PROGNOSTIC SIGNIFICANCE OF CERTAIN CLINICAL FINDINGS IN PATIENTS WITH YERSINIA ARTHRITIS

SummaryDisseminated intravascular coagulation (DIC) can develop infrequently in patients with tuberculosis and has a very high mortality rate. We conducted a retrospective study to evaluate the incidence of tuberculosis-induced DIC and to investigate the clinical manifestation, outcome, and prognostic factors of such patients. From January 2002 to December 2003, all culture-proven tuberculosis patients who developed DIC before starting anti-tuberculosis treatments were selected for this study. Patients who had other clinical conditions or were infected by other pathogens that may have been responsible for their DIC were excluded. Survival analysis was performed for each variable with possible prognostic significance. Our results showed that 27 (3.2%) out of the 833 patients with culture-proven tuberculosis had tuberculosis-induced DIC with a mortality rate of 63.0%. The most common clinical manifestations were fever (63.0%) and multiple patches of pulmonary consolidation (59.3%). Seven (25.9%) patients had disseminated tuberculosis. Twelve (44.4%) developed acute respiratory distress syndrome and three (11.1%) were associated with hemophagocytosis. Twenty-four (88.9%) patients had findings that were unusual for an acute bacterial infection, such as positive acid-fast smear, miliary pulmonary lesions, lymphocytotic exudative pleural effusion, and mediastinal lymphadenopathy. Early anti-tuberculosis treatment significantly improved survival. In conclusion, tuberculosis can cause DIC. Patients with non-miliary, non-disseminated tuberculosis could also develop the rare clinical manifestation. Since the prognosis was very poor in patients not treated at an early stage, a high index of suspicion is required, especially in those with clinical findings suggestive of tuberculosis.

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Usefulness of electrophysiology in the prediction of outcome of Bell’s palsy patients

Egyptian Rheumatology and Rehabilitation ◽

10.1186/s43166-020-00022-5 ◽

2020 ◽

Vol 47 (1) ◽

Author(s):

Ibrahim Tharwat Abdelal ◽

Enas Abdelkader Eliwa ◽

Amany Mohammad Ebaid ◽

Marwa Mohammad Abdelfattah

Keyword(s):

Facial Nerve ◽

Multiple Logistic Regression Analysis ◽

Prognostic Significance ◽

Roc Curves ◽

Blink Reflex ◽

Bell’S Palsy ◽

Clinical Findings ◽

Nerve Lesion ◽

Bell's Palsy ◽

Prediction Of Outcome

Abstract Background Bell’s palsy (BP) is a common idiopathic cranial mononeuropathy. The electrophysiological tests are one of supportive tools for localizing the site of facial nerve lesion, and to determine the severity and prognosis of the injury. The aim of this study was to evaluate the role of electrophysiology in the prediction of outcome of patients with Bell’s palsy. This study was carried out on 30 adult patients with Bell’s palsy. All study subjects were assessed clinically by Sunnybrook facial nerve grading score (SBS) and electrophysiologically by electroneurography (ENoG), blink reflex (BR), and electromyography (EMG); first evaluation was within 7th to10th day from onset, the second evaluation was done at 20th day, and the follow-up visit was after 1 month to assess the clinical grading system (SBS). Results At 1 month, 20 patients (66.7%) had good recovery, while 10 patients (33.3%) had poor recovery according to the Sunnybrook scale. Multiple logistic regression analysis showed that the most significant predictive indicator of BP recovery was ENoG value and R1 latency of BR test. The receiver operating characteristic (ROC) curves showed ENoG degeneration index of 74.6%, considered as a critical cutoff value of non-recovery, with the sensitivity 95% and specificity 90%, and the highest specificity was with blink reflex parameters (R1, R2 latency) 100%. Conclusion BR and ENoG were the best predictors of non-recovery of facial function, while EMG findings did not add any prognostic significance. The combination of both tests BR and ENoG, along with clinical findings can be considered a good indication in the acute phase of BP for the possibility to develop palsy residua.

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Prognostic information from cytogenetic analysis in chronic B- lymphocytic leukemia and leukemic immunocytoma

Blood ◽

10.1182/blood.v65.1.134.bloodjournal651134 ◽

1985 ◽

Vol 65 (1) ◽

pp. 134-141 ◽

Cited By ~ 6

Author(s):

G Juliusson ◽

KH Robert ◽

A Ost ◽

K Friberg ◽

P Biberfeld ◽

...

Keyword(s):

Cell Clone ◽

Extra Chromosome ◽

Prognostic Significance ◽

Normal Karyotype ◽

Clinical Findings ◽

Lymphocytic Leukemia ◽

Chromosome 12 ◽

Prognostic Information ◽

Prolymphocytic Leukemia ◽

Significant Difference

Fifty-five patients with a clonal expansion of B lymphocytes in the peripheral blood were studied. According to the Kiel classification, 22 patients had chronic lymphocytic leukemia (CLL), 29 had immunocytoma (IC), two had prolymphocytic leukemia, and one had centrocytic lymphoma; one was not subclassified. Cytogenetic studies after B cell mitogen stimulation showed that six patients had an extra chromosome 12 as the sole abnormality. Another ten patients had an extra chromosome 12 together with other abnormalities. One patient had dup(12). Fifteen patients showed clonal aberrations without +12. Eleven patients showed only normal metaphases, and 12 patients were not evaluated cytogenetically. The cytogenetic subgroup pattern did not distinguish between CLL and IC patients. There was no significant difference between the CLL and IC groups as regards clinical findings and prognosis. However, the cytogenetic typing proved to be of prognostic significance. Increasing numbers of chromosomal aberrations within the cell clone were significantly associated with a poorer prognosis, ie, with impairment of survival (P = .04) and therapy-free survival (P less than 10(-4]. Patients with complex karyotypes (at least clonal aberrations) showed the poorest survival (P = .007). Patients with +12 required treatment earlier than patients with a normal karyotype (P = .01) and patients with karyotypic changes other than +12 (P = .006). These latter differences were even more pronounced when only IC patients were considered (P = .005 and P = .002, respectively). A multivariate analysis revealed that +12 was as strong an indicator of poor survival as advanced Rai or Binet stages and a stronger predictor of therapy-demanding disease.

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Prognostic information from cytogenetic analysis in chronic B- lymphocytic leukemia and leukemic immunocytoma

Blood ◽

10.1182/blood.v65.1.134.134 ◽

1985 ◽

Vol 65 (1) ◽

pp. 134-141 ◽

Cited By ~ 92

Author(s):

G Juliusson ◽

KH Robert ◽

A Ost ◽

K Friberg ◽

P Biberfeld ◽

...

Keyword(s):

Cell Clone ◽

Extra Chromosome ◽

Prognostic Significance ◽

Normal Karyotype ◽

Clinical Findings ◽

Lymphocytic Leukemia ◽

Chromosome 12 ◽

Prognostic Information ◽

Prolymphocytic Leukemia ◽

Significant Difference

Abstract Fifty-five patients with a clonal expansion of B lymphocytes in the peripheral blood were studied. According to the Kiel classification, 22 patients had chronic lymphocytic leukemia (CLL), 29 had immunocytoma (IC), two had prolymphocytic leukemia, and one had centrocytic lymphoma; one was not subclassified. Cytogenetic studies after B cell mitogen stimulation showed that six patients had an extra chromosome 12 as the sole abnormality. Another ten patients had an extra chromosome 12 together with other abnormalities. One patient had dup(12). Fifteen patients showed clonal aberrations without +12. Eleven patients showed only normal metaphases, and 12 patients were not evaluated cytogenetically. The cytogenetic subgroup pattern did not distinguish between CLL and IC patients. There was no significant difference between the CLL and IC groups as regards clinical findings and prognosis. However, the cytogenetic typing proved to be of prognostic significance. Increasing numbers of chromosomal aberrations within the cell clone were significantly associated with a poorer prognosis, ie, with impairment of survival (P = .04) and therapy-free survival (P less than 10(-4]. Patients with complex karyotypes (at least clonal aberrations) showed the poorest survival (P = .007). Patients with +12 required treatment earlier than patients with a normal karyotype (P = .01) and patients with karyotypic changes other than +12 (P = .006). These latter differences were even more pronounced when only IC patients were considered (P = .005 and P = .002, respectively). A multivariate analysis revealed that +12 was as strong an indicator of poor survival as advanced Rai or Binet stages and a stronger predictor of therapy-demanding disease.

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Acute Pulmonary Embolism in Women: Focus on Estrogen Therapy as a Predisposing Factor

ACTA MEDICA IRANICA ◽

10.18502/acta.v59i6.6894 ◽

2021 ◽

Author(s):

Hassan Aghajani ◽

Mahboobeh Aghajani ◽

Saeed Ghodsi ◽

Yaser Jenab ◽

Azita Hajhossein Talasaz ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Prognostic Significance ◽

Estrogen Therapy ◽

Clinical Findings ◽

Recent History ◽

Predisposing Factor ◽

Mortality And Morbidity ◽

History Of

Acute pulmonary embolism (APE) is a potentially fatal disorder. The literature shows that estrogen therapy is correlated with an increase in mortality and morbidity. Accordingly, the purpose of the present study was to investigate the prevalence and prognostic significance of the recent history of estrogen therapy in women with APE. This study was conducted on female patients admitted to our hospital between January 2008 and January 2016. A total of 276 patients (mean age=62.66±08 y) with confirmed APE were divided into groups with and without recent estrogen therapy. The relationships between estrogen and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. Among the 276 women with APE at presentation, 37 (13.4%) patients had a recent history of estrogen therapy. The estrogen group had a lower frequency of hypertension (21.6% vs49.8%; P< .001), immobilization of at least 3 days (16.2% vs 33.5%; P= .035), and pleural effusion (0% vs16.7%; P= .007) than the group without recent estrogen use. Among the 276 patients, the rate of 1 year’s mortality was 15.8% for the group without recent estrogen therapy. No death occurred in the estrogen group. Older age, tachycardia, tachypnea, malignancy, and lack of obesity were the predictors of 1 year’s mortality. Among the patients with APE in our study, 13.4% had a history of recent estrogen therapy. No death occurred during the 1-year follow-up of these patients.

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Clinical Features of Superficially Located Brain Arteriovenous Malformations with Transdural Arterial Communication

Cerebrovascular Diseases ◽

10.1159/000443530 ◽

2016 ◽

Vol 41 (3-4) ◽

pp. 204-210 ◽

Cited By ~ 6

Author(s):

Hae-Won Koo ◽

Kyung-Il Jo ◽

Je-Young Yeon ◽

Keon Ha Kim ◽

Pyoung Jeon ◽

...

Keyword(s):

Clinical Features ◽

Arteriovenous Malformations ◽

Chronic Headache ◽

Prognostic Significance ◽

Clinical Findings ◽

Older Age ◽

Brain Arteriovenous Malformations ◽

Radiologic Findings ◽

Brain Avm ◽

Brain Avms

Background: Contrary to deeply located brain arteriovenous malformations (AVMs), superficially located AVMs are more likely to have transdural arterial communications (TACs). However, the clinical and radiologic characteristics of patients presenting with AVMs and TACs are poorly understood. The purpose of this study is to determine whether clinicoradiological features of cerebral AVMs differ according to TAC. Methods: Between 2002 and 2012, 438 consecutive patients with a brain AVM were treated in our hospital. Among them were 124 patients with superficially located brain AVMs who met the inclusion and exclusion criteria of our study. We retrospectively reviewed the clinicoradiological features of their TACs to explore the variation in characteristics. Results: Thirty-two of the 124 patients with a superficially located AVM (25.8%) had TAC. Radiologic findings of brain AVM images with TAC showed that TAC occurred significantly more frequently among larger AVMs (with vs. without TAC, 11.2 vs. 4.0 ml) and among diffuse AVMs (56.3 vs. 28.3%, p = 0.004). Clinical findings indicate that TAC was associated with chronic headache (43.8 vs. 12.0%, p < 0.001) and older age (43.1 vs. 36.6 years, p = 0.037). Conclusions: Brain AVM with TAC seems to be accompanied by distinctive clinical features, such as chronic headache and older age. Larger size and diffuseness of the AVM were also associated with TAC. Findings from this study and the prognostic significance of TAC should be further explored in a large prospective study.

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Ultrastructural features of prognostic significance in human oral cancer

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100123490 ◽

1992 ◽

Vol 50 (1) ◽

pp. 618-619

Author(s):

Karvita B. Ahluwalia ◽

Nidhi Sharma

Keyword(s):

Oral Cancer ◽

Squamous Cell ◽

Common Knowledge ◽

Prognostic Significance ◽

Growth Control ◽

Terminal Differentiation ◽

Squamous Cell Carcinomas ◽

Effective Therapy ◽

Invasive Potential ◽

Biological Behaviour

It is common knowledge that apparently similar tumors often show different responses to therapy. This experience has generated the idea that histologically similar tumors could have biologically distinct behaviour. The development of effective therapy therefore, has the explicit challenge of understanding biological behaviour of a tumor. The question is which parameters in a tumor could relate to its biological behaviour ? It is now recognised that the development of malignancy requires an alteration in the program of terminal differentiation in addition to aberrant growth control. In this study therefore, ultrastructural markers that relate to defective terminal differentiation and possibly invasive potential of cells have been identified in human oral leukoplakias, erythroleukoplakias and squamous cell carcinomas of the tongue.

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Clinical Findings with SAL Audiometry: Some Further Observations

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.3004.325 ◽

1965 ◽

Vol 30 (4) ◽

pp. 325-335

Author(s):

George E. Lynn ◽

Jack A. Willeford

Keyword(s):

Clinical Findings

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Spinal Impairment Evaluation: Fifth Edition Changes

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2001.janfeb01 ◽

2001 ◽

Vol 6 (1) ◽

pp. 1-3

Author(s):

Robert H. Haralson

Keyword(s):

Spinal Cord ◽

Lower Extremity ◽

Range Of Motion ◽

Upper Extremity ◽

Spinal Cord Injuries ◽

Clinical Findings ◽

Fourth Edition ◽

Treatment Results ◽

Standard Terminology ◽

Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

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Familial cold urticaria. Clinical findings

Archives of Dermatology ◽

10.1001/archderm.110.3.382 ◽

1974 ◽

Vol 110 (3) ◽

pp. 382-388 ◽

Cited By ~ 12

Author(s):

H. M. Doeglas

Keyword(s):

Clinical Findings ◽

Cold Urticaria

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