scholarly journals Trajectory Analysis for Long-Term Mortality in Survivors of Childhood Cancer: A Korean Nationwide Observational Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 5-6
Author(s):  
Hyery Kim ◽  
Hae Reong Kim ◽  
Yu Rang Park
Keyword(s):  
Childhood Cancer ◽  
Trajectory Analysis ◽  
Survival Rates ◽  
Population Based ◽  
Group 3 ◽  
Group 2 ◽  
Long Term Mortality ◽  
Group 1

Background Survival rates of childhood cancers have improved substantially over the past four decades. However, these improvements have been accompanied by substantial long-term morbidity and premature mortality. In this study, we analyzed trajectory groups that correlate with long-term mortality in childhood cancer survivors. M ethods The National Health Insurance Service (NHIS) database is a population-based cohort covering over 95% of the population across all regions of South Korea. We used the patient-level longitudinal NHIS database which included patients who first received a cancer code ([ICD 10: C]) under the age of 20 years from 2002-2017. The onset of cancer diagnosis was defined as the time of the earliest diagnosis in patients who were prescribed any treatment excluding surgery within one month after the initial diagnosis. Claims codes for chemotherapeutic agents, radiotherapy, and transplantation were designated and analyzed in the database. For trajectory analysis, the total numbers of claimed diagnostic codes per year were used as the input variable of the group-based trajectory method. The separate trajectories were identified using the Proc Traj procedure in SAS 9.4. Results A total of 71,323 people were extracted from the NHIS database. After washing out previously diagnosed patients in 2002, 58,964 people remained from 2003-2017. We included 14,101 patients without records of any treatment for 3 years after the first diagnosis in the final analysis. Trajectory groups were generated in 14,101 and 8,119 patients who have survived more than 5 years and more than 10 years, respectively. Among the ≥ 5 years survivors, three groups were classified: Group 1 (N=5,654; 40.1%), Group 2 (N=7,027; 49.8%), and Group 3 (N=1,420, 10.1%) (Figure 1(A)). Likewise, three trajectory groups were identified in ≥ 10 years survivors: Group 1 (N=3,104; 38.2%), Group 2 (N=4,148; 51.1%), and Group 3 (N=867; 10.7%) (Figure 1(B)). Notably, the risk of death was significantly different between each trajectory group according to Cox regression analysis after being corrected for age and sex (Table 1). In patients with a follow-up of 5 years or more, mortality risk was 4.84 times higher in Group 3 compared to Group 1 (P<0.001). Also, in patients with follow-up of 10 years or more, mortality risk was 11.55 times higher in Group 3 compared with Group 1 (P<0.001). In the survival graph from the timepoints of 5 or 10 years after diagnosis, there were significant differences in overall survival between each trajectory group of the two patient cohorts (P<0.001, Figure 2). To identify characteristics associated with survival differences between trajectory groups, baseline characteristics at diagnosis and treatments were analyzed (Table 2, 3). There were significant differences in age at time of diagnosis in three trajectory groups: in both cohorts, age at diagnosis was significantly younger in Group 3 of the lowest survival rates than other groups. For initial diagnosis, there were increasing trends of Lymphoid leukemia and brain tumors in Group 3 of both cohorts. For types of treatment, the proportions of patients who received only chemotherapy or radiotherapy decreased from Group 1 to Group 3. However, the proportions of patients who received combined treatment with any stem cell transplantation increased from Group 1 to Group 3. The follow-up periods were significantly lower in Group 3, which corresponded to the survival probabilities. Whereas the numbers of prescribed codes for any treatment were significantly higher in Group 3, indicating that patients in Group 3 received more frequent and condensed treatments within shorter periods than those in Group 2, and this relationship was also seen between Group 2 and Group 1. Conclusions This study is the first trajectory analysis conducted in childhood cancer survivors using population-based longitudinal data. In this study, unlike previous trajectory analyses based on characteristics at the time of diagnosis, trajectories were classified based on the burden of diagnosis during periods, which resulted in differences in long-term mortality, and then the differences in characteristics between each group were analyzed. Our findings indicate that that long-term mortality is related to age at diagnosis and concentration of treatment relative to total follow-up duration rather than the absolute duration or intensity of treatment. Disclosures No relevant conflicts of interest to declare.

scholarly journals Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anıl Özen ◽  
Metin Yılmaz ◽  
Görkem Yiğit ◽  
İsa Civelek ◽  
Mehmet Ali Türkçü ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Fold Increase ◽  
Abdominal Aortic ◽  
History Of ◽  
Group 2 ◽  
History Of Cancer ◽  
Long Term Mortality ◽  
Group 1

Abstract Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors (group 1) and the long-term mortality (group 2) groups. Cox regression analysis was used to determine independent predictors of late mortality. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Survival analysis was conducted using Kaplan-Meier. Results The study included 257 patients with a mean age of 69.75 ± 7.75 (46–92), who underwent EVAR due to AAA. Average follow up period was 18.98 ± 22.84 months (0–88). Fourty-five (17.8%) mortalities occured during long-term follow-up. A past medical history of cancer resulted in a 2.5 fold increase in risk of long-term mortality (OR: 2.52, 95% CI 1.10–5.76; p = 0.029). GAS values were higher in group 2 compared to group 1 (81.02 ± 10.33 vs. 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and the GAS cut-off value was 77.5 (specificity 64%, p < 0.001). The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% and 24.8% respectively (p = 0.014). Every 10 point increase in GAS resulted in approximately a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI 1.3–2.5; p < 0.001). Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). Conclusions The findings of our study suggests that an increase in GAS score may predict long-term mortality. In addition, the mortality rates in patients above the GAS cut-off value almost doubled compared to those below. Furthermore, the presence of a past history of cancer resulted in a 2.5 fold increase in long-term mortality risk. Addition of cancer to the GAS scoring system may be considered in future studies. Further studies are necessary to consolidate these findings.

scholarly journals Hybrid revascularization of the heart and brain: which carotid endarterectomy is preferable?

2021 ◽  
Vol 15 (4) ◽  
pp. 15-26
Author(s):  
Anton N. Kazantsev ◽  
Roman A. Vinogradov ◽  
Sergey V. Artyukhov ◽  
Lyudmila V. Roshkovskaya ◽  
Vyacheslav V. Matusevich ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Carotid Artery ◽  
Ischaemic Stroke ◽  
Intravenous Heparin ◽  
Hybrid Revascularization ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The aim of this study was to analyse the inpatient and long-term results of hybrid surgery, incorporating percutaneous coronary intervention (PCI) and different types of carotid endarterectomy (CEA). Materials and methods. A prospective, open-label cohort comparison study was conducted in 20182020 and included 363 patients with atherosclerosis of both the internal carotid artery (ICA) and coronary artery, who underwent hybrid revascularization of the brain and myocardium. All patients were divided into four groups based on the revascularization strategy: group 1 (n = 107; 29.5%) PCI + eversion CEA; group 2 (n = 98; 27%) PCI + classic CEA with patch angioplasty; group 3 (n = 72; 19.8%) PCI + glomus-sparing CEA according to R.A. Vinogradov; and group 4 (n = 86; 23.7%) PCI + glomus-sparing CEA according to A.N. Kazantsev. The follow-up period was 20.8 8.0 months. The patient received a loading dose of clopidogrel (300 mg) before the PCI, and the procedure was then performed in an endovascular operating room. A radial artery catheter was inserted, and the patient received 10,000 IU of intravenous heparin before the procedure. After the PCI, the patient was taken to the vascular operating room, where they underwent the CEA. The patient received 5,000 IU of intravenous heparin before artery clamping. Glomus-sparing CEA according to A.N. Kazantsev was performed as follows: an arteriotomy was conducted along the internal edge of the external carotid artery (ECA), adjacent to the carotid sinus and 23 cm above the ostium, and extending to the common carotid artery (CCA) (also 23 cm below the ECA ostium), depending on the size of the atherosclerotic plaque. The ICA was transected in the area bound by the ECA and CCA walls. Eversion CEA of the ICA was performed, followed by open CEA of the ECA and CCA. The ICA was implanted in its previous position in the preserved area. Results. No mortality was recorded during the inpatient follow-up period. All cases of myocardial infarction occurred after eversion and classic CEA: 3 in group 1 (2.8%) and 1 in group 2 (1.02%); р = 0.2. No ischaemic stroke was recorded only in patients who underwent CAE according to A.N. Kazantsev (р = 0.66); however, ischaemic stroke occurred in two patients in group 1 (1.8%), in two patients in group 2 (2.04%) and in one patient in group 3 (1.38%). The highest number of cardiovascular events occurred in group 1, due to carotid glomus injury, which led to poorly controlled hypertension during the inpatient stay. This tendency influenced the composite endpoints (death + myocardial infarction + ischaemic stroke), which were highest in group 1 (5 or 4.6%) compared to 3 (3.06%), 1 (1.38%) and 0 in groups 24, respectively (р = 0.18). The groups were comparable in the frequency of long-term complications. However, the incidence of ICA restenosis was lowest and no ECA thrombosis/occlusion was observed after glomus-sparing CEA according to R.A. Vinogradov and A.N. Kazantsev. Conclusion. A hybrid PCI + CEA for brain revascularization should be glomus-sparing. CEA according to A.N. Kazantsev was characterized by lack of procedural arteriotomy complications. This procedure enables blood pressure monitoring in the postoperative period, thus minimizing the risk of cardiovascular complications.

Results of Coarctation Repair by Thoracotomy in Pediatric Patients: A Single Institution Experience

2021 ◽  
Vol 12 (4) ◽  
pp. 492-499
Author(s):  
Louis Heremans ◽  
Arnaud Henkens ◽  
Geoffroy de Beco ◽  
Karlien Carbonez ◽  
Stéphane Moniotte ◽  
...  
Keyword(s):  
Aortic Coarctation ◽  
Interrupted Aortic Arch ◽  
Long Term Results ◽  
Coarctation Repair ◽  
Group 3 ◽  
Group 2 ◽  
Patient Prognosis ◽  
Group 1

Background: Aortic coarctation is among the most common cardiovascular congenital abnormalities requiring repair after birth. Besides mortality, morbidity remains an important aspect. Accordingly, we reviewed our 20-year experience of aortic coarctation repair by thoracotomy, with emphasis on both short- and long-term outcomes. Methods: From 1995 through 2014, 214 patients underwent coarctation repair via left thoracotomy. Associated arch lesions were distal arch hypoplasia (n = 117) or type A interrupted aortic arch (n = 6). Eighty-four patients had isolated coarctation (group 1), 66 associated ventricular septal defect (group 2), and 64 associated complex cardiac lesions (group 3). Median follow-up was 8.4 years. Results: There was one (0.5%) procedure-related death. Nine (4.2%) patients died during index admission. In-hospital mortality was 0.7% in group 1 and 2 and 12.5% in group 3 ( P < .001). No patient had paraplegia. Actuarial five-year survival was 97.5% in group 1, 94% group 2 and 66% in group 3. Recurrent coarctation developed in 29 patients, all but four (1.8%) successfully treated by balloon dilatation. Freedom from reintervention (dilatation or surgery) at five years was 86%. At hospital discharge, 28 (13.5%) patients were hypertensive. At follow-up, hypertension was present in 11 (5.3%) patients. Conclusions: Long-term results of aortic coarctation repair by thoracotomy are excellent, with percutaneous angioplasty being the procedure of choice for recurrences. Patient prognosis is dependent on associated cardiac malformations. In this study, the prevalence of late arterial hypertension was lower than previously reported.

P6437Growth differentiation factor-15 and stromal cell-derived factor-1 as long-term prognosis biomarkers in acute coronary syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O M Peiro Ibanez ◽  
N Farre ◽  
J Ordonez-Llanos ◽  
A Garcia ◽  
G Bonet ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Combined Use ◽  
Group 3 ◽  
Stromal Cell Derived Factor ◽  
Group 2 ◽  
Long Term Prognosis ◽  
Group 1

Abstract Introduction After an acute coronary syn bdrome (ACS) patients are at high risk of cardiovascular morbidity and mortality. In this scenario, Growth differentiation factor-15 (GDF-15) and Stromal cell derived factor-1 (SDF-1) has been reported as potential biomarkers in ACS. However, there is limited data about their combined use in long-term prognosis. Purpose To study the long-term prognostic value of GDF-15 and SDF-1 in ACS. Methods We included patients with ACS who underwent coronary angiography. During angiography an arterial blood sample was collected. Plasma SDF-1 and GDF-15 were measured and clinical data and long-term events were obtained. The cut-off point of SDF-1 and GDF-15 was identified individually by receiver operating characteristic curves. Patients were classified into 3 groups: 1) both biomarkers below cut-off points; 2) only one biomarker above cut-off points; 3) both biomarkers above cut-off points. Results A total of 238 patients were included. The median (IQR) age was 64 (55–74) year and 27.3% were female. Of all patients, 60.9% were admitted with non-ST-elevation myocardial infarction, 22.7% with ST-elevation myocardial infarction and 16.4% with unstable angina. The cut-off point of SDF-1 was 3283.5pg/mL and GDF-15 was 1849ng/L. A total of 127 patients were in group 1, 64 in group 2 and 47 in group 3. Group 3 patients were associated with older age, hypertension, dyslipidemia, diabetes mellitus and history of myocardial infarction (MI), stroke, chronic kidney disease and peripheral artery disease. Besides, they were more likely to have left ventricular dysfunction (ejection fraction <40%) and significant three vessels stenosis. During 6.5 years of follow-up 8 patients died (6.3%) in group 1, 7 patients died (10.9%) in group 2 and 25 patients died (53.2%) in group 3 (Figure 1). Multivariate Cox analysis showed that high levels of SDF-1 and GDF-15 (group 3) were an independent predictor of all-cause death (HR 5.8; 95% CI 2.4 - 14.1; p<0.001) and the composite of major adverse cardiovascular events (MACE) which were identified as all-cause death, nonfatal MI and heart failure (HR 3.9; 95% CI 2.1 - 7.3; p<0.001). During follow-up 1 patient had heart failure in group 1 (0.8%), 3 patients (4.7%) in group 2 and 9 patients (19.1%) in group 3. Despite the low number of events of heart failure, the multivariate competing risks regression showed association between group 3 and heart failure during follow-up (HR 28.0; 95% CI 3.5 - 225.2; p=0.002). Higher levels of SDF-1 and GDF-15 (group 3) were not associated with new MI in multivariate competing risks regression. Regarding group 2, all multivariate analyses were non-significant. Cumulative survival and incidence curves Conclusions Higher values of combined GDF-15 and SDF-1 are an excellent predictor of all-cause death, MACE and heart failure in long-term follow-up of patients with ACS. The combined use of SDF-1 and GDF-15 may be useful in long-term ACS prognosis.

scholarly journals Validation of a Web-Based Predictive Nomogram for Ipsilateral Breast Tumor Recurrence After Breast Conserving Therapy

2010 ◽  
Vol 28 (5) ◽  
pp. 718-722 ◽  
Author(s):  
Mona Sanghani ◽  
Pauline T. Truong ◽  
Rita Abi Raad ◽  
Andrzej Niemierko ◽  
Mary Lesperance ◽  
...  
Keyword(s):  
Ipsilateral Breast Tumor Recurrence ◽  
Breast Conserving Therapy ◽  
Population Based ◽  
Web Based ◽  
Group 4 ◽  
Version 2.0 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

PurposeIBTR! version 1.0 is a web-based tool that uses literature-derived relative risk ratios for seven clinicopathologic variables to predict ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT). Preliminary testing demonstrated over-estimation in high-risk subgroups. This study uses two independent population-based datasets to create and validate a modified nomogram, IBTR! version 2.0.MethodsCox regression modeling was performed on 7,811 patients treated with BCT at the British Columbia Cancer Agency (median follow-up, 9.4 years). Population-based hazard ratios were generated for the seven variables in the original nomogram. A modified nomogram was then tested against 664 patients from Massachusetts General Hospital (median follow-up, 9.3 years). The mean predicted and observed 10-year estimates were compared for the entire cohort and for four groups predefined by nomogram-predicted risks: group 1: less than 3%; group 2: 3% to 5%; group 3: 5% to 10%; and group 4: more than 10%.ResultsIBTR! version 2.0 predicted an overall 10-year IBTR estimate of 4.0% (95% CI, 3.8 to 4.2), while the observed estimate was 2.8% (95% CI, 1.6 to 4.7; P = .10). The predicted and observed IBTR estimates were: group 1 (n = 283): 2.2% versus 1.3%, P = .40; group 2 (n = 237): 3.8% versus 3.5%, P = .80; group 3 (n = 111): 6.7% versus 3.2%, P = .05; and group 4 (n = 33): 12.5% versus 8.7%, P = .50.ConclusionIBTR! version 2.0 is accurate in the majority of patients with a low to moderate risk of in-breast recurrence. The nomogram still overestimates risk in a minority of patients with higher risk features. Validation in a larger prospective data set is warranted.

scholarly journals Clinical Outcome of Invasive Pituitary Prolactinomas Treated with Cabergoline

2020 ◽  
Vol 15 (2) ◽  
pp. 50-57
Author(s):  
Bassam M Flamerz Arkawazi
Keyword(s):  
Complete Response ◽  
Neurological Dysfunction ◽  
Serum Prolactin ◽  
Group 4 ◽  
Long Term Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Treatment of invasive prolactinoma, which has several characteristics including invasive growth into cavernous sinuses and formation of giant adenomas compressing adjacent neural structures, resulting in neurological dysfunction, has been very challenging. There are relatively few reports available describing long-term treatment outcome. Aims of the study: In this study we evaluate the results of cabergoline administration as initial treatment during 4 years follow up period. Methods: We prospectively categorized 36 patients into four groups according to the results of 3 months of cabergoline treatment: group 1, tumor volume reduction (TVR) ˃25% with normalized serum prolactin (NP) (n = 24); group 2, TVR˃25% without NP (n = 4); group 3, TVR ˂25% with NP (n = 5); and group 4, TVR ˂25% without NP (n = 3). Results: During follow-up, 22 patients (91.7%) in group 1 achieved TVR˃50% with NP. Three patients (75%) in group 2 achieved TVR˃50% with NP after treatment for 8 months. In group 3, four patients (80.0%) continued medication because of improvement of symptoms and achieved additional TVR(18.8–46.4%). Surgery was performed on five patients (one in group 2, one in group 3, and three in group 4), and complete resection was achieved in four (80.0%). Overall, 25 (69.4%) of the 36 patients treated with cabergoline had complete response and 6 (16.7%) had partial response but did not require surgery. Thus, the overall response rate was 86%,with only five patients (14%) requiring surgical debulking. NP was not achieved by surgery alone in all cases, even after total resection of tumor. Conclusion: Patients who achieve TVR˃25%with NP with 3 months of cabergoline administration had a high possibility of showing good long term response (TVR˃50% with NP) to cabergoline. A higher dose of dopamine agonist (DA)  should be considered for patients who achieve TVR˃25% without NP.

scholarly journals Effects of posterior tibial slope on the mid-term results of medial unicompartmental knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Zhijie Chen ◽  
Kaizhe Chen ◽  
Yufei Yan ◽  
Jianmin Feng ◽  
Yi Wang ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Tibial Slope ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group 3 ◽  
Group 2 ◽  
Postoperative Knee ◽  
Group 1

Abstract Objective To evaluate the effect of medial posterior tibial slope (PTS) on mid-term postoperative range of motion (ROM) and functional improvement of the knee after medial unicompartmental knee arthroplasty (UKA). Methods Medical records of 113 patients who had undergone 124 medial UKAs between April 2009 through April 2014 were reviewed retrospectively. The mean follow-up lasted 7.6 years (range, 6.2–11.2 years). Collected were demographic data, including gender, age, height, weight of the patients. Anteroposterior (AP) and lateral knee radiographs of the operated knees were available in all patients. The knee function was evaluated during office follow-up or hospital stay. Meanwhile, postoperative PTS, ROM, maximal knee flexion and Hospital for Special Surgery (HSS) knee score (pre−/postoperative) of the operated side were measured and assessed. According to the size of the PTS, patients were divided into 3 groups: group 1 (<4°), group 2 (4° ~ 7°) and group 3 (>7°). The association between PTS and the knee function was investigated. Results In our cohort, the average PTS was 2.7° ± 0.6° in group 1, 5.6° ± 0.9° in group 2 and 8.7° ± 1.2° in group 3. Pairwise comparisons showed significant differences among them (p < 0.01). The average maximal flexion range of postoperative knees in each group was 112.4° ± 5.6°, 116.4° ± 7.2°, and 117.5° ± 6.1°, respectively, with significant difference found between group 1 and group 2 (p < 0.05), and between group 1 and group 3 (p < 0.05). However, the gender, age, and body mass index (BMI) did not differ between three groups and there was no significant difference between groups in terms of pre−/postoperative HSS scores or postoperative knee ROM. Conclusion A mid-term follow-up showed that an appropriate PTS (4° ~ 7°) can help improve the postoperative flexion of knee. On the other hand, too small a PTS could lead to limited postoperative knee flexion. Therefore, the PTS less than 4° should be avoided during medial UKA.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

scholarly journals Longitudinal Reproducibility of CO2-Triggered BOLD MRI for the Hemodynamic Evaluation of Adult Patients with Moyamoya Angiopathy

2021 ◽  
pp. 1-7
Author(s):  
Constantin Roder ◽  
Uwe Klose ◽  
Helene Hurth ◽  
Cornelia Brendle ◽  
Marcos Tatagiba ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Collateral Flow ◽  
Surgical Revascularization ◽  
Bold Mri ◽  
Promising Tool ◽  
Hemodynamic Evaluation ◽  
Group 2 ◽  
Group 1

<b><i>Background and Purpose:</i></b> Hemodynamic evaluation of moyamoya patients is crucial to decide the treatment strategy. Recently, CO<sub>2</sub>-triggered BOLD MRI has been shown to be a promising tool for the hemodynamic evaluation of moyamoya patients. However, the longitudinal reliability of this technique in follow-up examinations is unknown. This study aims to analyze longitudinal follow-up data of CO<sub>2</sub>-triggered BOLD MRI to prove the reliability of this technique for long-term control examinations in moyamoya patients. <b><i>Methods:</i></b> Longitudinal CO<sub>2</sub> BOLD MRI follow-up examinations of moyamoya patients with and without surgical revascularization have been analyzed for all 6 vascular territories retrospectively. If revascularization was performed, any directly (by the disease or the bypass) or indirectly (due to change of collateral flow after revascularization) affected territory was excluded based on angiography findings (group 1). In patients without surgical revascularization between the MRI examinations, all territories were analyzed (group 2). <b><i>Results:</i></b> Eighteen moyamoya patients with 39 CO<sub>2</sub> BOLD MRI examinations fulfilled the inclusion criteria. The median follow-up between the 2 examinations was 12 months (range 4–29 months). For 106 vascular territories analyzed in group 1, the intraclass correlation coefficient was 0.784, <i>p</i> &#x3c; 0.001, and for group 2 (84 territories), it was 0.899, <i>p</i> &#x3c; 0.001. Within the total follow-up duration of 140 patient months, none of the patients experienced a new stroke. <b><i>Conclusions:</i></b> CO<sub>2</sub> BOLD MRI is a promising tool for mid- and long-term follow-up examinations of cerebral hemodynamics in moyamoya patients. Systematic prospective evaluation is required prior to making it a routine examination.

Etiology of Cartilage Lesions Does Not Affect Clinical Outcomes of Patellofemoral Autologous Chondrocyte Implantation

Cartilage ◽  
2021 ◽  
pp. 194760352110309
Author(s):  
Alexandre Barbieri Mestriner ◽  
Jakob Ackermann ◽  
Gergo Merkely ◽  
Pedro Henrique Schmidt Alves Ferreira Galvão ◽  
Luiz Felipe Morlin Ambra ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Autologous Chondrocyte Implantation ◽  
Second Generation ◽  
Cartilage Lesion ◽  
Chondrocyte Implantation ◽  
Group 3 ◽  
Group 2 ◽  
Autologous Chondrocyte ◽  
Group 1

Objective To determine the relationship between cartilage lesion etiology and clinical outcomes after second-generation autologous chondrocyte implantation (ACI) in the patellofemoral joint (PFJ) with a minimum of 2 years’ follow-up. Methods A retrospective review of all patients that underwent ACI in the PFJ by a single surgeon was performed. Seventy-two patients with a mean follow-up of 4.2 ± 2.0 years were enrolled in this study and were stratified into 3 groups based on the etiology of PFJ cartilage lesions: patellar dislocation (group 1; n = 23); nontraumatic lesions, including chondromalacia, osteochondritis dissecans, and degenerative defects (group 2; n = 28); and other posttraumatic lesions besides patellar dislocations (group 3; n = 21). Patient’s mean age was 29.6 ± 8.7 years. Patients in group 1 were significantly younger (25.4 ± 7.9 years) than group 2 (31.7 ± 9.6 years; P = 0.025) and group 3 (31.5 ± 6.6 years; P = 0.05). Body mass index averaged 26.2 ± 4.3 kg/m2, with a significant difference between group 1 (24.4 ± 3.2 kg/m2) and group 3 (28.7 ± 4.5 kg/m2; P = 0.005). A clinical comparison was established between groups based on patient-reported outcome measures (PROMs) and failure rates. Results Neither pre- nor postoperative PROMs differed between groups ( P > 0.05). No difference was seen in survivorship between groups (95.7% vs. 82.2% vs. 90.5%, P > 0.05). Conclusion Cartilage lesion etiology did not influence clinical outcome in this retrospective study after second generation ACI in the PFJ. Level of Evidence Level III, retrospective comparative study.

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