scholarly journals Birth-related retinal hemorrhages: The Soonchunhyang University Cheonan Hospital universal newborn eye screening (SUCH-NES) study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259378
Author(s):  
In Hwan Cho ◽  
Min Seong Kim ◽  
Nam Hun Heo ◽  
So Young Kim
Keyword(s):  
Multivariate Analysis ◽  
Odds Ratio ◽  
Retinal Layer ◽  
Wide Field ◽  
Retinal Hemorrhages ◽  
Related Factors ◽  
Spontaneous Vaginal Delivery ◽  
Eye Screening ◽  
Severe Group

Purpose To report the prevalence, related factors, and characteristics of birth-related retinal hemorrhages (RHs) according to their severity in healthy newborns using a telemedicine network and wide-field digital retinal imaging (WFDRI). Methods Newborns who underwent WFDRI at 61 obstetrics/gynecology hospitals between January 2017 and December 2019 were enrolled. Demographics and related factors were compared among newborns with and without RHs. The newborns’ eyes were divided into the minimal, mild, moderate, and severe groups according to the number of RHs, and characteristics like bilaterality, laterality, involved retinal layer, involved zone, macular and/or optic nerve (ON) involvement were compared. Results Among 56247 newborns, 13026 had birth-related RHs (23.2%). Normal spontaneous vaginal delivery (NSVD) showed the highest association with RHs (odds ratio, 19.774; 95% confidence interval, 18.277–21.393; P < 0.001) on multivariate analysis. Bilateral RHs (8414/13026; 64.59%) were more common than unilateral RHs (4612/13026; 35.41%); however, unilateral RHs (2383/4217; 56.51%) were more common than bilateral RHs (1834/4217; 43.49%) in the minimal group. RHs showed no laterality differences between the two eyes (P = 0.493). Most RHs were intraretinal (18678/21440; 87.12%), and 2328 (31.65%) eyes with preretinal hemorrhage were observed in the severe group. Zone I RHs were common in the minimal (7072/7090; 99.75%), mild (4953/4960; 99.86%), and moderate (2013/2035; 98.92%) groups; zone I and II RHs were common in the severe group (4843/7355; 65.85%); and RHs in zone III were rare (7/21440; 0.03%). Most RHs showed no macular and/or ON involvement in the minimal and mild group; however, this was common in the severe group (7111/7355; 96.68%). Conclusions Birth-related RHs were common in healthy newborns and were significantly associated with NSVD. RHs were usually bilateral, intraretinal, and distributed posterior to the retina, but severe RHs had unique characteristics. Future long-term and longitudinal studies are required to elucidate the prognosis of severe RHs.

NOTCH1 Activation Neutralizes the Unfavorable Prognostic Effect of PTEN Mutations in BFM-Treated Children with T-ALL

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 740-740 ◽  
Author(s):  
Obul R Bandapalli ◽  
Corinne Kox ◽  
Martin Zimmermann ◽  
Martin Stanulla ◽  
Martin Schrappe ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Treatment Response ◽  
Odds Ratio ◽  
Favorable Effect ◽  
Early Treatment Response ◽  
Unfavorable Effect ◽  
Negative Effect ◽  
Wbc Count ◽  
Notch1 Mutations

Abstract Abstract 740 Despite recent advances in treatment results of pediatric T-ALL, approximately 20% of the patients relapse and then have a dismal prognosis. Therefore, we aimed to identify molecular biomarkers that help in stratifying patients according to risk early in the course of treatment. We have analysed the clinical interaction of PTEN and NOTCH1 mutations in a cohort of 301 children with T-ALL who were treated on ALL-BFM protocols. We found heterozygous exon 7 PTEN mutations in 50 patients (17%). PTEN mutations occurred in 19% of male and 9% of female patients (p=0.05) and were more common in leukemias without (21%) than in those with (12%) activating NOTCH1 mutations (p=0.04). Patients with PTEN mutations showed a poor prednisone response (PPR) significantly more frequently than those patients without PTEN mutations (58% vs. 37%; p= 0.007; odds ratio 2.4; 95%CI = 1.3–4.4, p=0.006). Furthermore, in a multivariate analysis including variables known to be associated with prednisone response (sex, age at diagnosis, presenting WBC count at diagnosis and T-cell immunophenotype), the negative effect of PTEN mutations retained its significant effect (odds ratio =2.6, 95% CI= 1.3–5.2, p=0.005). On day 33, only 4% of the patients with PTEN mutations showed a favorable MRD response as compared to 29% of PTEN non-mutated patients (p=0.001). On day 78, the MRD response remained unfavorable significantly more frequently than in patients without a PTEN mutation, although this difference was less pronounced (57% vs. 39%; p = 0.05). Logistic regression analysis showed that patients with PTEN mutations carried a 9.2 fold higher risk of not achieving a favorable MRD level on day 33 (95% CI 2.2–3.9, p=0.003) and a 2.1 fold higher risk for an unfavorable MRD on day 78 (95% CI 1.1–1.4, p=0.02). In a multivariate analysis with known variables to be associated with treatment response (sex, age at diagnosis, presenting WBC count at diagnosis and T-cell immunophenotype), the negative effect of PTEN mutation retained its significant effect on day 33 (Odds ratio= 11, 95% CI= 2.5–48.5, p= 0.001) and on day 78 (Odds ratio =2, 95% CI= 1–4.1, p=0.05). These differences between PTEN-mutated and PTEN-non-mutated patients in early treatment response were maintained as a trend towards an inferior pEFS of 0.82 vs. 0.70 (p=0.07). We next tested how PTEN mutations clinically interact with NOTCH1 mutations. The comparison of early treatment response showed that leukemias with NOTCH1 and PTEN mutations had a similar rate of PPR and unfavorable MRD day 33 responses as those leukemias with PTEN mutations only (61% vs. 56%, p=0.8; 94% vs. 96 %, p=1), whereas patients with NOTCH1 mutations only exhibited the known low rate of PPR and unfavorable day 33 MRD response (27%, p=0.006 and 64%, p=0.008). Leukemias with neither mutation showed intermediate rates of PPR (48%) and unfavorable day 33 MRD response (79%). These data indicate that the unfavorable effect of PTEN mutations dominates over the favorable effect of NOTCH1 activation during early induction. By contrast, the analysis of MRD responses on day 78 and of long term survival showed that the favorable effect of NOTCH1 neutralizes the unfavorable effect of PTEN. The groups with both, PTEN and NOTCH1 mutations or NOTCH1 mutations only show a similar pEFS of 0.88 and 0.87, respectively, while the group with PTEN mutations only shows a significantly inferior pEFS of 0.61. These results indicate that PTEN mutations represent unfavorable biomarkers in BFM-treated pediatric T-ALL patients when not combined with NOTCH1 mutations and that NOTCH1 activation neutralizes this unfavorable effect at the end of induction and in long- term outcome. Activating NOTCH1 mutations thus remain the dominant favorable risk marker in BFM-treated children with T-ALL. Disclosures: No relevant conflicts of interest to declare.

Prognostic analysis of Chinese patients with metastasic renal cell cancer (mRCC) receiving sorafenib: A multicenter retrospective study.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15582-e15582 ◽  
Author(s):  
Fang Guo ◽  
Xiaodong Xie ◽  
Zhaozhe Liu ◽  
Xishuang Song ◽  
Qifu Zhang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Lung Metastasis ◽  
Univariate Analysis ◽  
Chinese Patients ◽  
Related Factors ◽  
Metastatic Lesions ◽  
Long Term Study ◽  
Previous Therapy ◽  
Ecog Ps

e15582 Background: This study was to investigate long-term efficacy of sorafenib and survival-related factors in Chinese patients with mRCC. Methods: 406 consecutive patients enrolled in this study between Oct. 2006 and Oct. 2009 from 6 comprehensive cancer centres in China. All cases were diagnosed as mRCC histopathologically without exception. 400mg sorafenib was orally taken twice daily until PD, death or intolerable toxic reaction. The primary endpoint was OS. The secondary endpoints were PFS and survival-related factors such as gender, age, ECOG PS, previous therapy and primary metastatic lesions. Data was analyzed using the SPSS statistical software. OS and PFS curves were output using the Kaplan-Meier method. Clinical parameters were included on univariate and multivariate analysis to evaluate associations with OS and PFS by the log-rank test and Cox proportional hazard models, P<0.05 (two-sided) was considered statistically significant. Results: 131 patients were available for survival analysis, including 96 males and 35 females. The median age was 60 years old. The median follow-up periods were 16.9 months. The median OS was 16.1 months. 1-year, 2-year and 3-year survival rates were 64.9%, 35.9% and 5.3%, respectively. The median PFS was 10.5 months. Univariate analysis demonstrated that OS was significantly associated with ECOG PS, metastatic lesions and previous therapy, whereas PFS was merely associated with ECOG PS and previous therapy. Multivariate analysis suggested that ECOG PS and previous therapy were independent prognostic factors for OS(P=0.004, P=0.019) and PFS (P=0.000, P=0.003), metastatic lesions was merely independent prognostic factor for OS (P=0.003). In the subgroup of patients with visceral metastasis, patients with lung metastasis alone had better prognosis than those with liver metastasis or dimerous metastasis. Conclusions: This long-term study demonstrated that sorafenib had good effects on Chinese patients with mRCC, especially for patients with lung metastasis alone. ECOG PS, metastatic lesions and previous therapy could be important parameters for survival and need attention in future.

scholarly journals Long-term results of microvascular free-tissue transfer reanimation of the paralyzed face: Three cases

2008 ◽  
Vol 87 (4) ◽  
pp. 226-233
Author(s):  
John P. Leonetti ◽  
Chad A. Zender ◽  
Daryl Vandevender ◽  
Sam J. Marzo
Keyword(s):  
Facial Nerve ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Free Tissue Transfer ◽  
Long Term Results ◽  
Wide Field ◽  
Facial Movement ◽  
Tissue Transfer ◽  
Facial Reanimation

We conducted a retrospective case review at our tertiary care academic medical center to assess the long-term results of microvascular free-tissue transfer to achieve facial reanimation in 3 patients. These patients had undergone wide-field parotidectomy with facial nerve resection. Upper facial reanimation was accomplished with a proximal facial nerve–sural nerve graft, and lower facial movement was achieved through proximal facial nerve–long thoracic (serratus muscle) nerve anastomosis. Outcomes were determined by grading postoperative facial nerve function according to the House-Brackmann system. All 3 patients were able to close their eyes independent of lower facial movement, and all 3 had achieved House-Brackmann grade III function. We conclude that reanimating the paralyzed face with microvascular free-tissue transfer provides anatomic coverage and mimetic function after wide-field parotidectomy. Synkinesis is reduced by separating upper-and lower-division reanimation.

Multivariate analysis of long term water quality changes of shallow Lake Balaton

2006 ◽  
Vol 29 (4) ◽  
pp. 2051-2055 ◽  
Author(s):  
G. Kiss ◽  
Gy. Dévai ◽  
B. Tóthmérész ◽  
A. Szabó
Keyword(s):  
Water Quality ◽  
Multivariate Analysis ◽  
Shallow Lake ◽  
Lake Balaton ◽  
Quality Changes

scholarly journals Use of catheter with 2-methacryloyloxyethyl phosphorylcholine polymer coating is associated with long-term availability of central venous port

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuuki Iida ◽  
Kumiko Hongo ◽  
Takanobu Onoda ◽  
Yusuke Kita ◽  
Yukio Ishihara ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Polymer Coating ◽  
Venous Access ◽  
Preventive Effect ◽  
Central Venous ◽  
Factors Associated ◽  
Central Venous Port ◽  
Venous Port ◽  
Venous Access Device

AbstractCentral venous port (CVP) is a widely used totally implantable venous access device. Recognition of risks associated with CVP-related complications is clinically important for safe, reliable, and long-term intravenous access. We therefore investigated factors associated with CVP infection and evulsion, including the device type. A total of 308 consecutive patients with initial CVP implantation between January 2011 and December 2017 were retrospectively reviewed, and the association of clinical features with CVP-related complications were analyzed. Intraoperative and postoperative complications occurred in 11 (3.6%) and 39 (12.7%) patients, respectively. The overall rate of CVP availability at six months was 91.4%. Malignancy and 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymer-coated catheter use were negatively associated with the incidence of CVP infections. Accordingly, malignancy and MPC polymer-coated catheter use were independent predictors for lower CVP evulsion rate (odds ratio, 0.23 and 0.18, respectively). Furthermore, both factors were significantly associated with longer CVP availability (hazard ratio, 0.24 and 0.27, respectively). This retrospective study identified factors associated with CVP-related complications and long-term CVP availability. Notably, MPC polymer-coated catheter use was significantly associated with a lower rate of CVP infection and longer CVP availability, suggesting the preventive effect of MPC coating on CVP infection.

scholarly journals OP0146 LONG TERM OUTCOME AND PROGNOSIS FACTORS OF ISOLATED AORTITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 93.1-93
Author(s):  
Y. Ferfar ◽  
S. Morinet ◽  
O. Espitia ◽  
C. Agard ◽  
M. Vautier ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Giant Cell Arteritis ◽  
Takayasu Arteritis ◽  
Vascular Complications ◽  
Event Free Survival ◽  
Prognosis Factors ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival

Background:Aortitis is a group of disorders characterized by the inflammation of the aorta. The most common causes of aortitis are the large-vessel vasculitis i.e. giant cell arteritis (GCA) and Takayasu arteritis (TA). However, aortitis may be isolated. Because of the wide variation in the course of aortitis, predicting outcome is challenging. The optimal management strategy of isolated aortitis (IA) is still unclear as IA is poorly defined, with data consisting of small retrospective and case control studies.Objectives:To assess the long-term outcome and prognosis factors for vascular complications in patients with isolated aortitis.Methods:Retrospective multicenter study of 353 patients with non-infectious aortitis including 136 giant cell arteritis (GCA), 96 Takayasu arteritis (TA) and 73 isolated aortitis (IA). Factors associated with event-free survival, vascular event-free survival and revascularization-free survival were assessed. Risk factors for vascular complications were identified in multivariate analysis.Results:After a median follow up of 52 months, vascular complications were observed in 32.3 %, revascularization in 30 % and death in 7.6%. The 5-year cumulative incidence of vascular complications was 58% (41; 71), 20% (13; 29), and 19 % (11; 28) in IA, GCA and TA, respectively. In multivariate analysis, IA [HR, 1.85 (1.19 to 2.88), p=0.017] and male gender [1.77 (1.26 to 2.49), p<0.0001] were independently associated with vascular events. The 5-year surgery-free survival was 45% (31; 65), 71% (62; 81) and 76% (68; 86) in IA, TA and GCA, respectively.Conclusion:IA has a worse vascular prognosis than GCA and TA. Sixty percent of IA patients will experience a vascular complication within 5 years from diagnosis.Disclosure of Interests:None declared

Determinants of Anthropometric Failure Among Tribal Children Younger than 5 Years of Age in Palghar, Maharashtra, India

2021 ◽  
Vol 42 (1) ◽  
pp. 55-64
Author(s):  
Angeline Jeyakumar ◽  
Swapnil Godbharle ◽  
Bibek Raj Giri
Keyword(s):  
Odds Ratio ◽  
Composite Index ◽  
Z Score ◽  
Short Term ◽  
Cross Sectional Survey ◽  
Crude Odds Ratio ◽  
Cross Sectional ◽  
Independent Variables ◽  
Child Undernutrition

Background: Measuring undernutrition using composite index of anthropometric failure (CIAF) and identifying its determinants in tribal regions is essential to recognize the true burden of undernutrition in these settings. Objective: To determine anthropometric failure and its determinants among tribal children younger than 5 years in Palghar, Maharashtra, India. Methods: A cross-sectional survey employing CIAF was performed in children <5 years to estimate undernutrition in the tribal district of Palghar in Maharashtra, India. Anthropometric measurements, maternal and child characteristics were recorded from 577 mother–child pairs in 9 villages. Results: As per Z score, prevalence of stunting, wasting, and underweight were 48%, 13%, and 43%, respectively. According to CIAF, 66% of children had at least one manifestation of undernutrition and 40% had more than one manifestation of undernutrition. Odds of anthropometric failure were 1.5 times higher among children of mothers who were illiterate (adjusted odds ratio [AOR] =1.57, 95% CI: 1.0-2.3), children who had birth weight >2.5 kg had lesser odds (AOR: 0.63, 95% CI: 0.4-0.9) of anthropometric failure, and children who had initiated early breastfeeding had 1.5 times higher odds of anthropometric failure (crude odds ratio: 1.5, 95% CI: 1.0-2.1). However, when adjusted for other independent variables, the results were not significant. Conclusion: The alarming proportion of anthropometric failure among tribal children calls for urgent short-term interventions to correct undernutrition and long-term interventions to improve maternal literacy and awareness to prevent and manage child undernutrition.

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