scholarly journals O21 Is hypoalbuminaemia associated with amputation-free survival in chronic limb-threatening ischaemia? A retrospective cohort study

2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
A T O Nickinson ◽  
I Black ◽  
J S M Houghton ◽  
R D Sayers
Keyword(s):  
Nutritional Status ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Tissue Loss ◽  
Albumin Concentration ◽  
Free Survival ◽  
Cardiovascular Comorbidities ◽  
Operative Outcomes ◽  
One Year ◽  
The Relationship

Abstract Introduction Serum albumin is a recognised marker of nutritional status. Whilst associated with post-operative outcomes, the relationship with amputation-related outcomes in chronic limb-threatening ischaemia (CLTI) remains unclear. It is also uncertain whether any relationship may be confounded by systematic inflammation. We aimed to investigate whether hypoalbuminaemia is associated with amputation-related outcomes and evaluate its relationship with other inflammatory markers. Method A retrospective study of patients managed for CLTI at a vascular centre between 01/01/2013–31/12/2015 was undertaken. Patients were identified from local coding databases. Patient demographics and comorbidities, results of admission bloods and procedural data were recorded from electronic records. Hypoalbuminaemia was defined as albumin concentration <35 g/L. One-year amputation-free survival (AFS) was the primary outcome. Cox’s proportional hazard models were calculated to compare the risk of amputation/death. Linear regression was performed to investigate the relationship between albumin and other inflammatory markers. Result 374 patients were included (mean albumin concentration = 38.8g/L [SD = 5.2]), with 72 patients being hypoalbuminaemic. No differences were observed in sex (P=0.678), age (P=0.207), history of tissue loss (P=0.057), or cardiovascular comorbidities between groups, however a greater proportion of patients with hypoalbuminaemia had COPD (P=0.002). Patients with hypoalbuminaemia had a significantly higher combined risk of 1-year amputation/death compared to those with normal albumin concentration (HR 1.94, 95% CI 1.29–2.91). White cell count and CRP concentration were significant predictors of albumin concentration (r2=0.113, P<0.001). Conclusion Hypoalbuminaemia is an important prognostic biomarker of AFS in CLTI, however this association may relate to a complex relationship between nutritional status and inflammation. Take-home Message Albumin is more than just a marker of nutritional status in patients with chronic limb-threatening ischaemia.

scholarly journals The impact of in-hospital nutritional status deterioration on treatment outcome of adult gastroenterological patients

2016 ◽  
Vol 73 (8) ◽  
pp. 764-769
Author(s):  
Branka Roganovic ◽  
Sasa Peric ◽  
Snezana Jankovic
Keyword(s):  
Treatment Outcome ◽  
Nutritional Status ◽  
Independent Predictor ◽  
Skinfold Thickness ◽  
Favorable Outcome ◽  
Albumin Concentration ◽  
Status Assessment ◽  
The Impact ◽  
The Relationship ◽  
Triceps Skinfold Thickness

Background/Aim. In the current literature, data on impact of intrahospital changes in patients? nutritional status on the treatment outcome are limited. The aim of this study was to investigate the relationship between nutritional status deterioration and the treatment outcome among hospitalized gastroenterological patients. Methods. In 650 adult gastroenterological patients nutritional status on admission and at discharge was evaluated using the 6 nutritional status assessment parameters: body mass index, triceps skinfold thickness, mid-upper arm muscle circumference, serum albumin concentration, lymphocyte count and unintentional weight loss. The influence on treatment outcome was tested for the nutritional status on admission, nutritional status at discharge and intrahospital nutritional status deterioration. Results. The incidence of favorable outcome in the non-undernourished and undernourished patients on admission was in the range 93.4-97.3% and 81.2- 91.2%, respectively. The incidence of favorable outcome in the non-undernourished and undernourished patients at discharge was in the range 94-97.4% and 80.8-88.1%, respectively. Favorable outcomes were obtained in 95.6-98.9% of the patients without nutritional status deterioration and in 87.1-90.3% of the patients with nutritional status deterioration. Intrahospital nutritional status deterioration significantly influenced the outcome, no matter what assessment parameter had been used (p < 0.001 for all the applied parameters). Furthermore, only the deterioration of nutritional status was found to be an independent predictor of treatment outcome (multivariate analysis Forwald Wald, p ? 0.001; relative risk (RR) = 0.104-0.350; confidence intervals (CI) = 0.037-0.186/0.297-0.657). Conclusion. Deterioration of nutritional status is an independent predictor of adverse outcome.

Analysis of the relationship between different prognosis factors in patients with advanced colon cancer and progression-free survival.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15518-e15518
Author(s):  
Eduardo Richardet ◽  
Ignacio Magi ◽  
Luciana Paola Acosta ◽  
Maria gimena Ferreira ◽  
Matias Molina ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Free Survival ◽  
Advanced Colon Cancer ◽  
Number Of Patients ◽  
Significant Difference ◽  
One Year ◽  
The Relationship

e15518 Background: Colon tumors are a heterogeneous group of disease. As a result of the accumulation of different genetic and epigenetic alterations, the mutation of the RAS, BRAF oncogene and microsatellite instability stands out. A new line of research are immunological and inflammatory factors, the infiltrating lymphocytes of the tumor stroma (TILs) and the neutrophil to lymphocyte radio (NLR) have been studied by our work team. We understood could that these factors were associated with the survival rate in our patients. The main objective of this reseach is to determine the relationship between NLR and progression-free survival (PFS) in patients with advanced colon cancer. Secondary objective is to determine the relationship between the location of the primary tumor, RAS status, TILs, and PFS. in the same group of patients. Methods: A total of 93 medical records of patients with advanced colon cancer was analyzed. Those pts who had recieved first-line chemotherapy treatment with a FOLFOX scheme plus a monoclonal antibody were included. All patients had to have a minimum follow-up of 12 months. Regarding NLR, the patients were classified into two groups: high ( = > 4) and low ( < 4). Four TILs cut-off points were determined: > 40% intense; between 11-40% moderate, 1-10% mild, and 0% absent, which were group into two categories: intense and moderate; slight and absent. Localization was divided into left and right, and KRAS status was divided into mutated and wild-type (WT). PFS was calculated using the Kaplan-Meier test. Results: The median PFS of the general population was 8.74 (7.39-11.07) months. The median PFS was 9.86 (7.82-13.41) vs 5.09 (4.43-10.84) months for low and high NLR respectively, with statistical significance (p: 0.01). When the percentage of patients without progression after one year of treatment was analyzed, the difference was 45% vs 14% in favor of NLR < 4 on ≥4, this difference was also statistically significant (p: 0.02). PFS in relation to TILs after one year of follow up was 33% (8.61 months) for moderate-intense infiltrate vs 30% of mild-absent (7.10 months). PFS was 9.79 months for KRAS WT pts vs 7.82 months for mutated KRAS. In terms of location, PFS was 9.79 months for the left colon vs 8.28 months for the right colon. These factors did not have a statistically significant difference. Conclusions: The results of the study show how NLR < 4 is a prognostic factor with a positive impact on PFS. It should be noted that the median survival rates were numerically higher in moderate-intense vs mild-absent TILs, also in KRAS WT vs mutated and in left vs right location. It should also be noted that the possibly there was not a statistically significant difference between them due to the limited number of patients per what we will continue working on in the recruitment and analysis of these patients.

Upper Extremity Pulse Pressure Predicts Amputation-Free Survival after Lower Extremity Bypass

2017 ◽  
Vol 83 (7) ◽  
pp. 804-811
Author(s):  
Eric S. Wise ◽  
Justine E. Wergin ◽  
Eric H. Mace ◽  
Justiss A. Kallos ◽  
Whitney E. Muhlestein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Pulse Pressure ◽  
Multivariable Analysis ◽  
Hazard Ratio ◽  
Tissue Loss ◽  
Free Survival ◽  
Kaplan Meier ◽  
Poor Outcomes ◽  
One Year

Increased pulse pressure reflects pathologic arterial stiffening and predicts cardiovascular events and mortality. The effect of pulse pressure on outcomes in lower extremity bypass patients remains unknown. We thus investigated whether preoperative pulse pressure could predict amputation-free survival in patients undergoing lower extremity bypass for atherosclerotic occlusive disease. An institutional database identified 240 included patients undergoing lower extremity bypass from 2005 to 2014. Preoperative demographics, cardiovascular risk factors, operative factors, and systolic and diastolic blood pressures were recorded, and compared between patients with pulse pressures above and below 80 mm Hg. Factors were analyzed in bi- and multivariable models to assess independent predictors of amputation-free survival. Kaplan-Meier analysis was performed to evaluate the temporal effect of pulse pressure ≥80 mm Hg on amputation-free survival. Patients with a pulse pressure ≥80 mm Hg were older, male, and had higher systolic and lower diastolic pressures. Patients with pulse pressure <80 mm Hg demonstrated a survival advantage on Kaplan-Meier analysis at six months (log-rank P = 0.003) and one year (P = 0.005) postoperatively. In multivariable analysis, independent risk factors for decreased amputation-free survival at six months included nonwhite race, tissue loss, infrapopliteal target, and preoperative pulse pressure ≥80 mm Hg (hazard ratio 2.60; P = 0.02), while only tissue loss and pulse pressure ≥80 mm Hg (hazard ratio 2.30, P = 0.02) remained predictive at one year. Increased pulse pressure is independently associated with decreased amputation-free survival in patients undergoing lower extremity bypass. Further efforts to understand the relationship between increased arterial stiffness and poor outcomes in these patients are needed.

The relationship between nutritional status, inflammatory markers and survival in patients with advanced cancer: a prospective cohort study

2014 ◽  
Vol 23 (2) ◽  
pp. 385-391 ◽  
Author(s):  
Cindy S. Y. Tan ◽  
Jane A. Read ◽  
Viet H. Phan ◽  
Philip J. Beale ◽  
Jennifer K. Peat ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nutritional Status ◽  
Advanced Cancer ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Inflammatory Markers ◽  
The Relationship

scholarly journals A phase 2 trial of the somatostatin analog pasireotide to prevent GI toxicity and acute GVHD in allogeneic hematopoietic stem cell transplant

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252995
Author(s):  
Sendhilnathan Ramalingam ◽  
Sharareh Siamakpour-Reihani ◽  
Lauren Bohannan ◽  
Yi Ren ◽  
Alexander Sibley ◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
Acute Gvhd ◽  
Chronic Gvhd ◽  
Gastrointestinal Toxicity ◽  
Hematopoietic Stem ◽  
Free Survival ◽  
Phase 2 Trial ◽  
Gi Toxicity ◽  
Grade 3 ◽  
One Year

Background Allogeneic hematopoietic stem cell transplantation (HCT) is an often curative intent treatment, however it is associated with significant gastrointestinal (GI) toxicity and treatment related mortality. Graft-versus-host disease is a significant contributor to transplant-related mortality. We performed a phase 2 trial of the somatostatin analog pasireotide to prevent gastrointestinal toxicity and GVHD after myeloablative allogeneic HCT. Methods Patients received 0.9mg pasireotide every 12 hours from the day prior to conditioning through day +4 after HCT (or a maximum of 14 days). The primary outcomes were grade 3–4 gastrointestinal toxicity through day 30 and acute GVHD. Secondary outcomes were chronic GVHD, overall survival and relapse free survival at one year. Stool and blood samples were collected from before and after HCT for analyses of stool microbiome, local inflammatory markers, and systemic inflammatory and metabolic markers. Results were compared with matched controls. Results Twenty-six patients received pasireotide and were compared to 52 matched contemporaneous controls using a 1–2 match. Grade 3–4 GI toxicity occurred in 21 (81%) patients who received pasireotide and 35 (67%) controls (p = 0.33). Acute GVHD occurred in 15 (58%) patients in the pasireotide group and 28 (54%) controls (p = 0.94). Chronic GVHD occurred in 16 patients in the pasireotide group (64%) versus 22 patients in the control group (42%) (p = 0.12). Overall survival at 1 year in the pasireotide group was 63% (95% CI: 47%,86%) versus 82% (95% CI: 72%, 93%) in controls (log-rank p = 0.006). Relapse-free survival rate at one year was 40% (95% CI: 25%, 65%) in the pasireotide group versus 78% (95% CI: 68%, 91%) in controls (log-rank p = 0.002). After controlling for the effect of relevant covariates, patients in the pasireotide group had attenuated post-HCT loss of microbial diversity. Analysis of systemic inflammatory markers and metabolomics demonstrated feasibility of such analyses in patients undergoing allogeneic HCT. Baseline level and pre-to-post transplant changes in several inflammatory markers (including MIP1a, MIP1b, TNFa, IL8Pro, and IL6) correlated with likelihood of survival. Conclusions Pasireotide did not prevent gastrointestinal toxicity or acute GVHD compared to contemporaneous controls. Pasireotide was associated with numerically higher chronic GVHD and significantly decreased OS and RFS compared to contemporaneous controls. Pasireotide may provide a locally protective effect in the stool microbiome and in local inflammation as measured by stool calprotectin, stool beta-defensin, and stool diversity index.

The Relationship between Nutritional Knowledge and Attitudes toward Food Intake and Nutritional Status of People with HIVAIDS

2019 ◽  
Vol 22 (11) ◽  
pp. 213-223
Author(s):  
Meirina Dwi Larasati ◽  
Nurul Dwi Anggriyani ◽  
Susi Tursilowati ◽  
Ria Ambarwati ◽  
Yuniarti Yuniarti
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Nutritional Knowledge ◽  
Knowledge And Attitudes ◽  
The Relationship

Endothelial Dysfunction and Inflammatory Markers of Vascular Disease

2020 ◽  
Vol 19 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Sevket Balta
Keyword(s):  
Endothelial Dysfunction ◽  
Vascular Disease ◽  
Inflammatory Markers ◽  
Vascular Diseases ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Non Invasive ◽  
Von Willebrand ◽  
The Relationship ◽  
Willebrand Factor

: Vascular diseases are the main reason for morbidity and mortality worldwide. As we know, the earlier phase of vascular diseases is endothelial dysfunction in humans, the endothelial tissues play an important role in inflammation, coagulation, and angiogenesis, via organizing ligand-receptor associations and the various mediators’ secretion. We can use many inflammatory non-invasive tests (flowmediated dilatation, epicedial fat thickness, carotid-intima media thickness, arterial stiffness and anklebrachial index) for assessing the endothelial function. In addition, many biomarkers (ischemia modified albumin, pentraxin-3, E-selectin, angiopoietin, endothelial cell specific molecule 1, asymmetrical dimethylarginine, von Willebrand factor, endothelial microparticles and endothelial progenitor cells) can be used to evaluate endothelial dysfunction. We have focused on the relationship between endothelial dysfunction and inflammatory markers of vascular disease in this review.

scholarly journals Current FDA-Approved Therapies for High-Grade Malignant Gliomas

Biomedicines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 324
Author(s):  
Jacob P. Fisher ◽  
David C. Adamson
Keyword(s):  
Controlled Trial ◽  
Malignant Gliomas ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
High Grade ◽  
Tumor Treatment ◽  
Free Survival ◽  
Randomized Controlled ◽  
Significant Survival ◽  
One Year

The standard of care (SOC) for high-grade gliomas (HGG) is maximally safe surgical resection, followed by concurrent radiation therapy (RT) and temozolomide (TMZ) for 6 weeks, then adjuvant TMZ for 6 months. Before this SOC was established, glioblastoma (GBM) patients typically lived for less than one year after diagnosis, and no adjuvant chemotherapy had demonstrated significant survival benefits compared with radiation alone. In 2005, the Stupp et al. randomized controlled trial (RCT) on newly diagnosed GBM patients concluded that RT plus TMZ compared to RT alone significantly improved overall survival (OS) (14.6 vs. 12.1 months) and progression-free survival (PFS) at 6 months (PFS6) (53.9% vs. 36.4%). Outside of TMZ, there are four drugs and one device FDA-approved for the treatment of HGGs: lomustine, intravenous carmustine, carmustine wafer implants, bevacizumab (BVZ), and tumor treatment fields (TTFields). These treatments are now mainly used to treat recurrent HGGs and symptoms. TTFields is the only treatment that has been shown to improve OS (20.5 vs. 15.6 months) and PFS6 (56% vs. 37%) in comparison to the current SOC. TTFields is the newest addition to this list of FDA-approved treatments, but has not been universally accepted yet as part of SOC.

Sign in / Sign up

Export Citation Format

Share Document