%, and freedom from valve-related reoperation at 5 years was 92.7% ± 3.6%. In the last available echocardiograms, aortic regurgitation was absent or trivial in 116 patients (85.9%), mild in 16 (11.9%), moderate in 2 (1.5%), and severe in one (0.7%). The mean aortic valve gradient was 10.2 ± 4.5 mmHg, and the mean aortic valve orifice area index was 1.3 ± 0.3 cm2/m2. The 3-leaflet technique resulted in lower valve gradients and greater valve areas than did the 2-leaflet technique. Thus, in patients with BAV, AVRS yielded satisfactory early and midterm results with low mortality rates and low reoperation risk after the initial procedure.

Gli stili APA, Harvard, Vancouver, ISO e altri

33

Morshed, Ramin, Jason Chung, Vivek Sudhakar, Daniel Cummins, Jacob Young, Shawn Hervey-Jumper, Philip Theodosopoulos e Manish Aghi. "SURG-11. Surgery for control of brain metastases after prior checkpoint inhibitor immunotherapy: a single-center series". Neuro-Oncology Advances 3, Supplement_3 (1 agosto 2021): iii25—iii26. http://dx.doi.org/10.1093/noajnl/vdab071.104.

Testo completo

Abstract (sommario):

Abstract Background Despite the promising results for treating metastatic cancer with checkpoint inhibitor immunotherapies, there are limited data on surgical outcomes for brain metastases (BMs) that have progressed after prior checkpoint inhibitor treatment. The objective of this study was to identify factors associated with local progression, leptomeningeal disease, and survival for patients undergoing surgical resection of a BM in patients previously treated with checkpoint inhibitor immunotherapy. Methods A retrospective, single-center cohort study was conducted with inclusion of adult patients undergoing surgical resection of a BM in the setting of progression after prior checkpoint inhibitor treatment. Univariate and multivariate analyses were performed to identify factors associated with outcomes of interest. Results Over an 8-year period, 26 patients who underwent resection of 30 BMs met inclusion criteria. Median patient age at surgery was 63.9 years, and median clinical follow-up was 6.9 months (range 0.1 – 52.9). Extracranial disease was present at the time of surgery in 73.3% of cases. There were 6 postoperative complication events (20% of cases) by 30-days. By last follow-up, 65.4% of the cohort had died with a median censored survival of 7.6 months from surgery. Eight patients (30.8%) died within 3 months of surgery. On multivariate analysis, postoperative complications were associated with worse survival (HR 5.33, 95%CI 1.15–24.77, p=0.03). Four BMs had local progression (13.3%), and 60% of procedures were associated with distant progression within a median time of 3.6 months. Leptomeningeal disease developed in 32% of cases. On multivariate analysis, increased time from BM diagnosis to surgery was associated with a greater risk of leptomeningeal disease (OR 1.2, 95%CI 1.00–1.43, p=0.021). Conclusion Patients who require BM resection after prior checkpoint inhibitor treatment have an overall poor prognosis. Although local control rates are acceptable, these patients are at high risk for developing leptomeningeal disease postoperatively.

Gli stili APA, Harvard, Vancouver, ISO e altri

34

Riaz, Mariam, e Henna Khalid. "Role of Helicobacter Bacteria in Colitis and Colorectal Neoplasms: A Histopathological and Immunohistochemically Study". Pakistan Journal of Medical and Health Sciences 16, n. 9 (30 settembre 2022): 853–55. http://dx.doi.org/10.53350/pjmhs22169853.

Testo completo

Abstract (sommario):

Background and Aim: Adenocarcinomas have progressed from hyper proliferative epithelium through adenomatous lesions to adenocarcinomas and adenomas. In this case, the adenomatous foci are typically neoplastic intraluminal protrusions and occasionally flat, dysplastic glandular growths, which are either filamentous or villous in nature, depending on the architectural position, etiologically, and genetic factors associated in their genesis. The present study aimed to evaluate the role of helicobacter bacteria in colitis and colorectal neoplasms. Methodology: This retrospective study included 60 patients’ samples collected of paraffin blocks at the Department of Pathology, WMC, Abbottabad and LRH Peshawar during the period from March 2020 to March 2022. Demographic details and clinical data taken from the pathology sheet included age, gender, tumor size, colorectal carcinoma site, distant metastasis presence, ulcerating, and fungating. A serial section of 5 mm thickness was cut from each block and mounted on a glass slide for histological evaluation. After staining with hematoxylin and eosin (H&E), a second section was mounted on charged slides for immune-histochemical evaluation. SPSS version 26 was used for data analysis. Results: Of the total 60 patients, there were 32 (53.3%) men and 38 (46.7%) women. The overall mean age was 46.8±3.46 years with age ranges from 20 years to 80 years. The distribution of patients were as follows: normal colon 15 (25%), colitis 15 (25%), colonic tubular adenoma 10 (16.7%), and colorectal carcinoma 20 (33.3%). Among 60 patients stained for anti-H. pyroli, the prevalence of positive and negative antibodies was 16 (26.7%) and 44 (73.3%) respectively. The incidence of negative and positive anti-H. Pylori antibodies in normal colon, colitis, colonic tubular adenoma, and colorectal carcinoma were as follows: 4 (26.7%) and 11 (73.3%), 5 (33.3%) and 10 (66.7%), 3 (30%) and 7 (70%), and 5 (25%) and 15 (75%) respectively. Out of 20 colorectal carcinoma, the incidence of sigmoid colon, rectum, transverse colon, and right colon was 9 (45%), 6 (30%), 3 (15%), and 2 (10%) respectively. The occurrence of lesion diameter <5 cm and >5 cm was 11 (55%) and 9 (45%) respectively. The prevalence of circumferential infiltrating type, ulcerative type, and fungating type was 12 (60%), 6 (30%), and 2 (10%) respectively. Based on colorectal cancer patients histological class, the incidence of adenocarcinomas, mucoid adenocarcinoma, and adenocarcinoma with neuroendocrine differentiation was 14 (70%), 3 (15%), and 3 (15%) respectively. Conclusion: The present study concluded that positive antibodies of H. pylori had no significant association with carcinoma, normal colon, tabular adenoma, and colitis. Still, determination of odd ratio (OR) estimating risk showed that adenoma (OR 2.0) and colitis (OR 1.39) had significant association with positivity of H. pylori. Additionally, Sigmoid colon was the most prevalent site followed by rectum, transverse colon, and right colon. Keywords: Helicobacter bacteria, Colitis, Carcinoma, Immunohistology

Gli stili APA, Harvard, Vancouver, ISO e altri

35

Erlikh, A. D. "Novel score for mortality risk prediction 6 months after acute coronary syndrome". Russian Journal of Cardiology 25, n. 2 (11 marzo 2020): 19–24. http://dx.doi.org/10.15829/1560-4071-2020-2-3416.

Testo completo

Abstract (sommario):

Aim. To create a prediction score for assessing the mortality risk 6 months after hospitalization with acute coronary syndrome (ACS).Material and methods. Based on the results of ACS RECORD-3 register (Russia), we determined independent mortality predictors 6 months after ACS by performing multivariate regression analysis in patients discharged alive from the hospital with known outcomes.Results. The following predictors were obtained during the analysis: non-prescription of aspirin at discharge (odds ratio (OR) 5,8; 95% confidence interval (CI) 2,315,0; p<0,0001), newly diagnosed heart failure, pulmonary edema or shock in a hospital (OR 5,7; 95% CI 2,6-12,7; p<0,0001), age ≥75 years (OR 5,3; 95% CI 2,710,6; p<0,0001), non-prescription of beta-blockers at discharge (OR 5,0; 95% CI 2,3-10,8; p<0,0001), in-hospital management without immediate percutaneous coronary intervention (PCI) (primary PCI during ST-segment elevation ACS or PCI during the first 72 hours with non-ST-segment elevation ACS) (OR 3,9; 95% CI 1,69,8; p=0,004), the initial serum creatinine ≥100 µmol/L (OR 3,1; 95% CI 1,6-6,1; p=0,001), body mass index <30 kg/m2 (OR 2,8; 1,2-6,3; p=0,014). Each of them was evaluated at one point and was a component of the RECORD-6 score. Prediction sensitivity and specificity for the new score were 73,3% (95% CI 60,1-83,5) and 71,4% (95% CI 68,9-73,7), respectively; prediction accuracy, estimated as the area under the ROC curve was 0,931 (95% CI 0,897-0,964). The cut-off point was considered 3 points, which had the best ratio of prediction sensitivity and specificity. The mortality after 6 months with a value of <3 points was 1,6%, and with a value of ≥3 points — 10,1% (relative risk (RR) 0,16; 95% CI 0,09-0,28; p<0,0001), and the mortality after 12 months was 7,8% and 22,5%, respectively (RR 0,35; 95% CI 0,25-0,49; p<0,0001). Relative to the GRACE risk score for 6-month mortality showed that the prediction value of the RECORD-6 score was at least no worse.Conclusion. The novel RECORD-6 risk score is an accurate and simple prediction tool for assessing the mortality risk 6 months after discharge from the hospital. The prediction accuracy of the RECORD-6 risk score is not lower the GRACE risk score.

Gli stili APA, Harvard, Vancouver, ISO e altri

36

Ghahramani, Sulmaz, Hafez Shojaadini, Ashkan Akbarzade, Fatemeh Sadeghi, Vahid Hajianpour, Fatemeh Nozaie, Mohammad Sayari e Kamran Bagheri Lankarani. "Hospital Cost of Inflammatory Bowel Disease and Its Determinants in a Multicenter Study From Iran". Middle East Journal of Digestive Diseases 15, n. 3 (30 luglio 2023): 167–74. http://dx.doi.org/10.34172/mejdd.2023.339.

Testo completo

Abstract (sommario):

Background: In the current era of monitoring healthcare costs for patients with inflammatory bowel disease (IBD), there has been a shift in the pattern of such costs. In this cross-sectional study conducted in three hospitals in Iran from 2015 to 2021, we aimed to assess the in-hospital costs of IBD and identify predictors of higher total hospital costs in hospitalized patients with IBD. Methods: This cross-sectional study was conducted at three hospitals in Iran. For the purpose of this study, we collected demographic and clinical information, as well as cost data for patients with IBD. Two non-parametric statistical procedures, classification and regression trees (CARTs) and quantile regression forests (QRFs), were employed to identify the main factors related to hospital costs of IBD, which served as the dependent variable in our analysis. Results: During 7 years, 930 admissions occurred in these three hospitals. 22.3% of patients (138 of 619) were readmitted, and 306 (49.4%) were male. The mean age of the patients was 33 (SD=18.9) years. A total of 454 patients (73.3%) had ulcerative colitis (UC), and 165 patients (26.7%) had Crohn’s disease (CD). Hotelling and medication costs accounted for the largest share of the total hospital costs, with percentages of 30.61% and 23.40%, respectively. Length of stay (LOS) was found to be the most important variable related to hospital costs of IBD in both QRF and CART models, followed by age and year of hospital admission in QRF. Additionally, in the CART model, hospital type and year of hospital admission were also significant predictors of hospital costs for patients with IBD. Conclusion: The present study showed that LOS, age, year of admission, and the hospital where the patient is admitted are all important factors that determine hospital costs for patients with IBD. Patients admitted for 20.5 days or longer had the highest hospital costs. These findings can be used as thresholds for future DRG policies.

Gli stili APA, Harvard, Vancouver, ISO e altri

37

Gartland, Deirdre, Arwen Nikolof, Fiona Mensah, Graham Gee, Karen Glover, Cathy Leane, Heather Carter e Stephanie Janne Brown. "The Childhood Resilience Study: Resilience and emotional and behavioural wellbeing experienced by Australian Aboriginal and Torres Strait Islander boys and girls aged 5–9 years". PLOS ONE 19, n. 4 (16 aprile 2024): e0301620. http://dx.doi.org/10.1371/journal.pone.0301620.

Testo completo

Abstract (sommario):

Background Resilience is a process of drawing on internal or external strengths to regain, sustain or improve adaptive outcomes despite adversity. Using a child resilience measure co-designed with Aboriginal and Torres Strait Islander communities, we investigate: 1) children’s personal, family, school and community strengths; 2) gender differences; and 3) associations between resilience and wellbeing. Methods 1132 parent/caregivers of children aged 5–12 years were recruited to the Childhood Resilience Study, including through the Aboriginal Families Study. The Aboriginal Families Study is a population-based cohort of 344 mothers of an Aboriginal and/or Torres Strait Islander child. This paper focuses on the wave 2 survey data on child resilience at age 5–9 years (n = 231). Resilience was assessed with the Child Resilience Questionnaire-parent/caregiver report (CRQ-P/C), categorised into tertiles of low, moderate and high scores. Child emotional/behavioural wellbeing and mental health competence was assessed with the parent-report Strengths and Difficulties Questionnaire. All Tobit regression models adjusted for child age. Outcomes Aboriginal and Torres Strait Islander girls had higher resilience scores compared to boys (Adj.β = 0·9, 95%CI 0·9–1·4), with higher School Engagement, Friends and Connectedness to language scale scores. Resilience scores were strongly associated with wellbeing and high mental health competence. A higher proportion of girls with low resilience scores had positive wellbeing than did boys (73.3% versus 49.0%). High resilience scores were associated with lower SDQ total difficulties score after adjusting for child age, gender, maternal age and education and family location (major city, regional, remote) (Adj.β = -3.4, 95%CI -5.1, -1.7). Compared to the Childhood Resilience Study sample, Aboriginal Families Study children had higher mean CRQ-P/C scores in the personal and family domains. Interpretation High family strengths can support Aboriginal and Torres Strait Islander children at both an individual and cultural level. Boys may benefit from added scaffolding by schools, family and communities to support their social and academic connectedness.

Gli stili APA, Harvard, Vancouver, ISO e altri

38

Martin-Garcia, Agustin C., Deepa RJ Arachchillage, Aleksander Kempny, Rafael Alonso-Gonzalez, Ana Martin-Garcia, Anselm Uebing, Lorna Swan et al. "Platelet count and mean platelet volume predict outcome in adults with Eisenmenger syndrome". Heart 104, n. 1 (29 giugno 2017): 45–50. http://dx.doi.org/10.1136/heartjnl-2016-311144.

Testo completo

Abstract (sommario):

ObjectivesAlthough a significant proportion of patients with cyanotic congenital heart disease are thrombocytopaenic, its prevalence and clinical significance in adults with Eisenmenger syndrome (ES) is not well studied. Accordingly, we examined the relationship of thrombocytopaenia and mean platelet volume (MPV) to bleeding or thrombotic complications and survival in a contemporary cohort of patients with ES, including patients with Down syndrome.MethodsDemographics, laboratory and clinical data were analysed from 226 patients with ES under active follow-up over 11 years.ResultsAge at baseline was 34.6±11.4 years and 34.1% were men. Mean platelet count and MPV were 152.6±73.3×109/L and 9.6±1.2 fL, respectively. A strong inverse correlation was found between platelet count and haemoglobin concentration and MPV. During the study, there were 39 deaths, and 21 thrombotic and 43 bleeding events. On univariate Cox regression analysis, patients with a platelet count <100×109/L had a twofold increased mortality (HR 2.10, 95% CI 1.10 to 4.01, p=0.024). Platelet count was not associated with an increased risk of thrombosis. However, there was a threefold increased thrombotic risk with MPV >9.5 fL (HR 3.50, 95% CI 1.28 to 9.54, p=0.015). Patients with either severe secondary erythrocytosis (>220g/L) or anaemia (<130g/L) were at higher risk of thrombotic events (HR 3.93, 95% CI 1.60 to 9.67, p=0.003; and HR 4.75, 95% CI 1.03 to 21.84, p=0.045, respectively).ConclusionsThrombocytopaenia significantly increased the risk of mortality in ES. Furthermore, raised MPV, severe secondary erythrocytosis and anaemia, but not platelet count, were associated with an increased risk of thrombotic events in our adult cohort.

Gli stili APA, Harvard, Vancouver, ISO e altri

39

Jayram, Diya, Nouman Aziz, Hamza Naeem, Shahzaib Ahmad, Muhammad Ahsan Hanif Chaudhary, Shreyas S. Bellur, Mohammad Arfat Ganiyani, Fathima Shehnaz Ayoobkhan e Manmeet Singh Ahluwalia. "Survival outcomes in patients with advanced intrahepatic cholangiocarcinoma in United States: A nationwide analysis." Journal of Clinical Oncology 42, n. 16_suppl (1 giugno 2024): e16211-e16211. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.e16211.

Testo completo

Abstract (sommario):

e16211 Background: Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver malignancy after hepatocellular carcinoma. Anecdotal evidence shows that chemotherapy and radiotherapy after surgical resection confer better survival outcomes in patients with advanced disease. This study aims to demonstrate outcomes of different therapeutic options in patients with stage 4 ICC. Methods: We queried the National Cancer Database from 2004 to 2020 to identify patients with stage 4 ICC. The study compared median overall survival (mOS) using Kaplan-Meier methodology and pair-wise log-rank test among different therapeutic groups, including surgery (Sx) alone, chemotherapy (CT) alone, radiotherapy (RT) alone, surgery + chemotherapy (Sx+CT), surgery + chemoradiation (Sx+CRT), and chemoradiation (CRT). The results of the study were reported in concordance with STROBE guidelines. Results: Among 13,735 patients with stage 4 ICC, the median age was 64 years (range: 17-90+ years), 51.0% were male, 83.6% were White, 9.1% Black and 4.0 % Asian. 342 (2.5%) underwent Sx, 10061 (73.3%) CT alone, 427 (3.1%) underwent RT alone, 744 (5.4%) Sx+CT, 314 (2.3%) Sx+CRT, and 1847 (13.5%) underwent CRT. Patients who underwent Sx+CRT had better mOS (23.8 months, 95% CI 20.5-24.1) than all other modalities, including Sx (11.1 months, 95% CI 8.2-13.4), CT (8.6 months, 95% CI 8.4-8.9), RT (4.7 months, 95% CI 3.8-5.2), Sx+CT (21.9 months, 95% CI 20.0-24.1) and CRT (11.7 months, 95% CI 11.1-12.3) p < 0.01. Conclusions: Unlike other gastrointestinal malignancies, multimodal therapy i.e., chemoradiation after surgical resection of primary tumor improves survival in advanced ICC. However, prospective studies affirming these findings are warranted.[Table: see text]

Gli stili APA, Harvard, Vancouver, ISO e altri

40

Arico, Maurizio, Ottavio Ziino, Maria Grazia Valsecchi, Giovanni Cazzaniga, Carmelo Rizzari, Elena Barisone, Andrea Biondi et al. "TEL/AML1 Rearrangement Is Rare in Children with Acute Lymphoblastic Leukemia (ALL) and Down Syndrome (DS). Presenting Features and Treatment Outcome in the Experience of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP)." Blood 110, n. 11 (16 novembre 2007): 848. http://dx.doi.org/10.1182/blood.v110.11.848.848.

Testo completo

Abstract (sommario):

Abstract We compared the clinical and biologic features and treatment results of patients with DS-ALL (n=120, 1.9%), compared to those without DS (n=6237), enrolled in the AIEOP trials between 1988 and October 2004. DS patients had significantly more often the following characteristics: female gender (55.0% vs 44.9%, p=0.027), age 10 years or older (28.3 vs 17.7%, p=0.014), high risk by NCI criteria (41.7 vs. 33%, p=0.045); on the contrary significantly less often they belonged to high-risk group according to current stratification (10.8 vs. 20.3%, p=0.017) or had T-lineage immunophenotype (0.8 vs 11.8%, p=<0.001); the distribution of WBC count was not different (p=0.32) except for a mild reduction of cases with very high count (>100K/mm3: 6.6 vs. 10.8%). TEL/AML1 rearrangement was found in only 1 of 44 tested (2.2%). Of the 120 DS patients, 5 died during induction (4.2 vs 1.2% in non-DS), 1 was resistant (0.8 vs 1.4%). Leukemia relapse occurred in 31.6% of DS patients, compared with 24.9% of non-DS: bone marrow 22.5 vs 15.5%, CNS isolated 4.2 vs 3.6%, testis 0.8 vs 1.6%, BM combined 3.3 vs. 3.6%, other site 0.8 vs 0.6%. Death in complete remission occurred in 4.2 vs 2.0%. No second malignancy was reported. Overall, 59.2% of DS patients remained in first remission, compared with 70.2% of non-DS patients. This translated into a probability of EFS (SE) at 10 years of 56.2% (4.8) versus 67.7% (0.6) and a survival of 60.8% (5.0) versus 77.2% (0.6). 57 DS patients were diagnosed <1995: their EFS was 48.3% (6.7) versus 62.1% (0.9) in non-DS; their overall survival was 49% (6.8) versus 71.9% (0.8). For the 63 patients diagnosed ≥1995 EFS was 61.9% (7.5) versus 73.3% (1.1) in non-DS; their overall survival was 76.5% (5.9) versus 84.5% (0.7). According to NCI criteria, DS patients at standard risk had an EFS of 60.2% (6.2) vs 73.4% (0.7); in the 50 patients at high risk EFS was 50.7% (7.5) vs 56.2% (1.2). The presenting features of ALL in children with DS are significantly different from their non-DS counterparts: the usual excess of males is not reproduced, their WBC is less frequently very high, patients are are often older and never younger than 1 year, TEL/AML1 rearrangement as well as T-immunophenotype are very rare or exceptional. Treatment of DS-ALL remains complicated by inherent risk of infectious death not only during induction, while resistance is unusual. Leukemia relapse in the marrow remains the main cause of failure. Although the outcome has been traditionally inferior to that of non-DS patients, modern treatment and support and a more confident approach currently allow to rescue over 75% of such patients.

Gli stili APA, Harvard, Vancouver, ISO e altri

41

Lorigan, P., P. Corrie, D. Chao, P. Nathan, T. Ahmad, R. Marais, K. Burk, F. Erlandsson, M. Gore e T. Eisen. "Phase II trial of sorafenib combined with dacarbazine in metastatic melanoma patients". Journal of Clinical Oncology 24, n. 18_suppl (20 giugno 2006): 8012. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.8012.

Testo completo

Abstract (sommario):

8012 Background: Sorafenib inhibits tumor cell proliferation and angiogenesis through blockade of multiple kinases including Raf, VEGFR-2/-3, and PDGFR-β. In Phase I/II trials, sorafenib was generally well tolerated as a monotherapy or in combination with other agents. A Phase I study in combination with dacarbazine (DTIC) showed encouraging activity, which warranted this Phase II study. Methods: This multi-center, open-label, two-stage (30 patients in Stage 1; 52 in Stage 2), uncontrolled Phase II trial was performed to evaluate the primary endpoints of efficacy (according to RECIST) and tolerability of sorafenib in combination with DTIC in patients with advanced metastatic melanoma. Eligibility criteria included ECOG 0 or 1, life expectancy ≥12 weeks, adequate bone marrow, liver, and renal function. Oral sorafenib 400 mg twice daily (bid) was administered with repeated 3-week cycles of DTIC 1000 mg/m2. Results: At this interim end of Stage 1 analysis, 30 patients with metastatic melanoma had been treated (median age 61 years [range 30–78]; 73.3% male; 96.7% white). Five (16.7%) patients had PR as best response (two confirmed, three currently unconfirmed), 13 (43.3%) had SD, 10 (33.3%) had PD, and two (6.7%) were unevaluable for tumor response. The patients with confirmed PR continue on study drug at 6.4 months. Median progression-free survival for all patients was 3.6 months (range 0.9–6.1 months). The most frequently reported drug-related adverse events (AEs) were dermatologic (rash/desquamation [43%], hand-foot skin reaction [HFS, 33%]); gastrointestinal (constipation [47%], nausea [37%], diarrhea [27%]); constitutional (fatigue [43%]); and blood/bone marrow (neutrophils [40%], platelets [30%]). The most common grade 3/4 drug-related AEs were blood/bone marrow (neutrophils [23%], platelets [17%]), and fatigue (7%), while HFS and hypertension were observed in <5%. Conclusions: Continuous sorafenib 400 mg bid is generally well tolerated and shows promising preliminary anti-tumor activity in combination with DTIC. No toxicities were observed above those expected from either agent alone. Updated results will be presented, including the decision whether to proceed to Stage 2 of the study. [Table: see text]

Gli stili APA, Harvard, Vancouver, ISO e altri

42

Govardhanam, V., M. ZEGHAL e A. Cheung. "A287 LEVERAGING MACHINE LEARNING TO IMPROVE THE DIAGNOSTIC ACCURACY OF ULTRASOUND SCREENING FOR HEPATOCELLULAR CARCINOMA". Journal of the Canadian Association of Gastroenterology 7, Supplement_1 (14 febbraio 2024): 231–32. http://dx.doi.org/10.1093/jcag/gwad061.287.

Testo completo

Abstract (sommario):

Abstract Background Ultrasound screening stands out as the gold standard for hepatocellular carcinoma (HCC) detection, attributed to its broad accessibility, patient-friendly, and cost-efficient nature. Nevertheless, the five-year survival rate for HCC currently rests at 32.7%, with suboptimal screening being a key contributor to this. The recent years have witnessed the rise of machine learning models, powered by artificial neural networks. Among these, convolutional neural networks (CNNs) have taken the lead in revolutionizing medical image analysis, offering unprecedented success in predictive tasks and giving us hope for a brighter future in the fight against HCC Aims To train and test a machine learning algorithm using pre-trained CNNs to improve early detection of HCC through ultrasound screening. Methods In this retrospective study, 1835 charts of patients with chronic liver disease were reviewed: 346 with histologically confirmed HCC and 1457 with ultrasounds without HCC. A diagnosis of HCC was confirmed pathologically on biopsy or surgical resection, and/or radiographically with a Liver Imaging Reporting and Data System (LI-RADS) score of five on CT and/or MRI. Patients with benign lesions were required to have at least two ultrasounds three years apart that confirmed benign characteristics. Cases were excluded if they had a prior history of treated HCC, post-transplant HCC, or HCC with Barcelona Clinic Liver Cancer (BCLC) Stage B and above. All ultrasound images were reviewed by experienced radiologists, and segmented as liver lesions (HCC versus benign) and surrounding liver. Results A total of 149 patients have been included to date, comprising 72 with benign lesions, 73 with HCC, and four with both benign and malignant lesions. 224 lesions have been segmented, consisting of 87 HCC and 137 benign lesions. Candidate networks are under development and evaluation for the classification of liver lesions. Imaging pre-processing was performed such that the liver region of interest (ROI) and the lesion ROI were standardized, with 2-channel greyscale images on two separate channels. The algorithm was constructed using a per-lesion analysis. Initial testing has achieved an area under the curve (AUC) of 73.3%, 95% CI [68.6, 77.0] with 2 repetitions of 10-fold cross-validation. Conclusions Enhancing ultrasound screening for HCC is imperative for improving patient care. Analysis of remaining cases is ongoing. Future studies will be essential, including prospective evaluation and external validation. Funding Agencies None

Gli stili APA, Harvard, Vancouver, ISO e altri

43

Hung, C. C., C. W. Tseng, G. C. Gong, K. S. Chen, M. H. Chen e S. C. Hsu. "Fluxes of particulate organic carbon in the East China Sea in summer". Biogeosciences 10, n. 10 (11 ottobre 2013): 6469–84. http://dx.doi.org/10.5194/bg-10-6469-2013.

Testo completo

Abstract (sommario):

Abstract. To understand carbon cycling in marginal seas better, particulate organic carbon (POC) concentrations, POC fluxes and primary production (PP) were measured in the East China Sea (ECS) in summer 2007. Higher concentrations of POC were observed in the inner shelf, and lower POC values were found in the outer shelf. Similar to POC concentrations, elevated uncorrected POC fluxes (720–7300 mg C m−2 d−1) were found in the inner shelf, and lower POC fluxes (80–150 mg C m−2 d−1) were in the outer shelf, respectively. PP values (~ 340–3380 mg C m−2 d−1) had analogous distribution patterns to POC fluxes, while some of PP values were significantly lower than POC fluxes, suggesting that contributions of resuspended particles to POC fluxes need to be appropriately corrected. A vertical mixing model was used to correct effects of bottom sediment resuspension, and the lowest and highest corrected POC fluxes were in the outer shelf (58 ± 33 mg C m−2 d−1) and the inner shelf (785 ± 438 mg C m−2 d−1), respectively. The corrected POC fluxes (486 to 785 mg C m−2 d−1) in the inner shelf could be the minimum value because we could not exactly distinguish the effect of POC flux from Changjiang influence with turbid waters. The results suggest that 27–93% of the POC flux in the ECS might be from the contribution of resuspension of bottom sediments rather than from the actual biogenic carbon sinking flux. While the vertical mixing model is not a perfect model to solve sediment resuspension because it ignores biological degradation of sinking particles, Changjiang plume (or terrestrial) inputs and lateral transport, it makes significant progress in both correcting the resuspension problem and in assessing a reasonable quantitative estimate of POC flux in a marginal sea.

Gli stili APA, Harvard, Vancouver, ISO e altri

44

Onah, C. K., B. N. Azuogu, C. D. Umeokonkwo, C. O. Akpa, R. Utulu, P. O. Elom, A. S. Adeke, O. O. Okoro e U. Michael. "Risk Perception and Factors associated with Compliance to COVID-19 Preventive Measures among Commercial Drivers in Abakaliki Nigeria: An Imperative for Targeted Intervention". West Africa Journal of Medicine 38, n. 12 (30 dicembre 2021): 1190–99. http://dx.doi.org/10.55891/wajm.v38i12.48.

Testo completo

Abstract (sommario):

Background: Despite efforts to control COVID-19 pandemic, the outbreak has continued to ravage the world with high morbidity, mortality and economic hardship. The World Health Organisation reported that people are becoming complacent and their risk perceptions are lowering. Commercial drivers play significant role in outbreak control because of their regular mix with commuters from various sources. Objectives: We investigated risk perception and factors associated with compliance to COVID-19 preventive measures among commercial drivers. Methods: This study involved 502 commercial drivers in Abakaliki Nigeria using cross-sectional analytic design. Data was collected with interviewer-administered questionnaire and analyzed with IBM-SPSS version 23. Inferential statistics were done using Chi-square and binary logistic regression tests with significance set at p-value of 0.05. Results: The response rate was 502(98.4%) and mean age was 35.5±10.8 years. Majority of them were married 368(73.3%), had secondary education 279(55.6%) and operated commercial driving for 1-5 years 297(59.2%). There was high awareness, high-risk perception and good compliance with COVID-19 preventive measures in 99.8%, 69.1% and 54.4% of respondents respectively. Attaining tertiary education (aOR=6.5, 95% CI=1.5-28.1, p=0.012) and good knowledge of COVID-19 (aOR=4.3, 95% CI=2.7-6.8, p<0.001) significantly predicted high-risk perception while good knowledge of the disease alone predicted good compliance (aOR=5.5, 95% CI=3.6-8.3; p<0.001). Conclusion: The awareness of COVID-19 is high but there is relatively lower risk perception and compliance with the preventive measures. We recommend improved public education, sensitization and risk communication as well as review of policies and adoption of new approaches about COVID-19 outbreak control.

Gli stili APA, Harvard, Vancouver, ISO e altri

45

Khonglah, Tashi G., Bhaskar Borgohain, Wanlamkupar Khongwir e Kashif A. Ahmed. "Clinical outcome and cost analysis of negative pressure wound therapy in extremity wounds: a comparison to conventional wound management". International Journal of Research in Orthopaedics 7, n. 1 (23 dicembre 2020): 97. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20205568.

Testo completo

Abstract (sommario):

Background: Open fractures and traumatic wounds constitute a major health problem. Amongst the armamentarium of wound care products available, negative pressure wound therapy (NPWT) is a modality that has transformed wound care and has been recommended for treating all kinds of acute and chronic wounds.Methods: This prospective randomised comparative study was conducted at a tertiary care hospital in Northeast India. 30 patients were included in this study over a period of 24 months commencing from January 2018. The patients consisted of two groups of 15 each, the first group comprised patients who underwent treatment using NPWT and the second group was treated using standard wound therapy (SWT). The endpoint taken was a granulated wound or a wound ready for split skin grafting (SSG).Results: The mean wound size difference between the NPWT group and the SWT group on day nine was 13±7.17 mm and 4.53±0.99 mm, respectively. Likewise, on day nine, 11 (73.3%) patients in the group treated using NPWT had no positive bacterial cultures compared to 8(53.3%) patients on SWT. The estimated cost of materials for each NPWT dressing change was roughly INR₹ 3446 (US$ 45.57).Conclusions: NPWT is not a magic bullet and will not replace the basic methods of wound treatment such as wound debridement, infection control and ensuring adequate blood supply. Nevertheless, NPWT remains an integral part of the current scenario in wound care management and is cost effective under the condition that it accelerates wound healing when compared to traditional treatment.

Gli stili APA, Harvard, Vancouver, ISO e altri

46

Koroleva, I. A., e M. V. Kopp. "Oral combination of netupitant and palonosetron for the of nausea and vomiting induced by chemotherapy". Meditsinskiy sovet = Medical Council, n. 22 (6 dicembre 2022): 92–101. http://dx.doi.org/10.21518/2079-701x-2022-16-22-92-101.

Testo completo

Abstract (sommario):

Nausea and vomiting are the most frequent and painful adverse event of chemotherapy. Uncontrolled nausea and vomiting lead to a significant decrease in the quality of life of patients, nutritional insufficiency, breaking of the chemotherapy therapy regimen. Nausea and vomiting worsen the result of chemotherapy and the prognosis of the disease. In clinical studies of antiemetic drugs the “complete response” is used as the primary endpoint. The complete redponse is the absence of nausea and vomiting and the need for additional antiemetic drugs. The oral combination of netupitant and palonosetron is a modern drug for the prevention of nausea and vomiting induced by chemotherapy. This combination includes a highly selective anatagonist of NK1-receptors netupitant at a dose of 300 mg and an antagonist of 5-HT3 receptors palonosetron at a dose of 0.5 mg. The combination of net-upitant and palonosetron has high compliance, it is prescribed once before chemotherapy. The combination of netupitant and palonosetron makes it possible to achieve complete control of acute (0-24 hours) and delayed (24-120 hours) nausea and vomiting with highly emetogenic chemotherapy. In a randomized trial (n = 1455) with AC chemotherapy (doxorubicin + cyclophosphamide), the combination of netupitant and palonosetron resulted in a complete response during the general phase (0-120 hours) in 73.3% of patients. 78.4% of patients with the combination of netupitant and palonosteron experienced “no effect on daily life” due to nausea and vomiting. In an observational study of real clinical practice (n = 1197), the combination of netupitant and palonosetron in the AC chemotherapy regimen (doxorubicin + cyclophosphamide) had a complete response during the general phase (0-120 hours) in 81% of patients. Adverse events when using the combination of netupitant and palonosetron are minimal, constipation was noted in 1-8% of cases, headache in 1.4-3.6% of cases.

Gli stili APA, Harvard, Vancouver, ISO e altri

47

Lucas-Noll, Jorgina, José L. Clua-Espuny, Misericòrdia Carles-Lavila, Cristina Solà-Adell, Íngrid Roca-Burgueño, Anna Panisello-Tafalla, Ester Gavaldà-Espelta, Lluïsa Queralt-Tomas e Mar Lleixà-Fortuño. "Sex Disparities in the Direct Cost and Management of Stroke: A Population-Based Retrospective Study". Healthcare 12, n. 14 (9 luglio 2024): 1369. http://dx.doi.org/10.3390/healthcare12141369.

Testo completo

Abstract (sommario):

(1) Background: Previous studies have identified disparities in stroke care and outcomes by sex. Therefore, the main objective of this study was to evaluate the average cost of stroke care and the existence of differences in care provision by biological sex. (2) Methods: This observational study adhered to the recommendations of the STROBE statement. The calculation of costs was performed based on the production cost of the service or the rate paid for a set of services, depending on the availability of the corresponding information. (3) Results: A total of 336 patients were included, of which 47.9% were women, with a mean age of 73.3 ± 11.6 years. Women were typically older, had a higher prevalence of hypertension (p = 0.005), lower pre-stroke proportion of mRS 0-2 (p = 0.014), greater stroke severity (p < 0.001), and longer hospital stays (p = 0.017), and more were referred to residential services (p = 0.001) at 90 days. Women also required higher healthcare costs related to cardiovascular risk factors, transient ischemic strokes, institutionalization, and support needs; in contrast, they necessitated lower healthcare costs when undergoing endovascular therapy and receiving rehabilitation services. The unadjusted averaged cost of stroke care was EUR 22,605.66 (CI95% 20,442.8–24,768.4), being higher in women [p = 0.027]. The primary cost concept was hospital treatment (38.8%), followed by the costs associated with dependence and support needs (36.3%). At one year post-stroke, the percentage of women not evaluated for a degree of dependency was lower (p = 0.008). (4) Conclusions: The total unadjusted costs averaged EUR 22,605.66 (CI95% EUR 20,442.8–24,768.4), being higher in women compared to men. The primary cost concept was hospital treatment (38.8%), followed by the costs associated with dependence and support needs (36.3%).

Gli stili APA, Harvard, Vancouver, ISO e altri

48

Yehia, Lamis, Gilman Plitt, Ann M. Tushar, Julia Joo, Carol A. Burke, Steven C. Campbell, Katherine Heiden et al. "Longitudinal Analysis of Cancer Risk in Children and Adults With Germline PTEN Variants". JAMA Network Open 6, n. 4 (24 aprile 2023): e239705. http://dx.doi.org/10.1001/jamanetworkopen.2023.9705.

Testo completo

Abstract (sommario):

ImportanceIdentifying hereditary cancer predisposition facilitates high-risk organ-specific cancer surveillance and prevention. In PTEN hamartoma tumor syndrome (PHTS), longitudinal studies remain lacking, and there are insufficient data on cancers in children and young adults, as well as individuals with neurodevelopmental disorders (NDD).ObjectiveTo evaluate lifetime cancer risks, including second malignant neoplasms (SMN), among patients with PHTS.Design, Setting, and ParticipantsProspective longitudinal cohort study (September 1, 2005, through January 6, 2022). General population risks from the Surveillance, Epidemiology, and End Results database. Patients with PHTS, molecularly defined as carrying germline PTEN variants, were accrued from community and academic medical centers throughout North America, South America, Europe, Australia, and Asia. Data were analyzed from July 2022 to February 2023.ExposuresReview of physical and electronic medical records, and follow-up through clinical visits or telephone interviews.Main Outcomes and MeasuresLifetime cancer risks in PHTS relative to the general population.ResultsA total of 7302 patients were prospectively accrued, 701 of whom had germline PTEN variants (median [IQR] age at consent, 38 [12-52] years; 413 female patients [59%]). Longitudinal follow-up data could be obtained for 260 patients (37%), with a median (IQR) follow-up of 4 (2-8) years. Of the 701 patients, 341 (49%) received at least 1 cancer diagnosis, with 144 (42%) of those having SMN. The study found significantly elevated lifetime risks for breast (91%), endometrial (48%), thyroid (33%), kidney (30%), and colorectal cancers (17%), as well as melanoma (5%). Cancer diagnoses were also observed in children and young adults with PHTS (15%) and in patients with PHTS with neurodevelopmental disorders (11%). Elevated risks (P &lt; .001) of thyroid (age-adjusted standardized incidence ratios [SIR], 32.1; 95% CI, 26.0-39.0), kidney (SIR, 26.5; 95% CI, 18.8-36.3), endometrial (SIR, 26.0; 95% CI, 19.5-34.1), breast (SIR, 20.3; 95% CI, 17.3-23.7), and colorectal (SIR, 7.9; 95% CI, 5.2-11.7) cancers, and melanoma (SIR, 6.3; 95% CI, 3.5-10.5) were observed. Of the 341 patients with PHTS with cancer, 51 (15%) had 1 or more cancers diagnosed at age 29 years or younger, and 16 (31.4%) of those developed SMN at final follow-up. Twenty-three patients with PHTS with NDD and cancer were identified, with 5 (22%) having developed SMN at final follow-up. Individuals with PHTS and NDD showed higher lifetime cancer risks compared with individuals with PHTS but without NDD (hazard ratio, 2.7; 95% CI, 1.7-4.2; P &lt; .001).Conclusions and RelevanceThis cohort study found consistently elevated lifetime cancer risks in PHTS. Organ-specific surveillance should continue in patients with PHTS. Additional study is required to ascertain elevated cancer risks in patients with PHTS with NDD.

Gli stili APA, Harvard, Vancouver, ISO e altri

49

Chumachenko, G. V., Irina Yu Babaeva e M. G. Avdeeva. "The actuality of the problem co-infection of HIV and tuberculosis in current epidemiological conditions". Epidemiology and Infectious Diseases 21, n. 6 (15 dicembre 2016): 304–12. http://dx.doi.org/10.17816/eid40932.

Testo completo

Abstract (sommario):

The aim of the study. The analysis of clinical and epidemiological peculiarities of tuberculosis associated with HIV infection (TB+HIV), in the Tula region for 16 years from 1995 to 2012 to determine priority directions of the prevention and improvement of the quality of medical care. Materials and methods. There was executed the retrospective analysis of 818 inpatient medical records of TB+HIV patients and 645 outpatient medical cards (Tula regional antitubercular dispensary N1). Patients were observed and examined also in the Center for Prevention and Control ofAIDS and Infectious diseases. A study of HIV-associated TB was performed in 7 scientific and practical directions: clinical, radiological, immunological, microbiological, postmortem, statistical. Results and discussion. In the structure of TB+ HIV patients men (73.3%) prevailed, urban residents accounted for 76.76%, there is an increase in the dynamics of the proportion of women from 20.0% (2002) to 34.6% (2011), 83.38% ofpatients were aged of 21-40 years. Social portrait of the patient: the secondary (37.94%) or secondary special (32.65%) education and the lack of constant work (71.32%), 40.88% of the patients had previously been in prison. Two-thirds of patients (66.18%) were HIV infected due to the intravenous use of narcotics, however, during last 6 years of observation (from 2006 to 2012) the proportion of sexual transmission of HIV increased from 18.2% to 39.4%. The sexually transmitted HIV-infected cases most commonly occur in persons older than 41 years as well as in women. In most HIV cases TB appeared to be secondary infection, the average timespan between the onsets of these diseases was 6.3±2.77 years. In examined patients older 50 years HIV and tuberculosis were diagnosed simultaneously at the advanced stage of HIV infection. In 96.18% of cases (654 patients) tuberculosis had pulmonary localization, in most (67.1% of cases, 439patients) it was disseminated, including milliarytuberculosis, followed by infiltrative tuberculosis - 171 patients (26.1% ofpulmonary form cases). In long-term observation there was noted an increase in the proportion of infiltrative tuberculosis in the structure ofpulmonary forms. Conclusion. With taking in consideration the unfavorable epidemic situation, it is quite advisable to perform a comprehensive monitoring of social, medical and other factors, characterizing the patients suffered from TB associated with HIV infection.

Gli stili APA, Harvard, Vancouver, ISO e altri

50

Maheshwari, R., R. Sankaralingam, S. Chinnadurai, J. Antony, B. Chilukuri e M. Mani. "POS1397 HYDROXYCHLOROQUINE INDUCED RETINAL TOXICITY IN PATIENTS WITH RHEUMATIC DISEASES". Annals of the Rheumatic Diseases 80, Suppl 1 (19 maggio 2021): 981.2–982. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2922.

Testo completo

Abstract (sommario):

Background:Retinal toxicity from hydroxychloroquine (HCQ) is rare, but the vision loss maybe irreversible and could have medicolegal consequences.Objectives:To determine the prevalence and assess the predictors of retinal toxicity due to HCQ in patients with rheumatic diseases. There is paucity of literature on retinal toxicity due to HCQ in rheumatic diseases.Methods:A retrospective observational study was conducted in the Department of Clinical Immnuology and Rheumatology, Sri Ramachandra Institute of Higher Education and Research,Chennai, India from November 2018-May 2020, on patients taking HCQ for more than 6 months. All patients underwent ophthalmological screening at baseline and every 6 months, and thereafter by modern day screening methods-Humphrey Visual Field (HVF)10-2, Spectral Domain Optical Coherence Tomography(SD-OCT), except for patients with evidence of suspected retinal toxicity at baseline.Fundus autofluorescence (FAF) was done in feasible patients.Results:9 out of 743(1.2%) patients were identified to have retinal toxicity, detected via fundus examination (n=9), SD-OCT (n=8/9), HVF 10-2 (n=6/9), FAF (n=1/9). 55.5% (n=5/9) had Rheumatoid Arthritis(RA) and 44.4% (n=4/9) had Systemic Lupus Erythematosus(SLE) as their primary diagnosis. 77.7% (n=7/9) were females. The mean age was 47.5 years (20-72 years).75%(n=3/4) of SLE patients were below 30 years of age. The average daily and cumulative dose of HCQ in these 9 patients were 244 mg (200-400mg) and 311.22g(73-730g)respectively, whereas the mean recommended dose as per real body weight was 287.2mg/day. Average duration of HCQ consumption was 3.6 years (1-10 years).Only 11.1% (n=1/9) had presented with visual complaints of black floaters.Conclusion:The asymptomatic nature of this irreversible toxicity, warrants frequent screening.Retinal toxicity was not age-related.Toxicity was manifested at low daily and cumulative doses.Screening should be done atleast every 6 months by fundus examination.Objective tests like HVF and SD-OCT should be done annually, especially in patients with underlying rheumatic diseases.The early manifestation of retinal toxicity in young SLE patients could have a genetic association and needs further evaluation.References:[1]Mortada A Abozaid et al. hydoxychloroquine retinopathy in a ohort of patients from upper Egypt.Journal of Egyptioan Ophthalmological Society 2017;110:110-113[2]Roy AN,Samala V,Kumar YA,Fatima SS.Assessing the risk of retinopathy in Indian patients using hydroxychloroquine for rheumatic and musculoskeletal Diseases:A Retrospective Observational Study.Indian J Rheumatol 2020.Disclosure of Interests:None declared

Gli stili APA, Harvard, Vancouver, ISO e altri

Articoli di riviste sul tema "346.7303 har"

Cita una fonte nei formati APA, MLA, Chicago, Harvard e in molti altri stili