New-onset postoperative seizures in patients with diffuse gliomas: a risk assessment analysis

Abstract Background Glioma-related epilepsy (GRE) is the most common presenting sign of patients with diffuse glioma. According to clinical experience, new-onset postoperative seizures can be observed even in patients without preoperative GRE. The current study mainly aimed to explore the risk factors of new-onset postoperative seizures in those patients. In addition, the prognostic value of new-onset postoperative seizures was also discussed. Methods Data of 313 patients without GRE were retrospectively reviewed. Chi-square test or Fisher’s exact test were first performed to compare categorical variables between patients with new-onset postoperative seizures and those without. Subsequently, binary logistic regression analysis was conduct to further assess risk factors of new-onset postoperative seizures. Kaplan-Meier and Cox analysis were used to investigate the prognostic value of new-onset postoperative seizures for progression-free survival (PFS) and overall survival (OS). Results Patients with low-grade tumors (p = 0.006), isocitrate dehydrogenase 1 (IDH1) mutation (p = 0.040) or low Ki-67 expression (p = 0.005) showed a higher incidence of new-onset postoperative seizures. IDH1 mutation was identified as the only independent predictor for new-onset postoperative seizures (OR, 2.075; 95% CI, 1.051–4.098; p = 0.035). Additionally, new-onset postoperative seizure occurrence was demonstrated as an independent predicter of prolonged OS (OR, 0.574; 95% CI, 0.335–0.983; p = 0.043). Conclusions IDH1 mutation is an independent predictor for new-onset postoperative seizures in patients without preoperative GRE. Moreover, new-onset postoperative seizures can independently predict prolonged OS in those patients. The results of the current study can contribute to improving the individualized management of diffuse glioma.

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New-Onset Postoperative Seizures in Patients With Diffuse Gliomas: A Risk Assessment Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.682535 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lianwang Li ◽

Guanzhang Li ◽

Shengyu Fang ◽

Kenan Zhang ◽

Ruoyu Huang ◽

...

Keyword(s):

Risk Factors ◽

Prognostic Value ◽

Independent Predictor ◽

Idh1 Mutation ◽

Categorical Variables ◽

Binary Logistic Regression Analysis ◽

Low Grade ◽

Diffuse Glioma ◽

Ki 67 ◽

New Onset

Background: Glioma-related epilepsy (GRE) is the most common presenting sign of patients with diffuse glioma. According to clinical experience, new-onset postoperative seizures can be observed even in patients without preoperative GRE. The current study mainly aimed to explore the risk factors of new-onset postoperative seizures in those patients. In addition, the prognostic value of new-onset postoperative seizures was also discussed.Methods: Data of 313 patients without GRE were retrospectively reviewed. Chi-square test or Fisher's exact test were first performed to compare categorical variables between patients with new-onset postoperative seizures and those without. Subsequently, binary logistic regression analysis was conduct to further assess risk factors of new-onset postoperative seizures. Kaplan-Meier and Cox analysis were used to investigate the prognostic value of new-onset postoperative seizures for progression-free survival (PFS) and overall survival (OS).Results: Patients with low-grade tumors (p = 0.006), isocitrate dehydrogenase 1 (IDH1) mutation (p = 0.040) or low Ki-67 expression (p = 0.005) showed a higher incidence of new-onset postoperative seizures. IDH1 mutation was identified as the only independent predictor for new-onset postoperative seizures (OR, 2.075; 95% CI, 1.051–4.098; p = 0.035). Additionally, new-onset postoperative seizure occurrence was demonstrated as an independent predicter of prolonged OS (OR, 0.574; 95% CI, 0.335–0.983; p = 0.043), while younger age, gross total resection, low-grade and IDH1 mutation were independently correlated with prolonged OS and PFS.Conclusions: IDH1 mutation is an independent predictor for new-onset postoperative seizures in patients without preoperative GRE. Moreover, new-onset postoperative seizures can independently predict prolonged OS in those patients. The results of the current study can contribute to improving the individualized management of diffuse glioma.

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Low grade transitional cell carcinoma of the bladder: prognostic value of immunoreactivity for p16ink4a, p27kip1, pRb, p53, Ki-67 and bl2-10d1

European Journal of Cancer ◽

10.1016/s0959-8049(99)81837-1 ◽

1999 ◽

Vol 35 ◽

pp. S351

Author(s):

L. Santos ◽

T. Amaro ◽

C. Jeronimo ◽

M.J. Bento ◽

P. Lopes ◽

...

Keyword(s):

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Prognostic Value ◽

Transitional Cell ◽

Low Grade ◽

Ki 67 ◽

Carcinoma Of The Bladder

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3225Global longitudinal strain measured using feature-tracking cardiac magnetic resonance imaging is an independent predictor of all cause mortality in patients with preserved ejection fraction

European Heart Journal ◽

10.1093/eurheartj/ehz745.0044 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Cited By ~ 1

Author(s):

S Romano ◽

R Judd ◽

R Kim ◽

J Heitner ◽

D Shah ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Ejection Fraction ◽

Feature Tracking ◽

Prognostic Value ◽

Longitudinal Strain ◽

Independent Predictor ◽

Regression Modeling ◽

Preserved Ejection Fraction

Abstract Introduction Ejection fraction is the principal measure used clinically to assess cardiac mechanics and provides significant prognostic information. However, echocardiographic strain imaging has shown significant abnormalities of myocardial deformation can be present despite preserved ejection fraction, which maybe associated with adverse prognosis. Cardiac-Magnetic-Resonance (CMR) feature-tracking techniques now allow assessment of strain from routine cine-images, without specialized pulse sequences. Whether abnormalities of strain measured using CMR feature-tracking have prognostic value in patients with preserved ejection fraction is unknown. Purpose To evaluate the prognostic value of CMR feature-tracking derived global longitudinal strain (GLS) in a large multicenter population of patients with preserved ejection fraction. Methods Consecutive patients with preserved ejection fraction (EF ≥50%) and a clinical indication for CMR at four US medical centers were included in this study. Feature-tracking GLS was calculated from 3 long-axis-cine-views. The primary endpoint was all-cause death. Cox proportional hazards regression modeling was used to examine the independent association between GLS and death. The incremental prognostic value of GLS was assessed in nested models. Results Of the 1274 patients in this study, 115 died during a median follow-up of 6.2 years. By Kaplan-Meier analysis, patients with GLS ≥ median (−20%) had significantly reduced event free survival compared to those with GLS < median (log-rank p<0.001) (Figure, top panel). The continuous relationship between GLS and the hazard of death is shown in the cubic spline (Figure, lower panel). By Cox multivariable regression modeling, each 1% worsening in GLS was associated with a 23.6% increased risk-of-death after adjustment for clinical and imaging risk factors (HR=1.236 per %; p<0.001). Addition of GLS in this model resulted in significant-improvement in the global-chi-square (67 to 168; p<0.0001) and Harrel's C-statistic (0.716 to 0.825; p<0.0001). Conclusions CMR feature-tracking derived GLS is a powerful independent predictor of mortality in patients with preserved ejection fraction, incremental to common clinical and imaging risk factors.

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Early Pulse Pressure and Low-Grade Proteinuria as Independent Long-Term Risk Factors for New-Onset Diabetes Mellitus After Kidney Transplantation

American Journal of Transplantation ◽

10.1111/j.1600-6143.2008.02308.x ◽

2008 ◽

Vol 8 (8) ◽

pp. 1719-1728 ◽

Cited By ~ 34

Author(s):

M. Roland ◽

P. Gatault ◽

A. Al-Najjar ◽

C. Doute ◽

C. Barbet ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Kidney Transplantation ◽

Pulse Pressure ◽

Low Grade ◽

Onset Diabetes ◽

New Onset Diabetes Mellitus ◽

New Onset

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WP1-18 Risk factors and patterns of recurrence of low grade glioma: a systematic review

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-abn.19 ◽

2019 ◽

Vol 90 (3) ◽

pp. e6.3-e6

Author(s):

V Narbad ◽

JP Lavrador ◽

A Elhag ◽

S Acharya ◽

J Hanrahan ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Tp53 Mutation ◽

Methylation Status ◽

Low Grade Glioma ◽

Low Grade ◽

Diffuse Glioma ◽

Idh Mutation ◽

Mgmt Methylation ◽

Inclusion Criteria

ObjectivesTo review the risk factors and patterns of progression/recurrence of low grade glioma (LGG).DesignSystematic review of the published literature.SubjectsInclusion criteria were peer reviewed publications of cohort studies of recurrent/progressive LGG. Studies of wider populations were included if relevant LGG data could be analysed separately.MethodsMedline and Cochrane databases were searched using MeSH and non-MeSH terms, including ‘glioma’, ‘astrocytoma’, ‘oligoastrocytoma’, ‘diffuse glioma’, ‘oligodendroglioma’, ‘low grade’ and ‘disease recurrence’ by two independent reviewers.ResultsOverall, 917 studies were screened, of which 57 studies met the inclusion criteria. The most frequently described risk factor for recurrent LGG was suboptimal extent of resection (EOR) of the initial tumour (in 20 studies); recurrence was also associated with the patient’s age (2), tumour location (4), neurological status (3), tumour volume (6), bihemispherical tumour (3) and astrocytic histology (6). IDH mutation was associated with recurrence in 1 out of 3 studies, but TP53 mutation (2 of 4) and MGMT methylation status (4) were not. Malignant transformation was associated with TP53 mutations (3), IDH mutation (1) and EOR (1). Favourable progression free survival (PFS) and/or overall survival (OS) were associated with greater EOR (16), oligodendroglioma histology (2 of 4), initial KPS (3) and the use of adjuvant therapies (9 of 14). IDH mutation was associated with improved PFS and OS (3 of 4). TP53 mutation improved PFS in 1 of 3 studies. MGMT methylation and 1 p/19q codeletion may predict treatment response but their effects on survival are unclear.ConclusionsAstrocytoma histology, IDH and TP53 mutation statuses and surgical treatment (EOR) are essential in determining the time to recurrence or progression in LGG.

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Expression of YAP1 and pSTAT3-S727 and their prognostic value in glioma

Journal of Clinical Pathology ◽

10.1136/jclinpath-2020-206868 ◽

2020 ◽

pp. jclinpath-2020-206868

Author(s):

Wei Sang ◽

Jing Xue ◽

Li-Ping Su ◽

Abulajiang Gulinar ◽

Qian Wang ◽

...

Keyword(s):

Survival Analysis ◽

Progression Free Survival ◽

Idh1 Mutation ◽

Clinicopathological Parameters ◽

Low Grade ◽

Ki 67 ◽

Free Survival ◽

Tumour Location ◽

Spearman Correlation Test ◽

The Relationship

AimsA growing research demonstrated that YAP1 played important roles in gliomagenesis. We explored the expression of YAP1 and STAT3, the relationship between them and the effect of YAP1, STAT3 on prognosis in glioma.MethodsExpression of YAP1, p-YAP1, STAT3, pSTAT3-S727 and pSTAT3-Y705 in 141 cases of low-grade gliomas (LGG) and 74 cases of high-grade gliomas (HGG) of surgical specimens were measured by immunohistochemistry. Pearson’s X2 test was used to determine the correlation between immunohistochemical expressions and clinicopathological parameters. Pearson’s or Spearman correlation test was used to determine the association between these proteins expression. Survival analysis was used to investigate the effect of these proteins on prognosis.ResultsHigh expressions of YAP1, STAT3, pSTAT3-S727 and pSTAT3-Y705 were found in HGG compared with LGG (p=0.000). High expressions of YAP1, STAT3, pSTAT3-S727 and pSTAT3-Y705 were found in 63.5%, 59.5%, 66.2% and 31.1% cases of HGG, respectively. YAP1 expression was associated to tumour location, Ki-67 and P53, STAT3 expression was related with Ki-67 and P53, and the expression of pSTAT3-S727 was associated with Ki-67. There was a significantly positive correlation between YAP1 and pSTAT3-S727 (p<0.0001; r=0.5663). Survival analysis revealed that patients with YAP1 and pSTAT3-S727 coexpression had worse overall survival (OS) and progression-free survival (PFS) (p<0.0001). Tumour grade, age, Ki-67 and YAP1 expression were independent prognostic factors for OS. In LGG group, both YAP1 and pSTAT3-S727 expressions were negative correlation with IDH1 mutation, YAP1 and pSTAT3-S727 coexpression showed worse OS and PFS of glioma patients.ConclusionOur research showed that YAP1 and STAT3 were significantly activated in HGG compared with LGG. YAP1 significantly correlated with pSTAT3-S727 in glioma, YAP1 and pSTAT3-S727 coexpression may serve as a reliable prognostic biomarker and therapeutic target for glioma.

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Risk factors for infection with multidrug-resistant bacteria in non-ventilated patients with hospital-acquired pneumonia

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000300011 ◽

2013 ◽

Vol 39 (3) ◽

pp. 339-348 ◽

Cited By ~ 18

Author(s):

Renato Seligman ◽

Luis Francisco Ramos-Lima ◽

Vivian do Amaral Oliveira ◽

Carina Sanvicente ◽

Juliana Sartori ◽

...

Keyword(s):

Risk Factors ◽

Independent Predictor ◽

Univariate Analysis ◽

Tertiary Care ◽

Multidrug Resistant ◽

Categorical Variables ◽

Resistant Bacteria ◽

Hospital Acquired Pneumonia ◽

Hospital Acquired ◽

Ventilated Patients

OBJECTIVE: To identify risk factors for the development of hospital-acquired pneumonia (HAP) caused by multidrug-resistant (MDR) bacteria in non-ventilated patients. METHODS: This was a retrospective observational cohort study conducted over a three-year period at a tertiary-care teaching hospital. We included only non-ventilated patients diagnosed with HAP and presenting with positive bacterial cultures. Categorical variables were compared with chi-square test. Logistic regression analysis was used to determine risk factors for HAP caused by MDR bacteria. RESULTS: Of the 140 patients diagnosed with HAP, 59 (42.1%) were infected with MDR strains. Among the patients infected with methicillin-resistant Staphylococcus aureus and those infected with methicillin-susceptible S. aureus, mortality was 45.9% and 50.0%, respectively (p = 0.763). Among the patients infected with MDR and those infected with non-MDR gram-negative bacilli, mortality was 45.8% and 38.3%, respectively (p = 0.527). Univariate analysis identified the following risk factors for infection with MDR bacteria: COPD; congestive heart failure; chronic renal failure; dialysis; urinary catheterization; extrapulmonary infection; and use of antimicrobial therapy within the last 10 days before the diagnosis of HAP. Multivariate analysis showed that the use of antibiotics within the last 10 days before the diagnosis of HAP was the only independent predictor of infection with MDR bacteria (OR = 3.45; 95% CI: 1.56-7.61; p = 0.002). CONCLUSIONS: In this single-center study, the use of broad-spectrum antibiotics within the last 10 days before the diagnosis of HAP was the only independent predictor of infection with MDR bacteria in non-ventilated patients with HAP.

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Pulmonary mucoepidermoid carcinoma: Clinicopathological characteristics of 20 cases and a literature review

10.21203/rs.2.17790/v2 ◽

2020 ◽

Author(s):

Jing Zhang ◽

Yan Xiao Chen ◽

Jun Zi Qian ◽

Ping Yue ◽

Jialei Wang ◽

...

Keyword(s):

Tumor Markers ◽

Medical Records ◽

Mucoepidermoid Carcinoma ◽

Clinicopathological Characteristics ◽

Smoking History ◽

Categorical Variables ◽

Low Grade ◽

High Grade ◽

Alk Rearrangement ◽

Ki 67

Abstract Background: Pulmonary mucoepidermoid carcinoma is a rare tumor of the lung. The clinicopathological characteristics of pulmonary mucoepidermoid carcinoma are not well defined due to the low incidence. This study was performed to provide more supplementary clues for the identification and understanding of pulmonary mucoepidermoid carcinoma. Methods: We reviewed the medical records since January 1, 2000 to December 31, 2018. The patients’ medical records，including age at the time of diagnosis , gender, smoking history, preoperative evaluations, operative procedures, tumor location, tumor size, tumor stage, lymph node metastasis, pathological markers, prognosis and survival information were extracted and reviewed. Categorical variables were presented as parameters and percentages. A comparison was performed between patients with high and low grade of pulmonary mucoepidermoid carcinoma. Results: 20 patients were identified and the age span is from 18 to 67 year-old with the average age is 45. Mucoepidermoid carcinomas were commonly found in men（60%）. 80% patients had clinical presentations and the positive rate of tumor markers was 78%, although no specific tumor markers were found. TTF-1 were negative in all cases. ALK rearrangement was identified in a non-smoking woman with high grade pulmonary mucoepidermoid carcinoma. Surgery is the main procedure. 3-year survival rate is 72% and 80% patients achieved disease-free alive. High-grade patients tend to harbor older age (p=0.035), larger tumor volume (p=0.026) and higher index of ki-67(p=0.0005). Conclusions: Pulmonary mucoepidermoid carcinoma could occur in a wide age span. Early diagnosis and complete surgical resection may promise a good prognosis. Grading is a key factor to predict the overall survival time. Combined TTF-1 and MAML2 will benefit the identification of pulmonary mucoepidermoid carcinoma from other lung tumors. Future prospective randomized controlled trials and larger, multi-centric series are needed.

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Abstract 090: Outcomes of Hypertensive Crises as Predicted by Red Cell Distribution Width

Hypertension ◽

10.1161/hyp.66.suppl_1.090 ◽

2015 ◽

Vol 66 (suppl_1) ◽

Author(s):

Suraj Raheja ◽

Kush Patel ◽

Ruchir Patel ◽

Sagger Mawri ◽

Alexander Michaels ◽

...

Keyword(s):

Heart Failure ◽

Independent Predictor ◽

Hypertensive Crisis ◽

Red Cell Distribution Width ◽

Categorical Variables ◽

Red Cell ◽

Cell Distribution ◽

Distribution Width ◽

All Cause Mortality ◽

New Onset

Background: Red cell distribution width (RDW) is a measure of the variability in size of erythrocytes. A high RDW value indicates greater variation in size between individual erythrocytes and has been shown to be an independent predictor of mortality in patients with coronary artery disease, heart failure and in patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to evaluate the prognostic value of RDW in predicting clinical outcomes in patients with hypertensive crisis. Methods: We performed a retrospective study of 465 consecutive patients from January 2007 to March 2010 who presented with hypertensive crisis. Hypertensive crisis was defined as systolic BP >180 and/or diastolic BP >110mmHg with impending or progressive end organ dysfunction requiring inpatient hospitalization. The study sample consisted of 465 patients (38.9% men (181 of 465); mean age 59.6 ± 15.9). Baseline levels of RDW were measured at time of admission and analyzed as continuous and categorical variables (elevated RDW was defined as >14.5%). Multivariable regression analysis was performed for development of all-cause mortality, myocardial infarction, new-onset heart failure (defined as first time hospital admission for heart failure), stroke and MACE (MI, new-onset heart failure and stroke) at 2 years. Results: RDW > 14.5% was a strong independent predictor of all-cause mortality at 2 years (OR: 1.90, 95% CI: 1.1-3.3, p <0.05). Elevated RDW was also found to be an independent predictor of new-onset heart failure at 2 years (OR: 1.97, 95% CI: 1.1-3.7, p <0.05). Elevated RDW was not a predictor of MI, PCI or stroke at 2 years. Conclusions: Elevated RDW level in patients with hypertensive crisis was an independent predictor of all-cause mortality and new-onset heart failure in patients with hypertensive crisis.

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