scholarly journals Preoperative Liver Function Test Abnormalities Were Associated With Short-Term and Long-Term Prognosis in Cardiac Surgery Patients Without Liver Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Liqun Shang ◽  
Yuanhan Ao ◽  
Linhua Lv ◽  
Lihua Lv ◽  
Yubi Zhang ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Liver Disease ◽  
Hospital Stay ◽  
Total Bilirubin ◽  
Short Term ◽  
Icu Stay ◽  
Independent Risk Factors ◽  
Long Term Prognosis ◽  
Preoperative Liver Function

Aims: To explore the value of preoperative liver function tests (LFTs) for the prognosis of cardiac surgery patients without liver disease.Methods: The Medical Information Mart for Intensive Care III (MIMIC-III) database was used to extract the clinical data. Adult cardiac patients (≥18 years) without liver disease in the database were enrolled. The association of LFTs with the time of hospital stay and ICU stay was analyzed with the Spearman correlation. Survival curves were estimated using the Kaplan-Meier method and compared by the log-rank test. Multivariable logistic regression was used to identify LFTs that were independent prognostic factors of mortality.Results: A total of 2,565 patients were enrolled in this study. Albumin (ALB) was negatively associated with the time of hospital stay and ICU stay, while alanine transaminase (ALT), aspartate aminotransferase (AST), and total bilirubin were positively associated with the time of hospital stay and ICU stay (all p < 0.001). Abnormal ALB, ALT, AST, and total bilirubin were associated with lower 90-day and 4-year survival (all p < 0.001) and could be used as independent risk factors for hospital mortality and 90-day mortality. However, only ALB and total bilirubin were independent risk factors for 4-year mortality.Conclusion: Preoperative LFT abnormalities were associated with short-term and long-term prognosis of cardiac surgery patients without liver disease.

Relationship between magnetic resonance imaging findings and prognosis of intracranial tuberculosis

2021 ◽  
pp. 028418512110620
Author(s):  
Xuan Wu ◽  
Xiuhong Yang ◽  
Bo Wang ◽  
Nan Yin ◽  
Xiaohui Mao ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Resonance Imaging ◽  
Short Term ◽  
Enhanced Mri ◽  
Cranial Mri ◽  
Independent Risk Factors ◽  
Long Term Prognosis ◽  
The Relationship

Background Intracranial tuberculosis (TB) is an intracranial infection caused by Mycobacterium tuberculosis. Magnetic resonance imaging (MRI), in particular enhanced MRI scan, has the ability to detect characteristic lesions of tuberculous meningitis or cerebral parenchymal TB. Purpose To analyze the relationship between MRI findings and prognosis of patients with intracranial TB. Material and Methods In this retrospective study, a total of 60 patients were confirmed with intracranial TB in the hospital from May 2019 to December 2020. All enrolled patients underwent TB-related laboratory examinations, cranial MRI, and contrast-enhanced MRI. Laboratory tests were analyzed and the relationship between clinical prognosis and cranial MRI features was evaluated. Results Of the 60 patients, 28 (46.67%) had disseminated TB complications, 20 (36.67%) had secondary TB complications, and the remaining 10 (16.66%) had lymphatic TB or spinal TB complications. Of the patients, 25 had good short-term prognosis and 35 had poor short-term prognosis; 44 patients had good long-term prognosis and 16 had poor long-term prognosis. The incidence of cerebral parenchymal tuberculomas on enhanced MRI was significantly higher in the group with good prognosis compared to that in the group with poor prognosis ( P < 0.05). Logistic analysis suggested that hydrocephalus (odds ratio [OR] = 0.057, 95% confidence interval [CI] = 0.003–0.444; P = 0.018) and cistern involvement (OR = 0.100, 95% CI = 0.011–0.581; P = 0.017) were independent risk factors for poor short-term prognosis. Conclusion MRI can display the pathological changes of intracranial TB in detail; hydrocephalus and cistern involvement were independent risk factors for poor short-term prognosis.

scholarly journals Clinical and pathogenetic features of myocardial infarction in patients with atrial fibrillation

2020 ◽  
pp. 31-39
Author(s):  
S.Y. Borodashkina ◽  
◽  
K.V. Protasov ◽  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Observational Studies ◽  
Risk Group ◽  
Clinical Manifestations ◽  
High Risk Group ◽  
Short Term ◽  
Invasive Treatment ◽  
Long Term Prognosis

Patients with myocardial infarction (MI) and atrial fibrillation (AF), the number of which is progressively increasing every year, make up a high-risk group for both recurrent cardiovascular events and bleeding; they require special attention from clinicians. The literature review provides data on features of pathogenesis and clinical manifestations of MI in patients with AF. The analysis of data on AF effect observational studies on short-term and long-term prognosis in patients with myocardial infarction was carried out. Mechanisms of occurrence, clinical features and prognostic value of postinfarction AF are considered. From the standpoint of modern clinical guidelines, information is presented on features of MI invasive treatment in combination with AF. Algorithms of anticoagulant and antiarrhythmic therapy in patients of this category are considered.

Long‐term prognosis of patients with metabolic (dysfunction)‐associated fatty liver disease by non‐invasive methods

2022 ◽  
Author(s):  
Marie Decraecker ◽  
Dan Dutartre ◽  
Jean‐Baptiste Hiriart ◽  
Marie Irles‐Depé ◽  
Faiza Chermak ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Metabolic Dysfunction ◽  
Non Invasive ◽  
Long Term Prognosis

Physicians’ predictions of long-term survival and functional outcomes do not influence the decision to admit patients with advanced disease to intensive care: A prospective study

2020 ◽  
pp. 026921632096393
Author(s):  
Monica Escher ◽  
Mathieu Nendaz ◽  
Fabienne Scherer ◽  
Stéphane Cullati ◽  
Thomas Perneger
Keyword(s):  
Intensive Care ◽  
Functional Outcomes ◽  
Advanced Disease ◽  
Short Term ◽  
Term Survival ◽  
Admission Decisions ◽  
Long Term Prognosis ◽  
A Prospective Study ◽  
Short Term Survival

Background: Long-term survival and functional outcomes should influence admission decisions to intensive care, especially for patients with advanced disease. Aim: To determine whether physicians’ predictions of long-term prognosis influenced admission decisions for patients with and without advanced disease. Design: A prospective study was conducted. Physicians estimated patient survival with intensive care and with care on the ward, and the probability of 4 long-term outcomes: leaving hospital alive, survival at 6 months, recovery of functional status, and recovery of cognitive status. Patient mortality at 28 days was recorded. We built multivariate logistic regression models using admission to the intensive care unit (ICU) as the dependent variable. Setting/participants: ICU consultations for medical inpatients at a Swiss tertiary care hospital were included. Results: Of 201 evaluated patients, 105 (52.2%) had an advanced disease and 140 (69.7%) were admitted to the ICU. The probability of admission was strongly associated with the expected short-term survival benefit for patients with or without advanced disease. In contrast, the predicted likelihood that the patient would leave the hospital alive, would be alive 6 months later, would recover functional status, and would recover initial cognitive capacity was not associated with the decision to admit a patient to the ICU. Even for patients with advanced disease, none of these estimated outcomes influenced the admission decision. Conclusions: ICU admissions of patients with advanced disease were determined by short-term survival benefit, and not by long-term prognosis. Advance care planning and developing decision-aid tools for triage could help limit potentially inappropriate admissions to intensive care.

Significance of Tumor Capsular Invasion in Well-Differentiated Thyroid Carcinomas

2007 ◽  
Vol 73 (5) ◽  
pp. 484-491 ◽  
Author(s):  
Julio C. Furlan ◽  
Yvan C. Bedard ◽  
Irving B. Rosen
Keyword(s):  
Clinical Outcome ◽  
Prognostic Index ◽  
University Teaching ◽  
Biological Behavior ◽  
Capsular Invasion ◽  
Short Term ◽  
European Organization ◽  
Long Term Prognosis ◽  
Well Differentiated

This study examines the influence of tumor capsular invasion on the biological behavior of papillary (PTC) and follicular thyroid carcinoma (FTC) and the prognosis of surgically treated patients. This retrospective cohort study included 350 cases of PTC or FTC from a university teaching hospital. Patient charts were randomly selected and reviewed. The study population was divided into PTC and FTC groups. Each group was subdivided into CI+ (with tumor capsular invasion) and CI- subgroups (without tumor capsule or without capsular invasion). The long-term prognosis was assessed using the American Joint Committee on Cancer pTNM staging and the prognostic index was elaborated by the European Organization for Research and Treatment of Cancer. There were 284 women and 66 men (ages 19–89 years, mean of 44) with an incidence of 53.1 per cent for CI+ tumors. There were no significant differences between the PTC subgroups regarding the short-term clinical outcome and the long-term prognosis. Although patients with CI+ FTC showed lower incidence of lymph node metastasis than patients with CI- FTC, the FTC subgroups were comparable regarding the short-term clinical outcome and the long-term prognosis. Our results suggest that presence of tumor capsular invasion does not adversely influence biological behavior or survival of PTC or FTC. Moreover, the presence of tumor capsular invasion appears to not have significance for the long-term prognosis of patients with PTC or FTC.

Disability pensions in severely disturbed in-patient adolescents

1998 ◽  
Vol 172 (2) ◽  
pp. 159-163 ◽  
Author(s):  
M. Pelkonen ◽  
M. Marttunen ◽  
E. Pulkkinen ◽  
P. Laippala ◽  
J. Lönnqvist ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Disability Pension ◽  
Psychiatric Care ◽  
Critical Time ◽  
Working Capacity ◽  
Short Term ◽  
Related Factors ◽  
Long Term Prognosis

BackgroundKnowledge of working capacity from adolescence until adulthood among severely disturbed in-patients is scarce.MethodIn a follow-up study of 61 adolescent in-patients, we studied associations between being on a disability pension 20 years after hospitalisation, and the patients' psychopathology and treatment-related factors during the hospitalisation and seven-year follow-up.ResultsOf the former in-patients. 27% had not been on a disability pension, 20% had short-term pension periods, and 53% were pensioned. Subjects whose overall psychosocial functioning had improved and who had not utilised in-patient services until the seven-year follow-up, had a better prognosis in terms of working capacity Half of the subjects who had not been on pension during the follow-up had received a diagnosis of conduct disorder at discharge, and half of those pensioned had a psychotic disorder.ConclusionsThe patients' level of psychosocial functioning and capability to work in young adulthood were associated with long-term prognosis in terms of working capacity Adolescence seems to be the critical time for intensive psychiatric care combined with vocational rehabilitation programmes.

scholarly journals Therapy-induced selective loss of leukemia-initiating activity in murine adult T cell leukemia

2010 ◽  
Vol 207 (13) ◽  
pp. 2785-2792 ◽  
Author(s):  
Hiba El Hajj ◽  
Marwan El-Sabban ◽  
Hideki Hasegawa ◽  
Ghazi Zaatari ◽  
Julien Ablain ◽  
...  
Keyword(s):  
T Cell ◽  
Type I ◽  
T Cell Leukemia ◽  
Cell Leukemia ◽  
Short Term ◽  
Adult T Cell Leukemia ◽  
Human T Cell ◽  
Long Term Prognosis ◽  
Cell Immortality

Chronic HTLV-I (human T cell lymphotropic virus type I) infection may cause adult T cell leukemia/lymphoma (ATL), a disease with dismal long-term prognosis. The HTLV-I transactivator, Tax, initiates ATL in transgenic mice. In this study, we demonstrate that an As2O3 and IFN-α combination, known to trigger Tax proteolysis, cures Tax-driven ATL in mice. Unexpectedly, this combination therapy abrogated initial leukemia engraftment into secondary recipients, whereas the primary tumor bulk still grew in the primary hosts, only to ultimately abate later on. This loss of initial transplantability required proteasome function. A similar regimen recently yielded unprecedented disease control in human ATL. Our demonstration that this drug combination targeting Tax stability abrogates tumor cell immortality but not short-term growth may foretell a favorable long-term efficiency of this regimen in patients.

scholarly journals Efficacy of Statin Therapy Related to Baseline Renal Function in Patients with Rheumatic Heart Disease Undergoing Cardiac Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Rongjun Zou ◽  
Wanting Shi ◽  
Jun Tao ◽  
Xifeng Lin ◽  
Dingwen Zhang ◽  
...  
Keyword(s):  
Renal Function ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Renal Impairment ◽  
Hospital Stay ◽  
Normal Renal Function ◽  
Icu Stay ◽  
Drainage Time ◽  
Baseline Renal Function ◽  
Rheumatic Heart

Background. Renal impairment increases the risk of cardiovascular events and perioperative complications in patients with heart valve disease. This study aimed to determine the perioperative benefit of statin treatment related to baseline renal function in patients with rheumatic heart disease (RHD) who had cardiac surgery. Methods and Results. We performed a retrospective study on 136 patients with RHD who underwent valve replacement surgery. The mean age of the patients was 56.2 years, 59.6% were female, 8.8% patients had diabetes mellitus, and 27.2% of patients had hypertension. Overall, 3 patients died, 2 underwent reoperation, and 25 underwent thoracentesis during the study period. For patients with renal impairment, there was a higher risk of thoracic puncture (odds ratio [OR]: 3.33; 95% confidence interval [CI]: 1.36, 8.11; P<0.01) and a longer time of drainage (difference in means: 1; 95% CI: 0.88, 1.12; P<0.01), intensive care unit (ICU) stay (difference in means: 0.2; 95% CI: 0.17, 0.23; P=0.02), and hospital stay (difference in means: 6.6; 95% CI: 6.15, 7.05; P<0.01) compared with normal renal function. Furthermore, statins were associated with a reduction in drainage time (difference in means: −1.50; 95% CI: −1.86, −1.14; P=0.02), ICU stay (difference in means: −0.30; 95% CI: −0.40, −0.20; P=0.05), and hospital stay (difference in means: −5.40; 95% CI: −6.57, −4.23; P<0.01) in patients with renal impairment (interaction, P≤0.05 for all), but not in those with normal renal function. Conclusion. Statins have a greater clinical benefit in perioperative cardiac surgery with renal impairment. Statins are associated with a comparatively lower risk of thoracic puncture, as well as a reduced trend toward a reduction in drainage time, ICU stay, and hospital stay.

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