Study of Hs Troponin I & uric acid in patients of myocardial infarction

We aimed to provide Correlation of Hs Troponin I & Uric Acid in patients of Myocardial Infarction.: 100 patients who came to cardiac emergency in Shri Mahant Indresh Hospital. Serum samples taken for Hs Troponin I and Uric Acid for patients of Myocardial Infarction and run on VITROS 5600/7600 which is based on dry chemistry. : With 100 patients of more than 40 years of age 61 were males & 39 were females. For both males & females age mean & SD was 59.8±10.77.In our study we took 100 random patients coming to cardiac emergency out of which 50 patients had raised trop I and 45 patients had raised uric acid levels. Out of those 50 patients with raised HS Trop I 25 patients had raised values for uric acid. For Hs Trop I males – 21.88±48.8 & females 1676±57.58. For uric acid for males-6.545±3.75 & for females- 6.315±1.86.Therefore Hs Trop I & uric acid were both significant when compared with age T value was 2.7001 and P value was 0.0075. Whereas when compared with sex that is male and female to both Hs Trop I and uric acid then Hs Trop I was more significant with P value 0.0001.Uric acid is an economical marker that is readily, quickly and reliably obtainable & can be one of the predictable prognostic indicator in acute Myocardial Infarction.

Screening of Autophagy-Related Prognostic Genes in Metastatic Skin Melanoma

Cutaneous melanoma refers to a common skin tumor that is dangerous to health with a great risk of metastasis. Previous researches reported that autophagy is associated with the progression of cutaneous melanoma. Nevertheless, the role played by genes with a relation to autophagy (ARG) in the prediction of the course of metastatic cutaneous melanoma is still largely unknown. We observed that thirteen ARGs showed relations to overall survival (OS) in the Cox regression investigation based on a single variate. We developed 2-gene signature, which stratified metastatic cutaneous melanoma cases to groups at great and small risks. Cases suffering from metastatic cutaneous melanoma in the group at great risks had power OS compared with cases at small risks. The risk score, T phase, N phase, and age were proved to be individual factors in terms of the prediction of OS. Besides, the risk scores identified by the two ARGs were significantly correlated with metastatic cutaneous melanoma. Receiver operating characteristic (ROC) curve analysis demonstrated accurate predicting performance exhibited by the 2-gene signature. We also found that the immunization and stromal scores achieved by the group based on large risks were higher compared with those achieved by the group based on small risks. The metastatic cutaneous melanoma cases achieving the score based on small risks acquired greater expression of immune checkpoint molecules as compared with the high-risk group. In conclusion, the 2-ARG gene signature indicated a novel prognostic indicator for prognosis prediction of metastatic cutaneous melanoma, which served as an important tool for guiding the clinical treatment of cutaneous melanoma.

Acute Kidney Injury at Hospital Admission for SARS-CoV-2 Infection as a Marker of Poor Prognosis: Clinical Implications for Triage Risk Stratification

<b><i>Background/Aims:</i></b> The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a wide spectrum of effects, including acute kidney injury (AKI) in up to 40% of hospitalized patients. Given the established relationship between AKI and poor prognosis, whether AKI might be a prognostic indicator for patients admitted to the hospital for SARS-CoV-2 infection would allow for a straightforward risk stratification of these patients. <b><i>Methods:</i></b> We analyzed data of 623 patients admitted to San Raffaele Hospital (Milan, IT) between February 25 and April 19, 2020, for laboratory-confirmed SARS-CoV-2 infection. Incidence of AKI at hospital admission was calculated, with AKI defined according to the KDIGO criteria. Multivariable Cox regression models assessed the association between AKI and overall mortality and admission to the intensive care unit (ICU). <b><i>Results:</i></b> Overall, 108 (17%) patients had AKI at hospital admission for SARS-CoV-2 infection. After a median follow-up for survivors of 14 days (interquartile range: 8, 23), 123 patients died, while 84 patients were admitted to the ICU. After adjusting for confounders, patients who had AKI at hospital admission were at increased risk of overall mortality compared to those who did not have AKI (hazards ratio [HR]: 2.00; <i>p</i> = 0.0004), whereas we did not find evidence of an association between AKI and ICU admission (HR: 0.95; <i>p</i> = 0.9). <b><i>Conclusions:</i></b> These data suggest that AKI might be an indicator of poor prognosis for patients with SARS-CoV-2 infection, and as such, given its readily availability, it might be used to improve risk stratification at hospital admission.

Oral azacitidine prolongs survival of patients with AML in remission independent of measurable residual disease status

Measurable residual disease (MRD) in patients with acute myeloid leukemia (AML) in remission after intensive chemotherapy is predictive of early relapse and poor survival. Post-remission maintenance therapy that prolongs MRD negativity or converts MRD positive (MRD+) patients to MRD negative (MRD-) status may delay or prevent relapse and improve overall survival (OS). In the phase 3 QUAZAR AML-001 trial, oral azacitidine (Oral-AZA; formerly CC-486), a hypomethylating agent, significantly prolonged OS and relapse-free survival (RFS) compared with placebo in patients aged ≥55 years with AML in first remission after intensive chemotherapy who were not candidates for hematopoietic stem cell transplantation. In this trial, MRD (≥0.1% leukemic cells in bone marrow) was assessed by multiparameter flow cytometry in serial samples collected at baseline and on day 1 of every 3 cycles. As expected, baseline MRD status was significantly associated with both OS and RFS. Multivariate analyses showed Oral-AZA significantly improved OS and RFS vs. placebo independent of baseline MRD status. Oral-AZA treatment also extended the duration of MRD negativity by 6 months vs. placebo, and resulted in a higher rate of conversion from MRD+ at baseline to MRD- during treatment: 37% vs. 19%, respectively. In the Oral-AZA arm, 24% of MRD responders achieved MRD negativity &gt;6 months after treatment initiation. While presence or absence of MRD was a strong prognostic indicator of OS and RFS, there were added survival benefits with Oral-AZA maintenance therapy compared with placebo, independent of patients' MRD status at baseline. NCT01757535 Clinicaltrials.gov

Evaluation of Four Lymph Node Classifications for the Prediction of Survival in Hilar Cholangiocarcinoma

Background An important prognostic indicator of hilar cholangiocarcinoma (HCCA) in patients after surgery is metastasis of lymph nodes (LN). However, there are many types of LN staging systems to the issue of a better determination of the prognosis of patients through the lymphatic staging system which needs research. Based on the above, we tried to re-evaluate the staging system of HCCA LNs. We compared the American Joint Committee on Cancer (AJCC), number of metastatic LNs (MLN), ratio of LN (LNR), and log odds of MLNs (LODDS) in individuals undergoing curative resection to determine the best LN staging system. Methods In the current study, we retrospectively analyzed 229 patients undergoing curative resection. We evaluated the impact of the stage of AJCC pN, LNR, LODDS, and MLN on OS (overall survival) and RFS (recurrence-free survival). According to the curve of receiver operating characteristic (ROC), we compared the predictive capacity of different staging systems of LN for survival and recurrence. Results Multivariate analysis results revealed that LODDS > − 0.45 (95% CI = 1.115–2.709, P = 0.015; 95% CI = 1.187–2.780, P = 0.006) are independent risk factors affecting OS and RFS, respectively. Compared with LN status, AJCC pN stage, MLN, and LNR, the variable having the highest area under the ROC curve (AUC) was LODDS when predicting 1-year, 3-year, and 5-year OS and RFS. Conclusion This study shows that metastasis of LNs is a key indicator for predicting patient death and recurrence. Among them, LODDS is the best LN staging system for the prognostic evaluation of HCCA patients after surgery. Clinicians can incorporate LODDS into HCCA patient lymphatic staging system for a more accurate prognosis of HCCA patients post-surgery.

Preoperative T1 magnetic resonance imaging changes carry a poor postoperative prognosis in cervical myelopathy: A retrospective study of 182 patients

Background: T2 scans are widely used to determine the prognosis for patients undergoing surgery for cervical myelopathy. In this study, we determined whether T1 MR changes in addition to T2 MR changes could have prognostic importance. Methods: This retrospective analysis involved 182 patients undergoing surgery for cervical myelopathy (2017–2020). There were 110 patients in Group 1 (only T2 MR changes) and 72 in Group 2 (both T1 and T2 MR changes). In addition, demographic, visual analog score (VAS), modified Japanese Orthopaedic Association (mJOA) scores, and operative details were recorded at 1 month, 3 months, 6 months, and 1 year postoperatively. Results: Notably, VAS scores were comparable at each point in time and were significantly better than the preoperative scores at 1 year postoperatively. Although mJOA scores were comparable at 1 month in both groups, they were better thereafter for Group 1 patients. Conclusion: The presence of T1 changes on the preoperative magnetic resonance imaging represented a poor prognostic indicator for the postoperative outcome compared to the presence of T2 changes alone.

Prognostic Significance of SATB1, SMAD3, Ezrin and β-Catenin in Patients with Pancreatic Adenocarcinoma

The present study aimed to explore the role of SATB1, SMAD3, Ezrin and β-catenin as individual and combined biomarkers for the survival prediction in pancreatic adenocarcinoma (PAC). Notably, this study distinguished for the first time a potential prognostic value of SATB1 corresponding to its subcellular localization in PAC. Immunohistochemical staining on tissue macroarrays, as well as RNA-seq data from public sources, were investigated, and the results correlated with overall survival (OS) and clinicopathological features. The connectivity between the examined factors, as well as their common signaling pathways, were demonstrated by the functional enrichment analysis. Herein, the prognostic ability of cytoplasmic SATB1 in OS analysis was even superior to nuclear SATB1. Both staining patterns tended to have opposite roles in the prognosis of PAC: SATB1c was an independent prognostic factor for poor OS, whereas SATB1n expression reached no statistical significance, but Kaplan–Meier curves separated patients with low expression and adverse prognosis from patients with high expression and favorable prognosis. High levels of SATB1 mRNA appeared as an independent prognostic indicator for better OS. Furthermore, individual expression of SMAD3 or Ezrin, as well as combined expression of SATB1/SMAD3/Ezrin/β-catenin, were associated with OS independently of conventional risk factors, both in our cohort and TCGA dataset. In our series, patients with tumors harboring combined expression of SATB1n-high/SMAD3low/Ezrinlow/β-cateninlow experienced the highest survival rates, while those with SATB1c-present/SMAD3high/Ezrinhigh/β-cateninhigh had the worst survival. In conclusion, protein and/or mRNA expression levels of SATB1, SMAD3, Ezrin and β-catenin may serve as potential prognostic biomarkers for PAC, both as single predictors and even better when combined.

Factors influencing the development of recurrence and continued growth of primary extramedullary tumors removed using Nd:YAG laser

Objective. To assess the significance of clinical factors of extramedullary tumors and new methods of their resection as potential predictors of their recurrence and continued growth.Material and Methods. The long-term results of removal of primary extramedullary tumors in 412 patients operated on in 1998–2014 were analyzed comparing the use of standard methods of microsurgical technique for tumor removal (277 patients) and of those with additional use of neodymium laser radiation (135 patients).Results. The use of laser technologies for resection of extramedullary tumors can significantly reduce the number of their recurrences and continued growth, along with other clinical factors is a significant prognostic indicator in determining the nature of the disease course and can be a predictor of their occurrence. The most reliable clinical factors determining the prognosis of a decrease in the incidence of recurrences and continued growth when using laser techniques of surgical resection were repeated operations (p = 0.002), the presence of ependymomas of the cone and cauda equina (p = 0.017), operations for primary tumors in the thoracic spine (p = 0.039) and extramedullary tumors with Grade I anaplasia (p = 0.007). An increase in the number of these conditions was associated with operations on the cervical spine (p = 0.027), the presence of a tumor with Grade II anaplasia (p = 0.007), and a primary extramedullary tumor involving more than three vertebrae (p = 0.017).Conclusion. The use of the laser is indicated for reoperations when removing neoplasms, that have arisen as a result of recurrence or continued growth of extramedullary tumors of any level and length after removal of primary neoplasms with a Grade I malignancy confirmed by intraoperative cytological examination involving no more than three vertebrae in the thoracic, lumbar and sacral spine and during resection of ependymomas with extramedullary growth.