scholarly journals Prognosis and Survival Study in Patients with Glioblastoma Multiform and Its Relationship with EGFR Expression

2020 ◽  
Vol 6 (3) ◽  
pp. 113-120
Author(s):  
Zeinab Amirpour ◽  
◽  
Arezoo Bahari ◽  
Behrad Nafisi ◽  
Koorosh Rahmani ◽  
...  

Background and Aim: Glioblastoma multiforme (GBM) is the most common malignant and invasive tumor of the brain. The relation between prognosis and survival of GBM patients with Epidermal Growth Factor Receptor (EGFR) expression is challenging. Thus, we aimed to evaluate the prognosis and survival of patients with GBM and its relationship with EGFR expression. Materials and Methods: This single-arm cohort study was conducted on 70 patients with GBM during 2012-2018 in Shahid Rahnemoon and Mortaz hospitals. The immunohistochemistry technique was applied to paraffin blocks of brain tumors for examining EGFR expression. Other data were extracted from medical records. To determine the survival rate, the Kaplan–Meier curves were used. A chi-square test was used for the analysis of data. Statistically, p-value <0.05 was assumed significant. Results: The mean survival of patients with GBM was 22.3 ± 2.5 months (95% CI=17.41 - 27.10). In addition, 1, 2- and 5-year survival rates were 90%, 30% and 5%, respectively. The mean survival of patients with negative and positive EGFR was 27.4±7.3 and 20.6±2.4 months, respectively. Besides, 11.1% and 14.3% of patients in negative and positive EGFR groups were alive. There was no significant difference in patient’s survival in terms of EGFR expression (p=0.36). No significant difference was seen between the two groups (EGFR positive and negative groups), regarding the frequency of age, sex, tumor’s anatomical location, and place of living (p>0.05). Conclusion: Based on our study, it seems that the GBM tumor was associated with poor prognosis and a low survival rate. It was also found that the expression of the EGFR gene did not affect the survival rate of patients with GBM. Therefore, its use as a predictor factor for survival and prognosis is questionable.

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S128-S128
Author(s):  
Deniz Akyol ◽  
Ayşe Uyan Önal ◽  
Uğur Önal ◽  
Damla Akdağ ◽  
Cansu Bulut Avşar ◽  
...  

Abstract Background In this study it was aimed to compare the effects of qSOFA (Quick Sequential Organ Failure Assessment) score with modified qSOFA score (PLoS One. 2018 Sep 26;13(9):e0204608) for predicting one month survival in patients with diagnosed septic shock (SS) in a tertiary-care educational university hospital in a developing country. Methods Modified qSOFA was created by adding age factor (>50 years=1 point) to patients with qSOFA scale 1 or 2 or 3 who had SS (sepsis+hypotension+adrenergic agent) and consulted by Infectious Diseases consultants between December 2013-December 2018. Arterial lactate level of >2 mmol/L criterion was added as an including criteria for SS according to 3rd International Sepsis and Septic Shock Consensus Statement after 23rd February 2016. Statistical analysis was performed via Chi-square test and a p-value <0.05 was considered significant. Results The number of patients with qSOFA score of 1 or 2 or 3 from 527 patients are in Table1 [some of the cases were diagnosed as septic shock according to elder definition (without lactate criterion) and there was a subgroup with qSOFA score 1]. Among the >50-year aged group, the 30-day survival rate was lower in patients with qSOFA3 vs. qSOFA 2 vs. qSOFA 1 (Table1, 3x2 Chi Square test, P = 0.0057). Among the <50 years group, the qSOFA one month survival rate was lower in patients with qSOFA 3 vs. qSOFA 2 vs. qSOFA 1 (Table, 3x2 Chi Square Test, P = 0.0052). According to modified qSOFA, there was a significant difference for one month survival among SS cases with scores of 1, 2, 3 and 4 (12/21 57% vs. Fifty/126 40% vs. 78/269 29% vs. 22/111 20%, 4x2 Chi-square test, P = 0.0003). On the other hand, there was no significant difference in terms of one month survival when we performed subgroup analysis in qSOFA score 1, 2, or 3 subgroups, as ≤50 years vs. >50 years (table, Chi-square test, 12/21 vs. 39/97 P = 0.224, 11/29 vs. 75/244 P = 0.526, 3/25 vs. 22/111 P = 0.572). Conclusion In terms of survival at one month, there was a significant difference between qSOFA score 1, 2, 3 and 4 subgroups. In patients with qSOFA score of 1 or 2 or 3, being under 50 years did not have a significant effect on one-month survival. Modified qSOFA may be beneficial to foresee the probable mortality but these findings need to be validated in larger cohorts Disclosures All authors: No reported disclosures.


2021 ◽  
Vol 20 (1) ◽  
pp. 66-71
Author(s):  
Babak Alijani ◽  
◽  
Hamid Saeidi Saedi ◽  
Hadi Hajizadeh Fallah ◽  
Ehsan Kazemnejad Leili ◽  
...  

Background. In the central nervous system, glioblastoma multiforme (GBM) is one of the most important neoplasms in adults. Amplification of EGFR and VEGF genes is common in GBM. However, the role of overexpression of EGFR and VEGF in survival of patients with GBM has been a contentious issue. Therefore, we performed the present study to assess the survival rate of patients with EGFR and VEGF overexpression. Materials and methods. Resected samples of GBM patients were evaluated by immunohistochemistry for overexpression of VEGF and EGFR. The patients were followed up for a year. Results. The mean±sd of age of patients was 56.2±13.1 years. The majority of the patients were male (65.9%). Most of the patients had primary GBM (67%), notwithstanding 33% of the patients with secondary GBM. Moreover, 19.2% and 49.5% of the samples were VEGF-positive and EGFR-positive, respectively. Overall 6, 12-, and 18-month survival rates were shown to be 61.5±5.1%, 17.6±4%, and 4.4±2.1%, respectively. There was a significant difference between the mean±se survival rate in VEGF-negative patients (12±1.9 months) VEGF-positive patients (7.8±0.5 months) (P=0.045). Conclusions. We found an association between VEGF and EGFR over-expression and the survival rate of GBM patients. The VEGF overexpression was significantly associated with the overall survival rate of the GBM patients, but failed to have a prognostic value for their mortality rate. However, EGFR was a predictor of overall survival rate and mortality of GBM patients. Moreover, VEGF overexertion has a stronger association with survival rate in GBM, compared to EGFR overexpression.


2010 ◽  
Vol 80 (1) ◽  
pp. 37-42 ◽  
Author(s):  
S. M. Banabilh ◽  
A. R. Samsudin ◽  
A. H. Suzina ◽  
Sidek Dinsuhaimi

Abstract Objective: To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA). Materials and Methods: Subjects were 120 adult Malays aged 18 to 65 years (mean ± standard deviation [SD], 33.2 ± 13.31) divided into two groups of 60. Both groups underwent clinical examination and limited channel polysomnography (PSG). The mean OSA and control values were subjected to t-test and the chi square test. Results: Physical examination showed that 61.7% of the OSA patients were obese, and 41.7% of those obese patients had severe OSA. The mean body mass index (BMI) was significantly greater for the OSA group (33.2 kg/m2 ± 6.5) than for the control group (22.7 kg/m2 ± 3.5; P &lt; .001). The mean neck size and systolic blood pressure were greater for the OSA group (43.6 cm ± 6.02; 129.1 mm Hg ± 17.55) than for the control group (35.6 cm ± 3.52; 114.1 mm Hg ± 13.67; P &lt; .001). Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%), respectively; the chi square test revealed a significant difference in terms of facial profile and malocclusion class (P &lt; .05), but no significant difference in palatal shape was found. Conclusion: The null hypothesis is rejected. A convex facial profile and Class II malocclusion were significantly more common in the OSA group. The V palatal shape was a frequent finding in the OSA group.


2020 ◽  
Vol 10 (3) ◽  
pp. 49-56
Author(s):  
Türkan SEZEN ERHAMZA ◽  
Kübra A ARSLAN ÇARPAR

Introduction: The study aimed to evaluate the knowledge and awareness of orthodontics, a specialty of dentistry,amongst Medical Students. Materials and Method: A sample of 550 students (279 female, 226 male aged between 18 and 36 years) were attented.Of the subjects, 58.6% (n = 296) were preclinical students, while 41.4% (n = 209) were clinical students. The students were informed about the questionnaire and asked to fill in the questionnaire forms. For the comparison of data between groups (gender, level of education), the chi-square test was used. A chi-square test was used for statistical evaluation and the p-value < 0.05 was considered statistically significant. Result: 385 students (76.2%) had heard the term orthodontics although 41.2% of the subjects knew that orthodonticswas concerned with malocclusions and their treatment. The question about treatment procedures was answeredas scaling by 35.8%, tooth polishing by 40%, tooth aligning by 89.9% of the students. The percentage of knowingorthodontics to be related to tooth aligning showed a significant difference between female and male (p = 0.006), andpreclinical and clinical students (p = 0.033). Of the participants, 42.8% thought that dentures, 83% brackets, 78.8% ofremovable appliances were used by orthodontists. Conclusion: Our results have shown that medical students should have more information about orthodontics, aspecialty of dentistry.


2020 ◽  
Vol 8 (4) ◽  
pp. 193-199
Author(s):  
Pujan Balla ◽  
Anil Shrestha ◽  
Ninadini Shrestha ◽  
Navindra Bista ◽  
Moda Nath Marhatta

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.


Author(s):  
Mallikarjuna Rao I. ◽  
Usha Kiran Prayaga ◽  
Dharma Rao Uppada ◽  
Ramachandra Rao E. ◽  
B. L. Kudagi

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression.


2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.


2019 ◽  
Vol 82 (4) ◽  
pp. 405-415
Author(s):  
Archita Dey ◽  
Mahua Chanak ◽  
Kaustav Das ◽  
Koel Mukherjee ◽  
Kaushik Bose

Abstract Lip print pattern (LPP) is unique to each individual. For decades, forensic experts have used LPP for personal identification to solve criminal cases. However, studies investigating ethnic variation in LPP are scanty. Our study wanted to investigate variation in LPP between two ethnic groups, Oraon tribals and Bengalee Hindus, residing in West Bengal, India. A total of 280 participants included 112 Oraons and168 Bengalee Hindus of both. Prints were taken using dark shaded lipstick and transparent cellophane tape and recorded into white A4 sheet. Prints were divided into four quadrants and examined by magnifying glass. For analysis of results, classification of Suzuki and Tsuchihashi was followed. A p value of 0.05 was considered to be statistically significant. It was observed that Type II pattern was dominant in first and second quadrants in both ethnic groups, irrespective of sex. Combination of Type II+III was found to be the most common pattern in males among both Oraons (16.2%) and Bengalee Hindus (12.2%) whereas in females Type II pattern (25.0%) among Oraons and Type III pattern among Bengalee Hindus (11.4%) was the most common. Chi square test showed statistically significant difference among females (p<0.05) and in third and fourth quadrants among males (p<0.01) of both ethnic groups. Our investigation clearly demonstrated sex and ethnic variations in LPP. Further studies are required to investigate ethnic variation in LPP among the various populations groups, both tribal as well as non-tribal, from different regions of India.


2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Santosh Kumar ◽  
Rajesh Roat ◽  
Swati Agrawal ◽  
Kumar Jayant ◽  
Ravimohan S. Mavuduru ◽  
...  

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.


1957 ◽  
Vol 35 (1) ◽  
pp. 93-101 ◽  
Author(s):  
A. M. Lansing ◽  
J. A. F. Stevenson ◽  
C. W. Gowdey

Reports of the efficacy of l-noradrenaline in the treatment of clinical shock stimulated an investigation of its effect in controlled hemorrhagic hypotension. Seventy-three 350-g. male Sprague–Dawley rats were subjected to a standardized hemorrhagic shock procedure. Of 15 control animals that received no treatment, only one survived for 48 hours; none survived of the five controls that received a constant intravenous infusion, after the shock procedure, of 5% glucose in distilled water until death or for 36 hours. The treated animals received, after the shock procedure, an infusion of l-noradrenaline (0.5–2.0 μg./min.) in 5% glucose in distilled water. The survival rates for the treated animals were: treatment for 1 hour, 1/8; treatment for 4 hours, 4/15; treatment until death or for 36 hours, 8/15. Fifteen animals received, in addition to noradrenaline for 36 hours, hydrocortisone administered intravenously (0.7 μg./min.) or intramuscularly (2.5 mg. every 6 hours); seven of these animals survived.Analysis of variance showed that there was no difference in the shock procedure undergone by the controls and by the treated survivors. The Chi square test on the survival rates revealed that the infusion of noradrenaline for 1 hour or 4 hours did not improve survival, but infusion for 36 hours produced a very significant increase in survival time and in total survival rate. The addition of hydrocortisone neither enhanced nor impaired this improvement.


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