Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PROGNOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMed1989

The spread and prognosis of carcinoma in the region of the pancreatic head.

Tumor infiltration and prognosis were studied in 73 patients who underwent surgery for carcinoma in the region of the pancreatic head, in order to evaluate the grade of malignancy of pancreatic cancer. Twenty three patients had carcinoma of the head of the pancreas, 16 had carcinoma of the intrapancreatic bile duct and 34 had carcinoma of the papilla of Vater. It was found that the prognosis in carcinoma of the head of the pancreas was not related to tumor size, but to lymph node metastasis and the pancreatic capsular or perineural invasion of the tumor. The poorer prognosis seen in carcinoma of the head of the pancreas could be attributed to the fact that lymph node metastasis and invasion of the pancreatic capsule or nerve plexus occurred much more frequently in this carcinoma than in carcinoma of the other two areas. The 5-year survival rate of the patients with carcinoma of the head of the pancreas was 12.5 per cent, this being significantly lower than that of the patients with either carcinoma of the papilla of Vater (50.0 per cent) or carcinoma of the intrapancreatic bile duct (44.4 per cent). These findings suggest that lymph node metastasis and pancreatic capsular or perineural invasion closely correlate with the prognosis of patients with pancreatic carcinoma.

Ampulla of Vater↗
PubMed2007

[Estimating the prognosis of peripheral facial paralysis: is the minimal nerve excitability test still up to date?].

BACKGROUND: In this retrospective study, we assessed the long-term prognostic value of the minimal nerve excitability test (NET) by comparing the results it yielded with the House-Brackmann (HB) index in patients with the most common types of facial paralysis, Bell's palsy and traumatic facial palsy. PATIENTS AND METHODS: Three hundred and fifty patients aged 9-85 years (mean age 42.4 years; 156 male and 194 female), all of whom were treated initially with the same steroid therapy, entered on study. Patients in whom decompression surgery had been performed were excluded so as to avoid falsely optimistic prognoses. The 350 study patients were divided into two groups: group 1 was made up of 250 with Bell's palsy and group 2, of 100 with nonpenetrating traumatic facial palsy following temporal bone fracture. The NET was conducted repeatedly in all patients for 3 weeks from the start of day 3 of treatment, the value recorded on day 14 being used in the evaluation. For each patient, the result of the NET was recorded as 'normal', 'diminished' or 'without response' according to the difference between the two sides of the face. The final HB grading was determined after 1 year to check for the agreement between the electrical prognosis and the clinical outcome and thus the reliability of the prognosis indicated by the NET. RESULTS: The results indicate that a normal NET forecast a satisfactory outcome that could be classed as HB I-II in almost all the patients in both groups. Among patients who had no response on NET, 85% of those with Bell's palsy and 90% of those with traumatic facial palsy failed to recover nerve function. Diminished nerve excitability proved to be a sign of a relatively favourable prognosis: 74% of patients in each group recovered normal facial function. CONCLUSION: The NET is a method of investigation that is easily applied and can make a positive contribution to the assessment of prognosis in Bell's palsy and in traumatic facial palsy, reflecting the functional state of the facial nerve reliably in most of cases.

Adolescent↗
PubMed2005

Prognosis of hepatocellular carcinoma after hepatectomy in patients with renal dysfunction.

We evaluated the effect of renal dysfunction on the prognosis of hepatocellular carcinoma in 224 patients who underwent hepatic resection. Survival was compared between patients with (57 patients) and without renal dysfunction (116 patients), using a creatinine clearance </=70 ml/min as the cut-off value. There were no significant differences with respect to other preoperative characteristics, operative findings, or histology between the two groups. There was also no difference in survival between the two groups after hepatic resection. However, among 132 patients with a solitary tumor measuring </=5 cm in greatest dimension, the disease-free and overall survival rates of 36 patients with renal dysfunction were significantly worse after resection than those of the patients without renal dysfunction (p = 0.04 and p = 0.0003, respectively). By multivariate analysis, renal dysfunction was an independent factor indicating a poor prognosis for disease-free and overall survival after resection of small solitary tumors (p = 0.0401 and p = 0.0031, respectively). Renal dysfunction did not affect the overall prognosis after resection of hepatocellular carcinoma, but it worsened the prognosis of patients with small solitary lesions.

Adult↗
PubMed2005

The relationship between initial clinical manifestation and long-term prognosis of patients with systemic lupus erythematosus.

The relationship between clinical manifestations and prognosis was examined and evaluated among systemic lupus erythematosus (SLE) patients. A total of 542 patients with SLE were selected and divided into nine groups according to their main clinical manifestation at the time of initial diagnosis. The relationship between these clinical manifestations and long-term prognosis was evaluated in respect to the survival, remission, relapse rates, the development of a new clinical manifestation, and/or damage index. Patients with neuropsychiatric SLE (NPSLE), accompanied with acute confusional state/seizure disorder, cerebral vascular disease, or pneumonitis had poor survival rates with cause of death related to their major organ involvement. Patients with nephropathy or leukopenia had lower remission rates, and an increase in relapse rates was frequently recognized in patients with pneumonitis. Body damage (damage index) was higher in patients with lupus psychosis, pneumonitis, and/or arthritis. The translation of the main manifestations after diagnosis was confirmed in 64 patients (11.8%), and often observed in patients with autoimmune hemolytic anemia and arthritis. The majority of these manifestations were nephropathy, NPSLE, thrombocytopenia, and pneumonitis, and the prognosis of patients with nephropathy and thrombocytopenia as a new main manifestation had a poor outcome. The results of long-term prognosis in SLE greatly differed with respect to the initial clinical manifestation at the time of diagnosis.

Journal Article↗
PubMed2026

Integrated single-cell and bulk transcriptomic analysis identifies a novel senescent fibroblast subtype associated with poor prognosis in acral melanoma.

BACKGROUND: Acral melanoma (AM) exhibits significant intratumoral heterogeneity, but its tumor microenvironment (TME) and immune regulation remain unclear. This study aims to dissect TME heterogeneity and establish a prognostic model based on key cell subpopulations. METHODS: We collected AM single-cell RNA sequencing (scRNA-seq) and bulk RNA-seq data from the Gene Expression Omnibus (GEO) and the Cancer Genome Atlas (TCGA). Unsupervised clustering, CellChat, and Scissor analysis were performed to characterize cellular heterogeneity, cell-cell communication, and prognosis-related cell subpopulations. Kaplan-Meier analysis was used to assess the prognostic value of key genes, which were further validated by multiplex immunohistochemistry (mIHC). RESULTS: In AM, Mel_C2, C7, and C9 with high SEMA6A and KIT expression were strongly linked to poor prognosis. We further identified a senescent fibroblast subpopulation (sCAF_CDKN2A) characterized by high fibroblast senescence signature (FSS) scores. Integrating Scissor analysis of fibroblast subtypes with bulk prognostic data, we identified COL3A1, VCAN, and KIT as prognosis-associated genes upregulated in poor-outcome-related fibroblast subsets. Cell-cell communication analysis revealed that sCAF_CDKN2A engages in an immunosuppressive network, interacting with regulatory T cells (Tregs) via MIF signaling and receiving signals from exhausted CD8+ T cells through PPIA-BSG interactions. Using transcription factor expression patterns from these fibroblast subtypes, we constructed a prognostic model that effectively stratified patients into distinct risk groups with significant differences in overall survival (OS). mIHC confirmed significantly higher protein levels of SEMA6A and COL3A1 in tumor tissues compared to matched normal tissues. CONCLUSIONS: We established a novel prognostic model for AM and identified sCAF_CDKN2A as an immunosuppressive senescent fibroblast subpopulation driving poor prognosis.

Acral melanoma↗
PubMed1996

Combined Modality Treatment for Poor Prognosis Stages I and II Hodgkin's Disease.

Recommendations for the treatment of "poor prognosis" stages I and II Hodgkin's disease (HD) depend on the extent of staging. For centers that favor exploratory laparotomy and splenectomy, the standard treatment after negative surgical staging remains subtotal lymphoid irradiation. However, most centers recommend excluding selected patients from surgical staging. In particular, most specialists agree that patients with bulky mediastinal disease (large mediastinal adenopathy) should receive combined chemotherapy and radiotherapy without surgical staging. Centers that have eliminated staging laparotomy rely on clinical staging and have identified a number of poor prognostic factors that influence treatment recommendations. In 1995, the following factors were considered to be associated with an unfavorable prognosis in clinical stages (CS) I and II HD: advanced age, systemic symptoms, high erythrocyte sedimentation rate, large number of individual sites, and presence of bulky disease. For example, these factors have been used in the H7 and H8 European Organization for the Research and Treatment of Cancer trials and have been adopted by almost 100 participant groups. For CS I and II patients with unfavorable presentations, the literature suggests that the optimal treatment is a combination of chemotherapy and radiotherapy. Nevertheless, the optimal delivery of chemotherapy and radiotherapy is still debated and a number of the questions listed below are awaiting answers: 1. The chemotherapy schedule: Mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) alone can no longer be recommended (for toxicity reasons) for the routine treatment of poor prognosis CS I and II HD. Many centers, on theoretical arguments, favor seven or eight drug combinations (MOPP/ABV hybrid), although the advantage of these combinations in toxicity and efficacy over doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) alone has not been demonstrated. 2. The number of chemotherapy courses: Most groups use six cycle regimens, but reduction to three to four cycles is currently being investigated both in pilot and randomized studies. 3. Timing of chemotherapy: Chemotherapy is given first in most instances. Whether or not a "sandwiched" scheme is better than all the chemotherapy given upfront remains to be answered. 4. Volumes to be irradiated: Data suggest that the irradiated volumes can be safely limited to initially involved lymph node regions after effective chemotherapy. The question is presently being addressed in a few ongoing randomized trials. 5. Radiation dose to be delivered: The decrease of the radiation dose to 35 to 36 Gy after effective chemotherapy has gained a wide acceptance. Further dose reduction is being investigated. In conclusion, except for selected CS I and II patients still referred for surgical staging, combined modality therapy appears to be the treatment of choice for poor prognosis CS I and II HD.

Journal Article↗
PubMed2002

Incisional biopsy and melanoma prognosis.

BACKGROUND: There are many circumstances in clinical practice in which it is helpful to have a definitive diagnosis of melanoma before subjecting a patient to mutilating surgery. Previous studies on the effect of incisional biopsy on melanoma prognosis were conflicting and lacked a matched control group to account for the other prognostic indicators. OBJECTIVE: We set up this study to investigate the effect of incisional biopsy on melanoma prognosis. METHODS: The design was of a retrospective case control. Data were obtained from the database of the Scottish Melanoma Group; the database was set up in 1979 to collect detailed clinical, pathologic, and follow-up data on all patients diagnosed with melanoma in Scotland. Each incisional case was matched against 2 excision cases controlling for age, sex, sites, and Breslow thickness. The main outcome measures were time from initial biopsy to recurrence and to melanoma-related death. RESULTS: Two hundred sixty-five patients who had incisional biopsy before definitive excision of melanoma were included in the study; these were matched with 496 cases of excisional biopsy specimens. Cox's proportional hazard model for survival analysis showed that biopsy type had no significant effect on recurrence (P =.30) or melanoma-related death (P =.34). CONCLUSIONS: This study is the largest series on the effect of incisional biopsy on melanoma prognosis to date and the first to include matched controls. Melanoma prognosis is not influenced by incisional biopsy,. before definitive excision.

Adult↗
PubMed2005

Mood, anxiety and sense of humor in head and neck cancer patients in relation to disease stage, prognosis and quality of life.

CONCLUSION: At diagnosis, control patients had the lowest depression levels and anxiety scores, followed by those with limited HNSCC disease and these with extended HNSCC disease. Anxiety and depression levels at diagnosis predicted prognosis via an association with extent of disease. Sense of humor, but not anxiety or depression level, predicted lower QoL and depression levels at follow-up. OBJECTIVE: To study the association between anxiety score, depression level at sense of humor at diagnosis in head and neck squamous cell carcinoma (HNSCC) patients versus TNM stage, prognosis and depression level/quality of life (QOL) 6 years following diagnosis. A control group of patients with benign HN disease was also included. MATERIAL AND METHODS: Male patients with newly diagnosed HNSCC (n =78) or benign HN (n =61) disease completed the following questionnaires: the Beck Depression Inventory, the Spielberger Trait Anxiety Inventory (state) and the Svebak humor questionnaire. Patients with cachexia or those aged >80 years were excluded. In the HNSCC patients, TNM stage, prognosis and QOL/depression level (n =27) were determined following successful therapy. RESULTS: HNSCC patients reported high anxiety scores and lower depression levels than control patients, although there was overlap between the groups. N stage was associated with high anxiety scores and depression levels, whereas T stage was only associated with depression levels. Both anxiety scores and depression levels at diagnosis predicted prognosis through an association with TNM stage. Sense of humor, but not depression levels or anxiety scores, at diagnosis predicted QoL and depression levels at follow-up.

Affect↗
PubMed2005

Cytochrome p450 profile of colorectal cancer: identification of markers of prognosis.

PURPOSE: The cytochromes P450 (P450) are a multigene family of enzymes with a central role in the oxidative metabolism of a wide range of xenobiotics, including anticancer drugs, carcinogens, and endogenous compounds. The purpose of this study was to define the P450 profile of colorectal cancer and establish the prognostic significance of expression of individual P450s in colorectal cancer. EXPERIMENTAL DESIGN: Immunohistochemistry for a panel of 23 P450s was done on a colorectal cancer tissue microarray consisting of 264 primary colorectal cancers, 91 lymph node metastasis, and 10 normal colorectal samples. The intensity of immunoreactivity in each sample was established by light microscopy. RESULTS: The most frequently expressed form of P450 in normal colon was CYP3A4. In primary colorectal cancer, several P450s (CYP1B1, CYP2S1, CYP2U1, CYP3A5, and CYP51) were present at a significantly higher level of intensity compared with normal colon. P450 expression was also detected in lymph node metastasis and the presence of several P450s (CYP1B1, CYP2A/2B, CYP2F1, CYP4V2, and CYP39) in the lymph node metastasis strongly correlated with their presence in corresponding primary tumors. The presence of strong CYP51 (log-rank = 12.11, P = 0.0005) or strong CYP2S1 (log-rank = 6.72, P = 0.0095) immunoreactivity were associated with poor prognosis. CYP51 was also an independent marker of prognosis (P = 0.009). CONCLUSIONS: The expression of individual P450s has been established in colorectal cancer. Several P450s show increased expression in colorectal cancer. High expression of CYP51 or CYP2S1 were associated with poor prognosis and CYP51 is an independent marker of prognosis.

Aged↗
PubMed1997

Bronchiectasis: an orphan disease with a poorly-understood prognosis.

The prognosis and risk factors for bronchiectasis are at present poorly known. The aim of this study was to examine the long-term prognosis and cause of death in this disease. The National Hospital Discharge Register was used to search for patients aged 35-74 yrs, with newly-diagnosed bronchiectasis in the period 1982-1986. Each of the 842 patients identified was matched with an asthmatic patient and a patient with chronic obstructive pulmonary disease (COPD), who were of the same age and sex and who had been treated in hospital at the same time. The use of hospital services by these subjects was examined up to the end of 1992, and mortality to the end of 1993. The prognosis for the bronchiectatic patients treated in hospital was better than that for the COPD patients but poorer than that for the asthmatics; the risk of death being 1.25 (95% confidence interval (95% CI) 1.15-1.36) for the COPD patients and 0.79 (95% CI 0.71-0.87) for the asthmatics, relative to the bronchiectatic patients. Bronchiectasis was the main cause of death in 13% of bronchiectatic patients, the risk of death being increased by a factor of 1.21 in the presence of asthma as the main secondary diagnosis, by 1.31 with COPD, by 1.35 with tuberculosis and its sequelae, and by 1.32 with some other secondary diagnosis, as compared with cases for which no secondary diagnosis was indicated. The fact that the prognosis for bronchiectatic patients is poorer than that for asthmatics points to a continued need for focused care and follow-up, particularly in the presence of additional illnesses.

Adult↗
PubMedDate not supplied

[Factors related to the post-portoenterostomy prognosis of biliary atresia].

OBJECTIVE: This study considered the presence of congenital anomalies, ductal plate malformation, area of fibrosis and, mainly, the patient's age in cases of biliary atresia submitted to surgery. The present study verified the influence of these factors on the follow-up of a biliary atresia sample. METHODS: A sample of 47 patients with biliary atresia was evaluated in a cross-sectional study. Their histologic specimens were stained for antibody anticytokeratin 19 and CAM 5.2 through immunohistochemistry in order to study biliary structures, and for picrosirius red to evaluate the area of fibrosis. The study of biliary structures was performed by two pathologists and the first author of the study. They were "blind" with regard to the clinical follow-up. The area of fibrosis was quantitatively evaluated. Data on the patients with regard to age, death and occurrence of liver transplantation were searched on the patients records. RESULTS: Age at portoenterostomy varied between 24 and 251 days of life (90.4 +/- 44.8 days) and follow-up was available in 32 cases (72%). The nine cases (19%) with extrahepatic congenital anomalies associated to biliary atresia did not present different prognosis from the remaining patients. Age at portoenterostomy influenced the prognosis (p=0.016). The area of fibrosis was different on patients aged less than 60 days and those aged more than 90 days at portoenterostomy (p=0.023), but did not influence the prognosis. The presence of ductal plate malformation, as well, did not influence the follow-up. CONCLUSIONS: Age at portoenterostomy was the only factor that influenced prognosis on this sample of biliary atresia. It is necessary to increase the biliary atresia sample to check the influence of congenital extrahepatic anomalies on the follow-up post-portoenterostomy.

English Abstract↗
PubMed1996

High-dose therapy and autologous bone marrow transplantation in first complete or partial remission for poor prognosis Hodgkin's disease.

We report the experience of three French centres which evaluated high-dose therapy (HDT) as consolidation therapy for poor prognosis Hodgkin's disease (HD). From March 1986 to April 1990, 23 consecutive patients with poor prognosis stage IV HD underwent HDT followed by autologous bone marrow transplantation (ABMT) after achieving either complete remission (CR1) or good partial response (GPR1) (reduction mass> 75%). The median age was 31 years (range 18 to 55 years), 14 were male. All patients except one initially had at least 2 poor prognosis factors such as: systemic symptoms (n = 19), bulky tumor (n = 16), more than one extranodal site (n = 9), bone marrow involvement (n = 5), lymphocyte count < or = 1.10(9)/1 (n = 8) and biological stage B (n = 21). All patients had previously been treated with alternating MOPP/ABVD. Ten patients were in GPR1 and 13 in CR1 before transplant. The conditioning regimens were: CBV (n = 17), BEAM (n = 5), BEAC (n = 1) followed by bone marrow rescue. Radiotherapy was introduced just before the conditioning regimen for 6 patients or after ABMT for 5 patients. Nine of 10 patients in GPR1 achieved CR after ABMT but one died early of treatment-related toxicity. Five of 22 patients who were in CR posttransplant, relapsed (3, 4, 4, 18, 36 months). Seventeen patients remain alive in continuous CR with a median follow-up of 60 months (range: 30-100 months). The overall survival (OS) and disease-free survival (DFS) projected at 5 years are 92% and 77% respectively. Consolidation by HDT and ABMT proved to be well tolerated. An international trial is currently underway to attempt to demonstrate a clear benefit on survival for this subset of poor prognosis HD patients.

Adolescent↗
PubMed2002

[Approaches to late prognosis in patients with subacute infectious endocarditis].

AIM: To ascertain late prognosis of subacute infectious endocarditis (IE), factors involved in the prognosis, formulate approaches to assessment of late prognosis. MATERIAL AND METHODS: A retrospective trial included 98 patients discharged from a hospital with diagnosis "subacute IE", treated without surgery or without endocarditis of the prosthesis. The diagnosis was verified at echocardiography. A mean follow-up 4.8 +/- 3.7 years. Clinical and echo-CG follow-up findings were computer-processed. RESULTS: 5-year lethality was 31%. The patients died of cardiac failure (CF) and acute failure of cerebral circulation (84 and 16%, respectively). Late complications in the survivors were the following: severe CF (18 patients, 32%), moderate CF (18 patients, 32%), recurrent IE (12 patients, 20%). Such factors as IE variant (primary or secondary), affection of the aortic valve, severity of regurgitation, size of the left ventricle, CF progression in the acute phase proved to have a significant influence on late prognosis. CONCLUSION: The prevalent cause of death in IE is CF. The progression of CF depends on combination of the above factors. High risk group patients should be examined by a cardio-surgeon even in the absence of clinical symptoms of CF.

Adult↗
PubMed1991

[Possible long-term prognosis in epidemiologically significant virus infections].

The long-range prognosis of viral diseases must be assessed differently according to their geographical occurrence. The genetic disposition, environmental factors and additional infectious diseases play a decisive part here. Vaccinations are the most important measures in the prevention of these infections. The spectrum of possible chemotherapeutic intervention for viral infectious diseases is very small, which usually makes specific treatment impossible. The most important infective viruses epidemiologically, which lead to persistent complications, are discussed in detail as follows: influenza virus, measles virus, human T-cell leukaemia virus, human immuno-deficiency virus, hepatitis B and C virus. In a discussion conclusions are drawn from the virologist's point of view for a possible long-range prognosis, which depends on the one hand on the infective agent and on the other on individual reactivity. The last chapter talks about insurance medical aspects of the most important infective viruses, which have already been discussed virologically. Some scientific developments are shown which could be future solutions of problems in diagnosis and prognosis. Such new developments could help insurance medical officers to important decision parameters for long-range prognosis, which are still largely missing at present.

Cause of Death↗
PubMed2006

[Clinical features and prognosis of multiple primary tumors of lung combined with other organs--report of 281 cases].

BACKGROUND & OBJECTIVE: Along with the progress of tumor diagnosis, the detection of multiple primary tumors (MPT) of the lung combined with other organs is increasing, but their clinical features and prognosis are unclear yet. This study was to investigate clinical features and prognosis of MPT of the lung combined with other organs. METHODS: Of the 281 patients with MPT of the lung combined with other organs, treated in our hospital from Jan. 1990 to Dec. 2000, 115 had lung cancer diagnosed first (Group A), 116 had other cancers diagnosed first (Group B). Clinical features and prognosis of the patients were analyzed. RESULTS: There was no significant difference in sex distribution between the 2 groups (P=0.51). At the diagnosis of the first cancer of MPT, the median age of the patients was significantly older in Group A than in Group B (62.5 years vs. 54.5 years, P=0.02), while at the diagnosis of the second cancer, it showed no significant difference between the 2 groups (64.5 years vs. 63.5 years, P=0.08). The interval between first and second primary tumors was significantly shorter in Group A than in Group B (36.0 months vs. 49.0 months, P<0.001). The proportion of stage I-II lung cancer was significantly higher in Group A than in Group B (83.9% vs. 63.7%, P<0.01). Since the diagnosis of first primary cancer, the medium survival time was shorter in Group A than in Group B (69.0 months vs. 87.5 months), and the 5-year survival rate was significantly lower in Group A than in Group B (59.0% vs. 70.0%, P<0.001). Since the diagnosis of second primary cancer, no significant difference in medium survival time and 5-year survival rate was observed between the two groups (25.0 months vs. 28.0 months, 10.5% vs. 13.5%, P=0.92). Second primary cancers occurred in the lung, upper respiratory tract, breast, esophagus, colon, rectum, stomach, and cervix. Smoking was a significant risk factor in the development of MPT of the lung combined with upper respiratory tract. CONCLUSIONS: Lung cancer is closely correlated to upper respiratory tract tumors among MPTs of the lung combined with other organs, and smoking is a potential risk factor. Compared with the patients who had lung cancer diagnosed first, the patients who had other cancers diagnosed first are younger at the first diagnosis, and have longer interval between first and second primary tumors, with better prognosis.

Adenocarcinoma↗
PubMedDate not supplied

[Value of the intraoperative neuromonitoring in surgery for thyroid cancer in identification and prognosis of function of the recurrent laryngeal nerves].

INTRODUCTION: The aim of this study was both, to evaluate the usefulness of the method of neuromonitoring in intraoperative identification of the RLN and to estimate its value in the prognosis of postoperative RLN function in patients operated for TC. MATERIAL AND METHODS: Among 109 patients undergoing surgery for TC between 12/2004 and 12/2005 the neuromonitoring method was used in 69 (63.3%) individuals (including 5 operations of completion total thyroidectomy). A Neurosign 100 equipment with laryngeal electrodes was employed in identification and assessment of total number of 134 RLN. Intraoperative results were compared to the postoperative results of the ENT-specialist examination of vocal cords mobility in indirect laryngoscopy, in each patient. RESULTS: Transient vs. permanent, unilateral RLN palsy was noted in 3 vs. 2 patients (2.2% vs. 1.4% of nerves at risk). The method of neuromonitoring facilitated identification of 123 (91.8%) RLN being not helpful in 11 (8.2%) cases. However, neuromonitoring was helpful in identification of the RLN, the value of the method in prognosis of posteoperative function of the RLN was limited. Results of indirect neurostimulation were more accurate than direct neurostimulation and were more accurate in prognosis of late rather than early RLN function after surgery (sensitivity 98.3%; specificity 100%; positive predictive value 100%; negative predictive value 50%, accuracy 98.4%). CONCLUSIONS: Application of intraoperative neuromonitoring facilitates identification of the RLN during surgery for TC. However, the method is of limited value in prognosis of postoperative RLN dysfunction in cases of missing signal after nerve stimulation.

False Negative Reactions↗
PubMed1990

[Value of high-dose chemotherapy followed by bone marrow autograft in non-seminomatous germinal tumor with poor prognosis. Results of the combination of cisplatinum, etoposide and cyclophosphamide (PEC protocol)].

In recent years, the prognosis of non-seminomatous germ-cell tumors has been greatly improved by the use of novel chemotherapeutic regimens including platinum derivatives. However, the prognosis remains poor for a certain proportion of these patients. We have therefore developed an intensive chemotherapy protocol (PEC) followed by bone marrow autografting: cisplatin (40 mg/m2/day x 5 d), etoposide (350 mg/m2/day x 5 d), cyclophosphamide (1,600 mg/m2/day x 4 d). Forty-four poor-prognosis patients were thus treated. The results can be stratified into 3 categories, as follows: I: 12 refractory patients: 3 CR, 6 PR, 2 failures, 1 unevaluable. Median survival was short (7 months, range 2-16 months); II: 6 patients with sensitive relapse: 5 CR, 1 unevaluable. Four patients remained in CR at 42, 45, 46 and 48 months; III: 26 patients who received PEC as consolidation therapy in the first CR-PR after courses of conventional chemotherapy and who were selected at the time of diagnosis on the basis of factors of poor prognosis: 16 CR, 3 PR, 7 unevaluable. Two-year disease-free survival (Kaplan-Meier) is 60%. The median duration of neutropenia (less than 0.5 x 10(9)/l) was 15 d (range 6-37) and that of thrombocytopenia (less than 20 x 10(9)/l), 13 d (range 3-32). The most significant non-hematologic toxicity was of the gastrointestinal tract; in particular severe mucositis. Four iatrogenic deaths occurred (2 candidiasis, 1 aspergillosis and 1 hemorrhage). Pharmacokinetic studies were used to determine the optimum time for reinfusing the marrow and provided information on the mechanism of the mucositis. In conclusion, PEC protocol showed a high efficacy with 94% response rate (68.5% CR) among the 35 evaluable pts. Patients refractory to conventional treatment did not appear to benefit from this intensive chemotherapy. However, it appears that it may be useful for patients with relapses sensitive to salvage therapy. Encouraging results were obtained with the PEC protocol administered as early consolidation for patients with identifiable risk factors at diagnosis. A multicenter, randomized trial is currently underway in France to compare this approach with standard conventional chemotherapy.

Adolescent↗
PubMed1990

[Prognosis for requirements for oral antidiabetic agents in Bohemia].

The authors elaborated the prognosis of requirements of oral antidiabetics (PAD) in the CSR, based on the estimate of the number of diabetics, using the method of demographic projection and the estimate of the number of diabetics treated by this therapy. The respective numbers of diabetics are circulated for five-year age-groups, separately for men and women. The need of PAD is derived from the mean daily dose per diabetic patient treated with PAD, separately for biguanides and derivatives of sulphonyl urea. The prognosis respects the basic factors which influence the need of PAD, i.e. the development of the diabetic population, incl. the evolution of its structure, and the development of the attitude to PAD therapy. The application of various assumptions on the future development leads various to variants of the prognosis. Comparison with the actual development is important for evaluation of applied therapeutic methods and for planning purposes. The results of the prognosis indicate that in 1995 the need of PAD in the CSR will vary between 140 and 190% of the consumption in 1980, however, as a result of an uneven development the annual increment could be as high as 19% or there could be a slight drop.

Administration, Oral↗