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At least 1,225 records · Page 68Linked to original sources
PubMed1996

The prognosis of cystic fibrosis in the Western Cape region of South Africa.

OBJECTIVE: To study the prognosis of cystic fibrosis (CF) in South Africa. METHODOLOGY: Retrospective chart review of 102 children with CF over 20 years. RESULTS: Survival at 18 years was 54% (95% confidence intervals 30-79). Prognosis was not influenced by gender or genotype but survival was noted to be worse for Cape Coloured children than for European children. This appeared mainly to be due to the death of eight Cape Coloured Infants, four of whom presented with oedema and anaemia, mimicking kwashiorkor. Infection with Pseudomonas aeruginosa occurred earlier in Cape Coloured children than European children (median, 1 vs 4 years) and they had a worse 5-year survival (58 vs 89%, P < 0.05) after infection. Of the 40 children born in the second decade studied, six Coloured and no European children died. CONCLUSIONS: Ethnic differences in prognosis exist for children with CF in South Africa and are probably related to underrecognition of CF and the socio-economic status of some patients.

Adolescent↗
PubMed1978

On early and mid-adolescent schizophrenia.--Part II: prognosis, course and defect.

Twenty-three adolescent schizophrenics were studied in regard to the problems of the course of illness, prognosis and defect. Illustrations of cases (follow-up for three to 15 years) were presented. 1) The course was considered chiefly from the viewpoint of positive symptoms, namely paranoid-hallucinatory experiences. It was divided into the following four categories; remittent, persistent, scanty and fading types. At the same time, general characteristics of each type were discussed. 2) As to the changes in clinical forms, hebephrenia was gradually manifested in more than half of the cases. There were some cases in which the expansion of paranoid activities were observed. These two prominent tendencies might be explained in terms of personality disintegration and maturation. We were impressed, in this regard, that autistic tendencies and behavior disturbances were more manifest in the initial stages in patients who later turned more hebephrenic. 3) A mild defect was observed in fourteen cases, while a medium or severe defect was recognized in eight cases. Generally, the degree of defect seemed to be more manifest in female patients than in males. Moreover, the defect was generally more severe in early adolescent cases and in patients with insidious onsets as well as in those with a longer duration of illness than in mid-adolescent patients and those with acute onsets and a shorter duration of illness. 4) As the result of this investigation, it was substantiated that the prognosis in adolescent schizophrenia, especially in early adolescence, was unfavorable. 5) Finally, we were impressed by the fact that there were many patients who were treated mainly in ambulatory clinics or who stayed at home in spite of the above-mentioned unfavorable prognosis.

Adolescent↗
PubMed2006

Correlation of enhanced cell turnover with prognosis of gastrointestinal stromal tumors of the stomach: relevance of cellularity and p27kip1.

The aim of the present study was to determine whether expression of molecules associated with cell cycle regulation and apoptosis might reflect tumor grade and patients' prognosis of gastrointestinal stromal tumor (GIST). Forty-nine cases of gastric GIST were divided into three grades; low, intermediate, and high risk. Ki-67, cyclin A, cyclin D1, cyclin E, p16(Ink4), p21(Waf1), p27(Kip1), cyclin-dependent kinase (cdk)2, cdk4 and single-strand DNA (ssDNA) were immunohistochemically stained and assessed. Ki-67, ssDNA, cyclin A and cdk2 had higher labeling indices (LI) in high-risk than in low-risk cases. Cyclin E expression was greater in the intermediate- than in the low-risk grade. On Kaplan-Meier analysis, tumor size, necrosis, cellularity, Ki-67, ssDNA, and cyclin A LI were significantly correlated with disease-free survival. Necrosis, cellularity, and Ki-67 LI were significant as prognostic factors on univariate, and Ki-67 LI on multivariate Cox hazard tests. Within the high-risk grade, high cellularity and low p27(Kip1) subgroups had the worst prognosis. The histological grade is related to cell turnover, assessed in terms of Ki-67, ssDNA, cyclin A, cyclin E, and cdk2 levels. Ki-67, ssDNA, and cyclin A are useful for prediction of prognosis, with cellularity and p27(Kip1) expression as further prognostic factors in high-risk cases.

Aged↗
PubMed1995

Long-term prognosis and prognostic factors of Japanese children with mesangial proliferative glomerulonephritis without IgA deposition.

Mesangial proliferative glomerulonephritis without IgA deposition (non-IgA MesPGN) is commonly detected in biopsy specimens, but the clinicopathological correlation with the long-term prognosis still remains obscure. The aim of our study is to elucidate the long-term prognosis and the clinicopathological prognostic factors in patients with non-IgA MesPGN. We mailed questionnaires to 122 patients with primary glomerulonephritis who were biopsied between 1963 and 1975. Information was obtained from 109 of these 122 patients and 55 were histologically rediagnosed as having non-IgA MesPGN. The histological alterations of glomeruli and tubulointerstitium were classified into five grades. The mean period between the biopsy and the questionnaires was 20.5 years. Six of the 55 patients with non-IgA MesPGN developed end-stage renal failure and histopathological alterations of renal biopsies from these six patients were classified into grade IV or V. The presence of hypertension, heavy proteinuria of over 2+ or renal insufficiency at the biopsy was related to the severe histological changes, a grade of IV or V and to a poor prognosis. The renal survival rate of all the 55 patients was 88.3% at 20 years after the biopsy, while that of the 12 patients with severe histological changes was 48.6%. Although non-IgA MesPGN is considered to be a heterogeneous disease, we cannot ignore the incidence of this disease and thus consider it to be one of the important primary glomerulonephritides that occur in childhood.

Adolescent↗
PubMed1996

bl-2 [corrected] Expression on prostate cancer and its relationship to cell cycle and prognosis.

BACKGROUND: bcl-2 protein is an oncoprotein encoded by a protooncogene bcl-2 which is thought to be a key gene for the regulation of cell life and death. bcl-2 protein has been reported to be expressed in a subset of prostate cancers, and its biological role in this disease has not yet been elucidated. This present study focused on the cell cycle analysis of bcl-2 immunoreactivity in prostate tumor samples and correlated findings with the prognosis of the patients. METHODS: Archival tissues from 37 prostate cancers were submitted for immunohistochemistry and DNA analysis via flow cytometry. All tissues were obtained before the patients received any treatment. Immunohistochemistry was performed using streptavidin biotin procedures, and DNA flow cytometry was done by a combination of two methods. RESULTS: Fourteen of 37 prostate cancers (38%) exhibited bcl-2 immunoreactivity. bcl-2 positive prostate cancers significantly correlated with DNA aneuploidy and higher proliferation indices, but not with histological differentiation. Clinically, there was a poorer prognosis for patients with bcl-2 positive prostate cancer. CONCLUSIONS: Our data indicates that bcl-2 protein expression in prostate cancer is associated with cell proliferation and may serve as a predictive factor for the prognosis of prostate cancer.

Adenocarcinoma↗
PubMed1996

Serum prostate-specific antigen values for the prediction of clinical stage and prognosis in patients with prostate cancer: an analysis of 749 cases.

BACKGROUND: The clinical significance of pretreatment serum prostate-specific antigen (PSA) values was studied to determine the ability to predict clinical stage and prognosis using a relatively large number of patients with prostate cancer. METHODS: Serum PSA values at diagnosis were analyzed from 749 patients with newly-diagnosed prostate cancer and registered in the Tokai Urological Cancer Registry. Correlations between the PSA value, the clinical stage and prognosis of the patients were evaluated. RESULTS: Serum PSA values at each stage of diagnosis showed positivity (> or = 3.6 ng/mL) in 23% (stage A1) to 91.2% (stage D2) of patients, and it was possible to obtain statistical differences between the stages, even between A1 and A2. Based on a cumulative study of PSA distribution, stages greater than A2 could be diagnosed using a cut-off of 7.2 ng/mL, with a 99.2% positive predictive value (PPV), and a 16.2% negative predictive value (NPV). At a PSA level of 10.8 ng/mL, stages greater than B2 could be predicted with a PPV of 95.3% but an NPV of 40.3%. Pretreatment PSA values were a significant prognostic indicator in stage D2 patients using 100 to 150 ng/mL as the cut-off values. These differences were primarily found in the poorly differentiated group, which showed a statistical difference using cut-off PSA values from 75 to 150 ng/mL. CONCLUSIONS: Serum PSA levels from a large number of patients can be used to predict the stage and prognosis of prostate cancer patients.

Aged↗
PubMed2005

Cyclin D1, E2F1 expression levels are associated with characteristics and prognosis of esophageal squamous cell carcinoma.

SUMMARY. We performed a multi-institutional analysis of E2F1 and cyclin D1 expression in cases of esophageal squamous cell carcinoma (ESCC). Cyclin D1 and E2F1 are involved in the transition of cell cycle phases and associated with tumor progression. However, no previous studies have concurrently analyzed combined E2F1 and cyclin D1 expression. The purpose of this study was to clarify the relationship of E2F1 and cyclin D1 in ESCC. We studied 122 patients with primary ESCC who underwent surgical tumor resection. Immunohistochemical analyses were performed for E2F1 and cyclin D1. A statistical analysis of immunohistochemistry results, clinicopathological features, and prognosis was performed. E2F1/cyclin D1 (-/-) tumors were present in 31 patients (25.4%) and correlated with reduced tumor progression. In these patients, pT (P=0.0001), pN (P<0.0001), p-Stage (P=0.0019), and survival rates were better than in patients who were positive for either E2F1 or cyclin D1 (P=0.0232). The expression of E2F1 and cyclin D1 is an indicator of tumor progression and prognosis in patients with ESCC. Combined analysis of E2F1 and cyclin D1 expression helps to determine the characteristics and prognosis of ESCC.

Adult↗
PubMed2005

Elevated serum levels of C-reactive protein are indicative of a poor prognosis in patients with esophageal cancer.

SUMMARY: Despite improved results gained by the combination of neoadjuvant chemotherapy and radiotherapy with surgery, the prognosis for the esophageal carcinoma patient remains poor. There is a need for prognostic markers that can help improve patient selection. The aim of this study was to evaluate whether serum levels of C-reactive protein (CRP) have any influence on the patient prognosis in terms of prediction of chemoradiosensibility, and overall and disease-free survival. Blood samples were obtained at the time of diagnosis in 67 patients with biopsy-proven primary carcinoma of the esophagus. Although not significantly, the mean CRP level was higher than that of 20 patients with benign esophageal pathology who served as controls. No significant correlation could be found between CRP levels and baseline characteristics such as age, gender, histology, cancer localization, tumor depth, lymph node status or metastatic spread. However, patients with CRP levels higher than 6 mg/L were more frequently non-responders to chemoradiotherapy (P = 0.035), had a shorter overall survival (P = 0.061) and a shorter disease-free survival (P = 0.016). It is concluded from these results that pretreatment measurement of serum CRP levels in patients with esophageal cancer could to be used in routine practice as indicators of chemoradiosensibility and prognosis.

Aged↗
PubMed2005

Clinical features, risk factors, and prognosis in transient global amnesia: a follow-up study.

We previously observed a high frequency of psychopathological features in transient global amnesia (TGA). We aimed at assessing differences in risk factor profile and prognosis between TGA and transient ischemic attack (TIA) patients with a focus on aspects with possible psychopathological relevance. We studied 51 TGA patients (mean age +/- SD, 62.7 +/- 6.7 years; M/F = 24/27) and 51 control patients with TIA (mean age +/- SD, 63.8 +/- 6.7 years; M/F = 41/10) and followed them up for about 7 years. Compared with TIA controls, TGA patients more frequently had a history of psychiatric diseases (age and sex-corrected OR = 2.86, 95% CI: 1.01-8.05) and alcohol use (OR = 3.26, 95% CI: 1.10-9.66) and less frequently a history of cardiac (OR = 0.29, 95% CI: 0.11-0.76) or peripheral artery disease (OR = 0.11, 95% CI: 0.01-0.96). A family history of psychiatric diseases was reported more frequently by TGA than TIA patients (OR = 2.99, 95% CI: 1.04-8.59). On follow-up, in comparison with TIA patients, TGA patients had a significantly lower risk of combined stroke, myocardial infarct, and death (log-rank test, P = 0.0059). In the multivariate analysis, the dissimilar baseline risk factor profile explained most of the difference in prognosis between the two groups. In comparison with TIA patients, patients with TGA have more frequently a personal or family history of psychiatric diseases and a more favorable vascular risk factor profile and prognosis. These results have therapeutic implications and reinforce the hypothesis that TGA is a benign disorder.

Amnesia, Transient Global↗
PubMed1975

Locomotor prognosis in cerebral palsy.

A study of the prognosis for walking of 73 pre-school children who had cerebral palsy or delayed motor development is reported. The importance of prognostic signs, based upon the presence or absence of postural reflex activity, was confirmed. The prognosis was accurate in 94-5 per cent of the 73 children studied. The method of scoring a child's reflex responses and relating this to the prognosis seems to be a simple procedure, easy to understand and to apply. It is suggested that the assessment of treatment methods should include an analysis of the child's walking potential, based upon the methods delineated in this study, before treatment is started.

Age Factors↗
PubMed1976

Clinical aspects and long-term prognosis of intracranial tumours in infancy and childhood.

The long-term prognosis in 316 children (aged 0-14 years), in whom intracranial tumour was diagnosed during the years 1935 to 1959, has been evaluated. 196 patients survived for longer than four weeks after diagnosis or operation, and a total of 74 patients survived to follow-up after an observation period of 15 to 40 years. The prognosis for children with intracranial tumour is dependent on the age at which the diagnosis is made--the older the child the greater his chance of survival. However, in this study, the older-age group (10 to 14 years) also had the greatest number of recurrences after more than 10 years. A clinical history of more than six months is associated with a better prognosis. Long-term survival was independent of whether the tumour was supratentorial or infratentorial, but all patients with deep cerebral tumours and brain-stem tumours died within the observation period. Patients with intrapontine tumours had a very poor quality of life up to the time of death, whereas the majority of patients who survived for more than one year before recurrence were almost free from symptoms during the interval.

Adolescent↗
PubMed2006

Obesity as a risk factor for development and poor prognosis of breast cancer.

The evidence that obesity adversely affects women's health is overwhelming and indisputable. The risk of postmenopausal breast cancer increases with obesity; measured as weight gain, body mass index, waist-hip ratio or percent body fat. It is also established that obesity is associated with poor prognosis of breast cancer. This review examines in detail the possible mechanisms by which obesity causes poor prognosis of breast cancer such as estrogenic activity, advanced or more aggressive disease at diagnosis and high likelihood of both local and systemic treatment failure. After careful consideration of the available evidence, the author concludes that obesity contributes towards development and poor prognosis of breast cancer; therefore, weight management should be an integral part of any strategy to prevent and improve the outcome of breast cancer.

Antineoplastic Agents↗
PubMed2006

Do young hepatocellular carcinoma patients have worse prognosis? The paradox of age as a prognostic factor in the survival of hepatocellular carcinoma patients.

BACKGROUND/AIMS: Our previous study showed that male hepatocellular carcinoma (HCC) patients below 40 years of age had the worst survival in the initial several years, but had the best prognosis thereafter. Thus, it seems that age has a paradoxical influence on the prognosis. To further clarify the issue of age on HCC prognosis, we initiated this study. METHODS: A total of 11,312 HCC cases from seven medical centers from 1986 to 2002 were included. We analyzed the 1-year survival and survival after 1 year. RESULTS: Male gender, age younger than 40 years old and hepatitis B virus (HBV) were associated with worse 1-year survival. In contrast, male gender, age younger than 40 years old and HBV were associated with better survival after 1 year. Higher percentage of the young HCC patients had a tumor size larger than 3 cm. 83.7% of HCC patients below 40 years of age were male and 89.8% of them were HBV carriers. CONCLUSIONS: If we encountered a young HCC patient, the patient will probably be a male HBV carrier. He would probably have larger tumor and is more likely to expire within 1 year than the older HCC patients. However, if the young HCC patient can survive for more than 1 year, he would probably have better survival in the following years than the older patients.

Adult↗
PubMed1995

The prognosis and treatment of true local cutaneous recurrent malignant melanoma.

BACKGROUND: The prognosis and treatment of true local cutaneous recurrent malignant melanoma is presently unknown. We define this entity as melanoma bearing an in situ component that recurs contiguous with the scar of the primary excision. Although previously uncommon, the incidence of true local recurrent melanoma may rise due to the recent use of more narrow margins for excision of thin primary melanoma. OBJECTIVE: We hypothesized that there is a difference in prognosis between true local cutaneous recurrent melanoma versus local recurrence from satellite or in-transit metastases. Also, we defined guidelines for the surgical management of true local cutaneous recurrent melanoma. METHODS: We calculated the surgical margin necessary to reach a tumor-free plane using Mohs surgery in 50 patients with true local recurrent melanoma. Patient survival was determined by the Kaplan-Meier method. RESULTS: Seventy-six percent of the tumors were completely excised using a margin of less than 1 cm. However, a margin of up to 2 cm was required to successfully treat all 50 patients. Thicker tumors did require significantly larger margins. The Kaplan-Meier 5-year overall and melanoma survival rates were 89% and 98%, respectively. The 5-year disease-free survival rate was 66%. CONCLUSION: The prognosis of true local recurrent melanoma is related to tumor thickness. We recommend full-thickness excision of the entire old scar including a 2-cm margin or Mohs surgery if a narrower margin of resection is desired.

Adult↗
PubMed1999

Community-acquired pneumonia in the intensive care unit: epidemiological and prognosis data in older people.

OBJECTIVES: To compare epidemiological data, etiology, and prognosis of severe community-acquired pneumonia (CAP) in the intensive care unit (ICU) according to age (< or > or = 65 years) and to determine prognostic factors of CAP in older people. DESIGN: A retrospective (1987-1992) and prospective (1993-95) multicenter study. SETTING: Six ICUs in the north of France. PATIENTS: Five hundred five patients admitted to an ICU for severe CAP. MEASUREMENTS: Patient characteristics were compared with regard to age. Prognosis of CAP in older patients was studied by stepwise discriminant analysis. RESULTS: Two hundred seventy-eight patients (55%) were aged 65 years or older. Comparison of epidemiological data between older and younger patients revealed a higher prevalence of women (38% vs 29%), more severe underlying comorbidities (anticipated death within 5 years: 59% vs 26%), and more frequent chronic respiratory insufficiency (48% vs 33%) in the older patients. In this study group, 224 organisms were isolated from 172 patients (62%); those identified most frequently were Gram-negative bacilli (34%), S. pneumoniae (32%), and Staphylococcus sp. (19%). Compared with younger patients, no significant differences in bacteriological data were observed. However, crude and attributable mortality rates were significantly higher in the older patients (33% vs 21% and 30% vs 19%, respectively). Prognosis analysis identified four independent predictors of mortality in the older patients: initial septic shock (relative risk (RR) = 3), sepsis-related complications (RR = 4.3), hospital-acquired lower respiratory tract superinfections (RR = 2), and nonspecific pneumonia-related complications (RR = 2.8). CONCLUSION: The bacterial etiology provides some approaches to empirical therapy for older patients with severe community-acquired pneumonia. In addition, the inappropriateness of withholding intensive care for reasons of age alone is emphasized.

Age Factors↗
PubMed1999

Histopathological prognostic factors influencing long-term prognosis after surgical resection for hepatic metastases from colorectal cancer.

OBJECTIVE: We aimed to present new histopathological features of metastatic liver nodules as more reliable prognostic factors after surgical resection for colorectal metastatic cancer. METHODS: Clinicopathological features, including newly proposed histopathological ones, of 63 consecutive patients were reviewed retrospectively to determine which most strongly correlated with long-term prognosis after hepatectomy for metastatic tumors from colorectal cancers, using univariate and multivariate analysis. RESULTS: The 1-, 3-, and 5-year cancer-related survival rates after hepatectomy were 87.8%, 55.2%, and 47.3%, respectively. New histopathological features we proposed, which are expansive growth, marginal fibrosis, and peritumorous lymphocytic infiltration of hepatic tumor, were significant prognostic factors for cancer-related survival after hepatectomy in an univariate analysis. Also in a multivariate analysis, i.e., a stepwise Cox regression analysis, infiltrative, i.e., not expansive, growth of hepatic tumor was one of significant and independent poor prognostic factors for survival after hepatectomy, with moderate to severe lymphatic vessel involvement of the primary colorectal lesion, microscopic cancer invasion at the surgical margin of hepatectomy, and extrahepatic distant metastases. CONCLUSIONS: Our results suggest that our proposed new histopathological features of hepatic metastases were good predictors of prognosis after surgical resection for hepatic metastases from colorectal cancer. Especially, infiltrative growth of hepatic tumor is strongly correlated with a poor prognosis after hepatectomy.

Colorectal Neoplasms↗
PubMed2006

Oral glucose tolerance test predicts prognosis of patients with liver cirrhosis.

OBJECTIVE: The aim of this study was to evaluate whether oral glucose tolerance test (OGTT) was useful in evaluating the prognosis of patients with liver cirrhosis. METHODS: Fifty-six patients with liver cirrhosis were enrolled in a prospective cohort study. In all cases, glucose tolerance was diagnosed by a 75-g OGTT according to World Health Organization (WHO) criteria. The relationship of clinical variables to the cirrhosis-related prognosis was investigated using univariate and multivariate regression models. RESULTS: Diabetes mellitus (DM) was diagnosed in 21 subjects (38%), impaired glucose tolerance (IGT) in 13 subjects (23%), and normal glucose tolerance (NGT) in 22 subjects (39%) using OGTT. The cumulative survival rates of patients with liver cirrhosis and NGT were 94.7% at 5 yr; liver cirrhosis and IGT, 68.8% at 5 yr; liver cirrhosis and DM, 56.6% at 5 yr. The survival rates of patients with liver cirrhosis and DM significantly differed from those with NGT. Univariate analysis demonstrated that serum albumin, total bilirubin, prothrombin activity, Child-Pugh scores, and glucose intolerance were highly significant prognostic factors. Multiple regression analysis yielded albumin and DM as the most powerful independent negative predictors of survival. CONCLUSIONS: OGTT appears to be useful for evaluating the prognosis of cirrhotic patients.

Aged↗
PubMed1982

Prognosis of multiple sclerosis. Results from an epidemiological area in Germany.

Clinical data and the prognosis are presented for an epidemiological group of multiple sclerosis (MS) patients. Symptoms and signs of MS, with the exception of optic nerve involvement, were less frequent in the group of 221 patients from the epidemiological area of Southern Lower Saxony than in the hospital series (n = 1837), although the mean duration of the disease was somewhat longer in the epidemiological group. Fifty-two percent of the latter were unrestricted or minimally restricted upon examination compared to 26% of the hospital group. Taking a progression index as a measure for prognosis (disability grade divided by the duration of the disease) 36% of the epidemiological group belonged to a benign category compared to 16% in the hospital group. The progress of these patients was not more than 1 grade of disability within a 5-year-period (progression index 0.2 or less). A malignant course was defined as a progression of at least 7 grades during a 5-year period (progression index 1.4 or more). Ten percent of the hospital series belonged to this category compared to 2% of the epidemiological group. Thus data from a representative group of patients show that the overall prognosis of MS is considerably better than generally suspected.

Adult↗