scholarly journals Development and Validation of Prognostic Nomogram in Patients With WHO Grade III Meningioma: A Retrospective Cohort Study Based on SEER Database

2021 ◽  
Vol 11 ◽  
Author(s):  
Zetian Jia ◽  
Yaqi Yan ◽  
Jiuxin Wang ◽  
He Yang ◽  
Haihua Zhan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
World Health ◽  
Central Nervous System Tumor ◽  
Seer Database ◽  
Net Benefit ◽  
Who Grade ◽  
Who Grade Iii ◽  
Grade Iii

IntroductionWorld Health Organization (WHO) Grade III meningioma is a central nervous system tumor with a poor prognosis. In this retrospective cohort study, the authors constructed a nomogram for predicting the prognosis of WHO Grade III meningioma.MethodsThe patients of this nomogram were based on the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018. All patients were randomly divided into a development cohort (964 patients) and a validation cohort (410 patients) in a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) regression was used to screen the predictors. The Cox hazards regression model was constructed and the prognosis was visualized by nomogram. The performance of the prognostic nomogram was determined by consistency index (C-index), clinical net benefit, and calibration.ResultsEight variables were included in the nomogram: gender, race, age at diagnosis, histology, tumor site, tumor size, laterality, and surgical method. The C-index of the training set and verification set were 0.654 and 0.628. The calibration plots showed that the nomogram was in good agreement with the actual observation. The clinical decision curve indicates that the nomogram has a good clinical net benefit in WHO Grade III meningioma.ConclusionsA prognostic nomogram of a large cohort of WHO Grade III meningioma was established and verified based on the SEER database. The nomogram we established may help clinicians provide personalized treatment services and clinical decisions for patients.

scholarly journals Incidence of Secondary Microorganism Infections Following Utilization of Tocilizumab for the Treatment of COVID‑19 - A Matched Retrospective Cohort Study

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Joanna L. Moore ◽  
Stephanie J. Stroever ◽  
Patricia E. Rondain ◽  
Robyn N. Scatena
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Secondary Infection ◽  
World Health ◽  
Quantitative Relation ◽  
Secondary Outcome ◽  
Healthcare Associated Infection ◽  
Kaplan Meier ◽  
Healthcare Associated

Introduction: immunological disorder agent’s area unit theorized to focus on the protein storm syndrome in COVID‑19. However, the downstream effects concerning susceptibilities to secondary infection risk stay unknown. This study seeks to work out risk variations for secondary infections among COVID‑19 patients World Health Organization did and failed to receive tocilizumab. Methods: we have a tendency to conducted a matched retrospective cohort study from 2 giants, acute care hospitals in Western Connecticut from March 1 to May 31, 2020. we have a tendency to collected variables exploitation manual case history abstraction. the first exposure variable was any dose of tocilizumab. the first outcome was any healthcare‑associated microorganism or mycosis as outlined by the National Care Safety Network. we have a tendency to performed a Kaplan–Meier analysis to assess the crude distinction within the additive likelihood of healthcare‑associated infection (HAI) across exposure teams. we have a tendency to conjointly performed a multivariable Cox multivariate analysis to work out the hazard quantitative relation for HAI by exposure group whereas dominant for potential confounders. Results: The Kaplan–Meier analysis incontestable no distinction within the additive likelihood of HAI across teams. The adjusted hazard of HAI for patients given tocilizumab was zero.85 times that of patients not given tocilizumab (95% confidence interval = zero.29, 2.52, P = 0.780) once dominant for relevant confounders. Conclusions: Tocilizumab failed to increase the incidence of secondary infection among COVID‑19 patients. Larger, irregular trials ought to valuate infection as a secondary outcome to validate this finding.

scholarly journals Histological-subtypes and anatomical location correlated in meningeal brain tumors (meningiomas)

2014 ◽  
Vol 05 (03) ◽  
pp. 244-249
Author(s):  
Abdul Rashid Bhat ◽  
Muhammed Afzal Wani ◽  
Altaf Rehman Kirmani ◽  
Altaf Umar Ramzan
Keyword(s):  
Brain Tumors ◽  
High Mortality ◽  
World Health ◽  
Anatomical Location ◽  
X Rays ◽  
Histological Subtypes ◽  
Who Grade ◽  
Sphenoid Ridge ◽  
Who Grade Iii ◽  
Grade Iii

ABSTRACT Context: Not enough literature is available to suggest a link between the histological subtypes of intracranial meningeal brain tumors, called ‘meningiomas’ and their location of origin. Aim: The evidence of correlation between the anatomical location of the intracranial meningiomas and the histopathological grades will facilitate specific diagnosis and accurate treatment. Materials and Methods: The retrospective study was conducted in a single high-patient-inflow Neurosurgical Center, under a standard and uniform medical protocol, over a period of 30 years from December 1982 to December 2012. The records of all the operated 729 meningiomas were analyzed from the patient files in the Medical Records Department. The biodata, x-rays, angiography, computed tomography (CT) scans, imaging, histopathological reports, and mortality were evaluated and results drawn. Results: The uncommon histopathological types of meningiomas (16.88%) had common locations of origin in the sphenoid ridge, posterior parafalcine, jugular foramen, peritorcular and intraventricular regions, cerebellopontine angle, and tentorial and petroclival areas. The histopathological World Health Organization (WHO) Grade I (Benign Type) meningiomas were noted in 89.30%, WHO Grade II (Atypical Type) in 5.90%, and WHO Grade III (Malignant Type) in 4.80% of all meningiomas. Meningiomas of 64.60% were found in females, 47.32% were in the age group of 41-50 years, and 3.43% meningiomas were found in children. An overall mortality of 6.04% was noted. WHO Grade III (malignant meningiomas) carried a high mortality (25.71%) and the most common sites of meningiomas with high mortality were: The cerebellopontine angles, intraventricular region, sphenoid ridge, tuberculum sellae, and the posterior parafalcine areas. Conclusion: The correlation between the histological subtypes and the anatomical location of intracranial meningeal brain tumors, called meningiomas, is evident, but further research is required to establish the link.

scholarly journals Temporary disengagement and re-engagement in human immunodeficiency virus care in a rural county serving pastoralist communities in Kenya: a retrospective cohort study

2019 ◽  
Vol 12 (2) ◽  
pp. 95-100
Author(s):  
Paul Yonga ◽  
Stephen Kalya ◽  
Lutgarde Lynen ◽  
Tom Decroo
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Retention In Care ◽  
Virologic Response ◽  
World Health ◽  
Hiv Care ◽  
Pastoralist Communities ◽  
Immunodeficiency Virus

Abstract Background Pastoralist communities are known to be hard to reach. The magnitude of temporary disengagement from human immunodeficiency virus (HIV) care is understudied. Methods We conducted a retrospective cohort study of temporary disengagement (2 weeks late for a next appointment), virologic response, lost to follow-up (6 months late) and re-engagement in care among patients who started antiretroviral therapy between 2014 and 2016 in Baringo County, Kenya. Predictors of re-engagement after disengagement were estimated using logistic regression. Results Of 342 patients, 76.9% disengaged at least once (range 0–7). Of 218 patients with a viral load (VL), 78.0% had a suppressed VL. Those with a history of temporary disengagement from care were less likely to suppress their VL (p=0.002). Six patients had treatment failure (two consecutive VLs >1000 copies/mm3) and all had disengaged at least once. After disengagement from care, male patients (adjusted odds ratio [aOR] 0.3 [95% confidence interval {CI} 0.2 to 0.6]; p<0.001) and patients with World Health Organization stage III–IV (aOR 0.3 [95% CI 0.1 to 0.5; p<0.001) were less likely to re-engage in care. Conclusions Temporary disengagement was frequent in this pastoralist setting. This indicator is often overlooked, as most studies only report binary outcomes, such as retention in care. Innovative strategies are required to achieve HIV control in rural settings like this pastoralist setting.

scholarly journals Analysis of Prognostic Factors of World Health Organization Grade Ⅲ Meningiomas

2020 ◽  
Vol 10 ◽  
Author(s):  
Weidong Tian ◽  
Jingdian Liu ◽  
Kai Zhao ◽  
Junwen Wang ◽  
Wei Jiang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Postoperative Radiotherapy ◽  
World Health ◽  
Low Grade ◽  
Ki 67 ◽  
Who Grade ◽  
Who Grade Iii ◽  
Grade Iii

ObjectiveWHO grade III meningiomas are highly aggressive and lethal. However, there is a paucity of clinical information because of a low incidence rate, and little is known for prognostic factors. The aim of this work is to analyze clinical characteristics and prognosis in patients diagnosed as WHO grade III meningiomas.Methods36 patients with WHO grade III meningiomas were enrolled in this study. Data on gender, age, clinical presentation, preoperative Karnofsky Performance Status (KPS), histopathologic features, tumor size, location, radiologic findings, postoperative radiotherapy (RT), surgical treatment, and prognosis were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were evaluated using the Kaplan-Meier method. Univariate and multivariate analysis were conducted by the Cox regression model.ResultsMedian PFS is 20 months and median OS is 36 months in 36 patients with WHO grade III meningiomas. Patients with secondary tumors which transformed from low grade meningomas had lower PFS (p=0.0014) compared with primary group. Multivariate analysis revealed that tumors location (PFS, p=0.016; OS, p=0.013), Ki-67 index (PFS, p=0.004; OS, p<0.001) and postoperative radiotherapy (PFS, p=0.006; OS, p<0.001) were associated with prognosis.ConclusionWHO grade III meningiomas which progressed from low grade meningiomas were more prone to have recurrences or progression. Tumors location and Ki-67 index can be employed to predict patient outcomes. Adjuvant radiotherapy after surgery can significantly improve patient prognosis.

scholarly journals Breastfeeding cessation in the era of Elimination of Mother to Child Transmission of HIV in Uganda: a retrospective cohort study

2020 ◽  
Author(s):  
Jackslina Gaaniri Ngbapai ◽  
Jonathan Izudi ◽  
Stephen Okoboi
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Statistical Significance ◽  
World Health ◽  
Hiv Care ◽  
Breastfeeding Initiation ◽  
One Year ◽  
Postpartum Mothers ◽  
Mother To Child

Abstract Background: Among human immunodeficiency (HIV) infected mothers, the World Health Organization (WHO) recommends cessation of breastfeeding at one year to prevent HIV transmission but data are limited. We examined the frequency and factors associated with cessation of breastfeeding at one year among HIV infected postpartum mothers at Ndejje Health Center IV, a large peri-urban health facility in Uganda. Methods: This retrospective cohort study involved all HIV infected postpartum mothers enrolled in HIV care for at least 12 months between June 2014 and June 2018. We abstracted data from registers, held focused group discussions with HIV infected postpartum mothers, and key informant interviews with healthcare providers. Cessation of breastfeeding was defined as the proportion of HIV infected postpartum mothers who had stopped breastfeeding at one year. We summarized quantitative data descriptively, tested differences in outcome with the Chi-square and t-tests, and established independently associated factors using the modified Poisson regression analysis at 5% statistical significance level. We thematically analyzed qualitative data to enrich and triangulate the quantitative results. Results: Of 235 HIV infected postpartum mothers, 150 (63.8%) ceased breastfeeding at one year and this was independently associated with the HIV exposed infant (HEI) being female than male (Adjusted risk ratio (aRR): 1.25, 95% confidence interval (CI), 1.04, 1.50), the mother being multiparous than primparous (aRR, 1.26; 95% CI, 1.04-1.53), and breastfeeding initiation on same-day as birth (aRR, 0.06; 95% CI, 0.01-0.41). Qualitative results showed that partner reminders about breastfeeding adequacy of BF knowledge and maternal literacy facilitated continued breastfeeding until one year. Inadequate breastfeeding knowledge, casual and formal work demands, in addition to increased breastfeeding demand among boys led to cessation of breastfeeding before one year.Conclusion. Cessation of breastfeeding at one year among HIV infected postpartum mothers was suboptimal and this might increase risk of mother to child transmissions of HIV. Cessation of breastfeeding was more likely among female HEIs and multiparous mothers, and less likely when breastfeeding is initiated on same-day as birth. Interventions to enhance cessation of breastfeeding at one year should target groups of women with lower rates.

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