scholarly journals Survival of COVID-19 with Multimorbidity Patients

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1423
Author(s):  
E. Bustos-Vázquez ◽  
E. Padilla-González ◽  
D. Reyes-Gómez ◽  
M. C. Carmona-Ramos ◽  
J. A. Monroy-Vargas ◽  
...  
Keyword(s):  
Descriptive Analysis ◽  
Survival Rates ◽  
Hospitalized Patients ◽  
Sample Population ◽  
Mechanical Ventilators ◽  
Number Of Patients ◽  
Regression Test ◽  
Main Variable ◽  
Logistic Regression Test

Background: The outbreak of SARS-CoV-2 abruptly disseminated in early 2020, overcoming the capacity of health systems to respond the pandemic. It was not until the vaccines were launched worldwide that an increase in survival was observed. The objectives of this study were to analyse the characteristics of survivors and their relationship with comorbidities. We had access to a database containing information on 16,747 hospitalized patients from Mexico, all infected with SARS-CoV-2, as part of a regular follow-up. The descriptive analysis looked for clusters of either success or failure. We categorized the samples into no comorbidities, or one and up to five coexisting with the infection. We performed a logistic regression test to ascertain what factors were more influential in survival. The main variable of interest was survival associated with multimorbidity factors. The database hosted information on hospitalized patients from Mexico between March 2020 through to April 2021. Categories 2 and 3 had the largest number of patients. Survival rates were higher in categories 0 (64.8%), 1 (57.5%) and 2 (51.6%). In total, 1741 (10.5%) patients were allocated to an ICU unit. Mechanical ventilators were used on 1415 patients, corresponding to 8.76%. Survival was recorded in 9575 patients, accounting for 57.2% of the sample population. Patients without comorbidities, younger people and women were more likely to survive.

P5250Diastolic strain rate ratio as determined on MRI on detecting left ventricle stiffness and predict heart failure in post-STEMI patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Y Diao ◽  
S Huang ◽  
Y Gao ◽  
S He ◽  
Z G Yang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Logistic Regression ◽  
Left Ventricle ◽  
Strain Rate ◽  
Peak Strain ◽  
Short Axis ◽  
Diastolic Strain Rate ◽  
Regression Test ◽  
Logistic Regression Test

Abstract Background ST-elevation myocardial infarction (STEMI) Patients suffered from progressive heart failure, for which progressive and aggravated Left ventricle stiffness was one of the major culprit. Myocardial deformation in the early diastole is largely affected by the left ventricle compliance which could partly reflect chamber stiffness and potentially predict left ventricular remodeling for post-STEMI patients. Purpose To determine the value of diastolic strain rate in detecting left ventricle stiffness and early heart failure in post-STEMI patients. Methods A number of 52 (M/F: 46/6, age: 54.27 [46.8–62.3]yrs) patients with STEMI three months ago were prospectively recruited from 2016 to 2017. Follow-up was done until 2018. The primary end points were the symptoms of heart failure (NYHA II-IV). Consent was acquired from each patient and 3.0 T MRI was arranged. Imaging analysis was performed on Cvi 42 (V5.9.3 Canada). Peak radial strain (PS) and strain rate (SR) were extracted both from 2D short- and long-axis cine images, while peak circumferential parameters only from the short axis slices and longitudinal the long axis slices. The diastolic strain rate ratios (DSRRs) were calculated as the peak early diastolic SR divided by the peak late diastolic SR, which were derived from the two peak points on the corresponding curve of time-to-SR curve in the diastole (Figure 1a). Receiver-operating characteristics curve analysis and Logistic regression test were done for statistical analysis on R project and P<0.05 was considered as significant. Results Three patients were excluded due to unsatisfied cine images. Among the 52 patients, none of the patients died or had congestive heart failure. 23/52 (44.2%) patients complained of heart failure symptoms at the one-year follow-up. No significant difference was found in LVEF and three directional peak strain values or systolic peak strain rates between the patients with and without heart failure. Patients with symptoms had lower Longitudinal PS (P=0.049), early diastolic radial SR (P=0.01798), longitudinal SR (P=0.0042), and decreased DSRR in all directions (Figure 1b). Multivariate Logistic regression test showed that only DSRR in the radial direction on the short axis (DSRR-SR) was the independent predictor of the heart failure symptoms (6.59; range, 6.71–3.68; P=0.026). ROC analysis demonstrated that the DSRR-SR of 2.35 had sensitivity 91.3% and specificity 58.6% for the prediction of heart failure (Figure 1c). Figure 1 Conclusion DSRR especially DSRR-SR was more sensitive to left ventricle stiffness change and help predict the progression of heart failure for Post-STEMI patients. Further studies were needed to verify the its association with other cardiovascular clinical events. Acknowledgement/Funding the National Natural Science Foundation of China (81600299,81471721, 81471722, 81771887, and 81771897,);

scholarly journals The effects of PSA kinetics on the outcome of hypofractionated salvage radiotherapy for biochemical recurrence of prostate cancer after prostatectomy

2020 ◽  
Vol 61 (6) ◽  
pp. 908-919
Author(s):  
Hitoshi Ishikawa ◽  
Keiko Higuchi ◽  
Takuya Kaminuma ◽  
Yutaka Takezawa ◽  
Yoshitaka Saito ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Survival Rates ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Salvage Radiotherapy ◽  
Psa Kinetics ◽  
Prostate Bed ◽  
Number Of Patients

Abstract The feasibility and efficacy of hypofractionated salvage radiotherapy (HS-RT) for prostate cancer (PC) with biochemical recurrence (BR) after prostatectomy, and the usefulness of prostate-specific antigen (PSA) kinetics as a predictor of BR, were evaluated in 38 patients who received HS-RT without androgen deprivation therapy between May 2009 and January 2017. Their median age, PSA level and PSA doubling time (PSA-DT) at the start of HS-RT were 68 (53–74) years, 0.28 (0.20–0.79) ng/ml and 7.7 (2.3–38.5) months, respectively. A total dose of 60 Gy in 20 fractions (three times a week) was three-dimensionally delivered to the prostate bed. After a median follow-up of 62 (30–100) months, 19 (50%) patients developed a second BR after HS-RT, but only 1 patient died before the last follow-up. The 5-year overall survival and BR-free survival rates were 97.1 and 47.4%, respectively. Late grade 2 gastrointestinal and genitourinary morbidities were observed in 0 and 5 (13%) patients, respectively. The PSA level as well as pathological T-stage and surgical margin status were regarded as significant predictive factors for a second BR by multivariate analysis. BR developed within 6 months after HS-RT in 11 (85%) of 13 patients with a PSA-DT &lt; 10 months compared with 1 (17%) of 6 with a PSA-DT ≥ 10 months (median time to BR: 3 vs 14 months, P &lt; 0.05). Despite the small number of patients, our HS-RT protocol seems feasible, and PSA kinetics may be useful for predicting the risk of BR and determining the appropriate follow-up schedule.

scholarly journals PENGARUH ARUS KAS OPERASI, LIKUIDITAS, LEVERAGE, DIVERSIFIKASI, DAN UKURAN PERUSAHAAN TERHADAP FINANCIAL DISTRESS (Studi empiris pada perusahaan sektor aneka industri yang terdaftar di BEI 2014-2016)

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Febriyan Febriyan, Ari Hadi Prasetyo
Keyword(s):  
Cash Flow ◽  
Financial Distress ◽  
Technology Development ◽  
Descriptive Analysis ◽  
Secondary Data ◽  
Wald Test ◽  
Positive Direction ◽  
Regression Test ◽  
A Company ◽  
Logistic Regression Test

Recent era technology development escalate competition among companies. Most companies that unable overcome competion will not maximaze their profit, even tend to experience operating loss and the other side put the firm into financial distress. This research aims examine whether cash flow from operation, liquidity, leverage, diversification, and size are predictors that can be use to analyze companies financial distress. The sample of this research are 22 company related to various industry sector listed on IDX for year 2014-2016, the sample obtained is 66 companies. Stattistical technic analysis used are descriptive analysis, pooling test, logistic regression test , Hosmer and Lemeshow’s Goodness, Wald Test, -2 Log Likelihood test, and Nagelkerke’s R Square test. The data collected from secondary data, downloaded from www.idx.co.id. The research results shows that there is not enough evidence that cash flow from operation, liquidity, diversification, and size give significant effect to financial distress of company. While leverage have enough evidence gives significant effect with positive direction to the possibilty of financial distress of a company. Keywords : Cash Flow From Operation, Liquidity, Leverage, Diversification, Size, and Financial Distress

Time to review the role of intraluminal brachytherapy for dose escalation after concurrent chemoradiation in cancer esophagus: A retrospective audit.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16054-e16054
Author(s):  
Ankita Mehta ◽  
Piyush Kumar ◽  
Richa Gupta ◽  
Ayush Garg ◽  
Shubhi Agarwal
Keyword(s):  
Overall Survival ◽  
Dose Escalation ◽  
Survival Rates ◽  
Response Rates ◽  
Small Sample ◽  
Concurrent Chemoradiation ◽  
Intraluminal Brachytherapy ◽  
Treatment Characteristics ◽  
Number Of Patients

e16054 Background: Intraluminal brachytherapy (ILBT) for dose escalation after concurrent chemoradiation (CRT) in cancer esophagus is not routinely practiced. This is particularly attributable to radiotherapy toxicity in terms of strictures and fistulas. Cancer esophagus has poor locoregional control and overall survival rates in comparison to head and neck cancers. Dose escalation may be an option to counteract the high failure rates. Methods: A retrospective analysis was conducted for esophageal cancer patients treated between 2008 to 2016 planned for radical CRT to a minimum dose of 59.4 Gy in 33 fractions along with concurrent cisplatin 35 mg/m2 and 5 FU 375 mg/m2 on weekly basis. Further, the patients who received dose escalation after external beam radiotherapy (EBRT) completion by ILBT to a dose of 6 Gy in a single fraction to the pre EBRT volume were also analysed. The patient, tumor, treatment characteristics along with response rates, survival outcomes, and toxicities were evaluated and compared between the two groups - the patients who received ILBT and those who did not. Statistical significance between variables was analysed with the Chi-Square or Fischer’s exact test and t-test. Survival analysis was done by Log-Rank test. The analysis was done on a worst-case scenario basis where the patients lost to follow-up were considered dead. Results: The total number of patients treated by CRT was 69, out of which 13 patients received ILBT for dose escalation. The median age was 60 years (Range - 40 to 80 years) and the male: female ratio was 1.09, mean tumor length was 6.4 ± 2.4 cms (Range-1.5-12 cms). The commonest tumor site was the middle third observed in 58% patients. The median EBRT dose was 59.4 Gy (Range- 9 to 63 Gy). The median concurrent chemotherapy cycles were 5. The median follow-up period was 15 months (range 1-100 months). In terms of complete response rates, there was a trend towards significant improvement in patients receiving ILBT compared to those receiving EBRT alone (84.61% versus 57.49%, p=0.07). Also, the overall survival (OS) was significantly higher in the ILBT group (45.31 months versus 19.20 months; p = 0.005). The other patient, tumor, and treatment characteristics analyzed showed no significant impact on OS. There was no significant difference in the incidence of strictures (p=0.206) and severity (p=0.764) of strictures amongst both the groups. Grade ≥3 late toxicity was reported in 10 patients (17.85%) receiving EBRT alone and in 3 patients (23.07%) receiving ILBT. None of the patients receiving ILBT developed a fistula. Conclusions: The present study reveals a dramatic increase in OS by dose escalation with ILBT. The limitations of the present study were a small sample size and a lesser number of patients in the ILBT group. Recapitulating the concept of ILBT to increase the local tumoricidal dose may improve the survival rates.

scholarly journals Disability and Deformity in Patients of Hansen’s Disease Attending a Tertiary Care Center in Nepal

2020 ◽  
Vol 19 (1) ◽  
pp. 26-30
Author(s):  
Sagar Mani Jha ◽  
Nabin Bhakta Shakya ◽  
Sunil Shakya ◽  
Manisha Maharjan
Keyword(s):  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Lepromatous Leprosy ◽  
Age Group ◽  
Cross Sectional ◽  
Social Wellbeing ◽  
Number Of Patients ◽  
Leprosy Patients

Introduction: Leprosy is responsible for disability and deformity among patients. Nerve damage is one of the main features of leprosy and it is the main cause of disability in the patients. Developing deformity leads to restriction in professional work and hence reduced income as well as it also acts adversely on social wellbeing. The aim of this study was to study the spectrum of Grade 2 disability among all leprosy patients attending outpatient and inpatient according to WHO grading and to find the association with Ridley Joplingclassification. Methods: It was an observational cross sectional hospital based study. All the inpatients and outpatients of leprosy getting treatment and were on follow up in the Department of Dermatology between December 2017 to November 2019 were included. Details of disability and deformity were recorded and were Classified as per WHO grading and Ridley Jopling classification. Cross tab was used in descriptive analysis to compare between different variables and data was analysed in percentage. Results: A total of 88 patients were included in the study. Maximum number of patients 41 (46.7%) belonged to 30 to 50 years of age group. Various degrees of loss of sensation was seen in all patients and total number of patients with Grade 1 disability were 68 (77.3%) and Grade 2 disability were 20 (22.7%). Maximum number of patients 11 (12.5%) with Grade 2 disability was seen in Lepromatous Leprosy. Conclusions: Disability and deformity can occur in any spectrum of disease and intervention as early as possible will help reduce the incidence.

scholarly journals P1517SURVIVAL ON DIALYSIS: SWITZERLAND IN COMPARISON WITH OTHER COUNTRIES - A FOLLOW UP

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rebecca Winzeler ◽  
Patrice Max Ambühl
Keyword(s):  
Survival Rates ◽  
Age Groups ◽  
European Countries ◽  
Dialysis Patients ◽  
Survival Status ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Second Year ◽  
Two Age Groups

Abstract Background and Aims Survival in dialysis patients is substantially reduced compared to the general population. The aim of the present analysis was to compare the survival of Swiss dialysis patients with other countries with an additional year of follow up and a higher number of patients. Method Incident dialysis patients (hemo- or peritoneal dialysis; N=4525) from the Swiss dialysis registry were followed up from 2014 on until December 31, 2018 (mean follow up days=684). Deaths occurring during this time (N=976) were recorded and survival was examined using the Kaplan Meier method, censored for transplantation. Results Characteristics of the dialysis population stratified according to survival status are provided in Table 1. Dialysis patients in Switzerland have an approximately 8% higher survival in the first and second year after start of dialysis compared to other European countries (Annual ERA-EDTA Report 2016). In the oldest age group, it amounts to up to 13 and 14%, in the first and in the second year, respectively. The proportion in survival rates between genders is similar in Switzerland, as well as in Europe. Dialysis patients aged younger than 45 years have a worse survival in Switzerland compared to other European countries. Conclusion The markedly better survival in dialysis patients in Switzerland compared to other European countries could be confirmed with an additional year of follow up and more patients. Also, causes of death vary widely among European countries. With an additional year of follow up, data to analyze 5-year survival probability will be available for comparison with the ERA-EDTA report. In addition, we will be able to verify whether dialysis patients under 45 years in Switzerland have an increased mortality or whether this is due to the small number of patients in these two age groups.

scholarly journals Clinical and treatment profiles of patients affected by acute coronary syndromes derived from administrative databases in the ASSL 10 Veneto orientale

2015 ◽  
Vol 76 (1) ◽  
Author(s):  
Paolo Piergentili ◽  
Roberto Valle ◽  
Loredano Milani
Keyword(s):  
Myocardial Infarction ◽  
Sharp Decrease ◽  
Administrative Databases ◽  
First Year ◽  
Sample Population ◽  
Local Health ◽  
Local Health Unit ◽  
Number Of Patients ◽  
Second Year

Background. This paper presents a revision of services provided to patient over two years following a myocardial infarction (MI) based on data derived from administrative databases. The study aims to evaluate the burden and the resources consumed by these patients, as well as the adherence to clinical guidelines. Methods. All patient hospitalised for myocardial infarction in the cardiology unit of the hospital of San Donà di Piave (Venice, Italy) were identified. The clinical record was reviewed to reconstruct clinical history. Then from the Local Health Unit n. 10 all information regarding these patient were collected and analysed after record linkage. Results. The patients with MI were 236. Of these, 20 died during the first hospitalization, 2 were lost to the follow up and 40 died within the two years period. The 214 patients who were alive after the first hospitalization produced 447 ordinary and 57 day hospital hospitalization. Specialist services were 23.250, and of these 17.583 were evaluated as being related to the cardiac disease. The value of drug prescribed over the two year period was € 553.108. The number of prescriptions belonging to the anatomic ATC class C were 29.076, received by 210 people. The mean pro capita estimated cost was € 22.058 in the first year, and € 6.226 in the second year. Conclusions. The characteristics of the sample population of our patients with MI were similar to those described in the literature. Follow up showed a sharp decrease of care and services received by patients during the second year after the acute event. In addition, a large part of services was not related to the cardiac diseases. Only a limited number of patients followed a rehabilitation programme. The estimated pro capita overall cost was very relevant in the first year, and the difference with the cost of the second year suggests a fall over time of the relevance attributed by the patients to the cardiac problems.

Six-And-A-Half Years of Experience with Three Two-Liter Daily Exchanges in CAPD

1988 ◽  
Vol 8 (3) ◽  
pp. 207-210 ◽  
Author(s):  
Jorge E. Henao ◽  
Gonzalo Mejia ◽  
Mario Arbelaez ◽  
Jorge L. Arango ◽  
Alvaro Garcia ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Survival Rates ◽  
Laboratory Data ◽  
Term Treatment ◽  
Actuarial Survival ◽  
Hospitalization Rates ◽  
Number Of Patients ◽  
Long Term Treatment

Our continuous ambulatory peritoneal dialysis (CAPD) program consists of three 2- L daily exchanges (usually two of 1.5% and one of 4.25% dextrose concentration). Between March 1981 and November 1987, 87 patients were started on this program. Mean age was 35 years, 55% were males, and mean follow-up was 20.1 ± 2 months for a total experience of 1748 patient months. At the end of the study, 27 (31%) were still on CAPD, 43 (49.5%) had received renal transplants, 8 (9.2%) had returned to hemodialysis, 6 (6.9%) had been transferred to other units, 2 (2.3%) died, and 1 (1.1%) voluntarily quit. Actuarial survival rates were 90%, 81 %, and 57% for patients, method, and catheters, respectively, at 66 months. Peritonitis appeared at a rate of one episode per 14 patient months for a total of 121 episodes occurring in 51 patients. Rates of other complications were not higher than those reported by others. Hospitalization rates were low. Hypertension improved, patient weight did not change, and laboratory data tended towards normal levels or normalized. In selected patients, three 2- L exchanges per day appear to be enough for an adequate CAPD, even for long-term treatment. At the same time, it allows a 25% reduction in cost and risk of peritonitis. Larger number of patients and longer follow-up periods will be required to exactly define its real usefulness and safety.

MO818SURVIVAL ON DIALYSIS: SWITZERLAND IN COMPARISON WITH OTHER COUNTRIES – A FOLLOW UP

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rebecca Winzeler ◽  
Patrice Max Ambühl
Keyword(s):  
Survival Probability ◽  
Survival Rates ◽  
European Countries ◽  
Dialysis Patients ◽  
Survival Status ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Second Year ◽  
First Time

Abstract Background and Aims Survival in dialysis patients is substantially reduced compared to the general population. The aim of the present analysis was to compare the survival of dialysis patients in Switzerland with other countries with an additional year of follow up and a higher number of patients. Method Incident dialysis patients (hemo- or peritoneal dialysis; N=5'406) from the Swiss dialysis registry were followed up from 2014 to December 31, 2019 (median follow up days=658). Deaths occurring during this time (N=1'353) were recorded and survival was examined using the Kaplan Meier method, censored for transplantation. Results Characteristics of the dialysis population stratified according to survival status are provided in Table 1. Dialysis patients in Switzerland have an approximately 8% higher survival in the first and second year and about 10% higher 5 years after start of dialysis, compared to other European countries (Annual ERA-EDTA Report 2017). In the first two years, the proportion in survival rates between genders is similar in Switzerland, as well as in Europe. After 5 years, however, a difference in survival rates between genders becomes apparent, with women having a 5-year survival probability of 56.6%, compared to a lower 5-year survival probability of 49.7% in men. Conclusion The markedly better survival in dialysis patients in Switzerland compared to other European countries could be confirmed with an additional year of follow up and more patients. Also, causes of death vary widely among European countries. 5-year survival was calculated for the first time, with Switzerland showing almost 10% better survival rates than other European countries.

Confronting the practice of surgery on differentiated thyroid cancer with current guidelines in Germany

2005 ◽  
Vol 44 (05) ◽  
pp. 185-191 ◽  
Author(s):  
H. Wieler ◽  
S. Birtel ◽  
E. Ostwald-Lenz ◽  
K. P. Kaiser ◽  
H. P. Becker ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Survival Rates ◽  
Perioperative Morbidity ◽  
Referral Hospitals ◽  
Principles Of Treatment ◽  
Current Guidelines ◽  
Papillary Microcarcinomas ◽  
Retrospective Multicenter Study

Summary:Aim: For the surgical therapy of differentiated thyroid cancer precise guidelines are applied by the German medical societies. In a retrospective multicenter study, we investigated the following issues: Are the current guidelines respected?. Is there a difference concerning the surgical radicalism and the outcome?. Does the perioperative morbidity increase with the higher radicalism of the procedure?. Patients, methods: Data gained from 102 patients from 17 regional referral hospitals who underwent surgery for thyroid cancer and a following radioiodine treatment (mean follow up: 42.7 [24-79] months) were analyzed. At least 71 criterias were analyzed in a SPSS file. Results: 46.1% of carcinomas were incidentally detected during goiter surgery. The thyroid cancer (papillary n = 78; follicular n = 24) occurred in 87% unilateral and in 13% bilateral. Papillary carcinomas <1 cm were detected in 25 cases; in five of these cases (20%) contralateral carcinomas <1 cm were found. There were significant differences concerning the surgical radicalism: a range from hemithyroidectomy to radical thyroidectomy with lateral neck dissection. Analysis of the histopathologic reports revealed that lymph node dissection was not performed according to guidelines in 55% of all patients. The perioperative morbidity was lower in departments with a high case load. The postoperative dysfunction of the recurrent laryngeal nerve (mean: 7.9% total / 4.9% nerves at risk) variated highly, depending on differences in radicalism and hospitals. Up to now these variations in surgical treatment have shown no differences in their outcome and survival rates, when followed by radioiodine therapy. Conclusion: Current surgical regimes did not follow the guidelines in more than 50% of all cases. This low acceptance has to be discussed. The actual discussion about principles of treatment regarding, the socalled papillary microcarcinomas (old term) has to be respected within the current guidelines.

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