prognostic assessment
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2022 ◽  
Vol 20 (8) ◽  
pp. 3106
Author(s):  
M. M. Lukyanov ◽  
S. Yu. Martsevich ◽  
A. A. Pulin ◽  
N. P. Kutishenko ◽  
E. Yu. Andreenko ◽  
...  

Aim. According to hospital-based registry, to evaluate the age characteristics and prevalence of concomitant cardiovascular and non-сardiovascular diseases in patients hospitalized with COVID-19 during epidemic wave.Material and methods. The TARGET-VIP register included 1130 patients aged 57,5+12,8 years (men, 51,2%) hospitalized at the Pirogov National Medical and Surgical Center from April 6, 2020 to June 22, 2020 with COVID-19. Cardiovascular diseases (CVDs) were diagnosed in 51,6% of patients, non-сardiovascular chronic diseases — in 48,6%, while CVDs and/or non-сardiovascular chronic diseases — in 65,8% of patients.Results. The average age of patients significantly increased by an average of 0,77 years per week (p<0,001), while the difference between the 1st week (52,8 years) and 11th week (62,2 years) was 9,4 years; the proportion of men did not change significantly. The proportion of patients with CVDs increased significantly — from 34,2% to 66,7%, on average by 3,7% per week (p<0,001; Incidence Risk Ratio (IRR)=1,037; 95% confidence interval (CI), 1,017-1,058), with chronic non-cardiovascular diseases — from 32,5% to 43,2%, on average by 2,5% per week (p<0,001; IRR=1,025; 95% CI, 1,002-1,049), as well as those with CVDs and/or chronic non-cardiovascular diseases — from 47,5% to 75,3%, on average by 3,2% per week (p<0,001; IRR=1,032; 95% CI, 1,017-1,048). Over the entire period, the proportion of people with hypertension (HTN) was 47,0%, with coronary artery disease (CAD) — 15,4%, with heart failure (HF) — 4,0%, and with atrial fibrillation (AF) — 10,1%. The proportion of patients with HTN increased by 9,5% (p<0,001; OR=1,095; 95% CI, 1,047-1,144), with СAD — by 9,4% (p=0,01; OR=1,094; 95% CI, 1,022-1,172) and with AF — by 9,4% (p<0,001; OR=1,094; 95% CI, 1,023-1,170) per week. The proportion of patients with diabetes was 16,5%, with respiratory diseases — 11,4%, with chronic kidney disease (CKD) — 12,6%, with digestive diseases — 22,5%, with obesity — 6,1%. During the epidemic wave, the most pronounced increase in the proportion of patients with CKD was by 6,2% (p=0,036; OR=1,062; 95% CI, 1,004-1,124) and with digestive diseases — by 6,0% (p=0,01; OR=1,060; 95% CI, 1,014-1,109) per week.Conclusion. According to the 11-week TARGET-VIP registry, the age of patients increased by 9,4 years, CVD cases — by 1,9 times (mainly HTN, CAD, AF), and chronic non­сardiovascular pathology — by 1,3 times (mainly CKD and digestive diseases). These trends in hospital practice corresponded to a weekly increase in the proportion of patients with a higher risk of fatal and non-fatal complications, which is the basis for further research in order to develop a system for a comprehensive prognostic assessment of the degree and rate of increase in the load on hospitals during COVID-19 epidemic wave.


Author(s):  
E. A. Ignat’eva

Introduction. Sarcoidosis is a significant social and medical problem. Diagnosis is based on consistency of the clinical picture, histological evidence of granulomatous inflammation, exclusion of alternative diseases, and evidence of systemic involvement. There is no “gold” diagnostic standard for sarcoidosis. Aim. Review of the latest world literature data on the possibilities of modern radiation diagnosis of sarcoidosis. Materials and methods. The review summarizes data from literature published mainly over the past five years in PubMed and eLibrary. Earlier publications were also included as necessary. Results. In the literature review, modern medical imaging methods used to diagnose sarcoidosis, which in some cases can avoid biopsy, are considered. First of all, these are X-ray methods. Today, high-resolution multispiral computed tomography with three-dimensional imaging, as the method with the highest sensitivity, plays a decisive role in the diagnosis and monitoring of sarcoidosis. The use of magnetic resonance imaging and low-dose computed tomography is not well understood in patients with sarcoidosis. Quantitative computed tomography and radiomics techniques have only been partially tested in sarcoidosis. Conclusion. The imaging of sarcoidosis is the subject of a large number of publications that provide detailed descriptions of X-ray and computed tomography techniques. Nevertheless, despite the introduction of new computerized tools for the analysis of chest imaging, traditional X-ray techniques still remain an important role in both the diagnostic and prognostic assessment of changes characteristic of sarcoidosis


Metabolites ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 1
Author(s):  
Konlawij Trongtrakul ◽  
Chanisa Thonusin ◽  
Chaicharn Pothirat ◽  
Siriporn C. Chattipakorn ◽  
Nipon Chattipakorn

A disruption of several metabolic pathways in critically ill patients with sepsis indicates that metabolomics might be used as a more precise tool for sepsis and septic shock when compared with the conventional biomarkers. This article provides information regarding metabolomics studies in sepsis and septic shock patients. It has been shown that a variety of metabolomic pathways are altered in sepsis and septic shock, including amino acid metabolism, fatty acid oxidation, phospholipid metabolism, glycolysis, and tricarboxylic acid cycle. Based upon this comprehensive review, here, we demonstrate that metabolomics is about to change the world of sepsis biomarkers, not only for its utilization in sepsis diagnosis, but also for prognosticating and monitoring the therapeutic response. Additionally, the future direction regarding the establishment of studies integrating metabolomics with other molecular modalities and studies identifying the relationships between metabolomic profiles and clinical characteristics to address clinical application are discussed in this article. All of the information from this review indicates the important impact of metabolomics as a tool for diagnosis, monitoring therapeutic response, and prognostic assessment of sepsis and septic shock. These findings also encourage further clinical investigations to warrant its use in routine clinical settings.


2021 ◽  
Vol 23 (1) ◽  
pp. 4
Author(s):  
Zachery R. Reichert ◽  
Tadas Kasputis ◽  
Srinivas Nallandhighal ◽  
Sophia M. Abusamra ◽  
Amy Kasputis ◽  
...  

The substantial biological heterogeneity of metastatic prostate cancer has hindered the development of personalized therapeutic approaches. Therefore, it is difficult to predict the course of metastatic hormone-sensitive prostate cancer (mHSPC), with some men remaining on first-line androgen deprivation therapy (ADT) for several years while others progress more rapidly. Improving our ability to risk-stratify patients would allow for the optimization of systemic therapies and support the development of stratified prospective clinical trials focused on patients likely to have the greatest potential benefit. Here, we applied a liquid biopsy approach to identify clinically relevant, blood-based prognostic biomarkers in patients with mHSPC. Gene expression indicating the presence of CTCs was greater in CHAARTED high-volume (HV) patients (52% CTChigh) than in low-volume (LV) patients (23% CTChigh; * p = 0.03). HV disease (p = 0.005, q = 0.033) and CTC presence at baseline prior to treatment initiation (p = 0.008, q = 0.033) were found to be independently associated with the risk of nonresponse at 7 months. The pooled gene expression from CTCs of pre-ADT samples found AR, DSG2, KLK3, MDK, and PCA3 as genes predictive of nonresponse. These observations support the utility of liquid biomarker approaches to identify patients with poor initial response. This approach could facilitate more precise treatment intensification in the highest risk patients.


2021 ◽  
Vol 27 (4) ◽  
pp. 5-12
Author(s):  
I.I. Andriievskyi ◽  
О.А. Serebrennikova ◽  
S.A. Bondar ◽  
A.V. Shayuk ◽  
I.V. Gunas

It is known that both genetic factors and environmental influences affect the development of the human body. This statement also applies to a person’s personality, ie the big five – the main features that make it up. The study of the relationship between physique and personality traits among a healthy population is very relevant and is a promising area for anthropology and psychology. The purpose of the work is to conduct a prognostic assessment of the influence of anthropo-somatotypological indicators on the personality indicators in practically healthy Ukrainian women without and taking into account the somatotype. Primary anthropo-somatotypological (anthropometry according to Bunak’s scheme, Heath-Carter somatotype determination, Matiegka and American Institute of Nutrition weight composition) and personality indicators (determination of leading typological characteristics of temperament according to Eysenck, psychodynamic features of personality according to Spielberger and features of accentuated personality traits according to Shmishek, components of internality according to Rotter) of practically healthy Ukrainian women of the first mature age are selected from the data bank of materials of the research center of National Pirogov Memorial Medical University, Vinnytsya. Factor analysis was performed in the license package "Statistica 6.1". The main factors that indicate the association of personality traits of practically healthy Ukrainian women of different somatotypes with some anthropo-somatotypological indicators: mesomorphs – "the size of the girth and fat size of the body" and "the size of the longitudinal size of the body"; in ectomorphs – "the size of the girth of the body" and "the size of the fat size of the body"; in endo-mesomorphs - "the magnitude of the circumferential size of the body" and "the magnitude of the width of the mandible"; in representatives of the middle intermediate somatotype – "the magnitude of the longitudinal and circumferential dimensions of the body" and "the magnitude of SFT on the posterior surface of the shoulder." In the general group of women, it is impossible to single out the second factor that has a significant load. Analysis of the obtained relationships of interdependence of personality traits, which have the greatest prognostic value in terms of formation of human personality with anthropo-somatotypological indicators showed that women of different somatotypes identified interdependencies have certain features. Thus, the application of factor analysis made it possible to determine the most significant relationships of personality indicators with the constitutional parameters of the body in practically healthy Ukrainian women of different somatotypes.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yuanyin Zhao ◽  
Jia Li ◽  
Limeng Dai ◽  
Yongyi Ma ◽  
Yun Bai ◽  
...  

Prenatal risk assessment of carriers of heterozygous X-linked deletion is a big challenge due to the phenotypic modification induced by X chromosome inactivation (XCI). Herein, we described four Chinese pedigrees with maternal-inherited X-deletions above 1 Mb. The pathogenic evaluation revealed that all X-deletions are harmful to heterozygous carriers; however, the asymptomatic pregnant female carriers in these families tremendously complicate the prognostic assessment of the unborn heterozygous embryos. In this study, we detected the XCI pattern of 11 female carriers of heterozygous X-linked deletions and 4 non-carrier females in these families and performed the first prenatal XCI pattern analysis in a fetal female carrier of heterozygous PCDH19-deletion to make risk prediction. In an adult female who lost one copy of the terminal of X chromosome short arm (Xp), a region enriching a large number of XCI escapees, the expression level of representative XCI escape genes was also detected. Pregnancy outcomes of all families were followed up or retrospected. Our research provides clinical evidence that X-deletions above 1 Mb are indeed associated with extremely skewed XCI. The favorable skewed XCI in combination with potential compensatory upregulation of XCI escapees would protect some but not all female carriers with pathogenic X-deletion from severe clinical consequences, mainly depending on the specific genetic contents involved in the deletion region. For PCDH19-disorder, the XCI pattern is considered as the decisive factor of phenotype expression, of which prenatal XCI assay using uncultured amniocytes could be a practicable way for risk prediction of this disease. These results provide valuable information about the usage of XCI assay in the prenatal risk assessment of heterozygous X-linked deletions.


2021 ◽  
Vol 22 (24) ◽  
pp. 13421
Author(s):  
Dimitrios Kalafatis ◽  
Anna Löfdahl ◽  
Per Näsman ◽  
Göran Dellgren ◽  
Åsa M. Wheelock ◽  
...  

Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease with an unmet need of biomarkers that can aid in the diagnostic and prognostic assessment of the disease and response to treatment. In this two-part explorative proteomic study, we demonstrate how proteins associated with tissue remodeling, inflammation and chemotaxis such as MMP7, CXCL13 and CCL19 are released in response to aberrant extracellular matrix (ECM) in IPF lung. We used a novel ex vivo model where decellularized lung tissue from IPF patients and healthy donors were repopulated with healthy fibroblasts to monitor locally released mediators. Results were validated in longitudinally collected serum samples from 38 IPF patients and from 77 healthy controls. We demonstrate how proteins elevated in the ex vivo model (e.g., MMP7), and other serum proteins found elevated in IPF patients such as HGF, VEGFA, MCP-3, IL-6 and TNFRSF12A, are associated with disease severity and progression and their response to antifibrotic treatment. Our study supports the model’s applicability in studying mechanisms involved in IPF and provides additional evidence for both established and potentially new biomarkers in IPF.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Magdalena Pływaczewska ◽  
David Jiménez ◽  
Mareike Lankeit ◽  
Piotr Pruszczyk ◽  
Maciej Kostrubiec

Introduction. Risk stratification is mandatory for optimal management of patients with acute pulmonary embolism (APE). Previous studies indicated that renal dysfunction predicts outcome and can improve risk assessment in APE. Aim. The aim of the study was a comparison of estimated glomerular filtration rate (eGFR) formulas, MDRD, and Cockcroft-Gault (CG), in the prognostic assessment of patients with APE. Materials and Methods. Data from 2274 (1147 M/1127 F, median 71 years) hospitalised patients with APE prospectively included in a multicenter, observational, cohort study were analysed. A serum creatinine measurement as a routine laboratory parameter at the cooperating centers and eGFR calculation were performed on admission. Patients were followed for 180 days. The primary outcome was death from any cause within 30 days. Results. The eGFR levels assessed by both, MDRD (eGFRMDRD) and CG formula (eGFRCG), were highest in patients with low-risk APE and lowest in high-risk APE. The eGFR (using both methods) was significantly lower in nonsurvivors compared to survivors. Using a threshold of <60 ml/min/1.73 m2, eGFRMDRD revealed the primary outcome with sensitivity 67%, specificity 52%, PPV 8%, and NPV 97%, while eGFRCG had a sensitivity 62%, specificity 62%, PPV 8.6%, and NPV 96%. The area under the ROC curve for eGFRCG tended to be higher than that for eGFRMDRD: 0.658 (95% CI: 0.608-0.709) vs. 0.631 (95% CI: 0.578-0.683), p = 0.12 . A subanalysis of ROC curves in a population above 65 yrs showed a higher AUC for eGFRCG than based on MDRD. Kaplan-Meier analysis showed a worse long-term outcome in patients with impaired renal function. Conclusion. eGFRMDRD and eGFRCG assessed on admission significant short- and long-term mortality predictors in patients with APE. The eGFRCG seems to be a slightly better 30-day mortality predictor than eGFRMDRD in the elderly.


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