Intensive care unit (ICU) is a very special unit of a hospital, where healthcare professionals provide treatment and, later, close follow-up to the patients. It is crucial to estimate mortality in ICU patients from many viewpoints. The purpose of this study is to classify the status of patients with acute kidney injury (AKI) in ICU as early mortality, late mortality, and survival by the application of Classification and Regression Trees (CART) algorithm to the patients' attributes such as blood urea nitrogen, creatinine, serum and urine neutrophil gelatinase-associated lipocalin (NGAL), alkaline phosphatase, lactate dehydrogenase (LDH), gamma-glutamyl transferase, laboratory electrolytes, blood gas, mean arterial pressure, central venous pressure and demographic details of patients. This study was conducted 50 patients with AKI who were followed up in the ICU. The study also aims to determine the significance of relationship between the attributes used in the prediction of mortality in CART and patients' status by employing the Kruskal-Wallis H test. The classification accuracy, sensitivity, and specificity of CART for the tested attributes for the prediction of early mortality, late mortality, and survival of patients were 90.00%, 83.33%, and 91.67%, respectively. The values of both urine NGAL and LDH on day 7 showed a considerable difference according to the patients' status after being examined by the Kruskal-Wallis H test.

• MeSH
• akutní poškození ledvin * mortalita   MeSH
• algoritmy MeSH
• biologické markery analýza   MeSH
• data mining metody   MeSH
• dospělí MeSH
• klasifikace MeSH
• laktátdehydrogenasy analýza   MeSH
• lidé MeSH
• lipokalin-2 analýza   MeSH
• metody pro podporu rozhodování MeSH
• mortalita v nemocnicích * MeSH
• prognóza MeSH
• rozhodovací podpůrné systémy pro řízení MeSH
• rozhodovací stromy MeSH
• statistika jako téma MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH

For most patients, the HIV viral load can be made undetectable by highly active antiretroviral treatments highly active antiretroviral therapy: the virus, however, cannot be eradicated. Thus, the major problem is to try to reduce the side effects of the treatment that patients have to take during their life time. We tackle the problem of monitoring the treatment dose, with the aim of giving the minimum dose that yields an undetectable viral load. The approach is based on mechanistic models of the interaction between virus and the immune system. It is shown that the "activated cells model," allows making good predictions of the effect of dose changes and, thus, could be a good basis for treatment monitoring. Then, we use the fact that in dynamical models, there is a nontrivial equilibrium point, that is with a virus load larger than zero, only if the reproductive number R(0) is larger than one. For reducing side effects, we may give a dose just above the critical dose corresponding to R(0) equal to 1. A prior distribution of the parameters of the model can be taken as the posterior arising from the analysis of previous clinical trials. Then the observations for a given patient can be used to dynamically tune the dose so that there is a high probability that the reproductive number is below one. The advantage of the approach is that it does not depend on a cost function, weighing side effects and efficiency of the drug. It is shown that it is possible to approach the critical dose if the model is correct. A sensitivity analysis assesses the robustness of the approach.

• MeSH
• algoritmy MeSH
• biologické modely MeSH
• biometrie MeSH
• CD4-pozitivní T-lymfocyty účinky léků   imunologie   virologie   MeSH
• HIV infekce farmakoterapie   imunologie   virologie   MeSH
• klinické zkoušky jako téma statistika a číselné údaje   MeSH
• látky proti HIV aplikace a dávkování   škodlivé účinky   MeSH
• lidé MeSH
• modely imunologické MeSH
• monitorování léčiv statistika a číselné údaje   MeSH
• statistické modely * MeSH
• virová nálož účinky léků   MeSH
• vysoce aktivní antiretrovirová terapie * škodlivé účinky   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Menarche is an indicator frequently used to study variation in growth, development, and related health conditions among members of living populations. As a life event, menarche is often associated with changes in an individual's social identity. The reproductive lifespan, which for females starts with menarche, is a paramount feature of palaeodemographic studies. Determination of menarche status from the skeletal remains of individuals of past populations can be obtained by assessing the developmental status of the iliac crest, as well as the hand and wrist bones, which are, unlike teeth, often poorly recovered in bioarchaeological contexts. The present study seeks to evaluate the link between dental mineralization and menarche in a population of known menarche status. The relationship between permanent teeth mineralization and menarche status was investigated by using data of developing permanent teeth (167 radiographs) rated in accordance with the well-known standards of Demirjian et al. and Moorrees et al. collected among 73 living French females of known menarcheal status. Using correlation ratios, GLMM and CART algorithm, menarcheal status is correlated with mineralization of the premolars. Menarcheal status is predicted correctly for 92 and 77% of radiographs of the learning and validation samples, respectively. Although promising, the results require caution prior to generalization to other populations. The age of menarche in this particular sample may simply coincide with the development of the premolars in this particular sample. Therefore, further investigation applied to populations with various mean ages of menarche is required in order to provide new evidence of variation in human growth and development from the correspondence between the mineralization of the permanent teeth and menarche.

• MeSH
• algoritmy MeSH
• antropologie fyzická MeSH
• dítě MeSH
• fyziologická kalcifikace fyziologie   MeSH
• lidé MeSH
• menarche fyziologie   MeSH
• mladiství MeSH
• rentgendiagnostika panoramatická MeSH
• zuby anatomie a histologie   diagnostické zobrazování   fyziologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

HIV infection is the major public health, social and economic problem in Georgia. Although the HIV epidemic is in its nascent phase in the country, the potential risk for development of a wide spread HIV epidemic is very high. The aim of this study is to evaluate the effectiveness of ARV treatment principles in Georgia, including treatment and monitoring methods. MATERIALS AND METHODS: The study included 985 people living with HIV/AIDS in Georgia registered at Infectious Disease, AIDS and Clinical Immunology Research Center since 2004. To ensure universal access to ARV therapy all HIV/AIDS individuals included in the study were investigated by special algorithm, all identified patients requiring ARV therapy were offered treatment and monitored during therapy on treatment effectiveness and side effects. HIV-1 RNA in plasma was measured by quantitative Polymerase Chain Reaction. For determination of percentages and absolute count of T-lymphocyte subpopulations single-platform immunophenotyping technique using the Becton-Dickinson FACSCalibur flow cytometer was applied. For resistance testing TRUGENE HIV-1 Genotyping Kit with the OpenGene DNA Sequencing System (Siemens) was used. Reasons of treatment failure and mortality rate among ARV treated patients were analyzed. RESULTS AND CONCLUSIONS: Treatment was offered to 398 HIV/AIDS patients. 397 patients started treatment, 1 patient refused. Out of 397 HIV/AIDS patients treated 21 patients discontinued, 54 patients died and 322 patients are currently on ARV treatment. Out of the treated patients 281 adults and 11 children are receiving first-line treatment, 27 adults and 2 children are on second-line treatment and 1 adult is receiving salvage regimen. Treatment failure was defined in 52 cases. Among them immunological failure was observed in 7 cases, clinical failure in 1 case and virologic failure in 44 cases. Prevalence of drug resistance among virologic failure cases accounted for 73% and inadequate adherence for 27% cases. Out of drug resistance cases 3% has three-class drug resistance, 84%--two-class drug resistance and 13% found to be resistant to one class. In ARV naive patients the prevalence of drug resistance to any class was 4.33%. The majority of death cases among ARV treated patients was due to non-AIDS related or incurable conditions, while deaths due to AIDS related conditions were mainly associated with delayed referral of patients in already advanced stage of disease. It's worth to mention that the highest number of death cases was due to liver failure in HIV/HCV and/or HBV co-infected patients.

• MeSH
• adherence k farmakoterapii MeSH
• dospělí MeSH
• HIV infekce farmakoterapie   mortalita   virologie   MeSH
• HIV-1 genetika   účinky léků   MeSH
• lidé MeSH
• mnohočetná virová léková rezistence MeSH
• neúspěšná terapie MeSH
• oportunní infekce doprovázející AIDS mortalita   MeSH
• předškolní dítě MeSH
• prevalence MeSH
• registrace MeSH
• vysoce aktivní antiretrovirová terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Geografické názvy
• Gruzie MeSH

A trend towards greater benefit from adjuvant chemotherapy (ACT) in pN+ bladder cancer (BCa) has been observed in multiple randomized controlled trials. However, it is still unclear which patients might benefit the most from this approach. We retrospectively analyzed a multicenter cohort of 1381 patients with pTany pN1-3 cM0 R0 urothelial BCa treated with radical cystectomy (RC) with or without cisplatin-based ACT. The main endpoint was overall survival (OS) after RC. We performed 1:1 propensity score matching to adjust for baseline characteristics and conducted a classification and regression tree (CART) analysis to assess postoperative risk groups and Cox regression analyses to predict OS. Overall, 391 patients (28%) received cisplatin-based ACT. After matching, two cohorts of 281 patients with pN+ BCa were obtained. CART analysis stratified patients into three risk groups: favorable prognosis (≤pT2 and positive lymph node [PLN] count ≤2; odds ratio [OR] 0.43), intermediate prognosis (≥pT3 and PLN count ≤2; OR 0.92), and poor prognosis (pTany and PLN count ≥3; OR 1.36). Only patients with poor prognosis benefitted from ACT in terms of OS (HR 0.51; p < 0.001). We created the first algorithm that stratifies patients with pN+ BCa into prognostic classes and identified patients with pTany BCa with PLN ≥3 as the most suitable candidates for cisplatin-based ACT. PATIENT SUMMARY: We found that overall survival among patients with bladder cancer and evidence of lymph node involvement depends on cancer stage and the number of positive lymph nodes. Patients with more than three nodes affected by metastases seem to experience the greatest overall survival benefit from cisplatin-based chemotherapy after bladder removal. Our study suggests that patients with the highest risk should be prioritized for cisplatin-based chemotherapy after bladder removal.

• MeSH
• adjuvantní chemoterapie MeSH
• cisplatina terapeutické užití   MeSH
• cystektomie * škodlivé účinky   MeSH
• lidé MeSH
• močový měchýř patologie   MeSH
• nádory močového měchýře * farmakoterapie   chirurgie   patologie   MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH