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The Journal of International Medical... Apr 2024In recent years, radiomics has emerged as a novel research methodology that plays a crucial role in the diagnosis and treatment of ischemic stroke. By integrating... (Review)
Review
In recent years, radiomics has emerged as a novel research methodology that plays a crucial role in the diagnosis and treatment of ischemic stroke. By integrating multimodal medical imaging techniques such as computed tomography and magnetic resonance imaging, radiomics offers in-depth insights into aspects such as the extent of brain tissue damage and hemodynamics. These data help physicians to accurately assess patient condition, select optimal treatment strategies, and predict recovery trajectories and long-term prognoses, thereby enhancing treatment efficacy and reducing the risk of complications. With the anticipated further advancements in radiomic technology, this methodology has great potential for expanded applications in the early detection, treatment, and prognosis of ischemic stroke. The present narrative review explores the burgeoning field of radiomics and its transformative impact on ischemic stroke.
Topics: Humans; Ischemic Stroke; Radiomics; Prognosis; Tomography, X-Ray Computed; Treatment Outcome; Stroke
PubMed: 38565321
DOI: 10.1177/03000605241238141 -
Journal of Global Health Apr 2021To assess the impact of the health care reform on stroke prognoses among low-income Chinese residents.
BACKGROUND
To assess the impact of the health care reform on stroke prognoses among low-income Chinese residents.
METHODS
Stroke events and all-cause deaths were registered during 1992-2018 in Tianjin, China. Trends in stroke management and prognoses were compared during the study periods1992-2008 and 2009-2018.
RESULTS
A total of 1462 patients were diagnosed with first-ever stroke during the study periods. For patients aged ≥45 years, the rates of neuroimaging-based diagnoses and hospitalization were greater in 2009-2018 than in 1992-2008, regardless of patient sex or stroke type. Overall, the one-year case fatality rate was significantly lower in 2009-2018 than in the earlier period; the case fatality rate for women aged ≥65 years decreased by 30.0%. Between both periods, the stroke recurrence rate increased 1.9-fold, including a 2.5-fold increase in men (all < 0.05). During the 2009-2018 period, the one-year case fatality rate was higher among elderly male patients not using medical insurance than among those using it (32.8% vs 20.7%; = 0.050). After 2009, a significant decline in the recurrence rate ( = 0.001) and a significant increase in the hospitalization rate ( = 0.004) were observed in the interrupted time-series analysis.
CONCLUSIONS
These findings suggest that the implementation of universal medical insurance for residents in urban and rural China played a major role in improving the prognoses of low-income, rural, first-ever stroke patients, especially for elderly (≥65 years old) residents. However, elderly male patients not using medical insurance benefits had a high case fatality rate. Thus, restructuring of the government medical insurance policy to facilitate its use by low-income, rural residents is crucial for reducing the stroke burden in China.
Topics: Aged; China; Female; Health Care Reform; Humans; Male; Poverty; Prognosis; Rural Population; Stroke
PubMed: 33884194
DOI: 10.7189/jogh.11.08002 -
Archives of Gynecology and Obstetrics Mar 2016Uterine cervical conization is related to adverse pregnancy outcomes in subsequent pregnancies. To deal with this problem, we started conservative coin-shaped conization...
PURPOSE
Uterine cervical conization is related to adverse pregnancy outcomes in subsequent pregnancies. To deal with this problem, we started conservative coin-shaped conization for reproductive-aged patients with cervical intraepithelial neoplasia (CIN). Here we report both the obstetrical and oncological impacts of this operation in comparison with the standard cone-shaped resection.
METHODS
A total of 401 women 44 years old or younger were treated in our hospital by CO2 laser conization between 2003 and 2012, and subsequently 50 patients became pregnant. The patients were divided into two groups, a standard cone-shaped conization group (until 2008) and a shallow coin-shaped conization group (beginning in 2008). The pregnancy courses and oncological prognoses of these two groups were studied.
RESULTS
Cone height reduction of about 3 mm was done. However, there were no significant differences between the two groups with regard to the occurrence of oncological complications. In the standard conization group, 18 of the 25 patients delivered at term. In the coin-shaped conization group, 20 of the 25 patients delivered at term. There were no significant differences between the two groups with regard to the occurrence of various obstetrical complications. However, the reduction rate of cervical length over the pregnancy was smaller in the coin-shaped group and the number of patients with a short cervix length of 2 cm or less was smaller in the coin-shaped group.
CONCLUSIONS
Although conservative coin-shaped conization did not markedly improve the obstetrical prognosis, this operative procedure improved the reduction rate of uterine cervical length over the pregnancy without any increase in oncological complications.
Topics: Adolescent; Adult; Conization; Female; Humans; Laser Therapy; Lasers, Gas; Neoplasm Staging; Pregnancy; Pregnancy Outcome; Prognosis; Retrospective Studies; Risk Factors; Treatment Outcome; Uterine Cervical Neoplasms; Uterine Cervical Dysplasia
PubMed: 26305031
DOI: 10.1007/s00404-015-3860-5 -
Chinese Clinical Oncology Oct 2016Hepatocellular carcinoma (HCC), the fifth most common cancer globally and third leading cause of cancer-related mortality is a heterogeneous disease with a highly... (Review)
Review
Hepatocellular carcinoma (HCC), the fifth most common cancer globally and third leading cause of cancer-related mortality is a heterogeneous disease with a highly variable clinical course. The inherent biological diversity of hepatic carcinomas may hinder therapeutic decision making and prognostication for patients. One distinct, albeit rare, subtype of primary hepatic carcinoma is combined intrahepatic cholangiocarcinoma and hepatocellular carcinoma (cHCC-ICC), which carries an overall worse prognosis than either HCC or intrahepatic cholangiocarcinoma (ICC) alone. cHCC-ICC is a primary hepatic neoplasm containing unequivocal elements of both HCC and ICC. This review will focus on understanding further the histopathology of this unique tumor type, current treatment approaches and prognoses for this rare patient population.
Topics: Carcinoma, Hepatocellular; Cholangiocarcinoma; Disease-Free Survival; Humans; Prognosis
PubMed: 27829279
DOI: 10.21037/cco.2016.10.02 -
Gan To Kagaku Ryoho. Cancer &... Apr 2000About 3% to 5% of all germ cell tumors are thought to be primary extratesticular tumors, including a small group of benign tumors. Though the testes are clinically... (Review)
Review
About 3% to 5% of all germ cell tumors are thought to be primary extratesticular tumors, including a small group of benign tumors. Though the testes are clinically normal, diagnosing whether the tumor is primary or metastatic is problematic. Developments in ultrasonography have enabled the detection of tiny testicular lesions, and ultrasonography is applied to determine the biopsy sites. Nevertheless, burned-out tumor and carcinoma in situ are not always easy to find. Extratesticular germ cell tumors are usually treated using methods similar to those for advanced testicular tumors; however, the results are discouraging. Only limited cases are suitable for a monotherapy of surgery, so a combined treatment of cisplatin based chemotherapy and surgery is prevalent. Against seminomas, radiotherapy is effective. In addition to the advent of such pharmaceuticals as G-CSF and serotonin receptor antagonists, recent development of peripheral blood stem cell transplantation is expected to produce improved prognoses among patients burdened with this refractory disease. A prognostic factor-based staging system developed by the International Germ Cell Cancer Collaborative Group is reasonable and useful. Non-seminomas are classified as having good or intermediate prognoses if retroperitoneal tumors having no non-pulmonary visceral metastases show good or intermediate markers. A poor prognosis is associated with extratesticular tumors with mediastinal primary or non-pulmonary visceral metastases or poor markers. Seminomas with normal AFP are classified as having good or intermediate prognoses if no non-pulmonary visceral metastases are seen or discarded. No seminomas are classified in the poor prognosis group.
Topics: Adult; Child; Female; Germinoma; Humans; Male; Prognosis
PubMed: 10790995
DOI: No ID Found -
Arerugi = [Allergy] 2021Atopic dermatitis (AD) in early infancy can lead to severe protein-loss in atopic dermatitis (SPLAD). The aim of this study was to elucidate the prognosis of SPLAD. (Observational Study)
Observational Study
BACKGROUND
Atopic dermatitis (AD) in early infancy can lead to severe protein-loss in atopic dermatitis (SPLAD). The aim of this study was to elucidate the prognosis of SPLAD.
METHODS
This was a single-center, retrospective, observational study based on medical records. Participants comprised 61 children with SPLAD hospitalized at the Allergy Center, National Center for Child Health and Development, from 2002 to 2017. We examined patient characteristics, blood test results, and prognoses up to 3 years, including frequency of topical corticosteroid-(TCS) use and food intake status.
RESULTS
All participants improved hypoproteinemia and electrolyte abnormalities with AD treatment alone, without intravenous fluids. We performed proactive therapy to maintain remission by gradually decreasing the frequency of TCS-use. After 1, 2, and 3 years, 77%, 92%, and 95%, respectively, remission was maintained by using TCS 2 days a week or less, whereas 39% did not require TCS after 3 years. No participants received systemic therapy, including systemic steroids, immunosuppressants, or biologics. We observed that 29% of infants younger than 1 year at admission had eliminated one or more egg, milk, or wheat component after 3 years.
CONCLUSIONS
Even in patients with SPLAD, the most severe AD, TCS-use may be reduced to 2 days per week or less after 3 years with appropriate skin treatment.
Topics: Child; Dermatitis, Atopic; Dermatologic Agents; Humans; Infant; Prognosis; Retrospective Studies; Treatment Outcome
PubMed: 34911891
DOI: 10.15036/arerugi.70.1383 -
Scientific Reports Mar 2023Bladder cancer (BC) is a representative malignant tumor type, and the significance of N7-methyguanosine (m7G)-related lncRNAs in BC is still unclear. Utilizing...
Bladder cancer (BC) is a representative malignant tumor type, and the significance of N7-methyguanosine (m7G)-related lncRNAs in BC is still unclear. Utilizing m7G-related lncRNAs, we developed a prognostic model to evaluate BC's prognosis and tumor immunity. First, we selected prognostic lncRNAs related to m7G by co-expression analysis and univariate Cox regression and identified two clusters by consensus clustering. The two clusters differed significantly in terms of overall survival, clinicopathological factors, and immune microenvironment. Then, we further constructed a linear stepwise regression signature by multivariate Cox and least absolute shrinkage and selection operator (LASSO) regression analysis. Patients fell into high-risk (HR) and low-risk (LR) groups considering the train group risk score. HR group had worse prognoses when stratified by clinicopathological factors. The receiver operating curve (ROC) suggested that the signature had a better prognostic value. Tumor mutation burden (TMB) showed a negative relevance to the risk score, and patients with low TMB presented a better prognosis. Validation of the signature was carried out with multivariate and univariate Cox regression analysis, nomogram, principal component analysis (PCA), C-Index, and quantitative reverse transcriptase PCR (qRT-PCR). Finally, the gene set enrichment analysis (GSEA) demonstrated the enrichment of tumor-related pathways in HR groups, and single-sample gene set enrichment analysis (ssGSEA) indicated a close association of risk score with tumor immunity. According to the drug sensitivity test, the signature could predict the effects of conventional chemotherapy drugs. In conclusion, our study indicates the close relevance of m7G-related lncRNAs to BC, and the established risk signature can effectively evaluate patient prognosis and tumor immunity and is expected to become a novel prognostic marker for BC patients.
Topics: Humans; RNA, Long Noncoding; Urinary Bladder Neoplasms; Prognosis; Nomograms; Cluster Analysis; Tumor Microenvironment
PubMed: 36922569
DOI: 10.1038/s41598-023-31424-y -
Clinical and Investigative Medicine.... Dec 2022To measure interleukin (IL)-17 serum levels in thoracic trauma patients and to correlate these levels with other cytokines and with patient prognosis. Methods: This... (Observational Study)
Observational Study
To measure interleukin (IL)-17 serum levels in thoracic trauma patients and to correlate these levels with other cytokines and with patient prognosis. Methods: This prospective observational study recruited 130 thoracic trauma patients who were admitted to the Zhoupu Hospital Affiliated to Shanghai Medical College of Health June 2020 to April 2022 and 100 healthy volunteers. Patients were divided into two groups based on Injury Severity Score (ISS): ISS<16 (mild/moderate trauma) and ISS ≥16 (severe trauma). Serum IL-17, tumor necrosis factor α (TNF-α), IL-6, IL-1β and C-reactive protein (CRP) levels were measured by enzyme-linked immunosorbent assay. Patients with poor prognosis were defined as those who developed serious complications or died during hospitalization or follow-up. Results: Serum levels of IL-17, TNF-α, IL-6 and IL-1β were significantly elevated in patients with ISS ≥16 (p<0.05). Serum cytokines levels increased within 48 h in both groups and then gradually decreased during subsequent treatment and rehabilitation. Pearson's analysis indicated a positive correlation among IL-17, TNF-α and IL-1β. Serum IL-17 levels in patients with poor prognoses were higher than the patients with good prognoses at all time points (p<0.05). Furthermore, for patients with poor prognoses, the serum IL-17 levels had highest diagnostic value among all the cytokines measured. Logistic regression analysis showed that IL-17 was the risk factor for thoracic trauma patients with poor prognoses. Conclusion: Serum IL-17 levels were significantly elevated in thoracic trauma patients and decreased gradually with rehabilitation. IL-17 was a risk factor for thoracic trauma patients with poor prognoses. This study suggests a new diagnostic and therapeutic target for thoracic trauma patients.
Topics: Humans; Tumor Necrosis Factor-alpha; Interleukin-17; Interleukin-6; China; Cytokines; Prognosis
PubMed: 36586098
DOI: 10.25011/cim.v45i4.39558 -
The Journal of Hand Surgery, European... Jan 2023This study systematically and comprehensively analysed 129 thumb polydactylies in 122 patients using a duplicating range concept based on the level of skin and skeletal...
This study systematically and comprehensively analysed 129 thumb polydactylies in 122 patients using a duplicating range concept based on the level of skin and skeletal bifurcation. Numerical levels were defined along the longitudinal axis of the ulnar thumb duplicate from distal to proximal: level 0 (thumb tip) to level 6 (carpometacarpal joint). The relationships between duplication range and morphological parameters were evaluated. Nail asymmetry was associated with skin bifurcation levels 0 to 2. Proximal phalangeal asymmetry and interphalangeal joint deviation, associated with skin bifurcation levels were assigned scores of 1 to 2.5 and 1 to 2, respectively. Metacarpophalangeal joint deviation had a bimodal distribution, at levels 1.5 and 4 of the longitudinal axes. Morphological similarity was found in patients with the same duplication range. The duplication range concept could potentially improve our understanding of morphology variation and predicting prognoses in thumb polydactyly. III.
Topics: Humans; Thumb; Polydactyly; Finger Phalanges; Prognosis
PubMed: 36204982
DOI: 10.1177/17531934221126864 -
Current Opinion in Periodontology 1993Determining the prognosis for patients and individual sites with inflammatory periodontal diseases is difficult using present methods. Traditional approaches for... (Review)
Review
Determining the prognosis for patients and individual sites with inflammatory periodontal diseases is difficult using present methods. Traditional approaches for predicting when disease activity will occur have proved inadequate in some cases. New diagnostic tests and updated methods of traditional tests will eventually allow clinicians to improve their skills in determining prognosis; however, most of these tests are not yet proved or economically feasible. At present, if a patient is currently healthy and has no past history of attachment loss, their prognosis is favorable. The probability of periodontal breakdown occurring in these patients before the next regularly scheduled maintenance visit is slim. A history of attachment loss is the best predictor of future loss, but determining when more loss will occur is problematic. Clinical signs of inflammation, especially bleeding on probing and the presence of suppuration, also appear to predict breakdown, but to a lesser degree than previous attachment loss. It appears that the future holds much promise for improving our ability to make accurate prognoses, especially in cases of aggressive periodontal problems, but until these advances are well tested, traditional methods continue to be the standard.
Topics: Humans; Periodontal Attachment Loss; Periodontal Diseases; Prognosis
PubMed: 8401849
DOI: No ID Found