Risk of mortality and second malignancies in primary myelofibrosis before and after ruxolitinib approval

The method of liquid biopsy allows detection of circulating tumor DNA (ctDNA) in patient blood, but the clinical significance of this approach in pancreatic cancer is still unclear. In this regard, we have carried out a meta-analysis of the studies dedicated to the predictive significance of ctDNA in pancreatic cancer. Materials and methods.We carried out the search for the articles and abstracts in PubMed, ASCO and ESMO databases published before February 2020, containing data about the connection between ctDNA and the prognosis of pancreatic cancer. The exclusion criteria were the studies including 10 or less participating patients, absence of the data about the relative risk of mortality and/or progression, and the 95% confidence interval. The meta-analysis was carried out by using the Review Manager software (RevMan), Version 5.3. Results.There were no significant systematic errors associated with the publications. The presence of ctDNA in patient blood showed poor overall survival of patients (odds ratio OR 2.21, 95% confidence interval CI 1.35-3.33,p=0.001) regardless of the prevalence of the disease. In case of the resectable process, the detection of ctDNA in patient blood both before and after surgery was a factor of worse progression-free survival (OR 2.32, 95% CI 1.543.5,p0.001 and OR 3.06, 95% CI 1.635.76,р=0.0005 and overall survival (OR2.01, 95% CI 1.123.63,р=0,02 and OR 3.39, 95% CI 2.125.44,р0.00001, respectively). Conclusions.The detection of ctDNA in the bloodstream in pancreatic cancer patients is a factor of poor prognosis in both localized and advanced cancer. It is very important to make further prospective studies to develop the optimal protocol for detecting ctDNA in patient bloodstream.

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The protective association between statins use and adverse outcomes among COVID-19 patients: a systematic review and meta-analysis

10.1101/2021.02.08.21251070 ◽

2021 ◽

Author(s):

Ronald Chow ◽

James Im ◽

Nicholas Chiu ◽

Leonard Chiu ◽

Rahul Aggarwal ◽

...

Keyword(s):

Systematic Review ◽

Odds Ratio ◽

Lower Risk ◽

Meta Analysis ◽

Adverse Outcomes ◽

Risk Of Mortality ◽

Before And After ◽

Statin Usage ◽

Similar Risk ◽

Ventilation Studies

ABSTRACTIntroductionStatins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage.MethodsLiteratures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.ResultsThirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88).ConclusionPatients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

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High prevalence of physical inactivity after heart valve surgery and its association with long-term mortality: A nationwide cohort study

European Journal of Preventive Cardiology ◽

10.1177/2047487320903877 ◽

2020 ◽

pp. 204748732090387 ◽

Cited By ~ 1

Author(s):

Sun-Hyung Kim ◽

Seungwoo Cha ◽

Seongmin Kang ◽

Kyungdo Han ◽

Nam-Jong Paik ◽

...

Keyword(s):

Cardiac Rehabilitation ◽

Heart Valve ◽

Valve Surgery ◽

Active Group ◽

Heart Valve Surgery ◽

National Guidelines ◽

Risk Of Mortality ◽

Before And After ◽

Inactive Group

Aims Physical activity (PA) and systematic efforts, such as cardiac rehabilitation, are recommended by several national guidelines for those who have received heart valve surgery. However, only a few studies have demonstrated real-world situations, such as changes in the PA level after heart valve surgery, and their effects on long-term outcomes. We designed this study to investigate the changes in PA after heart valve surgery and their associations with mortality using nationwide representative data. Methods This study was performed using the Korean National Health Insurance Service database. We included patients who received heart valve surgery from 2009 to 2015 and underwent regular health checkups before and after surgery. Subjects were grouped according to their PA level before and after the surgery. Information on all-cause mortality was obtained until 31 December 2016, with a maximum follow-up period of 5 years. Results Of the 6587 subjects, 3258 (49.5%) were physically inactive after surgery. Among patients who were physically active ( n = 3070), 1196 (39.0%) became inactive after surgery. The postoperative ‘inactive’ group showed higher mortality than the ‘active’ group (hazard ratio (HR): 1.41, 95% confidence interval (CI): 1.08–1.83). The ‘inactive/inactive’ group showed the highest risk of mortality (HR: 1.69, 95% CI: 1.19–2.40) compared with the ‘active/active’ group. Conclusions Insufficient PA level after heart valve surgery is associated with higher risk of mortality. However, maintaining sufficient PA after heart valve surgery may be challenging for many patients. Therefore, systematic efforts, such as cardiac rehabilitation, should be considered in those who received heart valve surgery.

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Associations of Pre- and Postdiagnosis Diet Quality With Risk of Mortality Among Men and Women With Colorectal Cancer

Journal of Clinical Oncology ◽

10.1200/jco.18.00714 ◽

2018 ◽

Vol 36 (34) ◽

pp. 3404-3410 ◽

Cited By ~ 12

Author(s):

Mark A. Guinter ◽

Marjorie L. McCullough ◽

Susan M. Gapstur ◽

Peter T. Campbell

Keyword(s):

Colorectal Cancer ◽

Diet Quality ◽

Dietary Patterns ◽

Dash Score ◽

Cancer Society ◽

Animal Products ◽

Men And Women ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Before And After

Purpose Dietary patterns, indicators of overall diet quality, are associated with colorectal cancer (CRC) incidence but less consistently with mortality among CRC survivors. We prospectively evaluated associations of diet quality pre- and postdiagnosis with risk of mortality among men and women with CRC. Patients and Methods In the Cancer Prevention Study-II Nutrition Cohort, 2,801 participants were cancer free at baseline in 1992/1993 and subsequently diagnosed with invasive, nonmetastatic CRC during follow-up through June 2013. Pre- and postdiagnosis diet data were available for 2,671 and 1,321 participants, respectively, among whom 1,414 and 722 died. Concordance with the Dietary Approaches to Stop Hypertension (DASH), American Cancer Society nutrition guidelines (ACS-score), prudent, and Western dietary patterns was used to evaluate diet quality. Results Extreme scoring group comparisons showed that prediagnosis ACS-score was inversely associated with all-cause (hazard ratio high v low [HRHigh vLow], 0.78; 95% CI, 0.65 to 0.95) and CRC-specific (HRHigh vLow, 0.74; 95% CI, 0.54 to 1.03) mortality, whereas the Western diet score was associated with higher all-cause mortality (HRHigh vLow, 1.30; 95% CI, 1.03 to 1.64). For postdiagnosis diet, the ACS-score was associated with lower risk of all-cause (HRHigh vLow, 0.62; 95% CI, 0.47 to 0.83) and CRC-specific (HRHigh vLow, 0.35; 95% CI, 0.17 to 0.73) mortality, the DASH score was inversely associated with all-cause (HRHigh vLow, 0.79; 95% CI, 0.62 to 0.99) and CRC-specific (HRHigh vLow, 0.56; 95% CI, 0.35 to 0.89) mortality, and the prudent score was inversely associated with all-cause mortality (HRHigh vLow, 0.72; 95% CI, 0.56 to 0.93). Among participants with a low diet quality before diagnosis, improved DASH (HR, 0.54; 95% CI, 0.31 to 0.92) and prudent (HR, 0.53; 95% CI, 0.29 to 0.95) scores from pre- to postdiagnosis were inversely associated with CRC-specific mortality. Conclusion Dietary patterns reflective of high intakes of plant foods and low intakes of animal products before and after CRC diagnosis are associated with longer survival.

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Statin Use Is Associated with a Decreased Risk of Mortality among Patients with COVID-19

Journal of Clinical Medicine ◽

10.3390/jcm10071450 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1450

Author(s):

Chieh-Chen Wu ◽

An-Jen Lee ◽

Chun-Hsien Su ◽

Chu-Ya Huang ◽

Md. Mohaimenul Islam ◽

...

Keyword(s):

Epidemiological Studies ◽

Search Terms ◽

Online Databases ◽

Risk Of Mortality ◽

Before And After ◽

Randomized Control ◽

Meta Analyses ◽

Study Inclusion ◽

Related Mortality ◽

Statin Use

Background: Recent epidemiological studies remain controversial regarding the association between statin use and reducing the risk of mortality among individuals with COVID-19. Objective: The objective of this study was to clarify the association between statin use and the risk of mortality among patients with COVID-19. Methods: We conducted a systematic articles search of online databases (PubMed, EMBASE, Scopus, and Web of Science) between 1 February 2020 and 20 February 2021, with no restriction on language. The following search terms were used: “Statins” and “COVID-19 mortality or COVID19 mortality or SARS-CoV-2 related mortality”. Two authors individually examined all articles and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for study inclusion and exclusion. The overall risk ratio (RRs) with 95% confidence interval (CI) was calculated to show the strength of the association and the heterogeneity among the studies was presented Q and I2 statistic. Results: Twenty-eight studies were assessed for eligibility and 22 studies met the inclusion criteria. Statin use was associated with a significantly decreased risk of mortality among patients with COVID-19 (RR adjusted = 0.64; 95% CI: 0.57–0.72, p < 0.001). Moreover, statin use both before and after the admission was associated with lowering the risk of mortality among the COVID-19 patients (RR adjusted;before = 0.69; 95% CI: 0.56–0.84, p < 0.001 and RR adjusted;after = 0.57; 95% CI: 0.54–0.60, p < 0.001). Conclusion: This comprehensive study showed that statin use is associated with a decreased risk of mortality among individuals with COVID-19. A randomized control trial is needed to confirm and refute the association between them.

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Efficacy of bariatric surgery in a Colombian population

10.21203/rs.3.rs-67764/v1 ◽

2020 ◽

Author(s):

Claudia Y. Obando León ◽

William Otero Regino ◽

HERNANDO MARULANDA FERNANDEZ ◽

Hernán Ballén ◽

Elder Otero

Keyword(s):

Bariatric Surgery ◽

Antihypertensive Drugs ◽

Adjustable Gastric Band ◽

Hypertensive Patients ◽

Risk Of Mortality ◽

Before And After ◽

Excess Bmi Loss ◽

One Year ◽

The One

Abstract Background Obesity (OB) is defined as having a body mass index (BMI) of ≥ 30 kg/m2. It has a high risk of mortality due to its association with comorbidities. Bariatric surgery (BS) is indicated for a BMI of 40 kg/m2 or of 35 kg/m2 if concurrent with a metabolic disorder. Methods A retrospective observational study of patients subjected to BS, such as Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric band (AGB). A survey was applied to determine the BMI and patterns of comorbidities before and after BS. Results The study included 30 patients who underwent 25 RYGB, 4 SG and 1 AGB procedures. A total of 17 patients were evaluated at the one-year follow-up and all showed improvement in comorbidities and weight loss, with a mean excess BMI loss (%EBMIL) of 89.5% At the two-year follow-up, 3 patients reported a %EBMIL of 75%. At the three-year follow-up, 10 patients had a %EBMIL of 70.8%%, but 70% (7/10) still had a BMI > 30 kg/m2. Type 2 diabetes mellitus resolved in all (12/12) and the doses of antihypertensive drugs were reduced in 86.4% of hypertensive patients (11/13). Half of the patients followed a diet. Conclusion In our service, BS was effective one year after the procedure. After three years, BMI > 30 kg/m2 persisted in 70% of patients All diabetics were cured. The doses of antihypertensives were lowered in 86.4% of hypertensive patients. Ultrasound scan detected no fatty liver diseases at the one-year follow-up of 85.7% of patients.

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Comparison of Transvalvular Aortic Mean Gradients Obtained by Intraprocedural Echocardiography and Invasive Measurement in Balloon and Self‐Expanding Transcatheter Valves

Journal of the American Heart Association ◽

10.1161/jaha.120.021014 ◽

2021 ◽

Cited By ~ 1

Author(s):

Amr E. Abbas ◽

Ramy Mando ◽

Amer Kadri ◽

Houman Khalili ◽

George Hanzel ◽

...

Keyword(s):

Ejection Fraction ◽

Poor Correlation ◽

Weak Correlation ◽

Transcatheter Aortic Valve ◽

Risk Of Mortality ◽

Before And After ◽

Transcatheter Valves ◽

Predicted Risk ◽

Low Ejection Fraction ◽

Invasive Measurement

Background Concerns about discordance between echocardiographic and invasive mean gradients after transcatheter aortic valve replacement (TAVR) with balloon‐expandable valves (BEVs) versus self‐expanding valves (SEVs) exist. Methods and Results In a multicenter study, direct‐invasive and echocardiography‐derived transvalvular mean gradients obtained before and after TAVR were compared as well as post‐TAVR and discharge echocardiographic mean gradients in BEVs versus SEVs in 808 patients. Pre‐TAVR, there was good correlation ( R =0.614; P <0.0001) between direct‐invasive and echocardiography‐derived mean gradients and weak correlation ( R =0.138; P <0.0001) post‐TAVR. Compared with post‐TAVR echocardiographic mean gradients, both valves exhibit lower invasive and higher discharge echocardiographic mean gradients. Despite similar invasive mean gradients, a small BEV exhibits higher post‐TAVR and discharge echocardiographic mean gradients than a large BEV, whereas small and large SEVs exhibit similar post‐TAVR and discharge mean gradients. An ejection fraction <50% ( P =0.028) and higher Society of Thoracic Surgeons predicted risk of mortality score ( P =0.007), but not invasive or echocardiographic mean gradient ≥10 mm Hg ( P =0.378 and P =0.341, respectively), nor discharge echocardiographic mean gradient ≥20 mm Hg ( P =0.393), were associated with increased 2‐year mortality. Conclusions Invasively measured and echocardiography‐derived transvalvular mean gradients correlate well in aortic stenosis but weakly post‐TAVR. Post‐TAVR, echocardiography overestimates transvalvular mean gradients compared with invasive measurements, and poor correlation suggests these modalities cannot be used interchangeably. Moreover, echocardiographic mean gradients are higher on discharge than post‐TAVR in all valves. Despite similar invasive mean gradients, a small BEV exhibits higher post‐TAVR and discharge echocardiographic mean gradients than a large BEV, whereas small and large SEVs exhibit similar post‐TAVR and discharge mean gradients. Immediately post‐TAVR, elevated echocardiographic‐derived mean gradients should be assessed with caution and compared with direct‐invasive mean gradients. A low ejection fraction and higher Society of Thoracic Surgeons score, but not elevated mean gradients, are associated with increased 2‐year mortality.

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Analysis of Factors Influencing the Prognostic Significance of Hyponatremia in Peritoneal Dialysis Patients

American Journal of Nephrology ◽

10.1159/000504870 ◽

2019 ◽

Vol 51 (1) ◽

pp. 54-64

Author(s):

Luis Bravo González-Blas ◽

Leticia García-Gago ◽

Daniela Astudillo-Jarrín ◽

Catuxa Rodríguez-Magariños ◽

Antía López-Iglesias ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Serum Sodium ◽

Prognostic Significance ◽

Outcome Variable ◽

Reactive Protein ◽

Risk Of Mortality ◽

Before And After ◽

Main Outcome Variable ◽

Independent Marker ◽

Risk Pattern

Background: The evidence linking low serum sodium levels with the risk of mortality in peritoneal dialysis (PD) patients is controversial. Considering the different mechanisms contributing to hyponatremia in these patients, it is conceivable that the prognostic significance of this factor may vary, according to the clinical setting. Methods: Following a retrospective, observational design, we analyzed the association between hyponatremia and mortality in 748 patients incident on PD. We applied multivariate strategies of analysis, with the main objective of identifying subgroups of patients in whom hyponatremia could sustain different degrees of association with mortality (main outcome variable). For this purpose, we performed preliminary analyses to: (1) disclose predictors of serum sodium levels before and after (mean of first 3 months) initiation of PD (main study variable) and (2) investigate the overall prognostic significance of hyponatremia, in our patients. Results: Comorbidity, hypoalbuminemia, and lower glomerular filtration rate (GFR) were main predictors of hyponatremia. Use of icodextrin was another inverse correlate of serum sodium, and the only consistent predictor of a decline of natremia, once PD was started. Multivariate analysis confirmed early hyponatremia as an independent marker of survival. However, stratified analyses showed that this association was most apparent in specific subsets, namely, hypoalbuminemic, more anemic patients with higher baseline levels of GFR and C-reactive protein and faster peritoneal solute transport rates. Other factors potentially reinforcing the prognostic significance of hyponatremia included lower lean body mass levels, nonprescription of renin-angiotensin-aldosterone system antagonists, and use of icodextrin-based PD solution. On the contrary, baseline overhydration or categorization by classic predictors of mortality (age, comorbidity, diabetes) did not appear to influence the risk pattern associated with lower serum sodium levels. Conclusions: Our results suggest that hyponatremia performs as a consistent correlate of the risk of mortality mainly in PD patients manifesting direct or indirect signs of inflammation and wasting, while this association is not apparently linked to the presence of overhydration or nominal, preexisting comorbid conditions.

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The protective association between statins use and adverse outcomes among COVID-19 patients: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0253576 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253576

Author(s):

Ronald Chow ◽

James Im ◽

Nicholas Chiu ◽

Leonard Chiu ◽

Rahul Aggarwal ◽

...

Keyword(s):

Systematic Review ◽

Odds Ratio ◽

Lower Risk ◽

Meta Analysis ◽

Adverse Outcomes ◽

Risk Of Mortality ◽

Before And After ◽

Statin Usage ◽

Similar Risk ◽

Ventilation Studies

Introduction Statins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage. Methods Literatures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately. Results Thirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88). Conclusion Patients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

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Respiratory function in pediatric African SCA patients underwent bone marrow transplantation

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2017.030 ◽

2017 ◽

Vol 9 (1) ◽

pp. e2017030

Author(s):

Antonella Isgrò ◽

Javid Gaziev ◽

Marco Marziali ◽

Katia Paciaroni ◽

Gioia De Angelis ◽

...

Keyword(s):

Bone Marrow ◽

Plasmodium Falciparum ◽

Stem Cell ◽

Respiratory Function ◽

Common Finding ◽

Acute Chest Syndrome ◽

Hematopoietic Stem ◽

Risk Of Mortality ◽

Before And After ◽

Invasive Infections

Children with sickle cell anemia (SCA) are prone to invasive infections caused by S. pneumonia, H. influenzae, and Plasmodium falciparum. The presence of asthma increases the risk of mortality, and it has been shown an association between the presence of bronchial hyperactivity and the onset of acute chest syndrome. Like thalassemia, allogeneic hematopoietic stem cell transplantation (HSCT) is curative in most individuals with SCA. We report pulmonary function analyzed by spirometry, before and after transplantation, in a group of Nigerian SCA children. Our results indicate that restrictive pulmonary pattern (RVP) is a common finding in these patients. Although we do not observe significant improvements in lung function after 3-6 months of transplantation, it is useful to perform a spirometric evaluation of these patients at the time of transplant.

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