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Retrospective analysis of stage IV advanced gastric cancer treated with S-1 or other chemotherapy.

BACKGROUND: We retrospectively analyzed the influence of various clinicopathologic factors on the survival of patients treated with chemotherapy. METHODS: A retrospective analysis was made of 110 patients with stage IV gastric cancer who were treated from January 1996 to June 2004. RESULTS: Median survival time was 429 days for patients treated with S-1 therapy and 236 days for patients without S-1 therapy. A better survival was demonstrated in patients who had good performance status, one metastatic site, or had been given a second-line chemotherapy (P < 0.01). But very few patients (17%; 5/29) with multiple metastatic sites were able to receive the second-line chemotherapy. CONCLUSION: Patients treated with S-1 therapy had a better prognosis than patients without S-1. One metastatic site and being given second-line chemotherapy were other factors for better prognosis. For patients with only one metastatic site, a good prognosis can be obtained by second-line chemotherapy for those refractory to S-1. The prognosis of patients who had more than two metastatic sites remained poor; more effective chemotherapy might improve the survival of such patients if they retain good performance status.

Adult↗

A retrospective survey of tube-related complications in patients receiving long-term home enteral nutrition.

Percutaneous gastrostomy tubes are associated with low insertional morbidity. The purpose of this study was to determine the long-term complications of enteral feeding tubes and the effect of these complications on patients, their caregivers and health care utilization. In the province of Manitoba, a regional program supervises all individuals on home enteral nutrition. A retrospective survey was administered to individuals agreeing to participate in the study. This retrospective survey included 30 questions relating to the frequency and severity of tube-related problems, utilization of health care resources due to tube-related problems, and effects of tube feeding on the quality of life of patients and their caregivers. The survey was completed by 55/211 patients in the home enteral nutrition program. Adult and pediatric patients were included and the mean duration of time on home enteral nutrition was 25.9 months. Common complications (percentage of patients experiencing complication) included granulation tissue formation (67%), broken or leaking tube (56%) leakage around the tube site (60%) and stomal infection requiring antibiotics (45%). Health care utilization (% of individuals) related to gastrostomy tubes included phone contact (69%), clinic visit (45%) ER visit (35%), and hospital admission (11%). This survey reveals that tube-related complications are common in patients receiving long-term home enteral nutrition. While these complications are not life threatening, they are associated with increased health care utilization. Prospective studies are needed to confirm these findings and assess the effect of these complications on health care utilization and quality of life of the patient and the primary caregiver.

Adolescent↗

A retrospective search for predictors of clinical response to selective granulocyte and monocyte apheresis in patients with ulcerative colitis.

Recently, selective granulocytapheresis (Adacolumn) has appeared as a new treatment for patients with inflammatory bowel disease. This study sought to determine predictors of response to this new nonpharmacologic mode of therapy by retrospectively evaluating 28 patients who received granulocytapheresis after experiencing active ulcerative colitis (UC). Between April 2000 and March 2004, 28 consecutive patients received granulocytapheresis for active UC with the Adacolumn, which is filled with cellulose acetate beads as the column leukocytapheresis carriers; the carriers adsorb granulocytes, monocytes/macrophages, and a small fraction of lymphocytes (FcgammaR and complement receptors bearing leukocytes). Each patient could receive up to 10 Adacolumn sessions, at 2 sessions per week. In 2004, clinical response was retrospectively evaluated. Seven days after the last Adacolumn session, 20 of 28 patients had remission (colitis activity index [CAI] < or =4) including all 8 patients who had their first UC episode. The mean duration of UC in the 8 first episode cases was 3.4 months compared with 40.2 months for all 28 patients and 65.4 months for the 8 nonresponders. The response to Adacolumn was independent of basal CAI. The 8 nonresponders were given conventional medication (CM) or cyclosporine (CsA) if the former failed. Two responded to CM, 3 to CsA, and 3 underwent colectomy. First UC episode and short disease duration appear good predictors of response to granulocytapheresis. Selective granulocytapheresis might be an effective first-line treatment.

Adolescent↗

The first year inventory: retrospective parent responses to a questionnaire designed to identify one-year-olds at risk for autism.

The First Year Inventory (FYI) is a parent questionnaire designed to assess behaviors in 12-month-olds that suggest risk for an eventual diagnosis of autism. We examined the construct validity of the FYI by comparing retrospective responses of parents of preschool children with autism spectrum disorders (ASD; n = 38), other developmental disabilities (DD; n = 15), and typical development (TD; n = 40). Children with ASD were rated at significantly higher risk on the FYI than children with DD or TD. The DD group was at intermediate risk, also significantly higher than the TD group. These retrospective data strengthen the validity of the FYI and have implications for refining the FYI to improve its utility for prospective screening of 12-month-olds.

Autistic Disorder↗

Clinical and Genomic Insights into the Allodiploid Hybrid Pathogen Aspergillus latus: A Retrospective Case Series.

Aspergillus latus is an emerging cryptic allodiploid hybrid pathogen within Aspergillus section Nidulantes that closely resembles related species and therefore prone to misidentification by routine diagnostic methods. Therefore, its true clinical burden is likely underestimated. In this study, we retrospectively characterized five patients with A. latus infections identified by metagenomic next-generation sequencing (mNGS) at a tertiary hospital in China. Clinical manifestations varied according to host immune status, ranging from a subclinical pulmonary lesion in an immunocompetent individual to aggressive disease in highly immunocompromised patients. Conventional microbiological methods showed limited sensitivity and consistently misidentified the isolates as A. nidulans, whereas mNGS enabled accurate detection of A. latus together with complex co-infections. Three viable clinical isolates were recovered for morphological characterization, antifungal susceptibility testing, and whole-genome sequencing (WGS). All tested isolates demonstrated reduced susceptibility to echinocandins but remained susceptible to mold-active triazoles and amphotericin B. Furthermore, WGS and macrosynteny analyses confirmed their allodiploid hybrid nature, revealing a mosaic genome derived from A. spinulosporus and an A. quadrilineatus-related lineage. Collectively, these findings highlight that A. latus may be missed by routine diagnostic methods and may exhibit a distinct antifungal susceptibility profile. Molecular approaches such as mNGS and WGS may therefore help achieve accurate species-level identification and support targeted antifungal therapy. Given this small retrospective case series, larger prospective and multicenter studies are needed to validate these observations and better define the epidemiology, clinical spectrum, and therapeutic implications of this emerging allodiploid hybrid pathogen.

Retrospective Studies↗

Fetal movements registered by the pregnant woman correlated to retrospective estimations of fetal movements from cardiotocographic tracings.

After reviewing 30 cardiotocographic tracings from 15 pregnant women who directly registered fetal movements (FM) on the cardiotocographic (CT) tracings, we have found no correlation between the actual number of FM and the FM found by retrospective estimation from CT tracings. Ours is the first study to show this lack of correlation. On the contrary, we have found that by using the "retrospective" or "indirect" methods, almost 90% of the FM are overlooked. This is a very important loss of information since registration of FM seems to be a good method for surveillance of the fetus at risk. We also discuss our own methods for overcoming these problems.

Female↗

Self-monitoring of panic attacks and retrospective estimates of panic: discordant findings.

An event sampling method was used to study the frequency of panic attacks during treatment of agoraphobics. Results revealed a much lower incidence of panic attacks in agoraphobics according to self-monitoring than was expected on account of their retrospective estimation. When more stringent criteria for panic attacks are applied, retrospective overestimation becomes even more apparent. The implication of this finding for the classification of panic disorder patients is discussed.

Agoraphobia↗

[Classical anticoagulant treatment of venous thromboembolic disease in cancer patients. Apropos of a retrospective study of 71 patients].

In order to evaluate the efficiency of classical anticoagulant therapy for venous thromboembolic disease in cancer patients, we retrospectively analysed 71 patients treated with intravenous heparin first and then with antivitamin K. After a mean follow-up of 185 +/- 25 days, 23 patients (33%) were dead; nine patients (12%) had suffered from major haemorrhagic complications, which were not fatal, four of which were due to heparin overdosage; 17 patients (24%) showed recurrent venous thromboembolic disease. According to univariate statistical analysis, risk of major bleeding was not associated with the presence of either thrombocytopenia, abnormal blood coagulation, metastases and/or any other hemorrhagic risk factors; recurrence of venous thromboembolic disease was not associated with the presence of other risk factors for venous thromboembolic disease, nor with the presence or absence of metastases and/or of ongoing chemotherapy. Such results suggest that classical anticoagulant therapy for venous thromboembolic disease in cancer patients is neither effective nor safe. The present retrospective study underlines needs for further prospective analyses in order to evaluate potential benefit from other therapeutic strategies, such as use of low molecular weight heparins and/or vena cava filter placement.

4-Hydroxycoumarins↗

The reproducibility of the Lukes-Collins classification of non-Hodgkin's lymphomas in a retrospective reclassification.

In a retrospective reclassification of 148 non-Hodgkin's lymphomas the reproducibility of the Lukes-Collins classification used was tested by comparing a joint diagnosis with that of each author separately. Thirty-six percent of the lymphoma cases were follicular center cell lymphomas, the figure being clearly lower than that of materials published previously. The relatively high portions of small lymphocytic and mycosis fungoides lymphomas (20 and 10% respectively) were also deviant findings in comparison to formerly published retrospective materials. In this reproducibility study the cases of disagreement were usually proved to have happened within lymphoma groups with an equivalent prognosis. An exception was the relatively high disagreement rate between the subclasses of small lymphocytic and small non-cleaved lymphomas, and this represents the most important finding clinicopathologically. The results of the study indicate that the Lukes-Collins classification as such does not cover the whole spectrum of non-Hodgkin's lymphomas. The studies published already give some clues as to the fact that distribution and cell types of non-Hodgkin's lymphomas vary in different areas of the world.

Female↗

Collecting retrospective data: development of a reliable method and a pilot study of its use.

The present paper argues that a need will remain for data which have been collected retrospectively. Recent developments in oral history and sociology are described to suggest a method of collecting retrospective data which may minimize recall bias. Pilot work is reported on the adaptation of the method for a study of chronic respiratory disease. The results of the pilot study proved promising. The technical properties of the measures appeared adequate. The results of the substantive analysis were consistent with existing knowledge and went beyond existing knowledge to suggest new areas of research. Ways of further validating the method are identified and its wider application discussed.

Aged↗

Retrospective evaluation of admission criteria for paediatric electrical injuries.

In the medical community, the practice of admitting all electrical burns for 24-48 h of observation, monitoring and laboratory evaluation is widespread. This retrospective review of paediatric electrical burns was conducted to determine which patients may safely be treated as outpatients. Retrospective analysis of all paediatric burns admitted between 1980 and 1991 identified 35 patients with electrical injuries. Patients were divided into two groups for analysis: those burned by exposure to household voltages (120-240 V; n = 26) and those exposed to high voltages, in excess of 1000 V (n = 9). The majority of household electrical injuries occurred secondary to contact with the household 120 V (21/26). Contact with an extremity accounted for the largest number of these injuries (18/26). The mouth was the second most frequent site of injury (7/26). Most of these patients (20/26) had < 1 per cent BSA burn. No patient in the household-voltage group had an arrythmia that required treatment, nor were there any identified examples of compartment syndrome or other vascular complications. Seven patients did require minimal skin grafting. No deaths occurred in either group. The patients in the household-voltage group were significantly younger. High-voltage electrical injuries occurred in an older patient population and required more aggressive care and surgical intervention. This was evident at the time of initial evaluation. Based on these data, healthy children with small partial-thickness electrical burns and no initial evidence of cardiac or neurovascular injury do not appear to need hospital admission.

Adolescent↗

Retrospective analysis in smoking cessation research.

The use of retrospective data in smoking research represents possible sources of bias resulting from: (1) baseline incomparability of current, former, and non-smokers, (2) instability of parameters under investigation, and (3) difficulties in recall. A self-report measure of smoking motives was employed in a longitudinal design to examine bias associated with retrospective data analysis. Thirty-six pairs of former smokers and recidivists (smokers who had tried to quit) were matched on age and amount smoked. Although initial responses for both groups were comparable, former smokers were significantly higher on smoking motive factors after quitting compared to recidivists who stayed essentially the same. The findings suggest that mean differences in smoking motives between recidivists and former smokers assessed cross-sectionally may not accurately reflect the magnitude of the differences that existed when both groups were smoking.

Adult↗

An investigation of potential time effects in retrospective reports of cocaine relapses.

Retrospective reports are widely used in social science research, such as studies of the relapse process. There is evidence, however, that such reports can be affected by a number of factors, including the passage of time. The goal of this study was to determine whether retrospective reports of cocaine relapses were influenced by the amount of time that had elapsed between the onset of the relapse and when the relapse interview was administered. A structured cocaine relapse interview was used to gather information on experiences prior to relapse and attributions for relapse. Evidence of linear and/or nonlinear time effects was found in two of the six subscales assessing experiences prior to relapse (Social Pressure to Use Drugs and Sensation Seeking), and there was evidence of logarithmic time effects in four of the six subscales that assessed attributions for relapses. These findings indicate that the amount of time between the onset of a relapse and when the subject is interviewed can influence reports of experiences prior to relapse and attributions for relapse. However, the magnitude of the time effects was generally small.

Adult↗

Radiotherapy and chemotherapy for invasive thymomas: a multicentric retrospective review of 90 cases. The FNCLCC trialists. Fédération Nationale des Centres de Lutte Contre le Cancer.

PURPOSE: Thymoma is a rare disease. The treatment of patients with invasive thymoma remains controversial. The prognosis of such patients is poor, even with the use of postoperative radiation therapy and chemotherapy. We retrospectively reviewed the outcome and prognostic factors in a series of 90 patients presenting with an invasive thymoma treated by partial resection or biopsy and radiation therapy. METHODS AND MATERIALS: From 1979-1990, 163 patients with the diagnosis of lymphoepithelial thymoma were treated in 10 French cancer centers. Patients were staged using the postoperative "GETT" classification derived from that of Masaoka. Ninety patients who presented with an invasive thymoma, 58 Stage III (21 IIIA: partial resection and 37 IIIB: biopsy) and 32 Stage IVA (intrathoracic thymoma spread), are the subject of this report. Treatment combined surgery and radiation therapy (+/- chemotherapy), with curative intent. Surgery consisted of partial resection in 31 patients (21 Stage III), and biopsy in 55 patients (37 Stage III). The median radiation dose to the tumor was 50 Gy (30-70 Gy). Supraclavicular radiation was performed in 59 patients (median dose 40 Gy). Chemotherapy, combined with radiation in 59 patients, consisted of multidrug regimens, mainly platinum based. RESULTS: The median follow-up is 105 months (20-165 months). The 5- and 10-year overall survival rates are 51 and 39%, respectively. There is a great impact of the extent of surgery on survival: the 5- and 10-year survival rates were 64% and 43%, respectively, after partial resection, compared to 39% and 31% after biopsy (p < 0.02). Local control at 8.5 years was obtained in 59 of 90 patients (66%): 40 Stage III, 19 Stage IVA. There is a significant relationship between the extent of surgery and the local control (16% of relapse after partial resection vs. 45% after biopsy, p < 0.05). Seven patients developed significant (grades 3-4 WHO grading system) treatment-induced side effects. Stage, histologic type, and chemotherapy were not prognostic factors. CONCLUSION: In this large multicentric retrospective study of invasive thymomas (Stage III-IVA) treated by surgery and radiation, results show the importance of loco-regional treatments, such as surgery and radiation therapy. There is also a great impact of radiation on local control. However, the rate of local recurrence (34%) justifies recommending a higher dose of radiation (> 50 Gy) than doses used in this study, for incompletely resected patients. The role of chemotherapy needs to be further assessed.

Adolescent↗

Climacteric complaints and their relation to menopausal development--a retrospective analysis.

The present study had two objectives: (1) to register the prevalence of a number of climacteric complaints in a Danish general population cohort and (2) retrospectively to test the validity of an association between climacteric complaints, menopausal development, occurrence of life events and social background. A postal questionnaire sent to the 51-year-old female population living in four Copenhagen suburbs, (N = 597, response rate = 88%) included information on menstrual pattern and change, hormonal treatment, socioeconomic data and a 4-year retrospective annual registration of prevalence of a number of climacteric complaints and life events. Logistic regression analyses performed on a restricted sample (women who experienced a natural menopausal development) revealed prevalence of hot flushes, moodiness and fatigue to be significantly associated with transitions in menopausal status. Fatigue, moodiness and depression were strongly associated with socio-economic variables. Life events were only occasionally associated with prevalence of the studied complaints.

Affect↗

Duration of bulimia nervosa and symptom progression: a retrospective analysis of treatment-seeking bulimics.

Severity of bulimia nervosa upon presentation for treatment may be influenced by duration and age of onset of bulimic behaviors. This hypothesis was investigated in a retrospective study by correlating duration of bulimia and age of onset with sets of variables measuring the primary symptoms and other psychopathology associated with bulimia nervosa. The experimental design was cross-sectional. The sample included 153 women who had been diagnosed with bulimia nervosa. Canonical correlations indicated that younger age of onset and longer duration were associated with more severe bulimic symptoms and increased body image distortion. Anorexic symptoms were reduced over time, however, and weight gain (at a rate of about 0.54 Kg [1.2 lbs] per year) was correlated with duration of bulimic behaviors. Also, older age of onset and longer duration were associated with increasing social introversion. These findings were interpreted as supportive of the hypothesis that younger age of onset and longer duration of bulimic behaviors are associated with more severe bulimia and general psychopathology. Though limited by the retrospective nature of the study, these results substantiate the need for longitudinal investigations of bulimia nervosa.

Adolescent↗

Memory failure in epilepsy: retrospective reports and prospective recordings.

People with epilepsy frequently complain of memory difficulties and previous research provides some support for the existence of memory dysfunction. However, our clinical experience is that many who report serious memory difficulties perform quite adequately on psychometric tests. One explanation for this discrepancy is that these patients are exaggerating the difficulties they encounter in their daily lives. This study aimed to examine this hypothesis by comparing patients' retrospective reports of memory to prospective recordings of everyday memory failures. Results demonstrated that far from over-emphasizing their daily problems, people with epilepsy believed fewer memory failures occurred when rated retrospectively than was indicated by a prospective recording device. While there was good agreement between the methods of assessing memory failures for the frequency of their most troublesome difficulties, subjects tended to underestimate the incidence of the less pervasive everyday problems. The results are interpreted through the theory of memory introspection proposed by Herrmann.

Adult↗

A hospital-based retrospective survey of human cystic and alveolar echinococcosis in Ningxia Hui Autonomous Region, PR China.

A retrospective study of in-patient records for the period 1985-2001 collected from 11 hospitals in Ningxia Hui Autonomous Region (NHAR), China revealed a total of 2216 cases of echinococcosis. The survey showed that cystic echinococcosis (CE) occurs throughout NHAR but that human alveolar echinococcosis (AE) cases were only located in a confluence area of three counties, Xiji, Haiyuan and Guyuan. Incidence rates between counties within southern NHAR showed a highly heterogeneous distribution of cases, suggestive of different echinococcal transmission patterns. There was a significant difference in incidence between males and females, and farm labourers accounted for the majority of cases. Radical surgery with or without albendazole/mebendazole drug treatment was the major method of treatment for CE and repeat surgery was common; drug treatment alone was used mainly for AE. Epigastric pain was the main reason for patients seeking medical advice, the liver was the primary location of echinococcosis lesions and the majority of echinococcosis cases were diagnosed by ultrasound. Over a 12 year period, the average bed utilization rate in the Second Provincial Hospital of NHAR for patients with echinococcosis was 78% and echinococcosis cases accounted, on average, for 0.7% among the total hospital in-patients. Taking inflation into account, charges for echinococcosis hospitalization and treatment increased three-fold over the period 1994-2002. This study indicates that echinococcosisis is a significant public health problem in NHAR, especially in the south. The data from the hospital retrospective study are clearly underestimates and community surveys are required to determine the true echinococcosis prevalence levels, especially in the more remote areas of NHAR.

China↗