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Abdominal Radiology (New York) Jan 2021Orthotopic liver transplant (OLT) is established as the definitive treatment of choice for end stage liver disease. Over the years, refined surgical techniques as well... (Review)
Review
Orthotopic liver transplant (OLT) is established as the definitive treatment of choice for end stage liver disease. Over the years, refined surgical techniques as well as advancements in organ preservation and immunosuppressive regimens have improved graft and patient survival rates. Imaging has also contributed to improved graft and patient survival. Ultrasound is the initial investigation of choice for evaluation of post-transplant anatomy and for identifying early complications. A thorough knowledge of surgical techniques and normal post-operative appearance of the OLT is needed to accurately identify and characterize graft complications. The objective of this article is to review the sonographic findings of normal liver transplant as well as post-operative complications. Indications and contraindications for OLT as well as different surgical techniques will also be briefly reviewed.
Topics: End Stage Liver Disease; Humans; Liver Transplantation; Postoperative Complications; Survival Rate; Ultrasonography
PubMed: 33043396
DOI: 10.1007/s00261-020-02799-7 -
World Neurosurgery Dec 2021A chordoma is a slow-growing, invasive neoplasm in the neuraxis that is thought to arise from notochordal cells. At 10-year follow-up, the average survival rate is 50%,... (Review)
Review
BACKGROUND
A chordoma is a slow-growing, invasive neoplasm in the neuraxis that is thought to arise from notochordal cells. At 10-year follow-up, the average survival rate is 50%, though individual prognosis varies substantially. We aimed to provide a comprehensive overview of the genes and proteins expressed in these tumors and their prognostic value to facilitate prognostication for patients with chordoma.
METHODS
A systematic search of clinical studies that investigated expressed factors related to chordoma survival was performed in PubMed. Data extracted included RNA and protein expression data and prognostic value (in terms of overall survival, progression-free survival, disease-free survival, and recurrence-free survival) from univariate and multivariate analyses.
RESULTS
This review included 78 original studies that collectively evaluated 134 expressed factors. Of these molecular factors, 96 by univariate analysis and 32 by multivariate analysis had a predictive value for patient survival. Of the molecular factors studied in multivariate analyses, 26 factors had a negative effect while 6 had a positive effect on patient survival.
CONCLUSIONS
Identification of molecular factors that are associated with survival contributes to better prognostication of patients with chordoma. Given the rarity of chordoma, often only univariate analyses can be performed. Robust multivariate analyses are scarcer but provide independently significant prognostic factors. The data presented in this review can aid in prognostication for the individual patient and facilitate the development of targeted therapies.
Topics: Biomarkers, Tumor; Chordoma; Gene Regulatory Networks; Humans; Prognosis; Survival Rate
PubMed: 34530149
DOI: 10.1016/j.wneu.2021.09.027 -
Statistics in Medicine Nov 2021We propose a class of alternative estimates and tests to restricted mean survival time (RMST) which improves power in numerous survival scenarios while maintaining a...
We propose a class of alternative estimates and tests to restricted mean survival time (RMST) which improves power in numerous survival scenarios while maintaining a level of interpretability. The industry standards for interpretable hypothesis tests in survival analysis, RMST and logrank tests (LRTs), can suffer from low power in cases where the proportional hazards assumption fails. In particular, when late differences occur between survival curves, our proposed estimate and class of tests, window mean survival time (WMST), outperforms both RMST and LRT without sacrificing interpretability, unlike weighted rank tests (WRTs). WMST has the added advantage of maintaining high power when the proportional hazards assumption is met, while WRTs do not. With testing methods often being chosen in advance of data collection, WMST can ensure adequate power without distributional assumptions and is robust to the choice of its restriction parameters. Functions for performing WMST analysis are provided in the survWM2 package in R.
Topics: Humans; Proportional Hazards Models; Research Design; Survival Analysis; Survival Rate
PubMed: 34258772
DOI: 10.1002/sim.9138 -
Annals of the New York Academy of... Jan 2022Cardiac arrest (CA) is a sudden and devastating disease process resulting in more deaths in the United States than many cancers, metabolic diseases, and even car... (Review)
Review
Cardiac arrest (CA) is a sudden and devastating disease process resulting in more deaths in the United States than many cancers, metabolic diseases, and even car accidents. Despite such a heavy mortality burden, effective treatments have remained elusive. The past century has been productive in establishing the guidelines for resuscitation, known as cardiopulmonary resuscitation (CPR), as well as developing a scientific field whose aim is to elucidate the underlying mechanisms of CA and develop therapies to save lives. CPR has been successful in reinitiating the heart after arrest, enabling a survival rate of approximately 10% in out-of-hospital CA. Although current advanced resuscitation methods, including hypothermia and extracorporeal membrane oxygenation, have improved survival in some patients, they are unlikely to significantly improve the national survival rate any further without a paradigm shift. Such a change is possible with sustained efforts in the basic and clinical sciences of resuscitation and their implementation. This review seeks to discuss the current landscape in resuscitation medicine-how we got here and where we are going.
Topics: Animals; Anti-Inflammatory Agents; Antioxidants; Cardiopulmonary Resuscitation; Extracorporeal Membrane Oxygenation; Heart Arrest; Humans; Survival Rate; Time Factors
PubMed: 33040363
DOI: 10.1111/nyas.14507 -
International Journal of Molecular... Aug 2022Paediatric brain cancer is the second most common childhood cancer and is the leading cause of cancer-related deaths in children. Despite significant advancements in the... (Review)
Review
Paediatric brain cancer is the second most common childhood cancer and is the leading cause of cancer-related deaths in children. Despite significant advancements in the treatment modalities and improvements in the 5-year survival rate, it leaves long-term therapy-associated side effects in paediatric patients. Addressing these impairments demands further understanding of the molecularity and heterogeneity of these brain tumours, which can be demonstrated using different animal models of paediatric brain cancer. Here we review the use of zebrafish as potential in vivo models for paediatric brain tumour modelling, as well as catalogue the currently available zebrafish models used to study paediatric brain cancer pathophysiology, and discuss key findings, the unique attributes that these models add, current challenges and therapeutic significance.
Topics: Animals; Brain Neoplasms; Humans; Survival Rate; Zebrafish
PubMed: 36077320
DOI: 10.3390/ijms23179920 -
The British Journal of Dermatology May 2023
Topics: Humans; Survival Rate; Incidence; Skin Neoplasms; Skin; England
PubMed: 37226394
DOI: 10.1093/bjd/ljad147 -
Pediatrics May 2021Presence of a syndrome (or association) is predictive of poor survival in esophageal atresia (EA). However, most reports rely on historical patient outcomes, limiting...
BACKGROUND AND OBJECTIVES
Presence of a syndrome (or association) is predictive of poor survival in esophageal atresia (EA). However, most reports rely on historical patient outcomes, limiting their usefulness when estimating risk for neonates born today. We hypothesized improved syndromic EA survival due to advances in neonatal care.
METHODS
A retrospective single-center review of survival in 626 consecutive patients with EA from 1980 to 2017 was performed. Data were collected for recognized risk factors: preterm delivery; birth weight <1500 g; major cardiac disease; vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities (VACTERL); and non-VACTERL syndromes. Cox proportional hazards regression models were used to evaluate temporal trends in survival with respect to year of birth and syndromic EA.
RESULTS
Overall, 87% of 626 patients with EA survived, ranging from 82% in the 1980s to 91% in the 2010s. After adjusting for confounders, syndromic EA survival did not improve during the study, with no association found between year of birth and survival (hazard ratio [HR] 0.98, 95% confidence interval [CI]: 0.95-1.01). Aside from lethal non-VACTERL syndromes, patients with nonlethal non-VACTERL syndromes (HR 6.85, 95% CI: 3.50-13.41) and VACTERL syndrome (HR 3.02, 95% CI: 1.66-5.49) had a higher risk of death than those with nonsyndromic EA.
CONCLUSIONS
Survival of patients with syndromic EA has not improved, and patients with non-VACTERL syndromes have the highest risk of death. Importantly, this is independent of syndrome lethality, birth weight, and cardiac disease. This contemporary survival assessment will enable more accurate perinatal counseling of parents of patients with syndromic EA.
Topics: Esophageal Atresia; Female; Humans; Infant, Newborn; Male; Retrospective Studies; Survival Rate; Syndrome
PubMed: 33911029
DOI: 10.1542/peds.2020-029884 -
Pharmaceutical Statistics Jan 2023In a clinical trial with a time-to-event endpoint the treatment effect can be measured in various ways. Under proportional hazards all reasonable measures (such as the...
In a clinical trial with a time-to-event endpoint the treatment effect can be measured in various ways. Under proportional hazards all reasonable measures (such as the hazard ratio and the difference in restricted mean survival time) are consistent in the following sense: Take any control group survival distribution such that the hazard rate remains above zero; if there is no benefit by any measure there is no benefit by all measures, and as the magnitude of treatment benefit increases by any measure it increases by all measures. Under nonproportional hazards, however, survival curves can cross, and the direction of the effect for any pair of measures can be inconsistent. In this paper we critically evaluate a variety of treatment effect measures in common use and identify flaws with them. In particular, we demonstrate that a treatment's benefit has two distinct and independent dimensions which can be measured by the difference in the survival rate at the end of follow-up and the difference in restricted mean survival time, and that commonly used measures do not adequately capture both dimensions. We demonstrate that a generalized hazard difference, which can be estimated by the difference in exposure-adjusted subject incidence rates, captures both dimensions, and that its inverse, the number of patient-years of follow-up that results in one fewer event (the NYNT), is an easily interpretable measure of the magnitude of clinical benefit.
Topics: Humans; Proportional Hazards Models; Survival Rate; Survival Analysis
PubMed: 36204977
DOI: 10.1002/pst.2267 -
Pediatric Surgery International Sep 2022Liver transplantation is a life-saving treatment for children who are in liver failure. The survival rate index is used to assess the success rate of liver... (Meta-Analysis)
Meta-Analysis Review
Liver transplantation is a life-saving treatment for children who are in liver failure. The survival rate index is used to assess the success rate of liver transplantation. The study aimed to assess the survival rate of liver transplantation in children. We searched 5 international databases in this study, including Medline/PubMed, ProQuest, Scopus, Web of Knowledge, and Google Scholar, for published articles by the end of 2020. Also, meta-regression analysis was performed based on the year of the study, and subgroup analysis was performed according to continents. A total of 425 titles were reviewed. Based on the results, 96 articles were entered in the meta-analysis. Established on the random-effect model, the survival rates of 1, 3, 5, and 10 years of transplantation were 86.62%, 77.74%, 73.95%, and 68.60%, respectively. Also, based on the meta-regression results, there was a relationship between the year of the study and the survival rate, as the study year gets more recent, the survival rate is increased. This study can provide documented and comprehensive evidence which can be the basis of many policies and decisions in various sectors of health development, including evaluating treatment options and health interventions in transplantation.
Topics: Child; Humans; Liver Failure; Liver Transplantation; Survival Rate
PubMed: 35870002
DOI: 10.1007/s00383-022-05179-y -
Annals of the Academy of Medicine,... Nov 2019Sarcopenia is a condition in which patients have an abnormally low muscle mass with poor muscle function. It is prevalent in older patients and is often associated with... (Review)
Review
Sarcopenia is a condition in which patients have an abnormally low muscle mass with poor muscle function. It is prevalent in older patients and is often associated with frailty. It has gained increasing recognition as a significant indicator of poor surgical outcomes. In this review, we examine the concept of sarcopenia and its impact on surgical outcomes and current research on its management. We also discuss the diagnosis of sarcopenia in terms of muscle mass and muscle function and common definitions of both terms. An overview of the impact of sarcopenia on different surgical specialties is reviewed. Lastly, a survey of current treatments available for sarcopenia and their limited impact are discussed with a view to encouraging possible future studies.
Topics: Aged; Frailty; Geriatric Assessment; Global Health; Humans; Postoperative Complications; Prevalence; Sarcopenia; Surgical Procedures, Operative; Survival Rate
PubMed: 31960016
DOI: No ID Found