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2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohamed Aseafan ◽  
Edward Devol ◽  
Mahmoud AlAhwal ◽  
Riad Souissi ◽  
Reham Sindi ◽  
...  

AbstractThe Saudi Cancer Registry reported in 2007 the 5-year observed survival for the most common cancer sites for the years 1994–2004. In this report we looked at the cancer survival in the period 2005–2009 and evaluated the trend over the 15 years period from 1994 to 2009. Cases of the top 14 cancer sites reported by the population based Saudi Cancer Registry from 1 January 2005 to December 31, 2009, were submitted for survival analysis. The vital status of those patients was collected. Analysis of survival for the above period was compared with the prior reported 2 periods (1994–1999, 2000–2004). In addition, analysis was done according to age, sex, disease stage and the province. Data of 25,969 patients of the commonest cancer sites were submitted. Of those 14,146 patients (54%) had complete demographic data available and vital status was reported. Thyroid cancer had the highest 5- year observed survival of 94% (95% confidence interval (CI) 93–95%)), followed by Breast (72%, 95% CI 71–74%). In hematological malignancies, Hodgkin’s Lymphoma had the highest 5-year survival of 86% (95% CI 84–88%). Survival rates has improved in most of the cancers sites for the studied periods except for lung, uterine and Hodgkin’s lymphoma which plateaued. Our study confirms a steady improvement in the 5-year observed survival over time for the majority of cancers. Our survival data were comparable to western countries. This data should be used by policy makers to improve on cancer care in the kingdom.


Pathogens ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 52
Author(s):  
Marija Santini ◽  
Sara Haberle ◽  
Snježana Židovec-Lepej ◽  
Vladimir Savić ◽  
Marija Kusulja ◽  
...  

West Nile Virus Neuroinvasive Disease (WNV NID) requires prolonged intensive care treatment, resulting in high mortality and early disability. Long-term results are lacking. We have conducted an observational retrospective study with a prospective follow-up of WNV NID patients treated at the Intensive Care Unit (ICU), University Hospital for Infectious Diseases, Zagreb, Croatia, 2013–2018. Short-term outcomes were vital status, length of stay (LOS), modified Rankin Scale (mRS), and disposition at discharge. Long-term outcomes were vital status and mRS at follow-up. Twenty-three patients were identified, 78.3% males, median age 72 (range 33–84) years. Two patients (8.7%) died in the ICU, with no lethal outcomes after ICU discharge. The median ICU LOS was 19 days (range 5–73), and the median hospital LOS was 34 days (range 7–97). At discharge, 15 (65.2%) patients had moderate to severe/mRS 3–5, 6 (26.0%) had slight disability/mRS 2–1, no patients were symptom-free/mRS 0. Ten (47.6%) survivors were discharged to rehabilitation facilities. The median time to follow-up was nine months (range 6–69). At follow-up, seven patients died (30.5%), five (21.7%) had moderate to severe/mRS 3–5, one (4.3%) had slight disability/mRS 2–1, six (26.1%) had no symptoms/mRS 0, and four (17.4%) were lost to follow-up. Briefly, ten (43.5%) survivors improved their functional status, one (4.3%) was unaltered, and one (4.3%) aggravated. In patients with severe WNV NID, intensive treatment in the acute phase followed by inpatient rehabilitation resulted in significant recovery of functional status after several months.


2021 ◽  
Author(s):  
Naghib Bogere ◽  
Felix Bongomin ◽  
Andrew Katende ◽  
Blair Andrew Omaido ◽  
Elizabeth Namukwaya ◽  
...  

Abstract Background: Lung cancer is a leading cause of cancer-related deaths in Uganda. In this study, we aimed to describe the baseline characteristics and survival of patients with lung cancer at Uganda Cancer Institute (UCI). Methodology: We retrospectively reviewed medical records of all patients with a histological diagnosis of lung cancer registered at UCI between January 2008 and August 2018. Data on demographic, clinical, and treatment characteristics, and vital status were abstracted and analyzed. Patients with undocumented vital status on the medical records were contacted through phone calls. We determined survival as time from histological diagnosis to death. The Kaplan-Meier survival analysis was performed to estimate the median survival time and the 5-year overall survival rate. Results: Of the 207 patients enrolled, 56.5% (n=117) were female, median age was 60 years (range: 20-94), 78.7% (n=163) were never-smokers and 18 (8.7%) were living with HIV. Presumptive anti-tuberculosis treatment was given to 23.2% (n=48). Majority had non-small cell lung cancer (96.6%, n=200) with 74.5% (n=149) adenocarcinoma and 19% (n=38) squamous cell carcinoma. All had advanced (stage III or IV) disease with 96.1% (n=199) in stage IV. Chemotherapy (44.9%, n=93) and biological therapy (34.8%, n=72) were the commonest treatments used. Overall survival at 6 months, 1-, 2- and 5-years was 41.7%, 29.7%, 11.8% and 1.7% respectively. The median survival time was 4.4 months and was not different between NSCLC and SCLC (4.5 vs. 3.9 months respectively, p=.335). Conclusion: In Uganda, adenocarcinoma is the predominant histologic subtype of lung cancer predominantly occurring in females and non-smokers. Patients present late with advanced disease and poor overall survival. Public awareness should be heightened to facilitate early screening and improve outcomes.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 190-190
Author(s):  
Ryon Cobb

Abstract To date, little is known about the significance of the number of attributions for everyday discrimination on all-cause mortality risk among older Blacks. Data are from a subsample of older Black respondents in the Health and Retirement Study (HRS), a nationally representative panel study of adults above the age of 50 in the 2006/2008 HRS waves, respondents completed a battery of questions on experience with psychosocial stressors, which included the number of attributed reasons for everyday discrimination. Vital status was obtained from the National Death Index and reports from key household informants (spanning 2006–2016). Cox proportional hazard models were used to estimate the risk of mortality. During the 10-year observation period, 450 deaths occurred. A higher number of attributed reasons for everyday discrimination was associated with a higher likelihood of death after adjusting for demographic characteristics and remained significant after further adjustments for other psychosocial, health, behavioral, and economic covariates.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4998-4998
Author(s):  
Sai Giridhar Gundepalli ◽  
Hussain I Rangoonwala ◽  
Peter Silberstein

Abstract Background: Post-transplant lymphoproliferative disease (PTLD) is a rare, but well-known complication of solid organ transplants and hematopoietic stem cell transplantation. . In most affected patients, PTLD is an Epstein-Barr virus (EBV)-positive B cell proliferation occurring in the setting of immunosuppression and decreased T cell immune surveillance. PTLDs are among the most serious complications of transplantation. The principal risk factors underlying the development of PTLD are the degree of T cell immunosuppression and the Epstein-Barr virus (EBV) serologic status of the recipient. Early lesions of PTLD are treated with reduction in immunosuppression alone and those who do not have a complete response to this intervention have been treated with chemotherapy, immunotherapy, and occasionally surgical resection. Utilizing the NCDB, we aim to study the clinical and demographic characteristics of PTLD patients who were declared dead during period of 2010-2017. Methods A total of 425 patients diagnosed with PTLD above the age of 18 years between 2010 and 2017 were identified utilizing the National Cancer Database (NCDB). Patients were identified with ICD-O-3 morphologic code 9971/3 and data extracted from PUF using SPSS. Demographic factors (Race, gender, facility location, annual household income, facility type, Charlson-Deyo score, treatment received, age at diagnosis) were studied in relation to patient's vital status (alive or dead). We have separated data for patients declared dead during this period and formulated a table stating the demographic characteristics. We have excluded people whose vital status was unknown or missing (60 patients). Results Of the 365 patients diagnosed with PTLD between 2010-2017, 215 patients were alive during the entire period and 150 (41%) were declared dead in this time frame. Of these, 62.7% were in the age group less than 60 years and 37.3% above 60 years. 9.3% (14/150) received no treatment at all and 88% received some form of treatment, of which 39.3% (59/150) received immunotherapy (34 received immunotherapy alone and 23 received Immuno+chemo). Amongst these, 80% were Caucasians and 13.4% were African Americans. 41.6% (57/137) belonged to median income quartile >=$63,333, whereas 16% (22/137) belonged to median quartile income <$40,227 (Median Quartiles 2012-2016). 83.2% received care at an academic/research program and 8.8% in a Comprehensive community cancer program. 64.7% (97/150) of patient's had Charlson-Deyo score of 0 whereas 14% (21/150) had a score of 3. Conclusion This study contains largest cohort of patients diagnosed with PTLD, identifying clinical and demographic factors of patients with PTLD who were declared dead during the period of 2010-2017. The data shows significant variations in the populations stratified based on age, income quartiles, treatment received and race. These data may provide insight into identifying the factors influencing mortality of patients diagnosed with PTLD. The major limitations of our study include no data on specific therapy received, reasons for choosing the treatment modality used, no data on the cause of mortality and age at death. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Vol 12 (6) ◽  
pp. 773-777
Author(s):  
Mohamed F. Elsisy ◽  
Alberto Pochettino ◽  
Joseph A. Dearani ◽  
Thomas C. Bower ◽  
Robert D. McBane ◽  
...  

Background Cardiovascular surgical outcomes reports are few for vascular type IV of Ehlers- Danlos Syndrome (vEDS) compared to non-vascular types I-III (nEDS). Methods To define cardiovascular surgical outcomes among adult patients (≥18 years) with EDS types, a review of our institution's in-house STS Adult Cardiac Surgery Database-compliant software and electronic medical records from Mayo Clinic (1993–2019) was performed. Outcomes were compared for vEDS patients and nEDS patients. Demographics, baseline characteristics, operative, in-hospital complications and follow-up vital status were analyzed. Results Over the study time frame, 48 EDS patients underwent surgery (mean age 52.6 ± 14.6 years; 48% females). Of these, 17 patients had vEDS and 31 patients had nEDS. Six patients (12.5%) underwent prior sternotomy. Urgent or emergent surgery was performed in 10 patients (20.8%). Aortic (vEDS 76.5% vs. nEDS 16.1%) and mitral procedures (vEDS 11.8% vs. nEDS 48.4%) were the two most common cardiovascular surgeries performed (p < .01 and p = .007, respectively). Cardiopulmonary bypass time (CPB) (165 ± 18 vs. 90 ± 13 min; p = .015) and aortic cross clamp times (140 ± 14 vs. 62 ± 10 min; p < .001) were longer for vEDS patients. There was 1 (2.1%) early and 7 (14.6%) late deaths; 6 among vEDS and 2 among nEDS patients. Survival at 5 (80% vs. 93%), 10 (45% vs. 84%) and 15 years (45% vs. 84%) was lower in patients with vEDS (p = .015 for each comparison). Conclusion Cardiovascular surgeries are significantly more complex with longer bypass and cross clamp times for type IV vEDS compared to nEDS patients. Reduced overall survival underscores the complexity and fragility of vEDS patients.


PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257752
Author(s):  
Jordi Aligué ◽  
Mireia Vicente ◽  
Anna Arnau ◽  
Jaume Trapé ◽  
Eva Martínez ◽  
...  

Background Numerous studies on involuntary weight loss (IWL) have been published since the 1980s, although most of them have included small samples of patients with specific symptoms. The aim of the present study was to determine the causes, demographic and clinical characteristics and mortality at 12 months in patients attended at a rapid diagnostic unit (RDU) for isolated IWL. Methods A single-center retrospective observational study including all patients presenting to the RDU for isolated IWL between 2005 and 2013. The following data were recorded: demographic and clinical variables, results of complementary tests (blood tests, x-rays, computed tomography scan and digestive endoscopy), main diagnosis and vital status at 12 months. Results Seven hundred and ninety-one patients met the criteria for IWL. Mean age was 67.9 years (SD 4.7), 50.4% were male and mean weight loss was 8.3 kg (SD 4.7). The cause for IWL was malignant disease in 23.6% of patients, non-malignant organic disease in 44.5%, psychiatric disorder in 29.0% and unknown in 3.2%. Overall mortality at 12 months was 18.6% (95%CI: 16.1–21.6). The mortality rate was highest in the group with malignancy (61.1%; 95%CI: 54.2–68.2). Conclusions Almost a quarter of all patients attended at the RDU for IWL were diagnosed with cancer. Mortality at 12 months was higher in this group than in the other three. Malignancy should therefore be ruled out during the first visit for patients attended for IWL.


2021 ◽  
Vol 12 ◽  
Author(s):  
Moi Yamazaki ◽  
Quentin De Larochelambert ◽  
Guillaume Sauliere ◽  
Jean-François Toussaint ◽  
Juliana Antero

Purpose: This study aimed to identify the risk of neurodegenerative death (ND) that former Olympians endure due to their participation in sports grouped based on presumed repeated shocks to the head, and to understand the impact of their participation in such elite sports on their total longevity.Materials and Methods: The cohort included all former US Olympians, who participated in the Olympic Games (OG) between 1948 and 1972, and whose vital status and causes of death were verified (n = 2,193). Olympic sports were classified into three categories of exposure: Collision (the highest presumed risk of repeated shocks to the head), Contact, and No-Contact. The Fine-Gray competing risk regression model was used to compare the risk of ND where the No-Contact category was a reference group. The years-saved analysis was performed to quantify the number of years saved or lost to ND and total longevity compared with the US general population.Results: A total of 65 NDs were identified. Collision sports Olympians had a 3.11 (95% CI: 1.31–7.40) higher risk of ND while the Contact group showed a risk of 0.56 (95% CI: 0.21–1.48) compared with the No-Contact sports Olympians. Compared with the general population, the Collision group lost 0.61 (95% CI: -1.16—0.06) years of life from ND, while the Contact group saved 0.4 (95% CI: 0.26–0.54) and the No-Contact group saved 0.09 (-0.09–0.28) years of life up to the age of 90. Regarding the total longevity, Collision, Contact, and No-Contact groups saved 4.67 (95% CI: 3.13–6.22), 5.8 (95% CI: 4.93–6.67), and 6.24 (95% CI: 5.57–6.92) years of life, respectively, from all causes of death.Conclusion: There is an elevated risk of ND among US Olympians, who engaged in sports with the highest presumed risk of repeated shocks to the head compared with those exposed to no such hazard. Such risk does not jeopardize the total longevity among Olympians in Collision sports.


Author(s):  
Rutao Wang ◽  
Scot Garg ◽  
Chao Gao ◽  
Hideyuki Kawashima ◽  
Masafumi Ono ◽  
...  

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract


Drones ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 77
Author(s):  
Anastasiia Safonova ◽  
Yousif Hamad ◽  
Egor Dmitriev ◽  
Georgi Georgiev ◽  
Vladislav Trenkin ◽  
...  

Monitoring the structure parameters and damage to trees plays an important role in forest management. Remote-sensing data collected by an unmanned aerial vehicle (UAV) provides valuable resources to improve the efficiency of decision making. In this work, we propose an approach to enhance algorithms for species classification and assessment of the vital status of forest stands by using automated individual tree crowns delineation (ITCD). The approach can be potentially used for inventory and identifying the health status of trees in regional-scale forest areas. The proposed ITCD algorithm goes through three stages: preprocessing (contrast enhancement), crown segmentation based on wavelet transformation and morphological operations, and boundaries detection. The performance of the ITCD algorithm was demonstrated for different test plots containing homogeneous and complex structured forest stands. For typical scenes, the crown contouring accuracy is about 95%. The pixel-by-pixel classification is based on the ensemble supervised classification method error correcting output codes with the Gaussian kernel support vector machine chosen as a binary learner. We demonstrated that pixel-by-pixel species classification of multi-spectral images can be performed with a total error of about 1%, which is significantly less than by processing RGB images. The advantage of the proposed approach lies in the combined processing of multispectral and RGB photo images.


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