prognostic parameters
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BACKGROUND: Implant-associated infection (IAI) is a potential complication following total hip (THA) or knee arthroplasty (TKA). The initial phase of the inflammatory process can be measured by applying one of the inflammatory blood parameters (IBP). This systematic review aims to assess the response of IBP to trauma caused by orthopedic surgery and evaluate the clinical utility of quantitative measurements of IBP as prognostic factors for infection. METHODS: All studies indexed in Ovid MEDLINE (PubMed), Ovid EMBASE, the Cochrane Library and the ISI Web of Science databases, from inception until January 31, 2020, were analyzed. Studies included were those on adults who underwent THA or TKA with minimum follow up of 30 days after surgery. In addition to minimum follow up, data on the prognostic factors for pre- or post-THA/TKA IAI were mandatory. The Quality Assessment of Diagnostic Accuracy tool (version 2) (QUADAS-2) and Standards for Reporting of Diagnostic Accuracy Studies guideline 2015 (STARD) were used for quality assessment. RESULTS: Twelve studies fulfilled the inclusion and exclusion criteria. C-reactive protein was analyzed in seven studies, interleukin-6 in two studies and erythrocyte sedimentation rate in eight studies. White blood cell count and procalcitonin were analyzed in the only study. The overall quality of included studies was low. A potential for other cytokines (IL-1ra, IL-8) or MCP-1 was observed. CONCLUSIONS: This is the first systematic review of IBP response to orthopedic surgery which identified some IBP for pre/post-operative screening, despite insufficient data supporting their prognostic potential for patient risk stratification.
- Klíčová slova
- Arthroplasty, Hip, Infection, Inflammatory blood parameters, Knee, Prognostic factor,
- MeSH
- dospělí MeSH
- lidé MeSH
- náhrada kyčelního kloubu * škodlivé účinky MeSH
- ortopedické výkony * MeSH
- pooperační komplikace MeSH
- prognóza MeSH
- totální endoprotéza kolene * škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
BACKGROUND: Sarcopenia represents an established adverse prognostic factor in cancer patients. Consequently, different means to counteract sarcopenia have been proposed to improve cancer treatment. Computed tomography (CT)-based measurements, also labor intensive, are well validated for the analysis of sarcopenia. As inflammation plays a key role in the development of sarcopenia, we here studied the role of the modified Glasgow prognostic score (mGPS), consisting of inflammation parameters plasma C-reactive protein (CRP) and albumin, to predicting sarcopenia and adipose tissue-related body composition (BC) parameters at baseline and their changes during treatment and to analyze its prognostic role in conjunction with BC parameters. PATIENTS AND METHODS: CT measurements of BC parameters were carried out at baseline and week 12 in patients with advanced gastric or esophagogastric junction cancer from the phase III EXPAND trial, undergoing first-line platinum-fluoropyrimidine chemotherapy. mGPS was calculated from baseline CRP and albumin plasma levels. Pearson correlation and Cox regression analyses were carried out. RESULTS: mGPS is strongly prognostic for overall survival (OS). Baseline mGPS is significantly correlated with baseline mean muscle attenuation (MA; P < 0.0001). Baseline mGPS did not predict a decline in muscle or adipose tissue parameters during 12 weeks of treatment and a decline in muscle or adipose tissue parameters was not prognostic for OS. MA lost its prognostic role for OS when mGPS or CRP was entered into the Cox models. Eastern Cooperative Oncology Group performance status together with CRP or mGPS remained the sole baseline prognostic factors for OS. CONCLUSIONS: Our findings support a model where tumor-mediated inflammatory response represents a strong prognostic factor, which is causally related to sarcopenia, but with no direct causal path from sarcopenia to survival. Therefore, therapeutic targeting of systemic inflammation should be further explored as a promising strategy to improve both sarcopenia and the efficacy and tolerability of cancer treatment.
- Klíčová slova
- gastric cancer, inflammation, mean muscle attenuation, modified Glasgow prognostic score, prognosis, sarcopenia,
- MeSH
- albuminy MeSH
- gastroezofageální junkce MeSH
- lidé MeSH
- nádory * MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- sarkopenie * MeSH
- složení těla MeSH
- zánět MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- albuminy MeSH
Purpose: To investigate potential associations between selected laboratory markers (CRP, LDH, albumin, sodium, hemoglobin, neutrophils, and neutrophils/lymphocytes ratio [NLR]) and outcomes in patients with non-small cell lung cancer (NSCLC) treated with bevacizumab (BEV) plus chemotherapy. Patients and Methods: We retrospectively analyzed 105 patients with NSCLC from the Czech TULUNG registry treated at University Hospital in Pilsen with BEV + chemotherapy. Response to therapy was tested by Fisher's exact test. Survival statistics were evaluated using the Kaplan-Meier method and Cox analysis. Results: We showed significantly better disease control rate when CRP, albumin, hemoglobin, and NLR were within established "normal" values. In univariate analysis, normal values of CRP, LDH, albumin, sodium, hemoglobin, neutrophils, and NLR were associated with better overall survival (OS). Normal values of CRP, albumin, hemoglobin, neutrophils, and NLR were associated also with better progression-free survival (PFS). In a multivariate Cox model, normal values of LDH, albumin, and NLR were associated with significantly better OS while normal CRP, albumin, and NLR were associated with better PFS. Conclusions: LDH and sodium appear to be possible prognostic markers for BEV treatment in combination with chemotherapy in NSCLC. The parameters associated with inflammatory response (CRP, NLR, albumin, and possibly hemoglobin) appear to be promising predictive markers for this treatment combination.
- Klíčová slova
- CRP, NSCLC, albumin, bevacizumab, inflammation, predictive, prognostic,
- Publikační typ
- časopisecké články MeSH
Little is known about the prognostic importance of right ventricular (RV) systolic and diastolic function. The purpose of this study was to determine the prognostic power of systolic and diastolic RV functional parameters derived from Doppler tissue imaging of tricuspid annular motion and to assess whether their combination might improve the risk stratification of patients with heart failure. In all, 140 patients with symptomatic heart failure and left ventricular ejection fraction of 40% or less underwent standard echocardiography, Doppler tissue imaging of tricuspid annular motion, and right heart catheterization. They were followed up for a mean period of 17 months for cardiac-related death and nonfatal cardiac events including the implantation of cardioverter-defibrillator and hospitalization for heart failure decompensation. A total of 48 cardiac events occurred; 19 patients died, 26 were hospitalized for heart failure decompensation, and 3 because of the need for implantation of a cardioverter-defibrillator. The peak tricuspid annular velocity during systolic ejection of 10.8 cm/s or less, peak early diastolic tricuspid annular velocity of 8.9 cm/s or less, tricuspid annular acceleration during isovolumic contraction of 2.52 m/s 2 or less, and Doppler RV index (Tei index) of 1.20 or more were found to significantly worsen survival or event-free survival. However, their combination significantly exceeded the predictive potential of individual parameters. The worst survival was predicted by the combination of peak tricuspid annular velocity during systolic ejection of 10.8 cm/s or less plus peak early diastolic tricuspid annular velocity of 8.9 cm/s or less plus tricuspid annular acceleration during isovolumic contraction of 2.52 m/s 2 or less (relative risk 6.17, P < .001), whereas the worst event-free survival was identified by the combination of peak tricuspid annular velocity during systolic ejection of 10.8 cm/s or less plus peak early diastolic tricuspid annular velocity of 8.9 cm/s or less plus Doppler RV index (Tei index) of 1.20 or more (relative risk 3.62, P < .001). In conclusion, the combination of RV systolic and diastolic functional parameters represents a very powerful tool for risk stratification of patients with symptomatic heart failure.
- MeSH
- diastola fyziologie MeSH
- dopplerovská echokardiografie MeSH
- funkce pravé komory srdeční * MeSH
- hodnocení rizik MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- prognóza MeSH
- srdeční komory diagnostické zobrazování MeSH
- srdeční selhání mortalita patofyziologie MeSH
- systola fyziologie MeSH
- trikuspidální chlopeň diagnostické zobrazování MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- adhezivita trombocytů MeSH
- akutní nemoc MeSH
- časové faktory MeSH
- faktorová analýza statistická MeSH
- fibrinolýza MeSH
- infarkt myokardu krev MeSH
- lidé MeSH
- počítače MeSH
- prognóza MeSH
- regresní analýza MeSH
- tromboelastografie MeSH
- vyšetření krevní srážlivosti * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND AND AIM: The availability of new treatments for metastatic castrate-resistant prostate cancer (mCRPC) patients increases the need for reliable biomarkers to help clinicians to choose the better sequence strategy. The aim of the present retrospective and observational work is to investigate the prognostic value of 18F-fluorocholine (18F-FCH) positron emission tomography (PET) parameters in mCRPC. MATERIALS AND METHODS: Between March 2013 and August 2016, 29 patients with mCRPC were included. They all received three-weekly docetaxel after androgen deprivation therapy, and they underwent 18F-FCH PET/computed tomography (CT) before and after the therapy. Semi-quantitative indices such as maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean) with partial volume effect (PVC-SUV) correction, metabolically active tumour volume (MATV), and total lesion activity (TLA) with partial volume effect (PVC-TLA) correction were measured both in pre-treatment and post-treatment 18F-FCH PET/CT scans for each lesion. Whole-body indices were calculated as sum of values measured for each lesion (SSUVmax, SPVC-SUV, SMATV, and STLA). Progression-free survival (PFS) and overall survival (OS) were considered as clinical endpoints. Univariate and multivariate hazard ratios for whole-body 18F-FCH PET indices were performed, and p < 0.05 was considered as significant. RESULTS: Cox regression analysis showed a statistically significant correlation between PFS, SMATV, and STLA. No correlations between OS and 18F-FCH PET parameters were defined probably due to the small sample size. CONCLUSIONS: Semi-quantitative indices such as SMATV and STLA at baseline have a prognostic role in patients treated with docetaxel for mCRPC, suggesting a potential role of 18F-FCH PET/CT imaging in clinical decision-making.
- MeSH
- antagonisté androgenů aplikace a dávkování MeSH
- cholin aplikace a dávkování analogy a deriváty chemie MeSH
- doba přežití bez progrese choroby MeSH
- docetaxel aplikace a dávkování chemie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů MeSH
- multimodální zobrazování metody MeSH
- nádory prostaty rezistentní na kastraci diagnostické zobrazování farmakoterapie patologie MeSH
- PET/CT metody MeSH
- prognóza MeSH
- radioisotopová scintigrafie metody MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- tumor burden účinky léků MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antagonisté androgenů MeSH
- cholin MeSH
- docetaxel MeSH
- fluorocholine MeSH Prohlížeč
OBJECTIVES: This study aimed to retrospectively assess using computed tomography pulmonary angiography (CTPA) for predicting residual pulmonary hypertension (RPH) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA). METHODS: We retrospectively analyzed data of 131 patients with CTEPH who underwent PEA in our center (2008-2015). We measured several diameters of the pulmonary artery and thoracic aorta preoperatively. We evaluated the relationship between these measurements (and their indices) and signs of RPH represented by pulmonary artery systolic pressure (PASP) estimated by echocardiography. RESULTS: Significant correlations were observed between the aortopulmonary index and prediction of any residual hypertension and moderate/severe hypertension 1 year after PEA, and any residual hypertension and severe hypertension 2 years after PEA. The aortopulmonary index was significantly related to a reduction in PASP 1 year after the operation. A lower aortopulmonary index (≤0.88 for the ascending aorta and ≤0.64 for the descending aorta) predicted lower RPH. CONCLUSIONS: Preoperative CTPA parameters can be used to assess the risk of RPH after PEA. The aortopulmonary index has significant predictive value for RPH and a reduction in PASP after PEA. Lower values of the aortopulmonary index suggest a better outcome after PEA.
- Klíčová slova
- Chronic thromboembolic pulmonary hypertension, aortopulmonary index, computed tomography angiography, pulmonary artery systolic pressure, pulmonary endarterectomy, residual pulmonary hypertension,
- MeSH
- angiografie MeSH
- arteria pulmonalis diagnostické zobrazování chirurgie MeSH
- chronická nemoc MeSH
- endarterektomie MeSH
- lidé MeSH
- plicní embolie * diagnostické zobrazování chirurgie MeSH
- plicní hypertenze * diagnostické zobrazování chirurgie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Surgical site infection (SSI) is a potential complication of surgical procedure. SSI after implant surgery is a disaster both for patients and surgeons. Although predictive tools for SSI are available, none of them estimate early infection based on inflammatory blood parameters. The inflammatory process can be measured using several parameters including interleukin-6, C reactive protein, neutrophil to lymphocyte ratio, white cell count, erythrocyte sedimentation rate or procalcitonin. This systematic review aims to determine whether inflammatory blood parameters could be used as significant predictive factors for SSI after primary hip or knee arthroplasty. METHODS AND ANALYSIS: A systematic review of randomised controlled trials, cross-sectional studies, case-control studies and cohort studies, published in English, will be searched in the following electronic bibliographic databases: MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials and Web of Science. Studies performed in adult patients of all ages who underwent knee or hip arthroplasty, studies containing data on the risk/prognostic factors for preknee or postknee or hip arthroplasty SSI and studies with a minimum follow-up of 30 days after surgery will be included. A standardised form will be used to extract data from the included studies comprising study characteristics, participant characteristics, details of the intervention, study methodology and outcomes. Quality Assessment of Diagnostic Accuracy tool, second version, and Standards for Reporting of Diagnostic Accuracy Studies checklist will be used to assess risk of bias. Heterogeneity will be assessed using Cochran χ² statistic and I2 statistics where applicable. Grading of Recommendations Assessment, Development and Evaluation and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance will be used to report findings. ETHICS AND DISSEMINATION: No ethics approval is required. The findings will be disseminated at national and international scientific sessions, also to be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020147925.
- Klíčová slova
- adult orthopaedics, hip, infection control, knee,
- MeSH
- infekce chirurgické rány diagnóza epidemiologie etiologie MeSH
- lidé MeSH
- náhrada kyčelního kloubu * škodlivé účinky MeSH
- prognóza MeSH
- průřezové studie MeSH
- systematický přehled jako téma MeSH
- totální endoprotéza kolene * škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
PURPOSE OF THE STUDY: Especially in such complex salvage procedures as latissimus dorsi transfer for irreparable rotator cuff tears there is a need for valid prognostic prediction parameters. Parameters such as osteoarthritis, acromiohumeral distance, subscapularis, or teres minor insufficiency are controversial. The aim of this study is to present our data and to evaluate the literature regarding such parameters. METHODS: Fifty-seven patients with a follow-up of 3 years (range, 18-72 months, n = 57) were selected for this study. Average age of patients at the time of surgery was 64.9 years. Patients were evaluated using the age and gender adjusted scoring system according to Constant and Murley score (CS). Standard radiography was attempted containing a true-ap, outlet, and axillary view. The acromio-humeral distance was measured in the true ap view. The grade of glenohumeral osteoarthritis and cuff tear arthropathy was detected using the classification of Hamada et al. Differences in CS were compared for each of the PPP. RESULTS: Mean Constant score increased significantly (p < 0.0001) 3 years postoperatively from initially 22.7 points to 66.0 points (adjusted CS 80.3%). We found a major difference in the Constant score in patients with or without previous surgery (80.4% vs, 65.2%). CONCLUSION: Latissimus dorsi transfer is an excellent option in the treatment of irreparable postero-superior tears of the rotator cuff in well-selected patients. The literature remains ambiguous with regard to valid prognostic predictive parameters for complex salvage procedures, owing to the consistent use of small study samples. Thus, there is an overwhelming need for a multicenter study.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- poranění rotátorové manžety * MeSH
- přenos šlachy metody MeSH
- prognóza MeSH
- rotátorová manžeta chirurgie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a life-threatening disease with a heterogeneous course. Even some young patients are at increased risk of severe course or death, as they can face severe complications. It would be very useful to have a cheap and easily available marker to predict COVID-19 course in the early stages of the disease. The COVID-19 prognostic score could be a very useful clinical indicator available at the time of primary contact with the patient. METHODS: The COVID-19 prognostic score and the clinical condition together with selected laboratory parameters were evaluated in patients with respiratory tract infection and a positive PCR test for the SARS-CoV-2 during the first contact with the patient. Prognostic significance was evaluated using receiver operating characteristic curves (ROC) and area under the curve (AUC). Selected parameters of the blood count and hemostasis, as well as selected biochemical indicators, were examined too. RESULTS: Thirty-seven of 164 patients developed serious symptoms. The COVID-19 score had one of the highest AUC values (0.855) of all markers. The highest combination of sensitivity (91.9%) and specificity (71.7%) for identifying patients with a subsequent moderate and severe course of the disease was achieved at the threshold 1.5. The predictive value of a negative test is beneficial too (0.968). CONCLUSIONS: The COVID-19 prognostic score is a promising indicator stratifying patients with COVID-19 into prognostic groups at the time of the first contact, thus allowing the timely provision of increased care in patients at high risk of severe development.
- Klíčová slova
- COVID-19, coronavirus, hematology, hemocytometric prognostic score for COVID-19, laboratory hematology,
- MeSH
- COVID-19 * diagnóza MeSH
- infekce dýchací soustavy * MeSH
- lidé MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- ROC křivka MeSH
- SARS-CoV-2 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH