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At least 1,675 records · Page 93Linked to original sources
PubMed1986

[What effect does impaired left ventricular function have on prognosis following prosthetic aortic valve replacement?].

Data of 286 patients with advanced chronic aortic valve disease (NYHA class III or IV) who underwent aortic valve replacement between 1975 and 1982 were retrospectively analyzed using a multivariate Cox regression analysis. Preoperatively, left ventricular volumes and ejection fraction were determined angiographically in all patients. In patients with aortic stenosis and impaired left ventricular ejection fraction survival rate up to 7 years was identical as compared to those with aortic stenosis and normal ejection fraction. Survival rate in patients with aortic stenosis who were operated within 76 days after heart catheterization was better than in those who were operated after a longer time interval (p less than 0.05). In patients with aortic insufficiency and impaired left ventricular ejection fraction, prognosis was poorer after operation than in patients with aortic insufficiency and normal ejection fraction (p = 0.05). Thus, patients with advanced aortic stenosis should be operated as soon as the diagnosis is established. Impaired left ventricular ejection fraction is not a risk factor for prognosis after valve replacement for aortic stenosis. In contrast, in patients with aortic insufficiency left ventricular dysfunction is a risk factor for prognosis after operation.

Adult↗
PubMed1986

[A study of malignancy in gastro-intestinal carcinoids with special reference to the association of the prognosis and peptide hormone or oncofetal protein producing pattern].

It is difficult to differentiate malignant carcinoid tumors from benign ones early in the course of the illness. We investigated retrospectively a series of thirty-nine gastro-intestinal carcinoids not only for primary tumor anatomic site, macroscopic type, tumor size, histological depth, vessel invasion and mitosis, but also for peptide, ectopic hormone and oncofetal proteins by immunohistochemistry. Carcinoids primary in the appendix or rectum rarely metastasize, but those primary in the stomach or colon grow rapidly. Those greater than 2 cm in diameter and Borrmann's type had a poor prognosis. Carcinoids with deep penetration, vessel invasion or mitosis easily metastasize to lymph nodes or to the liver. Peptide hormone producing carcinoids were present in 21 of 39 (54%) tumors, but there were no correlation between the prognosis and peptide hormone producing patterns. Carcinoids producing carcinoembryonic antigen (CEA) were demonstrated in 11 of 37 (29%) tumors. These tumors were greater in size, more deeply penetrating and had more remarkable vessel invasion and mitosis than CEA non-producing ones. These results show that CEA producing carcinoids grow rapidly and easily metastasize. We concluded that these findings in carcinoid tissue appeared to be a reliable markers for metastasis and poor prognosis.

Carcinoembryonic Antigen↗
PubMed1986

[Determinants of long-term prognosis following prosthetic mitral valve replacement].

UNLABELLED: Data of 235 patients with chronic mitral valve disease (NYHA class III or IV) were analyzed retrospectively. Mitral valve replacement was performed in all patients between 1974 and 1983, 46 patients underwent additional tricuspid valve repair during the same operation. Preoperatively, right and left heart catheterization as well as coronary angiography were carried out in all patients. Operative mortality was 8%. For all patients 5 year survival rate was 76% and 10 year survival rate was 72%. Patients with pure mitral insufficiency had a poorer long-term prognosis than patients with mitral stenosis or patients with mixed mitral valve disease (5 year survival rate 54 versus 79%, p less than 0.0014). Patients with previous closed mitral commissurotomy had a poorer long-term prognosis than patients without previous surgery (5 year survival rate 62 versus 81%, p less than 0.0019). Age, NYHA class, associated tricuspid valve repair, pulmonary vascular resistance and mean right atrial pressure had no effect on survival. CONCLUSION: Long-term survival is generally good after mitral valve replacement, but pure mitral insufficiency and previous closed mitral commissurotomy are risk factors for long-term prognosis.

Cardiac Catheterization↗
PubMed1986

A multifactorial approach for the prognosis of patients with carcinoma of the stomach after curative resection.

This study was done to define the prognostic role of some clinical and pathologic variables in patients with carcinoma of the stomach who underwent a curative subtotal gastrectomy for cancer located at the lower two-thirds of the stomach. An univariate and multivariate analysis, according to Cox's regression model, was retrospectively performed upon 361 patients operated upon at the Istituto Nazionale Tumori of Milan from 1965 to 1979 by a curative subtotal gastrectomy. Data were stored by an IBM 4331 computer. Several factors were taken into consideration: age, sex, site and size of tumor, gross appearance, histologic type, invasion of the gastric wall, nodal status and symptoms. Of six variables selected by the univariate analysis, only four (sex, age, lymph node status and degree of invasion in the gastric wall) were validated by the multivariate evaluation, whereas tumor size and symptoms lost their prognostic relevance. The most important variables were nodal status and the degree of invasion in the gastric wall. The influence of age had a different impact on survival time, depending upon nodal status. In fact, patients with positive nodes who were less than 60 years old had the worst prognosis; the same age group with negative nodes had the best prognosis. Multifactorial analysis, according to the automatic interaction detection procedure, showed that prognosis worsened progressively beginning with female patients with negative nodes at pT1 or pT2 (91.6 per cent five year survival rate), male patients with negative nodes at pT1 or pT2 (76.3 per cent five year survival rate), female patients with negative nodes at pT3 or pT4 (62.4 per cent), male patients with negative nodes at pT3 or pT4 (40.0 per cent), patients more than 60 years old with negative nodes (36.8 per cent) and patients less than 60 years old with positive nodes (20.8 per cent). In our opinion, these parameters should be taken into consideration when stratification of patients as candidates to undergo adjuvant treatment after surgical treatment is planned.

Adult↗
PubMed1985

Prognosis in glomerulonephritis. A follow-up study of 395 consecutive, biopsy-verified cases. I. Classification, renal histology and outcome. Report from a Copenhagen study group of renal diseases.

Between 1967 and 1977, 395 consecutive cases of glomerulonephritis (GN) were collected by a Copenhagen study group. The diagnosis was established by histological and biochemical criteria. Light microscopy investigations of thin silver-stained sections were applied. In a follow-up in 1980 all cases were categorized by one of the following end points: death without uremia, uremia, recovery, or censored cases. The course is presented in figures showing the cumulated distribution of outcomes in relation to observation time. Each histological subgroup of GN had its own characteristic course with respect to initial rates of changes in the renal state, as well as to frequency of recovery, uremia and death. The prognosis was good in minimal changes GN and proliferative GN, bad in unclassified GN and worst in extracapillary GN. When part of a connective tissue disease, GN carried a poor prognosis. We conclude that histological classification of GN based on light microscopy offers a reliable means of predicting the long-term prognosis.

Adolescent↗
PubMed1979

[Prognosis and therapy of peripheral facial nerve paralysis. Electrodiagnostic ways of evaluation].

The function of the facial nerve can be examined by four electrodiagnostic methods. In the nerve excitability test and electroneurography with determination of the distal latency the facial nerve is stimulated over the stylomastoid foramen. Chronaximetry and electromyography are performed in the muscles. Whereas chronaximetry renders an impression of the severity of neural lesion, electromyography can also determine the onset of reinnervation activity. Early prognosis within 6 days of onset can be determined only by nerve excitability test and electroneurography, preferred by us, which assesses the muscle potential. If the potential amplitude decreases more than 35% within two days and the muscle potential disappears between the fourth and sixth day, total degeneration of the nerve with poor prognosis is indicated. Such data can be gathered by at least two electrodiagnostic investigations preferably on the third day after onset and one to three days later. The cosmetic disfigurement through peripheral facial nerve palsy poses immediately the question of prognosis and of the therapeutic possibilities. Usually, this question can be answered by clinical examination alone. As soon as paralysis of facial muscles exists, prognostical statements can be made by electrodiagnostical methods alone. Because of the possiblility of operative treatment it is necessary to assess the infavorable courses early.

Action Potentials↗
PubMed1979

Time trends in prognosis of patients with myocardial infarction: a population-based study.

A population-based study was conducted in metropolitan Baltimore, in which the prognosis of 504 patients hospitalized with acute myocardial infarction (MI) from July 1966 through June 1967 was compared with that of 803 patients hospitalized from January through December 1971. For patients admitted to coronary care units (CCUs), the in-hospital case-fatality rate (CFR) in 1971 (20%) was found to be significantly lower than that in 1966/67 (27.5%) (p less than .025), after simultaneous adjustment for 16 variables which may affect prognosis. No such significant difference was detected for patients not admitted to CCUs when the two time periods were compared. As a result of these time trends, CFRs were not significantly different between CCU and non-CCU patients in 1966/67, but in 1971 a significant advantage was shown for CCU patients (p less than .005). These results suggest that effectiveness of CCUs in prevention of in-hospital deaths increased between 1966/67 and 1971. For hospital survivors, regardless of admission to a CCU, no significant differences in long-term prognosis were found between patients discharged in 1971 and those discharged in 1966/67. This finding may reflect the lack of major therapeutic advances between the two study periods, aimed at reducing the progression of coronary atherosclerosis and/or the extent of the infarcted area.

Acute Disease↗
PubMed1979

Different chemotherapeutic sensitivities and host factors affecting prognosis in advanced ovarian carcinoma versus minimal residual disease.

Treatment of patients with advanced ovarian carcinoma (stages IIIB and IV) using either cyclophosphamide alone (1 g/m2) or cyclophosphamide (500 mg/m2) plus adriamycin (40 mg/m2) by iv injection every 3 weeks each produced partial regression in approximately one third of the patients. Survival curves and time-to-progression curves for the two regimens were nearly identical in these patients with advanced disease. These same regimens produced different results when used monthly in patients who had minimal residual disease (stages II and IIIA). In patients with minimal residual disease the therapeutic index of the combination regimen was superior to that of cyclophosphamide alone. Prognosis was better overall among patients with minimal residual disease than among patients with advanced disease. Within the minimal-disease group grossly complete excision of tumor prior to chemotherapy was associated with still better prognosis. Among patients with advanced disease, prognosis was significantly better for older patients despite their generally less favorable performance scores. Much of this prognostic superiority appeared to be related to menopausal status and presumably to the depletion of endogenous estrogens in the older patients.

Cyclophosphamide↗
PubMed1979

[Cervical lymph nodes metastasis from an unknown primary: diagnosis, treatment and prognosis. A retrospective study of 127 cases observed from 1959 to 1973 (author's transl)].

Authors present clinical records of 127 patients bearing metastatic cervical lymph nodes of unknown origin and referred to the Cl. Regaud Cancer Center between 1959 and 1973. According the prognosis, it is possible to distinguish patients into three groups. In group I, patients (10%) have a lower neck involvement by an adenocarcinoma. The survival is dramatically bad. Group II includes also 10% of patients who have a fairly better prognosis, they are younger people bearing poorly differenciated squamous metastatic lymphonode(s) in the upper neck. Group III. The remaining eighty per cent of patients are heavy drinkers and smokers. Their upper neck is hurt by lymphatic metastases from a well or moderately differenciated squamous cell carcinoma. They have much about the same prognosis than people bearing a known primary carcinoma of the upper aerodigestive tract. After having excluded the first group of patients who is at high risk of having a widely disseminated illness, we can remark that about one half of relapses occurred in the cervical area. A well planned combination of neck dissection and whole cervical lymphatic areas irradiation may further reduce such recurrences and so may enhance the present results: 23% survival 3 years after completion of treatment.

Adenocarcinoma↗
PubMed1979

Early and long-term prognosis after vasodilator therapy in the acute phase of myocardial infarction.

Cautious administration of vasocilator agents with careful hemodynamic monitoring may improve cardiac function in many patients with severe pump failure and cardiogenic shock complicating myocardial infarction. However, the immediate prognosis tends to improve only in a specific subset of patients, that is, those with left ventricular stroke work index above 10 g.m/m2 and elevated left ventricular filling pressure. In the presence of very severe pump failure, cardiogenic shock, stroke work index of less than 10 g.m/m2 and grossly elevated left ventricular filling pressure, vasodilator therapy alone does not tend to improve in-hospital mortality. Furthermore, the long-term prognosis in the survivors with severe pump failure complicating myocardial infarction remains unfavorable. The poor prognosis of these patients is probably a result of the extensive myocardial necrosis sustained at the onset of infarction.

Drug Evaluation↗
PubMed1979

[Long-term prognosis of cerebral infarction--influence of arterial stenotic lesion for survival (author's transl)].

Cerebral four vessel angiography was performed in 85 patients with non-embolic cerebral infarction and followed for ten years. Of 45 patients with arterial stenosis of 25 per cent or more, 21 (46.7%) survived at 5 years and 12 (26.7%) at 10 years after onset of the stroke. In contrast, survivors of 45 patients with stenosis less than 25 per cent or with no stenotic lesion, were 35 (87.5%) at 5 years and 29 (72.5%) at 10 years after the onset. The survival rate of the former patients group was lower significantly than the expected survival rate in a general population. Arterial stenosis of 25 per cent or more suggested a trend of poor prognosis in patients with multiple stenosis, especially those of bilateral internal carotid arteries, and of better prognosis in patients with stenosis in vertebrobasilar system. Patients with stenosis of 50 per cent or more in sphenoidal portion of the middle cerebral artery seemed to have a poor prognosis than those in the internal carotid artery.

Adult↗
PubMed1975

Long-term prognosis of 66 permanent anterior teeth with root fracture.

A longitudinal clinical and radiographic follow-up study was made of all permanent teeth with root fractures referred to the Oslo University Department of Pedodontics between 1953 and 1972 (n = 66). The material included 51 patients aged 6-21 years. The mean observation period was 5.2 years, ranging from 1 to 19 years. The present report documents background data and the long-term results. Two teeth with exarticulation of the coronal fragments (3%) were immediately extracted. Repair of the fracture area occurred in 51 teeth (77%). Pulp necrosis was found in 13 teeth (20%), nine of which were successfully treated endodontically; only four teeth had to be extracted. Several factors were found to influence the prognosis, most notably the degree of dislocation of the coronal fragment. The localization of the fracture influenced repair only slightly. Despite somewhat increased mobility in some cases, the longevity of teeth with fractures even in the coronal third of the root was not significantly shortened. It is concluded that when optimally treated by repositioning, fixation and relief of occlusion, anterior teeth with root fracture have a favorable prognosis. Even when pulp necrosis occurs, the long-term prognosis is good.

Adolescent↗
PubMed1978

Sacrococcygeal teratomas in infants and children: relationship of histology and prognosis in 40 cases.

Histological grading of teratomas is a useful method for evaluating patient prognosis. Although this has been repeatedly shown with ovarian teratomas, those of the sacrococcygeal area have not been scrutinized to a comparable extent. We believe that histologic grade and clinical behavior correlate closely in congenital sacrococcygeal teratomas. Correlation with clinical staging is less clear. There are some taxonomical and conceptual problems posed by the congenital nature of these tumors. The worst prognosis is dictated by the presence of yolk sac tumor areas, which was seen in seven of 40 teratomas examined. Although a neuroectodermal component is common, and was here proved to have metastasizing capacity, its inherent tendency may be toward spontaneous self-limiting differentiation. Vitelline differentiation, however, seems to imply irreversible progression and a uniformly bad prognosis.

Child, Preschool↗
PubMed1983

[Clinical aspects, course and prognosis of various forms of hypertrophic cardiomyopathy].

To characterize the different types of hypertrophic cardiomyopathy [typical (subaortic) hypertrophic obstructive cardiomyopathy (HOCM) (n = 235), atypical (midventricular or apical) HOCM (n = 33), and hypertrophic nonobstructive cardiomyopathy (HNCM) (n = 85)], studies of the clinical picture, course, and prognosis were performed in 353 patients. Clinical picture. There were found to be distinct differences between the diseases in terms of incidence, symptoms, findings at auscultation, carotid pulse tracings, ECG (incidence of abnormal negative T-waves), and echocardiography. Echochardiography proved to be diagnostically less specific than invasive methods, however, and in particular often failed to distinguish between atypical HOCM and HNCM. Clinical course. There was no evidence of a change from one form of hypertrophic cardiomyopathy to the other. The Sokolow-Lyon index in the ECG did not increase in any group. The rate of complications (endocarditis, systemic emboli) varied between 0.61 and 1.28 events per 100 patient years. Only 7.4%-23.5% of patients with HOCM improved as a result of conservative treatment, compared to 83%-87.5% of surgical patients. In addition, the rate of postoperative syncope was reduced by 90%. Prognosis. 90 patients were operated on. Operative mortality in typical HOCM was 4.5% over the last 5 years. If this is disregarded, the cumulative survival rates are significantly higher in surgical patients with typical HOCM than in those treated conservatively. The data confirm surgical treatment to be the therapy of choice in patients with HOCM refractory to conservative treatment. The prognosis seems to be improved by operation.

Adult↗
PubMedDate not supplied

[Short term prognosis of ulcerative colitis (author's transl)].

The authors analyse the short-term prognosis of ulcerative colitis from a series of 65 patients followed during ten years and treated with the same attitude. The results are compared to those of the most important published, from which they differ just a little. The medical treatment is effective in 84,6% of cases. The mortality of first attack is 6,1%. Only 1,4% of patients in our series are colectomised. It seems that the short-term prognosis has been slightly better during the last few years perhaps because of improvement in management and appearance of corticosteroids and/or salazosulfapyridine. The factors of bad prognosis in a first attack are its severity, its extension to the whole colon, its beginning after 60 years.

Adrenal Cortex Hormones↗
PubMed1978

[Prognosis in myocardial infarct complicated in the acute period by heart conduction disorders].

The influence of disorders of atrioventricular and intraventricular conduction, encountered in the acute period of myocardial infarction, on the immediate and remote prognosis of the disease was studied. In the acute period of myocardial infarction, III degree atrioventricular block and the right branch of the bundle of His block with the left posterior semiblock had a significant deteriorating effect on the prognosis. The remote prognosis was worse only due to the effect of III degree atrioventricular block.

Acute Disease↗
PubMed1983

Does the location of lung cancer affect its prognosis?

A series of 446 patients with lung cancer, comprising all the patients in a defined population who had lung cancer diagnosed over 4 years, were prospectively studied and followed up for 5 years or until death. Epidermoid carcinoma was relatively more common among the central tumours, and adenocarcinoma among the peripheral tumors; 79% of adenocarcinomas, but only 36% of epidermoid carcinomas being peripheral. The survival rate was significantly worse for the patients with central rather than peripheral tumours, although even so, only 3% of the former and 7% of the latter were alive 5 years after diagnosis. The patients with a tumour extending to the main bronchi had a poor prognosis. There was no consistent difference in the lobar distribution of the various histological types, and the prognosis was similar irrespective of the lobar location of the tumour. Unless located in the main bronchi, the site of lung cancer may be of little importance to the prognosis.

Adenocarcinoma↗
PubMed1983

[Method for the short-term prognosis of annual morbidity indices in Sonne-type dysentery].

A method for making the short-term prognosis of the annual morbidity rate in Sonne dysentery, both total and among individual groups of population, is presented. The preliminary prognosis is based on the expected data on meteorological factors, supplied by the weather forecast service, and the final prognosis, on the actual prognostic factors for June-July of the current (prognosed) year.

Computers↗