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At least 613 records · Page 34Linked to original sources
PubMed2000

[Risk factors and prognosis of nosocomial pneumonia due to gram-negative bacteria in a general hospital].

Nosocomial pneumonia due to Gram-negative bacteria is one of the most important infections because of its high frequency, morbidity and mortality. The objective of this study was to determine the risk factors and prognosis for nosocomial pneumonia caused by Gram-negative bacteria. A group of 50 patients with nosocomial pneumonia due to Gram-negative bacteria were studied in a prospective, consecutive manner and compared with another group of 50 patients with similar characteristics but without infection. The diagnostic criteria, acquisition, previous infections, prognosis of the underlying disease, the initial severity of the clinical situation, presence of complications, type and evolution of antibiotic treatment were adjusted according to the criteria in the literature. Univariate and multivariate statistical analysis of the results was carried out. The risk factors found included the following: male sex, high-risk hospital units, nosocomial acquisition and previous manipulation with intubation and mechanical ventilation, previous pulmonary infections, and the use of wide-spectrum antibiotics in the six weeks prior to the study. The most isolated Gram-negative bacterium was Pseudomonas aeruginosa (32%), followed by polymicrobial flora (18%). Bacteriemia was found in 30% of the cases. Mortality was 24%, with the factors significantly associated with a poor prognosis being a serious underlying disease, a clinically critical situation, previous surgery, complications, Gram-negative bacteria, use of wide-spectrum antibiotics in the six months before the study, and advanced age. The mortality of the group was 8%. It was concluded that knowledge of the risk factors and prognosis of nosocomial pneumonia due to Gram-negative bacteria is of high importance to improve treatment and decrease morbidity and mortality.

Anti-Bacterial Agents↗
PubMed2000

Intracellular distribution of macrophage migration inhibitory factor predicts the prognosis of patients with adenocarcinoma of the lung.

BACKGROUND: Macrophage migration inhibitory factor (MIF) is known to be a proinflammatory cytokine and glucocorticoid-induced immunomodulator as well as a regulator of tumor growth. Although positive and negative effects of MIF on tumor cell growth have been reported, to the authors' knowledge the precise role of MIF in tumorigenesis remains unclear. In the current study the authors assessed expression of MIF protein and mRNA in lung adenocarcinomas with regard to patient prognosis. METHODS: Immunohistochemical analysis was performed on tissue specimens surgically obtained from 74 patients with primary lung adenocarcinoma (American Joint Committee on Cancer pathologic Stages I, II, and IIIa). In addition, expression of MIF mRNA in the cancerous tissue was investigated using in situ hybridization. Patient prognosis was evaluated with regard to MIF expression levels and its distribution was analyzed with the Kaplan-Meier method. RESULTS: MIF mRNA and MIF protein were observed in the bronchial epithelium, alveolar epithelium, vascular smooth muscle, and alveolar macrophages in the normal lung tissue. In tumor tissue from lung adenocarcinoma specimens, both MIF mRNA and protein were observed at much higher levels than in the normal alveolar epithelium. MIF protein was observed diffusely in the cytoplasm of tumor cells in all tumor specimens examined. MIF protein also was observed in the nuclei of tumor cells from 59 patients (79.7%), whereas it was not observed in the nuclei of tumor cells from 15 patients (20.3%). The patients without nuclear MIF expression had a worse prognosis compared with those patients with MIF expression in the nuclei (P = 0.04). CONCLUSIONS: The results of the current study suggest that intracellular MIF distribution predicts patient prognosis in individuals with adenocarcinoma of the lung.

Adenocarcinoma↗
PubMedDate not supplied

[Long-term prognosis of gastric cancer in the population of Côte-d'Or].

AIMS: The aim of this study was to determine long term prognostic factors of gastric cancer in a population-based series. METHODS: Out of 1 462 gastric cancers diagnosed in the Côte-d'Or area (494 000 residents) over a 20-year period (1976-1995), 649 (44.4 %) were resected for cure. Prognostic factors were determined using the actuarial method and relative survival and a multidimensional relative survival model. RESULTS: The 10-year crude survival rate was 8.7 % and the corresponding relative survival rate was 14.9 %. Age, stage and period of diagnosis were independent prognostic factors. After surgery for cure, operative mortality decreased from 18.3 % (1976-1979) to 6.6 % (1988-1991) and 10-year relative survival increased from 30.8 % to 37.2 % (NS). After resection for cure (postoperative mortality excluded), the 10-year survival rate remained stable over time. Stage at diagnosis was the main prognostic factor: the relative risk of death was more than 10 times higher at stages IIIB and IV than at stage I. Age, site and macroscopic type of growth were prognostic factors independently of stage. Prognosis did not improve over time after resection for cure. CONCLUSION: Although improving, the overall prognosis of gastric cancer remains poor. Improvement in prognosis was mainly due to decrease in operative mortality. Earlier diagnosis and effective adjuvant treatment represent two ways to improve prognosis.

Aged↗
PubMed2000

[A comparative study of the prognosis for Japanese patients with idiopathic interstitial pneumonia or BOOP based on histopathologic subsets].

We explored the prognosis for 123 patients with either idiopathic interstitial pneumonia (IIP) or bronchiolitis obliterans organizing pneumonia (BOOP). All patients underwent either open lung biopsy or thoracoscopic lung biopsy procedures. The histopathologic diagnosis of IIP included patients with usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), and desquamative interstitial pneumonia with respiratory bronchiolitis-associated interstitial lung disease. The prognosis was poorest for patients with a histologic diagnosis of UIP, and excellent for those who received a diagnosis of BOOP. Although the prognosis is generally considered to be good for patients with NSIP, some NSIP patients in our study died. Histopathologic diagnosis based on surgical lung biopsy is useful in evaluating the prognosis for patients with IIP.

Aged↗
PubMed1975

[Some observations on prognosis in congenital hydrocephalus (second report) -with reference to the physical handicap in survival cases (author's transl)].

The prognosis of surgically treated congenital hydrocephalus has lately proven to give a remarkably increased expectation of life for patient. However, numerous reports hve shown that the prognosis of congenital hydrocephalus have not always shown favourable turns from the viewpoints of physical and mental disability. This problem has been considered many times over the past years. But, an important problem has been left unsolved. The children of social and physical disability are most serious problem, so we attempt to obain a new interpretation about the influence factors upon the prognosis. Present report consists of follow-up studies of long surviving patients who have studied the fatty acid metabolism in the cerebrospinal fluid during postoperatively, the influeence on prognosis of complicated central nervous system malformation and discussed motor and mental disability in survival cases. Since lipids are essential factors in composing the brain tissues, quantitative composition of fatty acid inC.S.F. was determined by the method of gaschromatography using the arachidic acid as an indicator...

Adolescent↗
PubMed2001

Carcinoma of the cervical stump. The radiumhemmet series 1959-1987. Treatment and prognosis.

BACKGROUND: The purpose of this retrospective study is to evaluate the longterm prognosis for cervical stump cancer compared to matched controls with cancer in an intact uterus. METHODS: From 1959 to 1987, 145 patients were treated for an infiltrating carcinoma of the cervical stump at Radiumhemmet representing 2.2% of all cervical cancers. Three control cases to each case were selected from the cohort of cervical carcinoma cases - matched to year of treatment, stage, histology and age (plus, minus 2 years). Actuarial survival was calculated for cases and controls. Survival differences were analyzed with the Kaplan-Meier technique. The age distribution for cases ranged between 36 and 84 years with a mean age of 60.6 years. The mean age for the control series is 9 years of age (range 35-86 years). Among the cases 87.6% were squamous cell carcinoma and 12.4% were adenocarcinomas. Treatment of carcinoma of the uterine stump at Radiumhemmet followed the same modality as was practised for ordinary cervical cancer cases i.e. two brachyradium applications with 3 weeks interval followed by external irradiation. The dose of irradiation from the intracavitary application given to the stump cancers was lower than that given to comparable cases of the common cervical cases. RESULTS: No evidence was found of poorer longterm prognosis for radiologically treated squamous cell carcinoma of the uterine stump compared to that of the ordinary cervical carcinomas. Stump cancers of the adenocarcinoma type had a worse prognosis than adenocarcinomas in an intact uterus (p<0.07) and also compared with stump cancers of the squamous epithelial type (p=0.05). The complication rate was higher for the stump cancer cases compared with that for cervical cancers in intact uterus. The mean time interval from subtotal hysterectomy to the stump cancer diagnosis was 17.6 years with a range from 1 to 46 years. CONCLUSIONS: Recent discussions argue for a better sexual function after subtotal hysterectomy. Our study gave no convincing argument in terms of poorer prognosis for radiologically treated carcinoma of the uterine stump compared to that of the total cervical cancer series. It is thus necessary to weigh the possible gains with subtotal hysterectomy against the relatively low risk to fall victim of a stump cancer. Complications following surgery, as well as possible physiologic and sexual functions of the cervix, should be taken into account.

Adenocarcinoma↗
PubMed2001

The loss of E-cadherin, alpha- and beta-catenin expression is associated with metastasis and poor prognosis in invasive breast cancer.

Loss of E-cadherin and catenin expression may be associated with distant and lymph node metastases in breast cancer. Heterogeneity of E-cadherin expression is associated with poor prognosis, suggesting that E-cadherin and catenins may serve as useful prognostic markers for invasive breast carcinoma. Reduction or loss of expression of either E-cadherin or catenins is associated with invasion, metastasis and poor prognosis in several types of human malignancies. We investigated the expression of E-cadherin, and alpha- and beta-catenins by immunohistochemistry in 171 cases of primary invasive breast cancer, and compared the expression with clinicopathological parameters to define the relationship between expression and prognosis. E-cadherin immunoreactive protein was shown to be expressed in 97 cases. Reduction or lack of expression of E-cadherin was associated with distant metastasis. Based on immunohistochemical heterogeneity, E-cadherin-positive tumors were classified into heterogeneous, homogeneous and intermediate types. Interestingly, although patients with heterogeneous type demonstrated the lowest incidence of distant metastasis at diagnosis, they showed a higher incidence of subsequent distant metastasis, after surgery, and a lower survival rate than those with homogeneous type (p<0.05). E-cadherin expression was reduced or negative in metastatic axillary lymph nodes regardless of the expression in the primary tumor, suggesting that changes in E-cadherin expression are associated with not only distant metastasis but also lymph node metastasis. Tumors negative for either alpha- or beta-catenin expression demonstrated a higher incidence of distant metastasis than those expressing both catenins, suggesting that the expression of catenins is involved in breast cancer metastasis. Reduction or loss of E-cadherin and catenin expression may be associated with distant and lymph node metastases in invasive breast cancer, and the heterogeneous type may be associated with poor prognosis.

Adult↗
PubMed2000

[The systemic analysis of the predictors of clinico-social prognosis in schizotypic pseudoneurotic disorder].

By means of the systemic analytic approach (a correlation-regression analysis) author estimated prognostic significance of clinical characteristics of premorbid, initial period and manifestations of schizotypic pseudoneurotic disorders in terms of the level of social adaptation. 232 patients were observed after the fist hospitalization during 10 years. Criteria of both favorable and unfavorable prognosis of the disease were determined. The best prognosis took place in 7.6% of the patients, moderate--in 53.4% and the worst (maladaptation)--in 38.8% of the cases. A favorable prognosis correlated with poorly differentiated (nonspecific for endogenic diseases) disorders and with lack of personal changes. Meanwhile, an unfavorable prognosis correlated with disorders typical for slow-progredient schizophrenia (polymorphic neurosis-like and affective disorders, deficient changes of the personality and cognitive disorders).

Adaptation, Psychological↗
PubMedDate not supplied

Serial determinations of aminoterminal propeptide of type III procollagen (PIIINP) and prognosis in ovarian cancer; comparison to CA125.

During malignant growth many changes take place in the metabolism of fibrillar type III collagens in the connective tissues. The aminoterminal propeptide of type III procollagen (PIIINP) has been found to be often elevated in ovarian cancer. In the present study the prognostic value of serum PIIINP concentration in epithelial ovarian cancer is evaluated in relation to serum CA125. Fifty-six women were enrolled in the study. Serial venous blood samples were taken preoperatively and 6, 9 and 12 months after operation for PIIINP and CA125 determinations. The results were correlated to the three-year survival. In Kaplan-Meier survival analysis the preoperative (P = 0.0422), 9-month (P = 0.0062) and 12-month (P = 0.0062) serum PIIINP concentration distinguished between the patients with good and poor prognosis while CA125 did so only at 9- (P = 0.0005) and 12-month (P < 0.0001) follow-up. In the multivariate analysis the independent predictors of prognosis were the preoperative PIIINP and 12-month CA125 concentrations. The percentage changes in serum PIIINP concentration did not differentiate the patients with good or poor prognosis at any time point, whereas the changes in CA125 concentration significantly divided the patients into two prognostic groups during the second half of the postoperative year. We found that PIIINP and CA125 are complementary to each other as predictors of prognosis in epithelial ovarian cancer as preoperative PIIINP was better than CA125 and 1-year CA125 better than PIIINP in this function.

Adult↗
PubMed2001

[Clinicopathological study of influential factors on prognosis in patients with renal cell carcinoma].

Between January 1986 and August 1996, 120 patients were diagnosed with renal cell carcinoma (RCC) at Kanagawa Cancer Center. In this study, we analyzed these patients in view of the clinicopathological factors, which affect the prognosis of these patients with univariate and multivariate analysis using Cox's proportional hazard model. Of these 120 patients, 40 patients (33%) died of RCC during this period. The cause specific survival rate was 65% after 5 years and 57% after 10 years. Univariate analysis showed some factors, performance status, symptoms, tumor size, histological grade, local invasion (pT), venous involvement (pV), lung metastasis, lymph-node metastasis, and bone metastasis, affected the prognosis. Furthermore, multivariate analysis using Cox's proportional hazard model showed that performance status, pT, pV, lung metastasis, lymphnode metastasis, and bone metastasis independently affected the prognosis. In summary, TMN factors and performance status importantly affect the prognosis of RCC patients.

Carcinoma, Renal Cell↗
PubMed2001

[Multilevel analysis of regional disparities in survival after heart failure: differences between county health services affect little patients' prognosis].

The prognosis for patients suffering from heart failure in Sweden differs from county to county, indicating a need for a comparative study in order to uncover the reasons. Conventional single-level analytical methods, however, underestimate the statistical uncertainty in such studies, leading to an inappropriate ranking of regions. Consequently, public opinion and decision-making may be misled. Conventional methods are also unable to disentangle the extent to which differences in prognosis may depend on individual or regional factors. Multilevel analysis, on the other hand, provides a better estimate of statistical uncertainty, and can both identify and quantify the extent to which differences in prognosis depend on either patient-related or regional factors. Using multilevel analysis, we examined the one-year mortality of 38,343 heart failure patients for the period 1992-1995 in every county in Sweden. Regional differences in one-year mortality were found to be very small, the most relevant factors being individual ones. The limited differences distinguishable at the county level may be explained in part by physician density: the more physicians in a county, the better an individual patient's prognosis.

Aged↗
PubMed2001

[Multivariate analysis of the parameters related to prognosis of astrocytoma].

OBJECTIVE: To investigate the clinical and pathological characteristics of astrocytoma and the factors related to pathologic gradings as well as prognosis in astrocytoma. METHODS: 120 cases of the astrocytoma with complete clinical data were selected as the study group, of which 94 cases had follow-up data. 20 cases of normal brain tissue and demyelinating plaques with astrocyte hyperplasia were used as the control group. The expression of Ki-67, VEGF, collagen IV and TRT by immunohistochemical staining and detection of TRTmRNA and telomerase RNA by in situ hybridization were studied. RESULTS: (1) Both astrocytoma and demyelinating lesions showed various positivity for Ki-67. The difference between different gradings of the astrocytoma and non-neoplastic lesions were significant(P < 0.01). Taking 8.5% of Ki-67 expression as threshold, there was significant difference between two survival curves indicating favorable and unfavorable prognosis in the tumor group respectively (P < 0.01). (2) Microvascular changes, such as the density of blood vessels, did not demonstrate any difference between grade I, II astrocytoma and normal tissue, but was significantly increased in grade III and IV astrocytoma and even more in the necrotic area (P < 0.01). The expression of VEGF correlated closely to the density of the blood vessel (P < 0.01). (3) The expression of TRT protein was negative in normal astrocytes but positive in proliferative disease and astrocytoma. The intensity of the positivity was enhanced by the grading of the tumor and correlated with the prognosis (P < 0.01). The expression of hTR, TRTmRNA was less than that of TRT but was well correlated to TRT expression. CONCLUSIONS: Use of the cox-regression model in multivariate analysis shows that there are six parameters closely related to the prognosis of astrocytoma, of which the pathological grade being the most critical factor. Ratio of Ki-67 positivity, age of patient, duration of symptoms are also important factors, while microcystic changes in the tumor and expression of VEGF are independent favorable factors for astrocytoma.

Adult↗
PubMed2001

[Prognosis of patients with bleeding caused by rupture of esophageal and gastric varices: a cohort study].

OBJECTIVES: To determine the factors of long-term survival in patients with bleeding caused by rupture of esophageal and gastric varices and evaluate the effects of surgical treatment, endoscopic treatment, TIPS, and combined therapy on the long-term survival. METHODS: Retrospective cohort study was used to analyze 202 patients with bleeding caused by rupture of esophageal and gastric varices who were admitted to Zhongshan Hospital from 1992 to 1999. All of the patients were divided into several groups according to the intervention they received: no-intervention group, surgery group, endoscopy group, TIPS group, and combined treatment group. The survival curves of different groups were compared. Multivariate analysis was conducted. RESULTS: Kaplan-Meier curves demonstrated that the combined treatment group and surgery group had better prognosis than the endoscopy group and control group (P < 0.01). There was no statistically significant difference in survival rate between the combined treatment group and surgery group and between the endoscopy group and control group. Child-Pugh stratification showed that the results were the same for patients in Child-Pugh A class and B class. Multivariate analysis based on Cox proportional hazard model showed that there were four independent variables associated with prognosis: prothrombin time, HBV-DNA, ascites, and operation. CONCLUSIONS: Surgery, sometimes combined with other treatment, may improve the prognosis of patients with bleeding caused by rupture of esophageal and gastric varices. The four factors associated with the prognosis of patients with bleeding caused by rupture of esophageal and gastric varices are: prothrombin time, HBV-DNA, ascites, and operation.

Adult↗
PubMedDate not supplied

Effects of quality of treatment on prognosis in primary breast cancer patients treated in daily practice.

UNLABELLED: Information on treatment outcome outside clinical trials is sparse. This is the first study that relates surgical and medical quality of care in daily practice with outcome. BACKGROUND: In a previous study we showed, that the quality of chemotherapy as described by a guideline and given in daily practice to premenopausal primary breast cancer patients was suboptimal with only 68% and 53% of the patients receiving chemotherapy with a dose intensity (DI) and relative dose intensity (RDI) of > or = 85%, respectively. Many invalid reasons for delay and dose reductions were identified. PATIENTS AND METHODS: Premenopausal node-positive primary breast cancer patients treated from 1988 to 1992 were traced using two national registries. Relevant data were collected from their records. The following treatment-related variables were correlated with prognosis: type of surgery, number of investigated lymph nodes, radiotherapy, chemotherapy, interval between surgery and start of chemotherapy, DI, duration, delays and dose adjustments of chemotherapy and hospital size. RESULTS: Twenty-four of the 254 traced patients did not receive any chemotherapy, 230 received the recommended schedule of cyclophosphamide (C), methotrexate (M) and 5-fluorouracil (F). The median time of follow-up was 6.7 (range 0.9-10.2) years. The 5-year disease-free survival (DFS) and overall survival (OS) was 61% and 77%, respectively. In an univariate analysis DI < 65% correlated with a worse DFS and OS (p=0.05 and p=0.03, respectively). The use of chemotherapy correlated with a better DFS (p=0.03) than no use. In a multivariate analysis DI between 65 and 85% resulted in a better DFS (p=0.02) than DI > or = 85% and DI < 65%. CONCLUSION: The prognosis of the breast cancer patients in this population was comparable with the results of randomised trials using adjuvant CMF. The only treatment related variable of value for prognosis was DI. Unexpectedly DI between 65% and 85% resulted in the best prognosis in this population. The relevance of this observation remains unclear and warrants further investigation.

Breast Neoplasms↗
PubMed2002

Influence of prior medication on mode of presentation and prognosis of acute coronary syndromes.

OBJECTIVES: To evaluate the influence of prior medication on mode of presentation and short-term prognosis of acute coronary syndromes (ACS). DESIGN: Prospective study. SETTING: Coronary intensive care unit in Santa Cruz Hospital. POPULATION: We included 425 consecutive patients admitted for ACS. METHODS: Prior medication with anti-platelet agents, beta-blockers, nitrates, calcium channel blockers, statins and angiotensin-converting enzyme (ACE) inhibitors was recorded on admission. Medication introduced in the last 7 days was excluded. Using a multivariate analysis model we examined the impact of baseline characteristics and previous medication on mode of presentation of ACS. We also evaluated their influence on short-term prognosis (death or non-fatal myocardial (re)infarction in the first 30 days). RESULTS: Of the 425 patients studied 228 (53.6%) presented with unstable angina (UA), the remainder with acute myocardial infarction (AMI) (24.7% with ST elevation). Medication prior to admission included anti-platelet agents in 53.7% of patients, beta-blockers in 44.2%, nitrates in 48.2%, calcium channel blockers in 36.9%, statins in 28.9% and ACE inhibitors in 38.6%. During the first 30 days, 14 deaths (3.3%) and 37 (re)infarctions (8.7%) occurred. The combined occurrence of death or (re)infarction was 10.8%. Variables with significant and independent influence on mode of presentation of ACS were male gender, presence of known coronary artery disease and previous medication with anti-platelet agents and beta-blockers. Male gender was a predictor of AMI as mode of presentation, whereas a previous history of coronary artery disease and medication with anti-platelet agents or beta-blockers predicted UA. Short-term prognosis was influenced by heart failure symptoms on admission, but not by previous medication. CONCLUSION: Previous medication with anti-platelet agents and beta-blockers was associated with an increased frequency of UA as mode of presentation of ACS. No relation between previous medication and short-term prognosis was observed in the present study.

Adrenergic beta-Antagonists↗
PubMed2002

[Posterior vitrectomy for dislocated nuclear fragments during phakoemulsification: incidence, risk factors and prognosis of postoperative retinal detachment].

INTRODUCTION: Dislocated nuclear fragments during phakoemulsification are a well-known complication. The treatment is often surgical, and serious complications, among which a retinal detachment may occur. The purpose of this study was to evaluate its incidence, risk factors, and prognosis. METHODS: This retrospective study included a consecutive series of 24 eyes undergoing posterior vitrectomy for dislocated nuclear fragments during phakoemulsification. The main outcome measures were the postoperative retinal detachment (incidence, risk factors, prognosis). RESULTS: Two retinal detachments occurred after vitrectomy, an incidence of 8%. In both cases, a significant inflammation of the anterior chamber and corneal decompensation were noted before vitrectomy. More than 50% of the nucleus was dislocated. Intraocular implant manipulation did not intervene in either case. Two tears occurred during vitrectomy in one case. The prognosis of the detachment, with proliferation, was poor in both cases. DISCUSSION: and conclusion: The high incidence of retinal detachment compares with that observed after phakoemulsification complicated by vitreous loss. Anterior segment deterioration, which compromises posterior segment visualization, and dislocation of more than 50% of the nucleus, that increases the risk of fragments falling on the retina during vitrectomy, may increase the occurrence of retinal detachment with a poor prognosis because of periretinal proliferation.

Adolescent↗
PubMed2002

[The course and prognosis of mesangioproliferative glomerulonephritis].

AIM: A retrospective analysis of a clinical course of mesangioproliferative glomerulonephritis (MPGN) in patients with glomerular deposition of IgA (IgA nephropathy--IgA-N), with glomerular deposition of other Ig to determine prognostic factors of MpGN progression including IgA-N and to examine the patients' sensitivity to immunodepressive therapy. MATERIAL AND METHODS: 2000 patients with primary MPGN followed up from 1980 to 1999 from the disease onset to development of chronic renal failure (creatinine > 2.5 mg%). Factors affecting kidney survival were studied using the Cox regression model, factors predicting sensitivity to immunodepressive therapy--using multiple logistic regression. RESULTS: IgA-N differed by the course and prognosis from other forms of MPGN. In IgA-N urinary syndrome and macrohematuria were encountered more frequently, in other forms of MPGN more frequent was nephrotic syndrome. Prognosis of patients with IgA-N was worse than in MPGN patients without IgA deposition: 10-year "renal survival" (creatinine < 2.5 mg%) was 64 and 97% (p < 0.05), respectively. Prognosis-deteriorating factors for MPGN patients were the following: male sex, nephritis onset in 40-year-olds and older subjects, acute nephritic syndrome (creatinine > 1.5 mg%), high proteinuria, hematuria (> 50 in sight), the presence of synechia and TIC in renal biopsy, location of immune deposits both in the mesangium and basal glomerular membranes. The responders to the immunodepressive therapy had 10-year renal survival 100%. Positive results of immunodepressive therapy were observed significantly more frequently in patients with normal level of creatinine, moderate hematuria, absence of synechias and TIC in renal biopsy, given large total course dose of corticosteroids and cytostatics. Efficiency of oral cyclophosphamide and its intravenous pulse-therapy did not differ significantly. In pulse therapy an average cumulative dose was lower 6 times, side effects occurred 3 times less frequently. CONCLUSION: The importance of morphological information for prognosis and predicting sensitivity of MPGN patients to immunosuppressive therapy necessitates renal biopsy before therapy. Intravenous pulse therapy with cyclophosphamide is preferable as an active treatment in patients with sclerosis in renal biopsy.

Administration, Oral↗
PubMed1975

[Proceedings: Evolutive forms of glomerulonephritis and their prognosis].

The prognosis in patients with glomerulonephritis can now be established with some confidence. The major advance has been the use and interpretation of renal biopsies. The different histological varieties have their own evolution and prognosis. The clinical/pathological correlations assist the physician in determining the prognosis in patients with glomerulonephritis. On the clinical side, the most important observation is the simplest: proteinuria or hematuria may persist separately for many years without alteration of renal function. However, in patients with persistent proteinuria associated with hematuria the prognosis is poor, as the evolution is towards renal failure.

Glomerulonephritis↗