The Effect of a Combined Ganciclovir, Methylprednisolone, and Immunoglobulin Regimen on Survival and Functional Outcomes in Patients With Japanese Encephalitis

Objective: There is currently no effective treatment for Japanese encephalitis, which has a high rate of morbidity and mortality. This study assessed the effectiveness of a ganciclovir, methylprednisolone, and immunoglobulin combination (TAGMIC) therapy in decreasing cognitive impairment and mortality among patients with Japanese encephalitis.Methods: We retrospectively assessed the clinical data of 31 patients diagnosed with Japanese encephalitis, who were admitted to an intensive care unit. Patients were divided into the TAGMIC and non-TAGMIC group according to their treatment regime. We compared the 60-day, 6-month, and overall mortality and survival curves between groups. We also compared Barthel Index scores, Montreal Cognitive Assessment (MoCA) scores, and diffusion tensor imaging (DTI) results.Results: There was no significant difference in the 30-day mortality rate or Kaplan–Meier survival curve between groups. The 60-day, 6-month, and overall mortality rates in the TAGMIC group were significantly reduced (P = 0.043, P = 0.018, and P = 0.018, respectively) compared with the non-TAGMIC group (0, 0, 0 vs. 31.25, 37.5, 37.5%, respectively). The 60-day, 6-month, and overall Kaplan–Meier survival curves were significantly different between groups (P = 0.020, P = 0.009, P = 0.009, respectively). There was no significant difference in the Barthel Index scores of surviving patients. Among the five patients who underwent MoCA and DTI, four had a score of 0/5 for delayed recall (no cue), while the remaining patient had a score of 2/5. All five patients were able to achieve a score of 5/5 with classification and multiple-choice prompts, and had sparse or broken corpus callosum (or other) fibre bundles.Conclusion: TAGMIC treatment can reduce mortality due to severe Japanese encephalitis. The memory loss of surviving patients is mainly due to a disorder of the memory retrieval process, which may be related to the breakage of related fibre bundles.

Download Full-text

Clinicopathological Variables and Outcome in Chronic Myeloid Leukemia Associated With BCR-ABL1 Transcript Type and Body Weight: An Outcome of European LeukemiaNet Project

Cancer Control ◽

10.1177/10732748211038429 ◽

2021 ◽

Vol 28 ◽

pp. 107327482110384

Author(s):

Mohammad A. J. Abdulla ◽

Prem Chandra ◽

Susanna El Akiki ◽

Mahmood B. Aldapt ◽

Sundus Sardar ◽

...

Keyword(s):

Body Weight ◽

Survival Curve ◽

Statistical Significance ◽

Response Assessment ◽

Test Methods ◽

Response To Treatment ◽

Molecular Response ◽

Kaplan Meier ◽

Significant Difference ◽

Transcript Type

Objective It is debatable whether BCR-ABL1 transcript type has an impact on outcome of treatment of patients with CML, and it is not widely studied whether body weight influences response to treatment. In this study, we tried to find out if any of these factors has an impact on response to treatment and outcome. Methodology We conducted a retrospective analysis of the files of 79 patients being treated in our center for CML with known BCR-ABL1 breakpoints, and patients’ management and response assessment was done based on ELN 2013 guidelines. The analysis was performed based on two main groups, obese vs. normal BMI, and then based on BCR-ABL1 transcripts: e13a2 vs. e14a2. Cumulative incidence of MMR, CCyR, and DMR were estimated using the Kaplan–Meier survival curve method, and comparisons between groups were performed by the Log-rank/Gray test methods. Results/conclusion In the patient-cohort studied, there was no statistically significant difference in molecular response between patients with CML based on body weight or transcript type although patients in the obesity group achieved higher and faster MMR with no statistical significance.

Download Full-text

In Vitro Fatigue Resistance of Teeth Restored With Bulk Fill versus Conventional Composite Resin

Brazilian Dental Journal ◽

10.1590/0103-6440201600836 ◽

2016 ◽

Vol 27 (4) ◽

pp. 452-457 ◽

Cited By ~ 2

Author(s):

Gabrielle Branco Rauber ◽

Jussara Karina Bernardon ◽

Luiz Clovis Cardoso Vieira ◽

Hamilton Pires Maia ◽

Françoá Horn ◽

...

Keyword(s):

Fatigue Resistance ◽

Composite Resin ◽

Survival Curve ◽

Maximum Force ◽

Lower Percentage ◽

Rank Test ◽

Log Rank Test ◽

Kaplan Meier ◽

Significant Difference ◽

Meier Survival Curve

Abstract The aim of this study was to compare the fatigue resistance of restored teeth with bulk fill composite resin, conventional composite resin with incremental insertion and unprepared sound teeth. Twenty-eight extracted maxillary premolars were selected and divided into 4 groups based on composite resin and insertion technique: control (C), conventional composite resin with incremental insertion (I) and bulk fill composite resin with three (BF3) or single increment (BF1). The restored specimens were submitted to fatigue resistance test with a 5 Hz frequency. An initial application of 5,000 sinusoidal load cycles with a minimum force of 50 N and a maximum force of 200 N was used. Next, were applied stages of 30,000 load cycles with the maximum force increasing gradually: 400, 600, 800, 1000, 1200 and 1400 N. The test was concluded when 185,000 load cycles were achieved or the specimen failed. The fatigue resistance data were recorded for comparison, using the Kaplan-Meier survival curve and analyzed by log-rank test at 0.05 significance. Fractures were classified based on the position of the failure - above or below the cementoenamel junction (CEJ). Statistical analysis of the Kaplan-Meier survival curve and log-rank test showed a significant difference between groups (p=0.001). The fracture analysis demonstrated that only 28.58% of failures were below the CEJ in group C, while for groups I, BF1 and BF3 they were 42.85%, 85.71% and 85.71%, respectively. Teeth restored with composite bulk fill in both techniques present similar fatigue resistance values compared with those restored with a conventional incremental insertion of composite, while the fatigue strength values of unprepared sound teeth were higher. Furthermore, unprepared sound teeth showed a lower percentage of fractures below the CEJ.

Download Full-text

Genetic defects of CHM and visual acuity outcome in 24 choroideremia patients from 16 Japanese families

Scientific Reports ◽

10.1038/s41598-020-72623-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Takaaki Hayashi ◽

Shuhei Kameya ◽

Kei Mizobuchi ◽

Daiki Kubota ◽

Sachiko Kikuchi ◽

...

Keyword(s):

Visual Acuity ◽

Survival Curve ◽

Japanese Patients ◽

Outcome Data ◽

High Rate ◽

Exon 2 ◽

Pathogenic Variants ◽

Kaplan Meier ◽

Whole Exome

Abstract Choroideremia (CHM) is an incurable progressive chorioretinal dystrophy. Little is known about the natural disease course of visual acuity in the Japanese population. We aimed to investigate the genetic spectrum of the CHM gene and visual acuity outcomes in 24 CHM patients from 16 Japanese families. We measured decimal best-corrected visual acuity (BCVA) at presentation and follow-up, converted to logMAR units for statistical analysis. Sanger and/or whole-exome sequencing were performed to identify pathogenic CHM variants/deletions. The median age at presentation was 37.0 years (range, 5–76 years). The mean follow-up interval was 8.2 years. BCVA of the better-seeing eye at presentation was significantly worsened with increasing age (r = 0.515, p < 0.01), with a high rate of BCVA decline in patients > 40 years old. A Kaplan–Meier survival curve suggested that a BCVA of Snellen equivalent 20/40 at follow-up remains until the fifties. Fourteen pathogenic variants, 6 of which were novel [c.49 + 5G > A, c.116 + 5G > A, p.(Gly176Glu, Glu177Ter), p.Tyr531Ter, an exon 2 deletion, and a 5.0-Mb deletion], were identified in 15 families. No variant was found in one family only. Our BCVA outcome data are useful for predicting visual prognosis and determining the timing of intervention in Japanese patients with CHM variants.

Download Full-text

The right atrial diameter as a risk factor predicting recurrence of atrial fibrillation after catheter ablation at mid-term follow-up

10.21203/rs.3.rs-23323/v1 ◽

2020 ◽

Author(s):

Wang Xiaofei ◽

Wang Wenli ◽

Zou Cao

Keyword(s):

Risk Factor ◽

Independent Risk Factor ◽

Cox Regression ◽

Survival Curve ◽

Right Atrial ◽

Cutoff Value ◽

Kaplan Meier ◽

Significant Difference ◽

Meier Survival Curve

Abstract Background Left atrial diameter (LAD) has been confirmed to predict recurrence of atrial fibrillation (AF) after catheter ablation (CA). The influence of right atrium (RA) size on the prognosis after CA was relatively unclear and lack of research. The objective of the present study was to investigate the relationship between right atrial diameter (RAD) and the mid-term outcome of AF after CA. Methods This study retrospectively examined 121 patients who underwent initial CA for symptomatic AF. Cox regression model was used to find risk factors of recurrence. Receiver operating characteristic (ROC) curve was used to evaluate predictive power and determine clinic cutoff value. Kaplan-Meier survival curve and log-rank test were used to analyze success rate. Results There were 94 (77.7%) patients of freedom from AF after 24.2 ± 4.5 months’ follow-up. Multivariate Cox regression analysis showed both hypertension and RAD were independent risk factors of arrhythmia recurrence after ablation regardless of AF type (HR: 4.915; 95% CI: 1.370-17.635; P = 0.015 and HR: 1.059; 95% CI: 1.001–1.120; P = 0.045, respectively). However, in patients with paroxysmal AF (par-AF), Multivariate analysis showed RAD become the only independent risk factor (HR: 1.031; 95% CI: 1.016–1.340; P = 0.029). ROC curve demonstrated the cutoff value of RAD was 35.5 mm with an area under the curve (AUC) of 0.715 (95% CI: 0.586–0.843, P = 0.009), sensitivity of 81.3% and specificity of 54.2%. Kaplan-Meier survival curve showed significant difference of freedom from par-AF (67.5 vs. 91.4%, log-rank, P = 0.015) between patients with RAD ≥ 35.5 mm and < 35.5 mm in this subgroup. Nevertheless, in patients with persistent AF (per-AF), no risk factor of arrhythmia recurrence was found. In addition, Kaplan-Meier survival curve showed no significant difference of freedom from per-AF (69.7 vs. 87.5%, log-rank, P = 0.31) between patients with RAD ≥ 35.5 mm and < 35.5 mm. Conclusions RAD was the independent risk factor predicting recurrence of AF after CA only in patients with par-AF. In patients with RAD < 35.5 mm, there was a significantly higher freedom from par-AF recurrence compared with RAD ≥ 35.5 mm after a mid-term follow-up.

Download Full-text

The prognosis of type III biliary atresia with a hilar cyst on ultrasonography might not be better than that without

10.21203/rs.2.10787/v1 ◽

2019 ◽

Author(s):

Quan-yuan Shan ◽

Bao-xian Liu ◽

Zhi-hai Zhong ◽

Hua-dong Chen ◽

Yu Guo ◽

...

Keyword(s):

Survival Rate ◽

Biliary Atresia ◽

Survival Curves ◽

Type Iii ◽

Kaplan Meier ◽

Significant Difference ◽

Native Liver ◽

Eventual Outcome ◽

Native Liver Survival ◽

Better Than

Abstract Background Biliary atresia (BA) with a hilar cyst is an uncommon variant of BA that may be misunderstood to have a relatively favorable prognosis. Methods A single-center retrospective review of patients that matched BA with a hilar cyst (n=27) with BA without a cyst (n=27) over a 5-years period was done. All patients were diagnosed as type III BA by histologic examination and cholangiograms. Results There were no significant intergroup differences between baseline characteristics and outcomes after Kasai portoenterostomy surgery in two groups. The Kaplan–Meier survival curves showed no significant difference in cumulative native liver survival rate of the two groups (p = 0.584). Of the 27 BA patients with a hilar cyst, 8 were showed the cyst communicated with the gallbladder on cholangiograms, and Kaplan-Meier survival curves indicated that the cumulative native liver survival rate was significantly shorter (P=0.045) in them than those who the cyst was not communicated with the gallbladder. Conclusions Type III BA with a hilar cyst had no better prognosis compared with Type III BA without a cyst. A cyst communicated with the gallbladder may be associated with a poor eventual outcome for Type III BA with a hilar cyst.

Download Full-text

Asymptotic convergence in distribution of the area bounded by prevalence-weighted Kaplan–Meier curves using empirical process modelling

Royal Society Open Science ◽

10.1098/rsos.180496 ◽

2018 ◽

Vol 5 (11) ◽

pp. 180496

Author(s):

Aaron Heuser ◽

Minh Huynh ◽

Joshua C. Chang

Keyword(s):

Empirical Process ◽

Survival Curve ◽

Population Level ◽

Weighted Averaging ◽

Event Analysis ◽

Social Security Administration ◽

Survival Curves ◽

Kaplan Meier ◽

Population Survival ◽

Product Limit

The Kaplan–Meier product-limit estimator is a simple and powerful tool in time to event analysis. An extension exists for populations stratified into cohorts where a population survival curve is generated by weighted averaging of cohort-level survival curves. For making population-level comparisons using this statistic, we analyse the statistics of the area between two such weighted survival curves. We derive the large sample behaviour of this statistic based on an empirical process of product-limit estimators. This estimator was used by an interdisciplinary National Institutes of Health–Social Security Administration team in the identification of medical conditions to prioritize for adjudication in disability benefits processing.

Download Full-text

Outcome of Adolescents and Young Adults with Acute Myeloid Leukemia (AML) As Compared to Pediatric AML Patients: Real World Data from SEER Registry

Blood ◽

10.1182/blood.v126.23.4484.4484 ◽

2015 ◽

Vol 126 (23) ◽

pp. 4484-4484

Author(s):

Smith Giri ◽

Nunnery Sara ◽

Syed S. Nasir ◽

Michael G Martin

Keyword(s):

Overall Survival ◽

Pediatric Patients ◽

Survival Curve ◽

Population Based ◽

Early Mortality ◽

Rank Test ◽

P Value ◽

Log Rank Test ◽

Kaplan Meier ◽

Significant Difference

Abstract Background: Limited data exists regarding the characteristics and outcomes of adolescents and young adults (AYAs) with acute myeloid leukemia (AML) which are largely under-represented in both pediatric and adult trials. We sought to compare the characteristics and outcomes of AYAs with AML using a large population based registry in the United States. Methods: We utilized Surveillance Epidemiology and End Results (SEER)-18 registry to identify all pediatric (0-18 years) and AYA (age 19-30 years) patients diagnosed with AML using appropriate histology codes based on the International Classification of Diseases for Oncology, 3rd version. Patients with acute promyelocytic leukemia (APL) were excluded from all analysis. Survival statistics were computed for each group using actuarial (Kaplan-Meier method) and compared using Z test for comparison of population proportions. Early mortality, defined as mortality within 1 month of diagnosis, was used as a surrogate for treatment related mortality. Kaplan Meier survival curves were plotted and compared using log-rank test. Multivariate analysis was done using logistic regression and Cox proportional hazard regression model. All p values were two sided and the level of significance was chosen at 0.05. Results: A total of 6343 eligible patients were identified, which comprised 2836 (44.7%) AYAs. A total of 52% (n=3346) were males, whereas 76%(n=4825) were whites. Histologically, majority of patients (56%; n=3545) were categorized as AML, not otherwise specified, followed by acute monocytic leukemia (9.9%, n=630). Majority (55%; n-3509) of the patients were diagnosed between 2001-2012. The early mortality rate was lower in the pediatric AML patients (pAML) as compared to AYAs (6.2% vs 9.2%; p<0.01). Similarly the 1 year (70.3% versus 62.1%; p <0.01) and 5 year (48.2% vs 36.4%; p<0.01) was higher in pediatric patients as compared to AYAs. Kaplan Meier plot showed worse overall survival of AYAs compared to pAMLs (Figure 1; p value of log rank <0.01). Multivariate logistic regression showed higher early mortality among AYAs as compared to pAML patients (OR 1.48; 95% CI 1.23-1.79; p<0.01). Similarly Cox regression showed worse overall survival among AYAs as compared to pAML (HR 1.34; 95% CI 1.26-1.44; p <0.01) Conclusions: Our population based analysis shows worse overall survival among AYAs as compared to pAML patients. Future clinical trials specifically focused on this age group are warranted to establish appropriate treatment regimens in this population. Figure 1. Kaplan Meier Survival curve showing cumulative survival among pediatric patients with AML as compared to AYAs. Log rank test showed statistically significant difference between the two curves (p value <0.01) Figure 1. Kaplan Meier Survival curve showing cumulative survival among pediatric patients with AML as compared to AYAs. Log rank test showed statistically significant difference between the two curves (p value <0.01) Disclosures No relevant conflicts of interest to declare.

Download Full-text

Comparison of early versus late laser goniopuncture following deep sclerectomy for the management of open-angle glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315392 ◽

2020 ◽

Vol 104 (10) ◽

pp. 1384-1389 ◽

Cited By ~ 1

Author(s):

David Holmes ◽

Michelle Mei Pik Hui ◽

Colin Clement

Keyword(s):

Intraocular Pressure ◽

Retrospective Study ◽

Open Angle Glaucoma ◽

Published Data ◽

Safe Procedure ◽

Deep Sclerectomy ◽

Open Angle ◽

Survival Curves ◽

Kaplan Meier ◽

Significant Difference

PurposeTo compare the outcome of early versus late Nd:YAG laser goniopuncture (LGP) after deep sclerectomy with mitomycin C (DSMMC) for open-angle glaucoma (OAG).MethodsA retrospective study of consecutive OAG eyes that underwent a LGP following DSMMC was recruited between June 2012 and November 2015. Success was defined as intraocular pressure (IOP) less than 21, 18 or 15 mm Hg with a reduction of more than 20% IOP from baseline without (complete success) or with medications (qualified success).Results99 eyes with OAG that underwent DSMMC were recruited into the study. Of these, 49 eyes (49.49%) had undergone LGP post-DSMMC. IOP was significantly reduced following LGP from 28.4 to 11.8 mm Hg. Comparison of Kaplan-Meier survival curves out to 60 months after LGP showed a trend towards better outcomes in the late LGP group with the only statistically significant difference noted for qualified success with IOP target <15 mm Hg. Complications were few with no difference noted between early and late LGP groups.ConclusionThere appears to be a trend towards late LGP being more effective after DSMMC when compared with early LGP; this however was not significant. This study corroborates previous published data confirming LGP is an effective and safe procedure for lowering IOP post-DSMMC procedure.

Download Full-text

DIALYSIS PATIENTS;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.03.2008 ◽

2014 ◽

Vol 21 (03) ◽

pp. 465-470

Author(s):

Isaac Shahzad ◽

Zahid Ahmad

Keyword(s):

Serum Albumin ◽

Survival Curve ◽

Primary Data ◽

Categorical Variables ◽

Rank Test ◽

Kaplan Meier ◽

Significant Difference ◽

Laboratory Variables ◽

The Difference ◽

Level Of Significance

Objectives: The objective of this study is to compare and analyze the survivaldistributions of the different categories of the socio-economic and laboratory variables of theESRD patients. Through which we can see the difference between the categories of the individualcategorical variable with respect to the survival distributions. Data Sources: The sample of 40patients was taken from the two hospitals of Lahore city. Jinnah Hospital Lahore. Lahore GeneralHospital, Lahore. Design of the Study: The sample methodology of the study is the convenience6 sampling . Data Collection: The questionnaire was used to collect the primary data from thepatients. Period of the Study: All the patients were followed up during the study duration of 122days. Materials and Methods: To examine the significant difference in the different categories ofthe socio-economic and laboratory variables with respect to the survival distribution the Kaplan-Meier method is used. To illustrate the survival distributions the survival curve and hazard curve2 were used . Results: All the p-values of socio-economic and laboratory are very large except thep-value of the Serum Albumin which is very small and less than 0.05 level of significance. Thecategories of all the laboratory variables were classified into “Normal values Range” and “Othervalues out of range values”. The categories of the Serum Albumin are significantly different.Conclusions: It is concluded that the survival distributions of all the categorical variables areequal and do not differ significantly. Furthermore the laboratory variable Serum Albumin is2 significantly differing by the log rank test . So it is clear indication that the serum albumin is not thestatus variable of nutrition.

Download Full-text

Longevity and Complication Rates of Ultrasound Guided Versus Traditional Peripheral Intravenous Catheters in a Pediatric Emergency Department

Journal of the Association for Vascular Access ◽

10.1016/j.java.2018.06.002 ◽

2018 ◽

Vol 23 (3) ◽

pp. 149-154

Author(s):

Krisha Desai ◽

Alexandra M. Vinograd ◽

Mary Kate F. Abbadessa ◽

Aaron E. Chen

Keyword(s):

Survival Time ◽

Rank Test ◽

Complication Rates ◽

Survival Times ◽

Ultrasound Guided ◽

Survival Curves ◽

Intravenous Line ◽

Log Rank Test ◽

Kaplan Meier ◽

Significant Difference

Abstract Background: Ultrasound-guided peripheral intravenous lines are frequently used in patients with difficult access. We have previously reported on the longevity and complication rates of ultrasound-guided peripheral intravenous lines, but there are limited data comparing outcomes of ultrasound-guided peripheral intravenous lines to traditionally placed peripheral intravenous lines in children. The aim of this study was to compare the longevity and complication rates of ultrasound-guided peripheral intravenous lines to traditionally placed intravenous lines in a pediatric population. Methods: This study analyzed 300 ultrasound-guided peripheral intravenous lines and 552 traditionally placed intravenous lines using patient records to determine the reason and timing for intravenous line removal. A t-test was used to compare overall mean survival times, and a log-rank test was used to compare Kaplan-Meier survival curves. Complication rates were compared using a chi-squared test. Results: The survival times of ultrasound-guided peripheral intravenous lines (mean = 73 hours, SD = 68 hours) were significantly longer than those of traditionally placed intravenous lines (mean = 38 hours, SD = 29.4 hours), t(559) = 8.51, P < .0001. Kaplan-Meier survival analysis yielded a median ultrasound-guided peripheral intravenous line survival time of 143 hours (IQR = 68–246) and a median traditionally placed intravenous line survival time of 100 hours (IQR = 65–106) with a significant difference between the 2 survival curves by the log-rank test. There was also no significant difference in complication rates between ultrasound-guided peripheral intravenous lines (34.8%) compared to traditionally placed intravenous lines (31.8%), x2(1, N = 517) = 0.465, P = .50. Conclusions: Our data suggests that ultrasound-guided peripheral intravenous lines are a viable option for children, including those with a history of difficult access. Survival times were longer for ultrasound-guided peripheral intravenous lines versus traditionally placed intravenous lines, and complication rates of the ultrasound-guided peripheral intravenous lines and traditionally placed intravenous lines were similar.

Download Full-text