Risk of Thrombosis in Cancer: Clinical Factors and Role of Primary Prophylaxis

2019 ◽  
pp. 55-68 ◽  
Author(s):  
Joanna Roopkumar ◽  
Alok A. Khorana
Keyword(s):  
Primary Prophylaxis ◽  
Clinical Factors

The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey

2016 ◽  
Vol 18 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Rosaria Gesuita ◽  
Edlira Skrami ◽  
Riccardo Bonfanti ◽  
Paola Cipriano ◽  
Lucia Ferrito ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Clinical Factors

Prognostic role of inflammatory biomarkers from peripheral blood and clinical factors in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with radium-223 (Ra-223) (BIO-Ra-223 study).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17026-e17026
Author(s):  
Sara Elena Rebuzzi ◽  
Matteo Bauckneht ◽  
Alessio Signori ◽  
Viviana Frantellizzi ◽  
Elisa Lodi Rizzini ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Peripheral Blood ◽  
Scoring System ◽  
Prognostic Score ◽  
Clinical Factors ◽  
Prognostic Role ◽  
Internal Validation ◽  
Prognostic Groups ◽  
Ecog Ps

e17026 Background: Ra-223 is a treatment option for mCRPC pts with bone metastases according to the survival benefit observed compared to placebo in the ALSYMPCA trial. In the last years, many studies showed this benefit in the real-life pts is lower than that reported in the trial, probably due to a suboptimal selection of pts with poor prognostic characteristics. Therefore, the identification of prognostic factors to select mCRPC pts most likely to benefit from Ra-223 is needed. The multicentre retrospective BIO-Ra-223 study has investigated the prognostic role of peripheral blood immune cells and clinical factors to develop a novel prognostic score for mCRPC pts treated with Ra-223. Methods: Complete blood count was assessed before Ra-223 treatment calculating neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII). Clinical factors included pre-treatment Eastern Cooperative Oncology Group performance status (ECOG PS), Gleason Score (GS) group, number of bone metastases, alkaline phosphatase (ALP), line of therapy, previous chemotherapy and the presence of lymphadenopathies. Statistical analyses included survival ROC curves for biomarkers’ cutoffs, univariable and multivariable Cox analyses, internal validation, c-index calculation and Schneeweiss scoring system. Results: From September 2013 to July 2020, 519 mCRPC pts received Ra-223 as 1st-2nd, 3rd-4th and further-line in 48%, 38% and 14% of pts. The median overall survival (mOS) of the entire cohort was 19.9 months. All biomarkers and clinical factors (except for GS group) significantly predicted OS at the univariable analyses. In the multivariable ones, all biomarkers, ECOG PS, number of bone metastases and ALP significantly correlated with OS. The multivariable model with NLR (< 3.1 vs ≥3.1), ECOG PS (0-1 vs 2-3), number of bone metastases (< 6, 6-20, > 20) and ALP (< 220 vs ≥220) showed the highest c-index (0.711), which was maintained after internal validation (bootstrap re-sampling) (c-index: 0.707). Using the Schneeweiss scoring system, ten categories were identified in 494 pts with complete data and merged in two prognostic groups with distinctive OSs: group 1 (score 0-4, 337 pts) with a mOS of 27.8 months and group 2 (score 5-10, 157 pts) with a mOS of 9.7 months (HR 4.03, p < 0.001). Conclusions: The obtained score, composed of NLR, ECOG PS, number of bone metastases, and ALP identifies two distinctive prognostic groups of mCRPC pts. Moreover, this score is easily and widely applicable for clinical practice and trials at no additional costs. Although external validation is needed, these preliminary results showed that this novel prognostic score is promising and could help the patients’ selection for Ra-223 treatment.

scholarly journals Subjective wellbeing as a determinant of glycated hemoglobin in older adults: longitudinal findings from the English Longitudinal Study of Ageing

2019 ◽  
Vol 50 (11) ◽  
pp. 1820-1828 ◽  
Author(s):  
Lydia Poole ◽  
Ruth A. Hackett ◽  
Laura Panagi ◽  
Andrew Steptoe
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Subjective Wellbeing ◽  
Glycated Hemoglobin ◽  
Linear Regression Models ◽  
Clinical Factors ◽  
Subclinical Disease ◽  
The Relationship ◽  
English Longitudinal Study

AbstractBackgroundPrevious research has shown an association between subjective wellbeing and incident diabetes. Less is known about the role of wellbeing for subclinical disease trajectories as captured via glycated hemoglobin (HbA1c). We aimed to explore the association between subjective wellbeing and future HbA1c levels, and the role of sociodemographic, behavioral and clinical factors in this association.MethodsWe used data from the English Longitudinal Study of Ageing for this study (N = 2161). Subjective wellbeing (CASP-19) was measured at wave 2 and HbA1c was measured 8 years later at wave 6. Participants were free from diabetes at baseline. We conducted a series of analyses to examine the extent to which the association was accounted for by a range of sociodemographic, behavioral and clinical factors in linear regression models.ResultsModels showed that subjective wellbeing (CASP-19 total score) was inversely associated with HbA1c 8 years later after controlling for depressive symptoms, age, sex, and baseline HbA1c (B = −0.035, 95% CI −0.060 to –0.011, p = 0.005). Inclusion of sociodemographic variables and behavioral factors in models accounted for a large proportion (17.0% and 24.5%, respectively) of the relationship between wellbeing and later HbA1c; clinical risk factors explained a smaller proportion of the relationship (3.4%).ConclusionsPoorer subjective wellbeing is associated with greater HbA1c over 8 years of follow-up and this relationship can in part be explained by sociodemographic, behavioral and clinical factors among older adults.

scholarly journals Febrile neutropenia (FN) rates in metastatic hormone sensitive prostate cancer: the role of antibiotics as primary prophylaxis

2020 ◽  
Author(s):  
Lara Pemberton ◽  
Kenrick Ng ◽  
Ursula McGovern ◽  
Alan Macdonald ◽  
Hasti Barot ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Febrile Neutropenia ◽  
Primary Prophylaxis ◽  
Hormone Sensitive

scholarly journals The role of orthopaedic surgery in haemophilia: current rationale, indications and results

2019 ◽  
Vol 4 (5) ◽  
pp. 165-173 ◽  
Author(s):  
E. Carlos Rodríguez-Merchán
Keyword(s):  
Coagulation Factor ◽  
Primary Prophylaxis ◽  
Venous Access ◽  
Arthroscopic Synovectomy ◽  
Haemophilic Arthropathy ◽  
Musculoskeletal Problems ◽  
Minor Injuries ◽  
End Stage ◽  
Immature Skeleton

The musculoskeletal problems of haemophilic patients begin in infancy when minor injuries lead to haemarthroses and haematomas. Early continuous haematological primary prophylaxis by means of the intravenous infusion of the deficient coagulation factor (ideally from cradle to grave) is of paramount importance because the immature skeleton is very sensitive to the complications of haemophilia: severe structural deficiencies may develop quickly. If primary haematological prophylaxis is not feasible due to expense or lack of venous access, joint bleeding will occur. Then, the orthopaedic surgeon must aggressively treat haemarthrosis (joint aspiration under factor coverage) to prevent progression to synovitis (that will require early radiosynovectomy or arthroscopic synovectomy), recurrent joint bleeds, and ultimately end-stage osteoarthritis (haemophilic arthropathy). Between the second and fourth decades, many haemophilic patients develop articular destruction. At this stage the main possible treatments include arthroscopic joint debridement (knee, ankle), articular fusion (ankle) and total joint arthroplasty (knee, hip, ankle, elbow).Cite this article: EFORT Open Rev 2019;4:165-173. DOI: 10.1302/2058-5241.4.180090

Life-threatening bleeding in factor VII deficiency: the role of prenatal diagnosis and primary prophylaxis

2014 ◽  
Vol 168 (3) ◽  
pp. 452-455 ◽  
Author(s):  
Roula Farah ◽  
Jad Al Danaf ◽  
Nabil Braiteh ◽  
Jean-Marc Costa ◽  
Hussein Farhat ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Primary Prophylaxis ◽  
Factor Vii ◽  
Factor Vii Deficiency ◽  
Life Threatening

Cancer-related venous thromboembolic disease: current management and areas of uncertainty

2012 ◽  
Vol 27 (2_suppl) ◽  
pp. 53-60 ◽  
Author(s):  
G Radhakrishna ◽  
D Berridge
Keyword(s):  
Cancer Patients ◽  
Treatment Options ◽  
Primary Prophylaxis ◽  
Assessment Tools ◽  
Current Management ◽  
Ivc Filters ◽  
Risk Assessment Tools ◽  
Venous Thromboembolic ◽  
Recent Developments

The relationship between cancer and venothromboembolic events is a complex, multifactorial process which is still not fully understood and therefore the use of current generic guidelines may be inadequate. Current management of cancer-related VTE may be suboptimal because of the lack of cancer-specific studies into the role of primary prophylaxis in both ambulant and non-ambulant cancer patients. Further research into developing cancer-specific risk assessment tools and the choice, dose and duration of prophylaxis is required. The management of confirmed symptomatic VTE in cancer patients is outlined but certain controversies remain. Areas for further research include the management of asymptomatic unsuspected VTE events, recurrent VTE events on treatment and the role of IVC filters and other treatment options are required. This paper attempts to cover some of the recent developments and areas of uncertainty surrounding the management of cancer-related VTE.

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