scholarly journals Prevalence and Prognostic Implications of PD-L1 Expression in Soft Tissue Sarcomas

2021 ◽  
Vol 27 ◽  
Author(s):  
Mohamed Kelany ◽  
Thomas FE. Barth ◽  
Dina Salem ◽  
Marwa M. Shakweer
Keyword(s):  
Soft Tissue ◽  
Statistical Significance ◽  
Soft Tissue Sarcomas ◽  
Predictive Marker ◽  
University Hospital ◽  
Chi Square ◽  
Tissue Samples ◽  
Cancer Subtypes ◽  
Chi Square Test ◽  
Prognostic Implications

Background: PD-L1 expression differs from 19 to 92% in various cancer subtypes. Its expression carries a worse prognostic value in various malignancies and could also be used as a predictive marker for immune checkpoint inhibitor response. This study aimed to explore the prevalence of PD-L1 expression in soft tissue sarcomas and the correlation of PD-L1 expression with clinicopathological features.Patients and Methods: The tissue samples of 50 patients with STS were tested for PD-L1 expression using immunohistochemistry (IHC). We followed a 6-step proportional scoring system. The patients were treated at Ain Shams University Hospital from 2011 to 2017. We also explored the correlation of PD-L1 expression with different clinical features of the patients. The chi-square test was used to calculate the differences among variables.Results: Twelve cases (24%) showed positive PD-L1 expression with the highest prevalence in rhabdomyosarcoma and desmoid tumors (2/2 and 2/3 cases, respectively), followed by GIST in 2/4 cases and liposarcoma in 3/11 cases. Patients with positive PD-L1 expression showed a trend for worse survival, with a median overall survival of 11 months vs. 19 months for patients with negative PD-L1 expression (p-value = 0.1) and a mean PFS of 6 months vs. 11 months for patients with negative PD-L1 expression (p-value = 0.1). However, these findings did not reach statistical significance.Conclusion: Although the results did not reach statistical significance due to the small number of cases, PD-L1 expression could represent a prognostic factor for poor outcome. Larger clinical trials are recommended for the validation of PD-L1 as a poor prognostic biomarker.

Understanding the expanding armamentarium for GIST: Engaged learning outcomes.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 837-837
Author(s):  
Michelle Arielle Worst ◽  
Emily Sherene Van Laar ◽  
Mindy Tanzola ◽  
Michael C. Heinrich ◽  
Victor Manuel Villalobos
Keyword(s):  
Clinical Care ◽  
Statistical Significance ◽  
Soft Tissue Sarcomas ◽  
Educational Activity ◽  
Chi Square ◽  
Assessment Scores ◽  
Confidence Assessment ◽  
Resistance Patterns ◽  
Chi Square Test ◽  
Post Assessment

837 Background: Gastrointestinal stromal tumors (GIST) are rare soft-tissue sarcomas that harbor specific genomic alterations, making GIST an ideal model for targeted therapy. Common oncogenic drivers include mutations in the KIT and PDGFR tyrosine kinase. Due to varying resistance patterns to existing TKIs, clinicians are challenged to stay current with new data and how best to integrate new agents into treatment paradigms. The objective of this study was to assess the changes in oncologists’ and gastroenterologists’ knowledge, competence, and confidence through participation in education regarding optimal GIST treatment. Methods: The educational activity consisted of a 30-minute online, 2 faculty, video discussion with synchronized slides. Educational effect was assessed with a repeated pairs pre-/post-assessment study with a 3-item, multiple choice, knowledge/competence questionnaire and one confidence assessment question. For all questions, each participant served as his/her own control. Pre- and post-assessment scores were compared to determine the relative changes in the proportion of correct responses. A chi-square test assessed statistical significance at the P < 0.05 level. The activity launched 25th June 2019; data were collected until 19th August 2019. Results: Overall significant improvements were seen after education for oncologists (N=52, P < 0.001) and gastroenterologists (N=127, P < 0.01). The relative improvement was 79% for oncologists and 44% for gastroenterologists (pre-/post-assessment average correct response rates were 24%/43% and 23%/33%, respectively). Following the activity, 44% of oncologists and 37% of gastroenterologists were more confident in their ability to select appropriate therapy for patients with metastatic GIST. Conclusions: Participation in an online, 30-minute video discussion CME intervention resulted in statistically significant improvements in knowledge, competence, and confidence of oncologists and gastroenterologists, that may lead to improvements in clinical care. As new data and agents emerge, new educational activities are necessary to reinforce knowledge, close persistent gaps, and increase oncologists’ confidence in this clinical setting.

PD-L1 expression in soft tissue sarcomas and its prognostic implication.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14261-e14261
Author(s):  
Mohamed Reda Kelany ◽  
Thomas Barth ◽  
Dina Salem ◽  
Marwa Mosaad
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Checkpoint Inhibitors ◽  
Soft Tissue Sarcomas ◽  
P Value ◽  
Pathological Feature ◽  
University Hospitals ◽  
Chi Square ◽  
Chi Square Test ◽  
Clinically Significant

e14261 Background: The expression rate of PD-L1 in human malignant tumors paid a lot of attention and has been reported to vary from 19% to 92%, and the expression of PD-L1 was associated with poor prognosis of various human and may predicted the response to immune checkpoint inhibitors. The purpose of this study to investigate the expression of PD-L1 and its clinic-pathological feature in soft tissue sarcomas (STS). Methods: We collected Paraffin embedded tissue of 50 Patients with STS retrospectively from the archives of Pathology and oncology Department, Ain Shams University Hospitals from 2011-2017.then we correlated between PD-L1 expression and the clinico-pathological features. For PD-L1 expression we followed the Cologne 6-step proportional scoring system, using the rabbit monoclonal antibody (E1L3N 13684) and Tumors with > /10% membranous stained cells were considered to be positive for expression. The differences among variables were calculated by chi-square test. Results: PD-L1 expression was found in 12 (24%) of cases. Of all sarcoma subtypes , desmoid tumors had the highest prevalence of PD-L1 expression noted in 2/3 (66%) of samples followed by GIST 2/4(50%), then liposarcoma 3/11(27%). In addition, there were 2 rhabdomyosarcoma cases with tumor positivity for PD-L1 expression. We found that STS patients with PD-L1 expression have shorter survival with a median OS 11 vs 19 months (p-value = 0.1) as well as a mean PFS 6 vs 11 months (p-value = 0.1) in PD-L1 positive and negative respectively; this finding considered as clinically significant, but not reached to statistical significant . Conclusions: We report here that PD-L1 expression is as prognostic factor for poorer outcome. This finding may be clinically significant but does not reach the statistically significant levels due to small number of samples included. Its role beyond that of a prognostic biomarker remains to be established in the context of larger clinical trials. Clinical trial information: 31/2017.

scholarly journals Computer-generated STOPP/START recommendations for hospitalised older adults: evaluation of the relationship between clinical relevance and rate of implementation in the SENATOR trial

2020 ◽  
Vol 49 (4) ◽  
pp. 615-621 ◽  
Author(s):  
Kieran Dalton ◽  
Denis Curtin ◽  
Denis O’Mahony ◽  
Stephen Byrne
Keyword(s):  
Older Adults ◽  
Clinical Relevance ◽  
Statistical Significance ◽  
University Hospital ◽  
Chi Square ◽  
Implementation Rate ◽  
Key Factor ◽  
Chi Square Test ◽  
The Relationship ◽  
Trial Intervention

Abstract Background findings from a recent qualitative study indicate that the perceived clinical relevance of computer-generated STOPP/START recommendations was a key factor affecting their implementation by physician prescribers caring for hospitalised older adults in the SENATOR trial. Aim to systematically evaluate the clinical relevance of these recommendations and to establish if clinical relevance significantly affected the implementation rate. Methods a pharmacist–physician pair retrospectively reviewed the case records for all SENATOR trial intervention patients at Cork University Hospital and assigned a degree of clinical relevance for each STOPP/START recommendation based on a previously validated six-point scale. The chi-square test was used to quantify the differences in prescriber implementation rates between recommendations of varying clinical relevance, with statistical significance set at P &lt; 0.05. Results in 204 intervention patients, the SENATOR software produced 925 STOPP/START recommendations. Nearly three quarters of recommendations were judged to be clinically relevant (73.6%); however, nearly half of these were deemed of ‘possibly low relevance’ (320/681; 47%). Recommendations deemed of higher clinical relevance were significantly more likely to be implemented than those of lower clinical relevance (P &lt; 0.05). Conclusions a large proportion (61%) of the computer-generated STOPP/START recommendations provided were of potential ‘adverse significance’, of ‘no clinical relevance’ or of ‘possibly low relevance’. The adjudicated clinical relevance of computer-generated medication recommendations significantly affects their implementation. Meticulous software refinement is required for future interventions of this type to increase the proportion of recommendations that are of high clinical relevance. This should facilitate their implementation, resulting in prescribing optimisation and improved clinical outcomes for multimorbid older adults.

scholarly journals PHLEBITIS IN PERIPHERAL VASCULAR CATHETERS OF HOSPITALIZED PATIENTS

2019 ◽  
Vol 5 ◽  
Author(s):  
Emile Rodrigues Da Silva ◽  
Rosane Soares
Keyword(s):  
Statistical Analysis ◽  
Statistical Significance ◽  
Signs And Symptoms ◽  
University Hospital ◽  
Peripheral Vascular ◽  
Chi Square ◽  
Multiprofessional Team ◽  
Venous Puncture ◽  
Chi Square Test ◽  
Vascular Catheters

Objective: To identify the occurrence of mechanical and chemical phlebitis in peripheral venous catheters of hospitalized adult patients. Method: a descriptive observational study with 100 patients over 18 years of age who underwent peripheral venous puncture, performed in September and October 2016 at the Adult Hospitalization Unit of a University Hospital. The site of insertion of the peripheral puncture device was evaluated daily in order to identify signs and symptoms of phlebitis. Statistical analysis was performed using the chi-square test, considering statistical significance when p <0.05. Results: Phlebitis occurred in 21% of cases, with grade 1 (52.4%) prevalent. Of the 21 cases, 14 occurred due to mechanical causes, 50% due to repeated punctures and 7 due to chemical causes, which presented a statistically significant value in relation to some medications used (p = 0.008). Conclusion: the result of the study made the importance of the multiprofessional team in the care of these patients perceptible.

scholarly journals Relative Sensitivity of Core-Needle Biopsy and Incisional Biopsy in the Diagnosis of Musculoskeletal Sarcomas

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1393
Author(s):  
Alexander Klein ◽  
Theresa Fell ◽  
Christof Birkenmaier ◽  
Julian Fromm ◽  
Volkmar Jansson ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Histopathological Examination ◽  
Statistical Significance ◽  
Soft Tissue Sarcomas ◽  
Incisional Biopsy ◽  
Tissue Samples ◽  
Core Needle ◽  
Significant Difference

Background: There is no evidence as to the diagnostic value of the two most frequently used methods of biopsies in sarcomas: Incisional or core needle biopsy. The aim of our study was to evaluate the diagnostic sensitivity of the incisional and the core needle biopsy techniques in the diagnosis of bone and soft tissue sarcomas. Methods: We included 417 patients with a definitive diagnosis of bone or soft tissue sarcoma in whom a total of 472 biopsies had been performed. We correlated the results of the biopsies with the result of the definitive histopathological examination of the resected tumor. Dignity, entity, and grading (whenever possible) of the tissue samples were evaluated. Results: A total of 258 biopsies (55%) were performed in order to diagnose a soft tissue tumor and 351 biopsies (74.4%) were core needle biopsies. The number of repeat core needle biopsies, necessitated because of inconclusive histopathological results, was significantly higher (50 vs. 5; p = 0.003). We observed no significant difference regarding dignity, entity, and grading between the 2 different types of biopsies. Only with regards to the determination of dignity and entity of chondroid tumors, incisional biopsy was superior with statistical significance (p = 0.024). Conclusions: This study represents the largest study on biopsies for bone and soft tissue sarcomas. Based only on our results, we are unable to favor one method of biopsy and found high accuracy with both methods. Considering the potential complications, the added oncological risks of incisional biopsies and the ready availability of core needle biopsies, the latter, in our assessment, represents a valid and favourable method for bone and soft tissue sarcomas.

Prognostic Implications of p53 Nuclear Overexpression and High Proliferation Index of Ki-67 in Adult Soft-Tissue Sarcomas

1994 ◽  
Vol 86 (7) ◽  
pp. 549-554 ◽  
Author(s):  
Marija Drobnjak ◽  
Esther Latres ◽  
Daphna Pollack ◽  
Martin Karpeh ◽  
Maria Dudas ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Proliferation Index ◽  
Ki 67 ◽  
Prognostic Implications

Change in perception of sclerotherapy results after exposure to pre–post intervention photographs

2017 ◽  
Vol 33 (4) ◽  
pp. 282-287 ◽  
Author(s):  
Fabricio R Santiago ◽  
Mario Piscoya ◽  
Yung-Wei Chi
Keyword(s):  
Varicose Veins ◽  
Statistical Significance ◽  
Wilcoxon Test ◽  
Clinical Severity ◽  
Post Intervention ◽  
Chi Square ◽  
Severity Scores ◽  
Venous Clinical Severity Score ◽  
Before And After ◽  
Chi Square Test

Objective To evaluate patients’ self-perception of cosmetic improvement before and after they were presented with pre- and postprocedure photographs after sclerotherapy with 75% dextrose. Methods Treatments included sclerotherapy of reticular and varicose veins using 75% dextrose. All treated limbs were photographed and classified according to Clinical, Etiology, Anatomy, and Pathology classification and Venous Clinical Severity Score pre- and posttreatment. The patients were queried before and after viewing the photos during these visits and indicated if they were very unsatisfied, dissatisfied, satisfied, or very satisfied. Nonparametric kappa correlation coefficient and a Chi square test were used to measure associations among agreement (p < 0.05 indicated statistical significance). The paired Wilcoxon test was used to compare statistical differences in mean Venous Clinical Severity Scores measured at different times (p < 0.05 indicated statistical significance). Data were analyzed using STATA software (version 12). Results Individuals were more satisfied with the results of sclerotherapy after exposure to images portraying their limbs two months after the procedure (p = 0.0028). This effect was maintained six months after sclerotherapy (p = 0.0027). Conclusion Patient exposure to pre- and postsurgical photographs is a simple intervention with the potential of improving patient satisfaction up to six months after treatment with sclerotherapy.

scholarly journals Frequency of dementia among elderly admitted to a Geriatrics Inpatients Sector of a Brazilian public hospital

2018 ◽  
Vol 12 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Rafael Thomazi ◽  
Liciana Vaz de Arruda Silveira ◽  
Paulo José Fortes Villas Boas ◽  
Alessandro Ferrari Jacinto
Keyword(s):  
Univariate Analysis ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
University Hospital ◽  
Chi Square ◽  
Diagnosis Of Dementia ◽  
Elderly Inpatients ◽  
Chi Square Test ◽  
Student’S T ◽  
Clinical Conditions

ABSTRACT Patients with dementia are commonly admitted to inpatient sectors. The aim of this study was to describe the frequency of dementia among elderly inpatients admitted to the Geriatrics Sector of a Brazilian Tertiary University Hospital, and to identify associations between dementia and clinical and sociodemographic factors. Methods: All patients admitted to the Geriatrics Sector of a public Brazilian university-hospital from March 1st 2014 to January 31st 2015 were assessed by geriatricians. The patients were divided into groups "with or without diagnosis of dementia". Univariate analysis was performed between these two groups using the Chi-Square Test, Student's t-test or the Mann-Whitney Test. Results: One hundred and three elderly inpatients, with a mean age of 82 (±7.9) years, were assessed. Overall, 74.7% had low educational level (<4 years), 66% used polypharmacy, 57.2% developed delirium during hospitalization and 59% were totally dependent for basic activities of daily living. The diagnosis of dementia was observed in 59 (57%) subjects. Conclusion: The frequency of dementia was high among the elderly inpatients evaluated. The association between dementia and certain clinical conditions, such as incontinence, delirium and use of psychoactive drugs, was in line with the medical literature.

scholarly journals Gloves Perforations in Minor Oral Surgical Procedures: A Comparison of Latex and Nitrile Gloves

2021 ◽  
Vol 30 (02) ◽  
pp. 103-106
Author(s):  
Ajeet Kumar ◽  
◽  
Naveed Iqbal ◽  
Javaria Farooq ◽  
Saad Uddin Siddiqui
Keyword(s):  
Local Anesthesia ◽  
Surgical Procedures ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
P Value ◽  
Dominant Hand ◽  
Chi Square ◽  
Oral Surgical Procedures ◽  
Latex Gloves ◽  
Chi Square Test

OBJECTIVE: This study was performed to compare incidence of perforations in Latex and Nitrile examination gloves during Minor Oral surgical procedures performed under local anesthesia. METHODOLOGY: 100 pairs of latex and 100 pairs of Nitrile examination gloves where used to perform 200 minor oral surgical procedures under local anesthesia. After completion of every minor oral surgical procedure each gloves was examined by Water Inflation method to observe presence or absence of Perforations. A data sheet was used to collect data including type of Gloves used (Latex or Nitrile) presence of perforations, sites of perforations and nature of minor oral surgical procedures. Data was entered and analyzed using SPSS version 20. Descriptive analysis was conducted to calculate frequency and percentages of Number and sites of perforations for both Nitrile and latex examination gloves. Chi Square test was used to find out statistical significance of difference of perforations rate between Nitrile and Latex gloves. P value of < 0.05 was considered significant. RESULTS: Out of 200 latex gloves 23 (11.5) had 29 perforations whereas out of total 200 Nitrile gloves 28 (14%) had 22 perforations. Nitrile gloves had a statistically significant higher rate of perforations as compared to Latex gloves. (P value 0.043). For both Nitrile and Latex gloves left non dominant hand had highest frequency of perforations Latex 18 (81.81%) perforations and Nitrile 18(62.06%). Index finger and thumb were most frequent sites of perforations in both Latex and Nitrile gloves. CONCLUSION: Gloves perforations were more common in Nitrile examination gloves however total number of perforations was more in Latex examination gloves.

scholarly journals Relationship of the Self-perception of Lifestyle with Level of Physical Activity in People with and without Type 2 Diabetes

2019 ◽  
pp. 1-7
Author(s):  
Briseida Mayel Perez-Avelino ◽  
Nicolás Padilla-Raygoza ◽  
Verónica Benitez-Guerrero ◽  
María Luisa Sánchez Padilla ◽  
Vicente Beltrán-Campos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Statistical Significance ◽  
Self Perception ◽  
Chi Square ◽  
Cross Sectional ◽  
Lifestyle Questionnaire ◽  
Chi Square Test ◽  
Relationship Of

Objective: To determine the relationship of the perception of lifestyle with the level of physical activity in people with type 2 diabetes and without type 2 diabetes. Study Design: Analytical cross-sectional observational study in Celaya, Guanajuato, Mexico. Methodology: Sample composed of 100 people with type 2 diabetes and 100 people without type 2 diabetes, the lifestyle questionnaire and IPAQ questionnaire were used. Descriptive statistics were calculated for sociodemographic variables; it was calculated Chi-square test and Odds Ratio.  To demonstrate the statistical significance of results, the value of P was set at .05. Statistical analysis was performed in STATA 13.0 ®. Results: In patients with Type 2 Diabetes predominated females, married, who never went school and elementary and BMI ≥ 25 kg/m2; among patients without Type 2 Diabetes, predominant males, singles, went school or university, BMI ≥25 kg/m2; no relationship was found between lifestyle perception and level of physical activity in adults with type 2 diabetes (X² = 0.0022 gl 1 P = .96) neither it was found a significant relationship between lifestyle perception and level of physical activity in adults without type 2 diabetes (X² = 5.23 gl 1 P = .02 RM = 2.85 95% CI = 0.80 to 10.4). Conclusion: The results show that self-perception of lifestyle and physical activity is different in people with less age, more schooling, males.

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