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PubMedDate not supplied

Psychological prognosis of diagnosed chronic organic solvent intoxication.

The psychological prognosis of 86 patients (40 men and 46 women) with previously diagnosed chronic solvent intoxication due to trichloroethylene, perchloroethylene, or solvent mixtures was studied after a follow-up period (mean 5.9 years). The patients' mean age at the time of diagnosis was 38.6 years, and the mean duration of solvent exposure was 10.7 years. Tests for intelligence, short-term memory, and sensory and motor functions were applied. The group means of the patients' intellectual functions were increased after the follow-up period. At the group level, the scores on one sensorimotor task and tasks requiring manual dexterity were lower. Individual patients performed better, worse, or equally when the results of the initial examination and the reexamination were compared. The overall prognosis of psychological test results was better with a longer follow-up period and lower age. Patients who used drugs with neurological effects had a poorer overall psychological prognosis. The characteristic of solvent exposure were related only to the prognosis of some single tests for sensory and motor functions.

Adult↗
PubMed1981

[Placental localisation : screening and prognosis (author's transl)].

Ultrasounds are the best means at present available for observing the placenta. It follows that it is necessary to appreciate the different phases that occur in placental development. Ultrasound will allow us to work out this evolution and to look for abnormalities that may develop. The placenta becomes an entity at about the 12th week of amenorrhoea. Precise localisation of the placenta is possible in the second trimester of pregnancy, but the final site of the placenta is not fixed in the uterus because different segments develop unevenly. All the same, it is necessary to make a prognosis of the risks of an abnormal insertion of the placenta at the end of pregnancy. It is therefore necessary to be precise in localising the placenta. There are several sources of error which have to be avoided: -- difficulty of exact localisation of the internal os of the cervix. -- the existence of thickening of the myometrium, which forms a reserve for uterine stretch.. These thickenings sometimes come at the same places as the placenta and it may be difficult to differentiate one from the other. -- the presence of placental folds. There are several different elements involving prognosis : -- the site of the lower edge of the placenta in relationship to the internal os. -- the site of the upper edge of the placenta in relationship to the fundus of the uterus. This, statistically, is the best index of prognosis, and so we suggest a classification. -- finally the volume of the myometrium between the lower edge of the placenta and the internal os gives an idea and allows us to work out how the lower segment can stretch. Finally, it is by combining all these elements in a study that a better prognosis can be worked out for the final site of the placenta in the uterus. It is only in the third trimester of pregnancy after the lower segment has formed that the final site of the placenta can be confirmed and that a decision can be taken on the way patient should be treated.

Cervix Uteri↗
PubMed1980

Factors affecting the prognosis of patients with carcinoma of the thyroid.

Of 763 patients with carcinoma of the thyroid who had undergone a primary operation between 1948 and 1970, 705 were observed for more than five years. Included were 545 patients with papillary carcinoma. 123 with follicular carcinoma, 59 with microcancer, 30 with undifferentiated carcinoma and six with medullary carcinoma. The relative survival rate for patients with pure undifferentiated carcinoma one year after operation was 27 per cent and that for those with mixed undifferentiated carcinoma was 24 per cent. For patients with differentiated carcinomas, the most important factors affecting the prognosis were age and sex. The 15 year survival rates for women less than 40 years of age with papillary or follicular carcinoma were 102 and 100 per cent, respectively, while for women more than 40 years with papillary or follicular carcinoma, they were 90 and 84 per cent, respectively. For men more than 40 years of age with papillary carcinoma, the relative survival rate was 67 per cent. The size of the tumor and the types of operation did not affect the prognosis in patients less than 40 years. The presence of chronic thyroiditis also had no effect upon the prognosis. The relative survival rate with tumors up to 99 grams in weight, after 20 years, was almost 100 per cent in women less than 40 years of age, while for women more than 40 years of age the survival rates were 95 per cent with tumors weighing less than 20 grams and 72 per cent with those weighing 20 to 99 grams, an indication that tumor size may affect prognosis in older patients.

Adenocarcinoma↗
PubMed1980

Intraventricular conduction disturbances in acute myocardial infarction: short- and long-term prognosis.

Short- and long-term prognosis were analysed in 59 patients admitted in the coronary care unit with an acute myocardial infarction, complicated with acute intraventricular (IV) conduction defects. In-hospital mortality of patients with IV conduction disturbances was more than twice (30%) the mortality of patients without IV conduction defects (13%; P less than 0.001). Mortality rate was very high among patients with all forms of incomplete trifascicular block or complete right bundle-branch block. Among survivors of the group with conduction defects, late death rate was significantly higher than in survivors of the group without IV blocks (25 vs 8%; P less than 0.01). Short-term prognosis of conduction defects in myocardial infarction depends on the extent of the necrosis. The conflicting results in long-term prognosis could be ascribed to variations in patient material and to different criteria used to define the acute nature of a block. Lastly the variable prognosis could correspond to differences in the site of the lesions within the conduction pathway.

Arrhythmias, Cardiac↗
PubMed1980

Variable prognosis in congestive cardiomyopathy. Role of left ventricular function, alcoholism, and pulmonary thrombosis.

Prognosis of 36 patients with congestive cardiomyopathy was studied in relation to various clinical factors. Half life of the survival curve after overt heart failure was about 7 years. Although left ventricular function was a major determinant of clinical course in congestive cardiomyopathy in general, its relation to prognosis was variable according to the type of cardiac involvement. In peripartal cardiomyopathy and in a type of cardiomyopathy named subacute cardiomyopathy with pulmonary thrombosis in this paper, factor(s) other than left ventricular function, possibly including pulmonary thrombosis, may be operative as more important determinant of extremely poor prognosis in these subtypes. Alcoholic cardiomyopathy was also unique in its favorable prognosis in association with reversible cardiomegaly following abstention from alcohol.

Adult↗
PubMedDate not supplied

Preliminary evaluation and prognosis in Legg-Calvé-Perthes disease.

Children younger than 4 years of age suffering from Legg-Calvé-Perthes' disease (LCPD) do not necessarily have a good prognosis. Girls generally have a poorer prognosis than boys. Clinical examination is not contributory to specific diagnosis or prognosis. Roentgenographic evaluation may reveal metaphyseal cysts and early physeal closure, both of which indicate a poor prognosis. Increased radiodensity cannot always be equated with osteonecrosis and therefore classification of extent and stage of the disease process on first examination is problematic and may vary as the condition progresses. Bilateral hip arthrography helps in determining which affected hip requires treatment because it detects protrusion of the osteochondral femoral head beyond the coverage of the lateral acetabular lip. This protrusion is the most important "risk factor." Scintiscanning may be valuable for diagnosis and to follow progress but interpretation of the examination is difficult. The differential diagnosis of LCPD from transient synovitis and other conditions presenting with femoral capital epiphyseal changes is mandatory.

Child↗
PubMed1995

[The biorhythmological types of work capacity and the late prognosis for patients who have had a myocardial infarct].

The authors analyze postmyocardial infarction 10-year survival and frequency of repeated cardiac accidents (fatal and nonfatal MI and sudden cardiac death). Biorhythmological types of mental and muscular performance were involved in long-term MI prognosis. Of 412 males who had their first myocardial infarction at the age under 59, 10-year prognosis was poor for those with early pattern of efficient work vs good prognosis in those who work most efficiently in the evening. The differences in the long-term prognosis of acute myocardial infarction related to performance biorhythm were observed both for subjects performing muscular and mental work.

Death, Sudden, Cardiac↗
PubMed1995

[Effect of lymph node dissection on prognosis of colon carcinoma].

Surgical treatment is essential for the prognosis of colon carcinoma. The extension of the lymph node excision depends on several factors, as operative technique and quality of the histopathological examination. In a retrospective analysis of 278 patients who had undergone curative primary resection for colon carcinoma the influence of lymph node excision on the prognosis has been proved. In the period of the analysis (between 1985 and 1993) the mean number of dissected lymph nodes could be increased. This had a strong influence on the prognosis. Whereas in early tumor stages and in patients with an extended lymph node metastasis no correlation between the quantity of lymph node excision and the prognosis could be found, patients with an extended local tumor growth without lymph node metastasis (pT3/4 pN0; p < 0.03) and patients with local lymph node metastasis (pN1; p < 0.0001) gained from the radical lymphadenectomy.

Aged↗
PubMed1994

Aneuploidy and aneusomy of chromosome 7 detected by fluorescence in situ hybridization are markers of poor prognosis in prostate cancer.

Fluorescence in situ hybridization is a new methodology which can be used to detect cytogenetic anomalies within interphase tumor cells. We used this technique to identify nonrandom numeric chromosomal alterations in tumor specimens from the poorest prognosis patients with pathological stages T2N0M0 and T3N0M0 prostate carcinomas. Among 1368 patients treated by radical prostatectomy, 25 study patients were ascertained who died most quickly from progressive prostate carcinoma within 3 years of diagnosis and surgery. Tumors from 25 control patients who survival for more than 5 years and who were matched for age, tumor histological grade, and pathological stage also were evaluated. The tumors from all 25 (100%) poor prognosis patients and from 11 of 25 (44%) control patients were found to be aneuploid by fluorescence in situ hybridization (P < 0.0001). Alterations of chromosome 7 were observed in 24 of the tumors (96%) from the poor prognosis patients versus 3 tumors (12%) from the control group (P < 0.0001). Moreover, a characteristic aneuploidy pattern with multiple abnormal chromosomes and a hypertetrasomic population was generally found in tumors from the poor prognosis patients. This preliminary study suggests that fluorescence in situ hybridization studies of prostate cancer specimens may help to identify those patients at highest risk for early cancer death.

Aged↗
PubMed1995

[Prognosis of acute tuberculous respiratory distress syndrome. 4 cases].

OBJECTIVES: We examined the characteristics of 4 cases of adult respiratory distress syndrome in patients with tuberculosis in an attempt to improve prognosis. METHODS: Four new cases of adult respiratory distress syndrome were described together with a review of the cases reported in the literature. Inclusion criteria were the presence of the syndrome as defined according to the American-European consensus conference and the criteria described by Murray et al. and identification of the mycobacteria causing tuberculosis. RESULTS: A total of 52 cases were included in the study. The sex ratio was 0.71 and mean age 46 +/- 15 years. Eight patients had a past history of pulmonary tuberculosis. Alcoholism was the primary immunodepression factor observed (35%) followed by human immunodeficiency virus infection (13%). For 74% of the patients, the disease course lasted 7 days. The initial chest X-ray was suggestive of tuberculosis in 11. Intradermoreaction to tuberculin was positive in 2 out of 17 patients. Direct examination of non-invasive respiratory samples was positive in 44% for mycobacteria. Disseminated tuberculosis was seen in 64%. Anti-tuberculosis antibiotherapy was started on the first day of intensive care in 68% of the patients; rapid treatment was associated with better prognosis: 1.5 +/- 1.2 days versus 3 +/- 2.7 in fatal cases (p = 0.02). Adjuvant corticosteroid therapy was used in 46% of the cases and was apparently associated with unfavourable outcome: 74% mortality versus 58% without corticosteroids. Ventilatory assistance was required in 88% and associated with poor prognosis (13% survival versus 100% without assistance) (p < 10(-3)). Outcome was fatal in 36 cases (70%) with a mean delay of 9.7 +/- 10.8 days. CONCLUSION: The conditions required for improving the prognosis of adult respiratory distress syndrome in tuberculosis patients included suspecting tuberculosis in all cases of acute respiratory failure of unknown origin, particularly in the immunodepressed patient, and to avoid missing this diagnosis in case of a non-suggestive chest X-ray and a negative though exhaustive microbiology search. Adjuvant corticotherapy is uneffective and may be dangerous.

Acute Disease↗
PubMed1994

A relation between c-myc expression and prognosis of leukemia patients in Indonesia.

Overexpression of c-myc, c-myb and c-fos proto-oncogene has been observed in many leukemia cells. However, a relation between those oncogene expressions and prognosis of the leukemia is not known in Indonesia. In order to elucidate the relation, expression of those oncogenes in leukemia cells from 52 patients in Indonesia was examined by Northern blot analysis and was compared with prognosis of the disease. The leukemia patients who survived for more than 2 years were 37% of the 52 patients. Many of the samples expressed c-myc mRNA (92%). Although strong expression of c-myb and c-fos mRNA was detected in the samples (c-myb expression in 35% of the leukemia cells and c-fos in 52%), those co-expressions with c-myc mRNA did not alter the prognosis. On the contrary, all of the 4 patients suffering from leukemia which did not express c-myc mRNA survived for more than 2 years. Therefore, c-myc expression in leukemia cells may be used as an indicator for deciding prognosis of the leukemia patients in Indonesia.

Adult↗
PubMed1995

Role of the argyrophilic nucleolar organizer regions in tumor detection and prognosis.

The expression of the argyrophilic nucleolar organizer regions (AgNORs) has been analyzed in renal, bladder, and pharyngeal carcinomas, multiple myeloma (MM), and skin melanocytic lesions to clarify their role in tumor detection and prognosis. Sections from formalin-fixed, paraffin-embedded biopsies were stained with the method of Ploton; the mean AgNOR number per nucleus (AgNOR count) and their distribution (configuration) were assessed examining 100 neoplastic cells. AgNOR counts and histologic grade were highly associated in bladder urotheliomas (6.01 for grade 1 [G1], 7.69 for G2, 13.35 for G3; p < 0.00001) and MM (3.18 for G1, 4.36 for G2, 6.13 for G3; p < 0.0001); they were not associated in renal cell carcinomas (5.35 for G1, 5.92 for G2, 7.99 for G3; p = 0.132) and pharyngeal carcinomas (11.1 for G2, 10.27 for G3; p = 0.08). AgNOR number was also related to the degree of malignancy in melanocytic lesions (2.93 for common blue nevus, 2.89 for benign nevus [BN], 3.69 for cellular blue nevus [CBN], 7.71 for malignant melanoma, and 8.33 for malignant cellular blue nevus [MCBN]; p < 0.00001). Association between AgNOR counts and pathologic stage was found in bladder carcinomas (6.43 for pTa, 10.19 for pT1, 12.57 for pT2-4; p < 0.00001) and MM (3.06 for cases with percentage of bone marrow plasma cells [BMPC%] < or = 20, 4.28 for BMPC% 21 to 50, 5.14 for BMPC% > 50; p < 0.0001]; no correlation was found in pharyngeal (11.18 for T1, 10.08 for T2, 10.68 for T3, 11.47 for T4; p = 0.18) or renal cell carcinomas (6.06 for pT2, 6.31 for pT3; p = 0.78). Few, large and grouped AgNORs were found in well-differentiated bladder carcinomas, MM, and benign melanocytic lesions; numerous, small and dispersed AgNORs were seen in poorly differentiated bladder, renal and pharyngeal carcinomas, MM and malignant melanocytic lesions. Significant association with prognosis was found in pharyngeal carcinomas (5-year survival: 68% for cases with < or = 10.31 AgNOR/cell, 20% for cases with > 10.31 AgNORs) and MM (5-year survival: 46% for cases with < or = 4.62 AgNOR/cell, 7% for cases with > 4.62 AgNORs; in MM the configuration too was related to prognosis: median of survival 72 months for tightly grouped, 16 for partially grouped, and 11 for dispersed AgNORs). Our results indicate that AgNOR number and configuration are useful in detection and prognosis of some neoplasias. They permit a rapid evaluation of morphology and tumor cell kinetics even on small biopsies.(ABSTRACT TRUNCATED AT 400 WORDS)

Antigens↗
PubMed1995

Correlation of the in situ detection of polymerase chain reaction-amplified metalloproteinase complementary DNAs and their inhibitors with prognosis in cervical carcinoma.

The purpose of this study was to correlate the presence of matrix metalloproteinase (MMP)-9 and MMP-2 and tissue inhibitors of metalloproteinase (TIMP)-1 and TIMP-2 mRNAs, detected in serial sections using the reverse transcriptase in situ PCR technique, with prognosis in 23 cases of cervical carcinoma. PCR-amplified MMP and TIMP cDNA were restricted to the invasive cancers cells and the surrounding stromal cells. The ratios of cancer and stromal cells expressing MMP-9 and MMP-2 to those expressing TIMP-1 and TIMP-2 were approximately 1 in those cancers with a good prognosis. This MMP:TIMP ratio in the cancer and stromal cells with a poor prognosis was significantly increased to 5.4 and 3.4 (P < 0.0001), respectively, reflecting a marked reduction in the TIMP detection rate in cancers with a poor prognosis. In cervical cancer cell lines SiHa and HeLa, the MMP:TIMP ratio was also close to 1 and, interestingly, these cell lines are invasive but rarely metastatic in nude mice. These data suggest that the balance of MMP-9 and MMP-2 to TIMP-1 and TIMP-2 expression is an essential factor in the aggressiveness of cervical cancer.

Base Sequence↗
PubMed1994

[Analyses of PCNA and AgNOR on advanced colorectal cancer as predictive indicators of the prognosis].

As part of a search for predictive indicators of the prognosis of advanced colon cancers, the significance of PCNA and AgNORs in terms of grading of biological malignancy was investigated. In 47 selected cases, which had been sufficiently followed up for the present study, PCNA labeling indices (PCNA LI) were 20.96 +/- 8.87 and 54.78 +/- 11.35 in normal colonic mucosa and colon cancer, respectively. With survival durations of more or less than 5 years, the PCNA LI values were 57.27 +/- 9.56 and 48.27 +/- 13.37, thus, suggesting a decrease with poor prognosis. PCNA LI decreased in proportion to the depth of cancer invasion and the progression of stage. In all of these cases statistically significant differences were apparent, whereas other histopathologic factors did not demonstrate any correlation. Numbers of AgNORs were 1.31 +/- 0.10 and 2.43 +/- 0.39 in normal tissues and cancers, the differences being statistically significant. However, no correlation with prognosis or histopathologic factors was noted for this parameter. In conclusion, our data suggest that PCNA LI might be an important predictive indicator of prognosis in advanced colon cancer. In contrast, AgNORs are of no assistance with this problem, although use of both or combination might facilitate differentiation between benign and malignant lesions.

Adenocarcinoma↗
PubMed1994

Assessing prognosis and predicting patient outcomes in community-acquired pneumonia.

Community-acquired pneumonia is a common medical illness, with clinical outcomes ranging from mild illness with rapid and complete recovery to a fulminant clinical course with morbid complications followed by death. A systematic review of the literature on pneumonia prognosis has identified a variety of demographic factors, symptoms and physical examination findings, comorbid illnesses, laboratory abnormalities, and etiologic agents that are independently associated with short-term mortality in patients with this illness. By combining these prognostic factors, investigators have developed a variety of indices to predict short-term mortality. Although these predictive instruments vary with respect to the patient populations studied, number of predictor variables included, statistical methods used, and overall clinical performance, these models can assist physicians in assessing patient prognosis and in making important management decisions such as the initial site of care (ie, home v hospital). Assessment of patient prognosis has also been used by clinicians and health services researchers who use the hospital severity of illness-adjusted mortality rate as a measure of the quality of medical care provided. Because the majority of patients with this illness survive, future assessments or predictions of prognosis in patients with community-acquired pneumonia should also evaluate a spectrum of other important health outcome measures including the occurrence of morbid complications, symptom resolution, quality of life, return to work and usual activities, and patient satisfaction with care.

Adult↗
PubMed1994

[Relation between neuroendocrine expression of prostatic carcinoma and prognosis].

To clarify the relationship between the neuroendocrine expression of prostatic carcinoma and prognosis, we studied immunohistochemically formalin-fixed and paraffin-embedded tissue sections from 30 cases of prostate cancer by means of neuroendocrine (NE) differentiation markers. The rate of NE positive-staining cases was 40% (12/30), and more than two kinds of NE markers were expressed in 9/12 cases. The NE markers were NSE (7 positive cases), Chromogranin-A (7), Calcitonin (2), Gastrin (2), hCG (4), S-100 Protein (2), Serotonin (3), EMA (23) and Lillie argentaffin staining (2). Follow-up of the 30 patients showed that NE negative tumors have a prognosis better than NE positive tumors (P < 0.005). Their poor prognosis is due to poor response to endocrine therapy, and the mechanism is that some neuropeptides secreted by NE cells affect the growth of tumor cells. Finally, how to improve the prognosis of the patients who have NE expression of their prostate cancer is discussed.

Carcinoma, Acinar Cell↗
PubMed1994

[The indication of operative procedure for a metastatic spine tumor: a scoring system for the preoperative evaluation of the prognosis].

Since 1987, the operative procedure for a metastatic spine tumor has been decided on the basis of a scoring system for the preoperative evaluation of prognosis. Six parameters which affected the prognosis were employed in this assessment: 1) the general condition, 2) the number of extraspinal bone metastases, 3) the number of metastases in the vertebral body, 4) incidence of metastasis to a major internal organ (lungs, liver, kidneys, and/or brain), 5) the primary site of the cancer, and 6) the severity of spinal cord palsy. Each parameter was scored from 0 (high risk) to 2 (low risk) points. An excisional operation was performed when the total score was above 9 points, while a palliative operation was indicated for those who scored under 5 points. This assessment system was evaluated for 113 cases who had undergone surgery according to this criterion. The survival period of 92.3% of patients who scored less than 6 points was less than 6 months, while that of 78.3% of patients who scored more than 8 points was more than one year. The total score obtained for each patient correlated with the prognosis, and was valuable in predicting prognosis for a lesion at any stage. In conclusion, it was appropriate to indicate the operative procedure for a metastatic spine tumor according to this scoring system.

Adolescent↗
PubMed1993

[Proliferating cell nuclear antigen (PCNA/cyclin) in gastric carcinoma in relation to its prognosis].

Expression of proliferating cell nuclear antigen (PCNA/Cyclin) in 73 cases of gastric carcinomas and its relationship to prognosis were semiquantitatively analysed by ABC immunoperoxidase method and its clinical application was explored. PCNA staining located in the nuclei of tumor cells. A semiquantitative PCNA grading showed a significant negative correlation with survival of the gastric carcinomas cases (P < 0.01). Survival analysis also presented that the prognosis of patients with intensive expression of PCNA was poor. Generally speaking, the expression of PCNA showed a significant positive correlation with the differentiation degree of the tumor and nodal metastasis (P < 0.05). However, among these cases, the poorly differentiated adenocarcinomas with a weak grade of PCNA expression generally considered as of a high malignant degree and poor prognosis, survived longer. The facts indicated that the in situ detection of PCNA in gastric carcinoma is more objective and reliable in assessing a proper prognosis than that made on the basis of traditional morphological differentiation grading.

Adenocarcinoma↗