prognostic importance
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2021 ◽  
Vol 8 (12) ◽  
pp. 740-744
Author(s):  
Tolga Köşeci ◽  
Polat Olgun ◽  
Serdar Ata ◽  
Ertuğrul Bayram ◽  
Mehmet Ali Sungur ◽  
...  

Objective: There are some studies about the significance of the peripheral blood  parameters in breast cancer. However, there is very few studies about prognostic importance of peripheral blood parameters in human epidermal growth factor-2 receptor (Her-2) positive breast cancer. We aimed to evaluate whether prognostic significance of peripheral blood parameters in patients Her-2 positive metastatic breast cancer with treated Pertuzumab, Trastuzumab, Docetaxel (PTD) Material and Methods: We included 56 patients with Her-2 positive metastatic breast cancer patients who were treated with PTD. We recorded patients' clinical,demographic features and we obtained peripheral blood parameters such as neutrophil-lymphocyte ratio (NLR), red blood cell distribution (RDW), mean platelet volume (MPV), lymphocyte, neutrophil after the  sixth cycle of the treatment and before the treatment. We separated the patients into two groups depending on the progression status. Progression-free survival was analyzed by Kaplan-Meier statistical analysis. Results: Patients mean age was 50.7. Progression was detected in 34 patients. When we explored and compared hemogram parameters in the groups before the treatment, there wasn’t statistically any significant difference between these parameters such as neutrophil, lymphocyte, neutrophil to lymphocyte ratio, mean platelet volume, red blood cell width. In the progressive group;,while pretreatment NLR was 3.83, it was detected 2.72 after six cycle treatment and difference was meaningful ( p: 0.043). The pretreamtent MPV was 8.63, and It was 8.15 after six cycle treatment, and difference between these counts was statistically important (p: 0.006). PFS was 18.0 months in the study group. Conclusion: Peripheral blood parameters were not statistically significant in both group comparisons. In the progression group, the difference between NLR and MPV count was statistically significant after the sixth cycle of the treatment and before the treatment.


2021 ◽  
Vol 12 ◽  
Author(s):  
Wen-Juan Wang ◽  
Jing-Jing Lu ◽  
Li-Ping Liu ◽  
Jiao-Kun Jia ◽  
Xing-Quan Zhao

Aims: Although prognostic importance of ultraearly hematoma growth (uHG) in acute, non-traumatic intracerebral hemorrhage (ICH) has been established for early outcomes, longer-term clinical outcomes are lacking. We aimed to determine the association of uHG with early and 1-year clinical outcomes after acute ICH in a larger and broader range of patients.Methods: We studied 589 patients with acute (<6 h) spontaneous ICH. uHG was defined as baseline ICH volume/onset-to-imaging time (OIT) (ml/h). Multivariable logistic regression analyses were performed to determine the association of uHG with in-hospital mortality, 90-day, and 1-year poor outcome [3 ≤ modified Rankin Scale (mRS)] after ICH.Results: The median speed of uHG was 4.8 ml/h. uHG > 9.3 ml/h was independently related to in-hospital mortality [odds ratio (OR) 2.81, 95% CI 1.52–5.23], 90-day poor outcome (OR 3.34, 95% CI 1.87–5.95), and 1-year poor outcome (OR 3.59, 95% CI 2.01–6.40) after ICH. The sensitivity of uHG > 9.3 ml/h in the prediction of in-hospital mortality, 90-day poor outcome, and 1-year poor outcome was 68.8, 48.0, and 51.1%, respectively.Conclusions: Ultraearly hematoma growth was a useful predictor of in-hospital mortality, 90-day, and 1-year poor outcome after acute ICH. The combination of both uHG and baseline ICH volume could allow better selection of patients with ICH at high risk of poorest clinical outcomes for future clinical trials to improve early- and long-term clinical outcomes.


Author(s):  
Claudia R.L. Cardoso ◽  
Gil F. Salles

The prognostic importance of changes in aortic stiffness for the occurrence of adverse cardiovascular outcomes and mortality has never been investigated in patients with resistant hypertension. We aimed to evaluate it in a prospective cohort of 442 resistant hypertension individuals. Changes in aortic stiffness were assessed by 2 carotid-femoral pulse wave velocity (CF-PWV) measurements performed over a median time interval of 4.7 years. Multivariate Cox analysis examined the associations between changes in CF-PWV (evaluated as continuous variables and categorized into quartiles and as increased/persistently high or reduced/persistently low) and the occurrence of total cardiovascular events (CVEs), major adverse CVEs, and cardiovascular/all-cause mortalities. During a median follow-up of 4.1 years after the second CF-PWV measurement, there were 49 total CVEs (42 major adverse CVEs) and 53 all-cause deaths (32 cardiovascular). As continuous variables, increments in absolute and relative changes in CF-PWV were associated with higher risks of CVEs and major adverse CVEs occurrence, but not of mortality. Divided into quartiles of CF-PWV changes, risks increased in the third and fourth quartile subgroups in relation to the reference first quartile subgroup (those with greatest CF-PWV reductions) for all outcomes. Patients who either increased or persisted with high CF-PWV had excess risks of cardiovascular morbidity/mortality, with hazard ratios ranging from 2.7 to 3.0, in relation to those who reduced or persisted with low CF-PWV values. In conclusion, reducing or preventing progression of aortic stiffness was associated with significant cardiovascular protection in patients with resistant hypertension, suggesting that it may be an additional clinical target of antihypertensive treatment.


2021 ◽  
Vol 6 (1) ◽  
pp. e000860
Author(s):  
Razek G Coussa ◽  
Christopher R Fortenbach ◽  
D Brice Critser ◽  
Malia M Collins ◽  
Budd A Tucker ◽  
...  

ObjectiveTo correlate structural features seen on optical coherence tomography (OCT) with best-corrected visual acuity (BCVA) and Gass lesion type in patients with best vitelliform macular dystrophy (BVMD).Methods and analysisThis is a retrospective case series of consecutive patients with molecularly confirmed BEST1-associated BVMD. OCT scans were reviewed for lesion status and presence of subretinal pillar, focal choroidal excavation (FCE), intraretinal fluid or atrophy. Available OCT angiography images were used to evaluate for the presence of choroidal neovascularisation (CNV). These features were then correlated with BCVA and Gass lesion type.Results95 eyes from 48 patients (mean age 38.9 years, range 4–87) were included. The presence of a pillar (24.2%), FCE (20.0%) and atrophy (7.4%) were associated with poor BCVA (p<0.05). Gass lesion type 1 eyes were correlated with good BCVA (LogMAR <0.4) whereas type 5 eyes had poor BCVA (LogMAR >0.4). Among 65 eyes with longitudinal data (mean follow-up 5.1 years), 7 eyes (10.8%) reverted from higher to lower Gass lesion type; of these, 4 eyes (57.1%) had CNV responsive to intravitreal anti-vascular endothelial growth factor treatment.ConclusionOCT-based structural features are readily identifiable in patients with BVMD and have prognostic importance due to their correlation with BCVA.


Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5887
Author(s):  
Ankit Dhamija ◽  
Jahnavi Kakuturu ◽  
J. W. Awori Hayanga ◽  
Alper Toker

A minimally invasive resection of thymomas has been accepted as standard of care in the last decade for early stage thymomas. This is somewhat controversial in terms of higher-staged thymomas and myasthenia gravis patients due to the prognostic importance of complete resections and the indolent characteristics of the disease process. Despite concerted efforts to standardize minimally invasive approaches, there is still controversy as to the extent of excision, approach of surgery, and the platform utilized. In this article, we aim to provide our surgical perspective of thymic resection and a review of the existing literature.


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