Prognostic indicators in coma.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Immunocompetence, as determined by skin reactivity to five microbial antigens, dinitrochlorobenzene (DNCB), and percent and absolute number of total T and B rosette-forming cells (RFC), was assessed before and up to 180 days after radiotherapy in 29 patients with carcinoma of the lung. Pretherapy evaluation showed a depressed response to microbial antigens (only 38% positive), to DNCB (50% positive), and lower level of T-RFC. Postradiotherapy determinations were further depressed. Patients with positive pretherapy responses to microbial antigens and DNCB and higher than median absolute numbers at total T-RFC had significantly longer survival. These data suggest that pretherapy immune evaluation is a good prognostic indicator. No prognostic significance was found in B-RFC evaluation. No correlation was seen between the stage of disease (locally advanced or with distant metastases) and the pretherapy immune response.
This study was done on 110 lung cancer patients who had received surgical resection consisted of two groups; one group of 43 who survived more than 5 years without recurrence and the other group of 67 who died within one year following surgery. Prognostic significance of the histopathological features at the primary tumor site as well as the regional lymph nodes were compared between the two groups. Blood vessel invasion by the tumor and lymph node metastasis appeared to be equally significant prognostic factors. Patients having the both factors had little chance for survival. Abundant lymphoid cell infiltration around the tumor was associated with longer survival. Lymphoid cell infiltration at the site of blood vessel invasion also was associated with better prognosis. Follicular hyperplasia and paracortical hyperplasia in the regional lymph nodes were favorable prognostic indicators, whereas sinus histocytosis was poorly significant prognostic indicator.
Blood and CSF gases, as well as the level of lactate and pyruvate in blood and CSF were determined in 43 cases. of severe stroke with softening of the brain. It transpired that the CSF lactate level is the best prognostic indicator of survival. CSF values above 2,5 mMol/1 in apoplexy imply a very unfavourable prognosis. The CSF lactate level is also a very useful prognostic indicator in patients suffering from diabetes and/or uraemic metabolic disorders. As the determination of CSF lactate presents no tecnical difficulties and furnishes valuable prognostic information it would merit inclusion as a routine procedure in relevant cases.
Tertiary lymphoid structures (TLSs) modulate immune responses in various solid tumors, but their comprehensive role in lung adenocarcinoma (LUAD) remains unclear. In this study, we analyzed RNA-seq data from 539 LUAD patients in The Cancer Genome Atlas (TCGA) and microarray data from 223 samples from the Gene Expression Omnibus (GEO, GSE13213, and GSE37745). TLS signatures were evaluated via unsupervised consensus clustering based on 12 chemokine transcriptome signatures. The relationships between TLS and clinical characteristics, tumor microenvironment (TME) cell infiltration, and prognosis were assessed using ESTIMATE and CIBERSORT. A prognostic model was established using LASSO regression and validated with external datasets. Additionally, H&E and IHC analyses were performed to explore associations between intratumoral TLS density, immune-related molecular expression, and patient prognosis in LUAD. Consensus clustering of the TCGA cohort revealed two distinct LUAD patient clusters according to TLS abundance. Cluster 1 exhibited greater immune cell infiltration, more favorable prognosis, and increased expression of immune checkpoint molecules. We developed a prognostic model comprising eight survival-associated genes that act as independent prognostic factors for patient survival. H&E/IHC analyses revealed that TLS density-regardless of pathological stage-was associated with better prognosis; higher intratumoral TLS density/proportion was also related to more favorable outcomes. IHC confirmed that survival-associated genes (CD5, HLA-DMB, and P2RY13) are independent prognostic indicators in LUAD. Our study demonstrated the close relationship between TLS signatures and an active immune microenvironment, highlighting their potential as independent prognostic indicators in LUAD.
The substantial prevalence of malnutrition in the hospitalized patient population has only been recently recognized. Preoperative nutritional and immunological assessment was performed prospectively on admission in 64 consecutive surgical patients. Factors measured included weight loss, triceps skinfold, midarm muscle circumference, creatinine-height index, serum albumin level, serum transferrin level, total lymphocyte count, serum complement level, serum immunoelectrophoresis, lymphocyte T rosettes formation, neutrophil migration, and delayed hypersensitivity. Using these criteria for malnutrition, 97% of the patients had at least one abnormal measurement and 35% had at least three abnormal measurements. Patients were monitored for complications during their hospital course. Serum albumin level, serum transferrin level, and delayed hypersensitivity reactions were the only accurate prognostic indicators of postoperative morbidity and mortality. Substantial unrecognized malnutrition exists in the surgical patient population. An isolated indicator of malnutrition should be interpreted with caution. The visceral protein compartment (serum albumin and serum transferrin levels and delayed hypersensitivity) is the most accurate prognostic indicator of postoperative morbidity and mortality. Perioperative nutritional support may reduce operative morbidity and mortality in the malnourished operative candidate.
Seventy-seven major thermal injury victims were studied with a number of hematologic and immunologic tests initially and sequentially during the first postburn month. The patients were grouped by initial prognostic index as well as by ultimate survival. Pairs were grouped by initial prognostic index as well as by ultimate survival. Pairs of test data from subjects studied at successive time intervals were compared with prognostic index and ultimate survival. Statistically significant changes in coagulation, fibrinolytic, complement, and kinin tests all occurred within these groups. These findings strongly suggest that intravascular contamination occurs following thermal injury in proportion to the extent of the burn, because of the occurrence and persistence of statistically significant multiple system changes. Regrouping all of the blood data according to ultimate death or survival reinforced the concept of intravascular contamination and provided the basis by which one can compute laboratory prognostic indices. The combination of plasminogen, C'3 complement, C'H50, one-minute kinin, and TEG index discriminated between death and survival with 91% accuracy by the end of the first postburn week. These data offer the potential for select blood measurements in refining current prognostic indicators. This may provide an objective data base for the analysis of new treatment programs in thermal injury victims.