Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Recurrence score”

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 1,333 records · Page 74Linked to original sources
PubMedDate not supplied

Posterior capsulolabral reconstruction in posterior shoulder instability: deltoid saving.

To determine the efficacy of an open posterior capsulolabral reconstruction (PCLR) with a posterior deltoid-saving approach, 30 PCLRs in 29 patients with unidirectional posterior instability were reviewed retrospectively. The mean follow-up period was 30 months (range, 25-59 months). Posterior capsular redundancy was observed in all cases, but a posteroinferior labral tear was found in only 5. Posterior capsular thinning developed in 6 patients. According to the Rowe scale, 24 shoulders were rated as excellent, 1 as good, 2 as fair, and 3 as poor. The modified American Shoulder and Elbow Surgeons score at last follow-up was 91. During follow-up, recurrence of instability was observed in 4 cases, including 3 cases of voluntary instability. The overall recurrence rate was 13.3%, but the success rate was 92.6% when cases of voluntary instability were excluded. Whereas the midterm clinical results of PCLRs were satisfactory, the risk of recurrence was very high in patients with voluntary posterior instability, even though some subjective improvement could be obtained through a PCLR.

Adolescent↗
PubMed2005

Management of an advanced ovarian cancer at 15 weeks of gestation: case report and literature review.

BACKGROUND: To report a case of advanced ovarian carcinoma diagnosed during gestation, which was managed with conservative surgery and chemotherapy until delivery. CASE: The patient underwent bilateral salpingo-oophorectomy, omentectomy, and appendectomy at 15 weeks of gestation. Six courses of chemotherapy with cisplatin were administered. Cesarean section followed by total hysterectomy were performed at 36 weeks of gestation. The male infant was 3000 g, Apgar score 9/9. Twenty-four months after delivery, the patient experienced pelvic recurrence and underwent surgery and six cycles of carboplatin and paclitaxel. The patient is alive with no evidence of disease. After 42 months of follow-up, the baby boy showed no evidence of sequelae. CONCLUSION: Medical and surgical management of ovarian cancer during pregnancy can be an option, although the risks and benefits have to be discussed with caution.

Adult↗
PubMed2001

Amplification of EIF3S3 gene is associated with advanced stage in prostate cancer.

Gain of the long arm of chromosome 8 (8q) is one of the most common gains found in the advanced prostate cancer by comparative genomic hybridization. We have previously identified a putative target gene for the 8q gain, EIF3S3, that encodes a p40 subunit of eukaryotic translation initiation factor 3 (eIF3). Here, we studied the frequency of the EIF3S3 amplification in different stages of prostate cancer and co-amplification of EIF3S3 and oncogene MYC. In addition, prognostic utility of the EIF3S3 copy number alteration was evaluated. The analyses were done with fluorescence in situ hybridization and tissue microarray technology. High-level amplification of EIF3S3 was found in 11 of 125 (9%) of pT1/pT2 tumors, 12 of 44 (27%) of pT3/pT4 tumors, and 8 of 37 (22%) of lymph node metastases as well as in 26 of 78 (33%) and 15 of 30 (50%) of hormone refractory locally recurrent tumors and metastases, respectively. The amplification was associated with high Gleason score (P < 0.001). One of the 79 tumors with EIF3S3 amplification had only two copies of MYC, whereas all tumors with amplification of MYC had also amplification of EIF3S3 indicating common co-amplification of the genes. Gain of EIF3S3 was associated with poor cancer-specific survival in incidentally found prostate carcinomas (P = 0.023). In the analyses of prostatectomy-treated patients, the amplification was not statistically significantly associated with progression-free time. In conclusion, amplification of EIF3S3 gene is common in late-stage prostate cancer suggesting that it may be functionally involved in the progression of the disease.

Aged↗
PubMed1997

Angiogenesis in colorectal cancer.

Angiogenesis is a complicated multistep process involving the breakdown of the endothelial cell basement membrane, digestion of the extracellular matrix, proliferation and migration of endothelial cells toward the angiogenic stimulus, and formation of functioning capillaries. This neovascular network not only provides nutrients for an expanding tumor mass but also a means of dissemination to sites far removed from the primary tumor site. The entire process is mediated by cytokines or growth factors released either by the tumor cells themselves or by endogenous cells within the microenvironment surrounding the tumor. The literature has conclusively shown that those lesions with high angiogenesis scores or microvessel densities are associated with a higher risk of metastases, recurrence, and early patient death. This is especially so for colorectal cancer. Antiangiogenesis therapy holds promise for the future and, in the adjuvant setting, has many theoretical advantages over conventional cytotoxic chemotherapy.

Angiogenesis Inducing Agents↗
PubMed2002

Evolution of the presentation and pathologic and biochemical outcomes after radical prostatectomy for patients with clinically localized prostate cancer diagnosed during the PSA era.

OBJECTIVES: To demonstrate the evolution of the clinical presentation and pathologic and biochemical outcomes for patients with clinically localized prostate cancer treated with radical prostatectomy during the prostate-specific antigen (PSA) era. METHODS: One thousand fifty-nine consecutive men treated with radical prostatectomy from January 1989 to December 2000 comprised the study cohort. A chi-squared metric was used to compare the proportions of patients during three intervals (1989 to 1992, 1993 to 1996, and 1997 to 2000) by categories of PSA level, biopsy Gleason score, clinical T stage, percent positive biopsy cores, age, and risk group, as well as pathologic T stage, Gleason score, margin status, and lymph node status. Actual 2-year PSA recurrence-free survival rates are reported for patients with a minimal follow-up of 24 months, stratified by the interval and preoperative risk group. RESULTS: There was a significant shift in the preoperative characteristics toward younger patients (P <0.0001) with nonpalpable disease (P <0.0001), lower PSA levels (P <0.0001), fewer percent positive biopsies (P <0.0001), and lower preoperative risk group classification (P <0.0001). Pathologically, a significant downward stage migration was found toward organ-confined disease (P <0.0001) and improvement in surgical margin status (P <0.001). The actual 2-year PSA recurrence-free survival rates improved during the three intervals spanning the PSA era from 60% to 78% and 82% (P <0.0001). CONCLUSIONS: With the introduction of serum PSA as a screening tool, we have noted an evolution toward a lower pathologic stage, grade, and improved PSA outcome. These findings provide further support that serum PSA screening increases the proportion of patients potentially curable after radical prostatectomy.

Disease-Free Survival↗
PubMed2000

Ambulatory surgery for groin hernia: the Gilbert repair.

The aim of this study was to evaluate the results of the Gilbert repair for primary treatment of indirect inguinal hernias performed as day cases. From September 1996 to September 1998, 145 patients who were admitted for ambulatory surgery underwent Gilbert tension-free repair for treatment of unilateral inguinal hernia. Sex, age, the American Society of Anaesthesiologists (ASA) preoperative assessment score, type of anaesthesia, operating time, postoperative recovery, postoperative pain, morbidity, mortality, recurrence, return to work and the normal daily activities were assessed. The mean follow-up was 21 months (range 12-36). Gilbert's classification, type 2 and 3 hernias were the most common. Spinal anaesthesia was used in 73% of patients. Mortality was zero. Four patients developed postoperative haematomas, two urinary retention, three seromas, and two wound infections. During the follow-up period, only two recurrences of hernia were noted (1.4%). In conclusion, these data show that Gilbert repair is a safe operation, which is simple to learn. It can be performed on an outpatient basis, with a low complication rate, a low level of pain and a short recovery period. Although it seems to have a low risk of recurrence, a long-term follow-up is needed.

Journal Article↗
PubMed2006

Botulinum toxin A for the management of vulvodynia.

Clinically, botulinum toxin A blocks the cholinergic innervation of the target tissue. Recently, it has been proved effective not only at a neuromuscular junction but also within parasympathetic or sympathetic neural synapses. Seven women with pain on genitalia that could not be controlled with conventional pain managements were enrolled in this study. Twenty to 40 U of botulinum toxin A were used in each injection. Injection sites were the vestibule, levator ani muscle or the perineal body. Repeat injections were administered every 2 weeks if the patient's symptoms had not fully subsided. In all patients, pain had disappeared with botulinum toxin A injections. Five patients needed to be injected twice; the other two patients needed only one injection. We did not observe complications related to botulinum toxin A injections, such as pain, hemorrhage, infection, muscle paralysis or other complications. The subjective pain score improved from 8.3 to 1.4, and no one has experienced a recurrence (the follow-up period was four to 24 months, with a mean follow-up of 11.6 months). Botulinum toxin A is effective in blocking nociception. Even though further investigation and well-controlled study will be necessary, we suggest that the botulinum toxin therapy would be useful and safe in managing vulvodynia of muscular or neuroinflammatory origins.

Adult↗
PubMed2003

The swing procedure for pelvic ring reconstruction following tumour excision.

AIM: High grade periacetabular osteosarcomas extending to the sacro-iliac region present a difficult management problem. We describe our experience of the swing procedure as a method of limb salvage. METHOD: The procedure was performed on three patients with stage II B osteosarcoma. RESULTS: Functional outcome was poor in all three with a mean Musculoskeletal Tumor Society score of 29% (27-30) at last review. All three developed local recurrence and one developed pulmonary metastases. The mean disease free interval post-operatively was 4.7 months (4-6) and they died of their disease at a mean of 10 months (5-16). CONCLUSIONS: This form of limb salvage is technically demanding and carries a high morbidity. Functional outcome is poor and the prognosis for this group of patients is not improved by surgery. Alternative treatment options are discussed.

Adolescent↗
PubMed2000

Transcommissural valvuloplasty: technique and results.

PURPOSE: The purpose of this study was to describe the technique of a variation of closed external venous valve repair (transcommissural valvuloplasty), its complication rate, and duplex scan durability. METHODS: The "blind" transcommissural valve repair of the vein was performed by placing transluminal sutures along the valve attachment lines, which simultaneously closed the valve attachment angle and also tightened the valve cusps. A total of 179 successfully repaired valve sites of 141 limbs in 129 patients were followed up 1 to 42 months through clinical observation and with duplex Doppler ultrasound scan. RESULTS: Postoperative complications (< 30 days) occurred in 12 (9%) of 141 limbs: superficial (1) and deep (1) wound infection, large wound hematoma (4), seroma (1), and deep vein thrombosis (5), with associated pulmonary embolus in one patient. Seventy-eight percent (reflux time </= 0.5 seconds) and 81% (reflux time </= 1.0 seconds) of valve sites were competent. The cumulative competency rate at 30 months was 59% and 63%, respectively. The cumulative ulcer recurrence-free interval was 63% at 30 months (n = 92). The pain score and swelling grade substantially improved. CONCLUSION: Transcommissural valvuloplasty is a safe procedure with low morbidity. It is relatively rapid and simple to perform, and its competency rates are comparable to those of internal valvuloplasty. Advantages over the internal repair are that venotomy is not required, repair can be extended to small-caliber veins, and multiple valve stations can be repaired in a single stage.

Adult↗
PubMed1989

The dose response of caudal morphine in children.

The authors compared the duration of analgesia and the frequency of side effects of three doses of caudal epidural morphine in children aged 1.2-7.9 yr. Caudal catheters were inserted in 32 children, randomly assigned to receive 0.033 mg.kg-1, 0.067 mg.kg-1, or 0.10 mg.kg-1 of preservative-free morphine for analgesia after major surgical procedures below the diaphragm. The first dose of caudal morphine was mixed with 0.25 ml.kg-1 of 1% lidocaine to confirm correct caudal catheter placement. By assessment of periodic pain scores and the time intervals between administration of caudal morphine and the recurrence of pain, the authors found that the mean (+/- SD) duration of analgesia was significantly longer after 0.10 mg.kg-1 (13.3 +/- 4.7 h) than after either 0.033 mg.kg-1 or 0.067 mg.kg-1 (10.0 +/- 3.3 and 10.4 +/- 4.2 h, respectively) (P less than 0.02). The frequency of vomiting, pruritus, and urinary retention was similar in each group. Vomiting was less common in patients who had nasogastric drainage than in patients who were fed soon after surgery (P less than 0.05). Delayed respiratory depression occurred in one child after 0.10 mg.kg-1 of caudal morphine. Caudal morphine, 0.033-0.10 mg.kg-1, provided prolonged analgesia in children. The authors recommend 0.033 mg.kg-1 of caudal morphine as an initial dose for children.

Child↗
PubMed2000

Well-adjusted children: an alternate view of children with inflammatory bowel disease and functional gastrointestinal complaints.

Previous studies have suggested impaired psychosocial adjustment in children and adolescents with inflammatory bowel disease (IBD). We examined 62 subjects referred to a regional Pediatric Gastroenterology Clinic with IBD or functional gastrointestinal (FGI) complaints. Characteristics of the clinic include a unified team approach, regularly scheduled appointments at 3-month intervals, proactive medical care emphasizing maintenance of full functioning, and close medical-surgical interaction (joint clinics). A research assistant administered a questionnaire regarding children's perceptions of their illness, as well as the Child Depression Inventory (CDI), the Piers-Harris (PH) test of self-concept, and the Child Behaviour Checklist (CBCL). The 36 children with IBD (25 Crohn's disease, 11 ulcerative colitis, mean age 13.3 +/- 3.0 years) were compared with 26 patients with FGI complaints (16 recurrent abdominal pain, 10 functional megacolon, mean age 11.4 +/- 2.8 years). The scores on the standardized tests were not clinically significant for either group. In comparison, however, children with IBD were less depressed and had fewer behaviour problems than the FGI group. Surprisingly, only 19% (7 of 36) of children with IBD described their illness as a problem to them, compared with 65% (17 of 26) of children with FGI symptoms. The latter children also considered themselves significantly sicker than did those with IBD. We conclude that normal psychosocial adjustment is possible in pediatric patients with IBD. We speculate that this group benefitted from the professional supports that our clinic specifically provides to patients with IBD. The FGI group may have suffered from a lack of such professional supports, as well as from the absence of a specific diagnosis.

Abdominal Pain↗
PubMed2005

Update on magnetic resonance imaging, ProstaScint, and novel imaging in prostate cancer.

PURPOSE OF REVIEW: Despite marked stage migration, approximately a third of patients with clinically organ-confined prostate cancer will have extracapsular extension on pathological analysis. To improve outcomes further, alternative modalities of determining extraprostatic disease must be investigated beyond the current clinical parameters of digital rectal examination, prostate-specific antigen, and Gleason score. In addition, discerning the location of tumor in patients with biochemical recurrence directly affects treatment choice. This review highlights developments in prostate cancer imaging that may improve staging and treatment planning for prostate cancer patients. RECENT FINDINGS: Magnetic resonance imaging is most useful in the initial evaluation of men with prostate cancer. Its high specificity for the diagnosis of extracapsular extension is tempered by its low sensitivity. Positron emission tomography is used to assess regional and distant metastasis in many malignancies. Investigation into the most appropriate radiotracer for prostate cancer is paramount in any future applicability. The unique role of ProstaScint has been in evaluating patients with biochemical failure and in trying to discern metastasis before definitive therapy. The addition of spectroscopic imaging and nanoparticle infusion may lead to further improvements. Therefore, in differentiating local versus distant recurrence, appropriate interventions with radiotherapy or hormonal manipulation may be instituted. SUMMARY: Magnetic resonance imaging, ProstaScint, and to some extent positron emission tomography are all relevant imaging modalities for the evaluation of patients with prostate cancer. Current technological advances in each arena are improving the accuracy of diagnosis. Despite their specific limitations, use in the proper clinical setting may provide essential information to improve management decisions and disease outcomes.

Antibodies, Monoclonal↗
PubMed2004

Trauma recidivism in a large urban canadian population.

BACKGROUND: Prevention of trauma might be achieved by risk factor modification. Identification of such risk factors can be pursued by various means. Trauma recidivists may possess and highlight risk factors. Accordingly, trauma recidivists were analyzed as a method to elucidate trauma risk factors. METHODS: A retrospective analysis of 13,057 trauma patients in Toronto was conducted. Forty-two recidivists were identified, and their first admission was compared with a control group of 84 non-recidivists. RESULTS: The rate of trauma recidivism was 0.38% overall. Trauma recidivists were more likely to be from the inner city, male, homeless, suffering from chronic medical conditions. In addition, psychiatric conditions, an alcoholism history or any alcohol at the time of injury, intentionally injured, or engaged in criminal activity were also significantly more common in recidivists (p <0.05). CONCLUSION: Risk factors for major trauma can be identified by analyzing recidivists in a large urban Canadian population.

Accident Proneness↗
PubMed2005

Living donor liver transplantation for primary biliary cirrhosis: retrospective analysis of 50 patients in a single center.

Summary Although living donor liver transplantation (LDLT) is accepted as an alternative therapy for primary biliary cirrhosis (PBC), the postoperative results are not well known. Fifty patients with PBC underwent LDLT at Tokyo University Hospital. Their clinical records were retrospectively analyzed. Postoperative death occurred in four patients within 2 months (mortality, 8%), while later death occurred in three patients. In the median follow-up period of 35 months (range 4-84 months), the 1, 3, and 5-year overall survival rates were 90%, 88%, and 80%, respectively. The laboratory data indicated that graft function was sufficient. No recurrence of PBC was confirmed. Multivariate analysis indicated that an updated Mayo score of <10 was a significantly favorable factor for short hospitalization (hazard ratio, 9.52; 95% confidence interval, 1.14-79.5; P = 0.03). In conclusion, LDLT provides a satisfactory long-term survival with the PBC patients.

Adult↗
PubMed2006

Clinically significant prostate cancer found incidentally in radical cystoprostatectomy specimens.

OBJECTIVE: To review the incidence, histopathological features and clinical outcomes of patients with incidental prostate cancer found in radical cystoprostatectomy (RCP) specimens excised for bladder cancer, to determine if these cancers affected the follow-up strategy and if prostate-sparing cystectomy would be appropriate for these patients. PATIENTS AND METHODS: We retrospectively reviewed the charts of men who had a RCP for transitional cell carcinoma (TCC) of the bladder, at our institution between 1987 and 2003. Patients with a preoperative diagnosis or clinical suspicion of prostate cancer were excluded from further analysis. We identified those men with incidental prostate cancer in the RCP specimens. The patients' demographic, histopathological and clinical outcome data were collected. RESULTS: In all, 217 men had RCP for TCC between 1987 and 2003; 13 were excluded from the study due to a preoperative diagnosis or clinical suspicion of prostate cancer, and 58 (28%) were found to have incidental prostate cancer. The mean (range) follow-up was 47 (6-157) months. Of these prostate cancers, 20% were of Gleason score > or = 7 and two patients developed local and metastatic prostate cancer recurrences. CONCLUSION: Incidental prostate cancer is a relatively common finding in RCP specimens, with a significant proportion having the characteristics of clinically relevant prostate cancer. The follow-up for prostate cancer should be incorporated with that for TCC and adapted according to the grade and stage of the prostate cancer. Preserving the prostate in an attempt to decrease the morbidity after RCP carries a high risk of significant prostate cancer in the residual prostatic tissue, suggesting that prostate-sparing cystectomy should only be reserved for a highly selected group of patients.

Aged↗
PubMed2002

Endovascular management of unruptured intracranial aneurysms: does outcome justify treatment?

OBJECTIVE: The appropriate management of unruptured intracranial aneurysms depends on a complete understanding of their natural history and on the risks and efficacy of treatment options. There is little current data on the risks of endovascular therapy for these aneurysms. The aim of this study was to assess outcome of endovascular treatment of unruptured intracranial aneurysms. METHOD: A retrospective analysis was performed on all unruptured aneurysms treated by Guglielmi detachable (GD) coils at this institution from 1994 to 2000. RESULTS: Seventy three unruptured aneurysms were treated in 62 patients. There were 52 female and 10 male patients, with a median age of 55.7 years. Clinical background was: subarachnoid haemorrhage due to rupture of an additional aneurysm (40), headache (4), third nerve palsy (four), familial (four), and incidental (10). There were 14 technical failures with no clinical sequelae. Four procedural complications occurred (5.5%, 95% confidence interval (95% CI) 0.3% to 10.9%). One patient had temporary clinical sequelae (1.4%, 95% CI 0% to 2.7%); 79% of treated aneurysms had stable occlusions at follow up, 10.5% showed improved occlusion grade, 10.5% showed some recurrence, and three patients have required retreatment. Follow up modified Glasgow outcome scores were grade 1, 71%; grade 2, 18%; grade 3, 3%; grade 4, 3%. There were no deaths or haemorrhages during the follow up period. Two patients died as a result of complications from subarachnoid haemorrhage. CONCLUSION: The endovascular treatment of patients with unruptured aneurysms is safe with few clinical or procedural complications. Poor outcomes were only seen in those patients who presented with subarachnoid haemorrhage due to rupture of an aneurysm at another site.

Adult↗
PubMed1981

Influence of aerobiology and weather on symptoms in children with asthma.

Local and central European weather, pollen (Castanea and Poaceae) and spore (alternaria and cladosporium) counts, and asthmatic complaints and drug requirements (expressed as "attack score") were correlated in a group of 40 asthmatic children (21 with recurrent symptoms) during a summer holiday camp for 6 weeks. It was shown that there are significant correlations between the cumulative 24-hour pollen count over 6 weeks and the attack frequency. 2-Hourly counts or daily counts did not correlate with complaints. Consecutive 10-day averages of attacks and pollen and spore counts showed good agreement. The influence of local weather was negligible. Low pressure gradients or high atmospheric pressure was not beneficial. Improvements of lung function are ascribed to training effects.

Adolescent↗
PubMed2002

Incidence and short-term outcome of cerebral infarction in young adults in western Norway.

BACKGROUND AND PURPOSE: We sought to determine the incidence and short-term outcome of people aged 15 to 49 years with first-ever cerebral infarction in 1988-1997 in Hordaland County, Norway. METHODS: Cases were found from computer search of hospital registries and detailed review of patient records. Stroke subtype was classified according to the major intracranial artery affected. Short-term outcome was evaluated by the modified Rankin Scale (mRS). RESULTS: A total of 96 women and 136 men met the inclusion criteria. The average annual incidence was 11.4/100 000. Women outnumbered men among those aged <30 years (P=0.059); men predominated among those aged > or =30 years (P=0.004). A total of 148 patients had anterior circulation infarction (64%), and 84 had posterior circulation infarction (36%) (P<0.001). Patients with posterior circulation infarction had better mRS score at discharge (P=0.005). Eighty percent had favorable outcome (mRS score < or =2). The 30-day case fatality rate was 3.4%. The recurrence rate in hospital was 2.2%. CONCLUSIONS: The incidence was in the lower range compared with other reports from western Europe. Although men predominated, there was a strong trend toward more women among patients aged <30 years. Short-term outcome was generally good. Patients with posterior circulation infarction had significantly better short-term outcome.

Adolescent↗