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At least 1,477 records · Page 82Linked to original sources
PubMed2000

[Appendicitis in Niger: current prognosis].

Acute appendicitis remains one of the most frequent emergencies in abdominal surgery. Surgery is usually straightforward and prognosis excellent. However, outcome depends essentially on how soon diagnosis is made. In Niger, the 1990s were marked by the development of private medicine and the deterioration of services in state health structures (health centres and hospitals). The goal of this prospective study, carried out over 24 months (March 1997-March 1999) was to analyse existing appendicitis prognosis in our country. The study population was made up of 362 patients and we based our survey on a number of factors found in the medical literature, and in particular on a similar study conducted in the same hospital in 1989 by another group of surgeons. Delays in diagnosis and thus therapy still today tends to transform prognosis for simple acute appendicitis into that of peritonitis. The numerous and varied post-operative complications keep the mortality rate at 4%.

Acute Disease↗
PubMed1999

[Clinico-pathological characteristics and prognosis of thymoma: an analysis of 159 cases].

OBJECTIVE: To investigate the clinicopathologic features of thymoma and assess prognostic factors. METHODS: Data of 159 patients operated for thymoma were collected. A retrospective analysis was performed, through comparison of survival rate computed by the actuarial method and rate of recurrence and metastasis. RESULTS: (1) The 3-, 5-, and 10-year survival rate was 78.9%, 63.7% and 46.3%, respectively. All patients treated by subtotal thymoma resection with postoperative radiotherapy survived more than 3 years. (2) Patient's age, location and image density of tumor play important role in differential diagnosis. (3) Tumors with epithelial predominance were more frequently seen in late stage than those of other histologic types(P < 0.01). (4) The prognosis of patients whose tumors had incomplete or no capsule was poor as compared to that of stage I tumor (P < 0.05). (5) According to multivariate analysis, the most important prognostic variables included completeness of resection (OR = 2.10) and clinicopathologic stage (OR = 1.73). Myasthenic crisis was the most important factor influencing operative death. Sex, symptoms and histologic classification did not influence prognosis. (6) Recurrence and metastasis occurred in all stages, but more frequent in the later stages of the disease. CONCLUSION: Complete resection helps decrease recurrence of thymoma. Prognosis of patients receiving palliative resection of thymoma may be improved by postoperative radiotherapy.

Adolescent↗
PubMed2001

[Multivariate analysis of prognosis of patients with stage IE non-Hodgkin's lymphomas of the nasal cavity].

OBJECTIVE: To analyze the factors affecting prognosis of patients with primary non-Hodgkin's lymphomas (NHL) of the nasal cavity. METHODS: From Jan. 1968 to Dec. 1997, a total of 71 patients with stage IE(Ann Arbor staging system, 1971) primary non-Hodgkin's lymphomas of the nasal cavity were treated in the Tumor Hospital of Sun Yat-sen University of Medical Sciences. In 37 of the 71 patients, the lesions were limited in the nasal cavity (limited IE), and in 34, the lesions were locally extended involving the adjacent structures (extended IE) Forty-four patients were treated with radiotherapy and 27 with radiotherapy plus chemotherapy. Survival analysis was done by the Kaplan-Meier method, and multivariate analysis was carried out using Cox proportional hazard model. RESULTS: The 5- and 10-year survival rate was 71.9% and 59.7% respectively in patients who had complete response to radiotherapy. The 5- and 10-year survival rate was both 13.9% in patients who had residual tumors after treatment. The 5- and 10-year survival rate was 69.8% and 56.7% in patients with limited IE lesions, but 40.7% and 35.6% in those with extended IE lesions. The prognosis was better in younger (< 44 years) than in older patients. The 10-year survival rate of patients received radiotherapy alone and those combined with chemotherapy was 52.0% and 75.0% respectively for limited IE as compared to 37.6% and 45.0% for extended IE. B symptoms did not significantly affect clinical outcome. Multivariate analysis showed that the immediate response to radiotherapy, invasion of the primary tumor outside of nasal cavity and patients' age were independent prognostic factors. CONCLUSION: Radiotherapy is the main treatment method for stage IE non-Hodgkin's lymphoma of the nasal cavity. Addition of chemotherapy can improve long-term survival. The local tumor response to radiotherapy, clinical staging and age of patients have significant influence on patients' prognosis.

Adolescent↗
PubMed2000

[Lung cancer: new staging system and prognosis].

OBJECTIVE: To evaluate the rationality the revised international system for staging lung cancer and its relationship with prognosis. METHODS: Between January 1961 and December 1988, 946 patients were subjected to removal of lung cancer and the data were analyzed using life-table, Log-rank test, and Cox regression model. Twenty-nine prognostic factors influencing the survival rate were evaluated with SAS6.12 software. The survival rate was calculated according to the two different staging systems. The revised system for staging lung cancer was evaluated. RESULTS: The factors influencing prognosis after surgical treatment of lung cancer were as follows: P-TNM staging, metastatic lymph nodes, radical or palliative resection, tumor size, and different cell types. The 5-year survival rate of patients with stage IA, IB, IIA, IIB, IIIA, IIIB was 68.4%, 59.5%, 44.8%, 36.5%, 26.3%, and staging 24.8%, respectively (IIIA and IIIB P > 0.05; other stages P < 0.05). CONCLUSIONS: The revised system for lung cancer is more rational and objective to estimate prognosis and direct treatment. But it should be revised further.

Adult↗
PubMed2000

[The relationship of expression of CD44v6 with metastasis and prognosis in breast cancer].

OBJECTIVE: To study the relationship of expression of CD44v6 with metastasis and prognosis in breast cancer. METHODS: The expression of CD44v6 protein in 78 paraffin and 37 fresh specimens of breast carcinomas was detected with immunohistochemistry (IHC). The expression of CD44v6 mRNA in 37 fresh specimens of breast carcinoma was detected with RT-PCR. The correlation of tumor size, TNM stage, status of axillary lymph node, tissue grade, prognosis and CD44v6 expression in breast cancer was analyzed to compare the sensitivity of the two methods. RESULTS: The expression of CD44v6 in breast cancer was correlated to metastasis of the axillary lymph node, tumor size and TNM stage. It was an important factor affecting survival of patients with breast cancer. Positive expressive rates of CD44v6 protein and mRNA were 70.3% and 59.5% respectively in 37 specimens of fresh carcinoma tissues (P > 0.05). CONCLUSIONS: The expression of CD44v6 is closely related to metastasis and prognosis in breast cancer, and the sensitivity to detect CD44v6 expression shows no significant difference between IHC and RT-PCR.

Adult↗
PubMed2000

[Expression of nm23 protein and estrogen receptor and prognosis of colorectal cancers].

OBJECTIVE: To explore the relationship between clinicobiological action and expression of nm23 protein and estrogen receptor (ER) for colorectal cancer. METHODS: The expression of nm23 protein and ER for 209 cases of colorectal cancer was detected by immunohistochemistry assay (LSAB). RESULTS: The expression of nm23 protein was correlated with that of ER for colorectal cancer (r = 0.5319, P < 0.01). The expression of nm23 protein and ER in colorectal cancers was not related with patient's age, sex, tumor position, pathological type, histological type, and Dukes stage (r < 0.4, P > 0.05). The expression was related with the prognosis of colorectal cancer (P < 0.01). The higher the expression of nm23 protein and/or ER the better the prognosis, whereas the less the expression of nm23 protein and/or ER the worse the prognosis. CONCLUSIONS: The abnormal expression of nm23 protein is correlated with the disturbance of estrogen metabolism in colorectal cancer. The detection of nm23 protein and ER is helpful for the diagnosis and prognostic evaluation of colorectal cancer.

Adult↗
PubMed2001

[Relationship between serum CA125 level and prognosis in the patients with uterine endometrial carcinoma].

OBJECTIVE: To study the relationship between serum CA125 level and prognosis of uterine endometrial carcinoma. METHODS: The serum CA125 levels in 71 patients with uterine endometrial carcinoma were measured by using microparticle enzyme immunoassay. The relationship between preoperative CA125 levels and surgical pathologic staging, histologic classification, and other prognostic factors was investigated. RESULTS: (1) The positive rate of serum CA125 in postmenopausal patients was significantly higher than in premenopausal patients. (2) The positive rate of serum CA125 was related to surgical pathologic staging. (3) Serum CA125 level was correlated not only with histological classification but also with other prognosis factors. (4) Increase of serum CA125 after operation predicted the possibility of relapse. CONCLUSION: CA125 is a useful marker in predicting the prognosis of uterine endometrial carcinoma.

Adolescent↗
PubMed2002

[Malignant pleural mesothelioma. From diagnosis to prognosis].

EPIDEMIOLOGY: The incidence of malignant pleural mesothelioma has constantly increased over the past forty years. The recent measures of ban on the use of asbestos and the long latency of this tumor after exposure means that its peak incidence can be foreseen for the years 2010-2020. DIAGNOSIS: Various health professionals are involved in the care of this tumor, which benefits equally from progresses in clinical and fundamental research. Some progress has been made in understanding its oncogenesis as well as its histopathologic analysis. PROGNOSIS: Malignant pleural mesothelioma symptoms are rapidly invalidating and the patient's prognosis is bad at short-term. However, hope may come from the detection of early stages of the disease and from the individualization of good prognosis factors, permitting the selection of patients for whom some curative therapies are in course of evaluation.

Diagnosis, Differential↗
PubMed2002

[Anal canal squamous-cell carcinomas in HIV positive patients: clinical features, treatments and prognosis].

UNLABELLED: The prevalence of squamous-cell carcinoma of the anus seems to be increasing in HIV positive patients. Clinical features and prognosis in this population have not been well evaluated. AIMS: To assess the prognosis of anal squamous-cell carcinoma in HIV positive patients as well as clinical features and treatment procedures. METHODS: A series of 20 HIV positive patients presenting with invasive anal squamous-cell carcinoma was retrospectively analyzed. Data have been compared to those obtained from 24 randomly selected HIV negative patients who were followed during the same periods in the same centers for anal carcinoma with similar histopathological features. RESULTS: The follow-up ranged from 10 to 172 months. No difference was observed between the two groups concerning the clinical features leading to anal cancer diagnosis, although HIV positive patients were younger. Anal cancer was more frequently associated with lymph node metastasis in HIV positive (60%) than in HIV negative (17%) patients, although its size was similar in both groups. Radiotherapy was similarly performed in both groups, while chemotherapy was administered less frequently in HIV positive than in HIV negative patients (54% vs 25%). Immediate side effects and mortality at 1 year follow-up were similar in both groups, whereas the objective initial response to therapy (50% versus 88%), the remission rate with anal conservation at 1 year follow-up (45% versus 88%), and the mortality at 3 years were better in HIV negative patients. CONCLUSION: The prognosis of anal squamous-cell carcinoma is poor in HIV positive patients. This correlates with a more advanced tumor stage and an alteration of systemic immunity status at the time of diagnosis and less response rate to treatment. Detection of precancerous lesions and treatment procedures should be evaluated in HIV infected patients.

Adult↗
PubMed2002

Determination of prognosis in patients with prostate cancer treated with radical prostatectomy: prognostic value of CD44v6 score.

PURPOSE: A third of the patients treated with radical prostatectomy experience progression even when tumors are confined pathologically to the prostate. CD44 may be a promising prognostic marker for determining malignant potential. However, there has not been a standard scoring system because of its heterogeneous staining pattern. Thus, we developed an objective scoring system to evaluate reliably CD44v6 (Bender Medsystems, Vienna, Austria) as a prognostic marker for prostate cancer. MATERIALS AND METHODS: A total of 22 patients with metastatic stage pT3bN0M0 or any pTN1M0 disease and 18 with nonmetastatic disease less than stage pT3bN0M0 were selected from a well examined group of 114 who underwent radical retropubic prostatectomy. Mean followup was 33 months (range 4 to 78). A combined CD44v6 score was determined by adding the scores of the primary and secondary areas. CD44v6 expression in terms of the CD44v6 score in primary and metastatic tissues was examined. The relationships of CD44v6 expression with pathological stage, progression and PSA-free survival were also evaluated. The prognostic value of the CD44v6 score for progression was analyzed by multivariate analysis. RESULTS: Progression in the metastatic group was significantly higher than in the nonmetastatic group (p <0.0001). CD44v6 expression of the primary tumors differed significantly in the 2 groups (p = 0.014). The CD44v6 score in primary tumor tissues inversely correlated with pathological stage (p = 0.004) and progression (p = 0.035), and positively correlated with PSA-free survival (p = 0.041). Furthermore, patients in the nonmetastatic group with a CD44v6 score of greater than 75 (cutoff value) had a significantly better prognosis (log rank test p = 0.0022), while those with a CD44v6 score of less than 75 had a prognosis similar to those in the metastatic group. On multivariate analysis pathological stage and surgical margin positivity were independent factors for progression but the CD44v6 score was not. CONCLUSIONS: According to our results the suggested CD44v6 score system is useful. A CD44v6 score of less than 75 may be a predictor of poor prognosis in the nonmetastatic group and this property may have potential application for planning adjuvant therapy.

Aged↗
PubMed2002

[Impact of micrometastasis in pathologically negative lymph node on staging and prognosis of non-small cell lung cancers].

OBJECTIVE: To study the influence of micrometastasis in lymph node on staging and prognosis of non-small-cell lung cancer (NSCLC). METHODS: In 39 NSCLC patients, micrometastasis in pathologically negative lymph nodes were tested through immunohistochemical cytokeratin (CK) analysis and the relationship between CK(+) and staging, survival were analyzed. RESULTS: In these 39 patients, the survival of CK(+) and CK(-) patients were 32 months and 48 months respectively (P = 0.0178). Multivariate analysis of Cox regression model showed: clinical stage (P = 0.0288) and relapse or metastasis (P = 0.0053) affected the prognosis while micrometastasis in lymphnodes (P = 0.7740) did not. CONCLUSION: The detection of micrometastasis in the lymphnodes may serve as a supplement to the present staging system for lung cancer. Even though the prognosis of patients with micrometastasis being poorer than those without, micrometastasis in the lymph nodes should not be regarded as an independent prognostic factor.

Adult↗
PubMed2002

Disclosure of cancer diagnosis and prognosis by physicians in Kuwait.

To analyse preferences for disclosure of cancer diagnosis and prognosis among physicians practising in Kuwait, a cross-sectional survey was conducted in public hospitals in both urban and suburban parts of the country, which included physicians likely to encounter adult cancer patients in their practice. A total of 217 physicians participated, 67% indicating they preferred full and complete disclosure of cancer diagnosis to patients. However, 79% of those would withhold the truth if the patient s family requested them to do so. Preference for concealment was more common among physicians who had experienced cancer directly with a friend or a family member, or who were in medical as opposed to surgical specialties. The belief that patients in Kuwait did not want to hear the truth about cancer diagnosis or prognosis was also significantly associated with concealment preference. Changes in public norms and expectations should be monitored, because they seem to play a major role in physicians preference for disclosure of cancer diagnosis and prognosis.

Adult↗
PubMed2000

[Relationship between the expression of bcl-2 apoptosis and acute myelogenous leukemia prognosis].

In order to check the anti-apoptosis gene bcl-2 protein expression in 58 AML patients we used the immunohistochemical method, and analyse the relationship between bcl-2 protein and prognosis of AML. The result showed that the high expression of bcl-2 protein was related to poor clinical prognosis of AML. This shows that the expression of bcl-2 gene can serve as an index for the prognosis of AML.

Adolescent↗
PubMed2000

[Analysis of prognosis of severe hepatitis].

OBJECTIVE: To study the effect of prognosis of severe hepatitis. METHODS: The prognosis factors of 286 patients with severe hepatitis were studied with monofactor analysis(chi 2 test, t test) and polyfactors analysis(logistic regressive analysis). RESULTS: The factors affected the prognosis of the patients were age, therapeutics, biochemistry data and complications. CONCLUSION: To decrease the mortality of the patients with severe hepatitis, we should adopt rational therapeutics and prevent complications in clinical practice.

Adult↗
PubMed1975

[Relationship between patient delay and prognosis in gastric cancer in an unselected population (author's transl)].

Whereas the morphology of malignant neoplastia is well known, exact information on the natural history of cancer is lacking. Some hints in this direction can be gained from detailed observations of the course of disease and from correlations between duration of history and prognosis. In the literature, views on the dependence of prognosis on duration of delay are conflicting. This was the reason why we examined this relationship in gastric cancer in the region of Erfurt, GDR, based on the unselected data of the cancer registry. 1838 cases of gastric cancer in male in 1960--1969 could be evaluated concerning prognosis and patient delay. In 2575 cases, relationship between duration of delay and clinical stage as well as mode of treatment could be investigated. From the statistical evaluation it was concluded that a long history is a sign of a less aggressive tumour growth. A short delay seems to be an index of adverse host-tumour relations. Better treatment results can be expected by shortening of patient delay. Possibilities to change the situation are discussed. A more centralized organisation of surgical care is proposed.

Germany, East↗
PubMed2002

Long-term prognosis of patients with type a aortic intramural hematoma.

BACKGROUND: Recent studies have shown an favorable short-term prognosis of patients with type A acute aortic intramural hematoma (IMH). The difference of aortic pathology may have a different impact on clinical course compared with classic aortic dissection (AD). The purpose of this study was to elucidate clinical features and long-term prognosis of patients with type A IMH. METHODS AND RESULTS: Clinical data were compared retrospectively between 30 patients with acute type A IMH (IMH group) and 101 patients with acute type A AD (AD group) who were admitted to our institutions from 1988 to 1998. In AD group, 72 patients underwent surgical repair and 29 patients were treated medically. All patients in IMH group were treated initially with supportive medical therapy. Thirteen patients who demonstrated progression to AD or increase in size of hematoma underwent timed surgical repair except for 1 patient. The overall in-hospital mortality rate in IMH group was significantly lower than that in AD group (7% and 34%, P=0.004). Follow-up periods were 56+/-37 (IMH group) and 60+/-42 months (AD group), which revealed 1 and 6 late deaths, respectively. The actuarial survival rates in IMH group were all 90% at 1, 2, and 5 years, which were significantly higher than those in AD group (67%, 66%, and 62%, respectively; P=0.004). CONCLUSIONS: Patients with type A IMH have better long-term prognosis than patients with AD.

Aged↗
PubMed2002

[Diagnosis, treatment, and prognosis of lung cancer in the Manche (France) (1997-1999) according to patients socioeconomic characteristics].

BACKGROUND: In France, data on social environment influence on cancer management and prognosis are rare and no study has been conducted on lung cancer. This study was designed to investigate the associations between place of residence and occupation class, and diagnosis, treatment and prognosis of lung cancer. METHODS: The study population consisted of the 585 cases of lung cancer collected by the cancer registry of the Manche department (France) over a three-year period (1997-1999). Distribution of qualitative variables was tested using chi(2) test. Multivariate analysis were conducted using logistic regressions. Differences in actuarial survival were tested using log-rank test. RESULTS: Difference in diagnostic conditions did not demonstrate any prominence by social characteristics. People living in rural areas did however have a higher probability of therapeutic abstention than people living in urban areas (adjusted odds ratio=2.20 [1.18-4.10]). Similarly, people without any occupational activity had a probability of therapeutic abstention higher than people with an occupational activity (adjusted odds ratio=3.40 [1.99-5.80]). Moreover, occupational class and place of residence had a significant influence on the place of diagnosis and treatment, lower class and rural people being less often managed in university hospitals. Regarding prognosis, our results do not give prominence to difference in survival according to social characteristics. CONCLUSION: This study suggests that the type of center providing patient care and the nature of treatment given could be associated with the socioeconomic status of the patient. Nevertheless, due to the small sample size, further studies in a larger series would be required to make any formal conclusion.

Adult↗
PubMed2002

[The effect of a treatment protocol on the prognosis of equine laminitis].

All horses and ponies with laminitis treated at the Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, between 1995 and 1998 were analysed retrospectively (n = 152). Based on the results of this study and on the world-wide knowledge on laminitis a standardised treatment protocol was adopted in 1999. Fifty-eight patients have been treated for laminitis between 1999 and 2001 following the treatment protocol. Compared to our hospital-population (orthopaedic patients), mares and ponies are at higher risk developing laminitis, but the prognosis does not differ between sexes as between breeds. Radiological evidence of rotation of the third phalanx seems to be of minor importance for the prognosis. Distal displacement of the third phalanx, however, seems to worsen the prognosis. The outcome of the acute cases is significantly better in the group treated following the protocol, than in the group without protocol. The outcome of the chronic cases is not influenced by the treatment protocol. Although the cases in both groups differ, as they are all clinical cases, our data suggest that the standardised treatment protocol results in a better outcome for cases of acute laminitis.

Acute Disease↗