Physical Condition Of Patient Research Articles

A CASE REPORT ON RIGHT SIDE CORTICO- CAVERNOUS FISTULA

INTRODUCTION: The cortico-cavernous fistula is uncommon and uncommonly uncommon. A cortico-cavernous fistula is characterized by an abnormal vascular connection between the internal or external carotid arteries and the venous channels of the cavernous sinus. If left untreated, it might cause additional complications such as intracerebral hematoma, subarachnoid hemorrhage, epistaxis, and otorrhagia. Secondary cortico-cavernous fistula cause glaucoma.CASE PRESENTATION: The interventional radiology unit of the tertiary care hospital in Wardha received an admission of a 22-year-old man. He arrived complaining of a 15-day-old facial and nasal bone injury, which had left him with suitable eye redness, pain, and edema in addition to a headache. Additionally, he was traumatized by a vehicle accident. There is no history of hematemesis, nausea, or vomiting. There is no history of a cold, a cough, or a concussion. Such illnesses as diabetes mellitus, hypertension, T.B., and asthma were absent. There was a physical examination. Save for the eye, other physical characteristics are typical. Redness and swelling are seen in the right eye. Above the conjunctiva, is a thick, red blood vessel. The S1 and S2 noises were usual. On the abdomen, there are no scars or enlargements.THERAPEUTIC MANAGEMENT: The patient was admitted for interventional radiology therapy of a cortico-cavernous fistula. Vital readings for the patient, like blood pressure, were 120/80. The measurements were 37 °C temperature, 75 b/m pulse, and 15 b/m respiration rate. After the patient's accident-related medical history was obtained, an evaluation of the patient's physical condition, blood work, a C.T. Scan, an MRI, an X-ray, and an E.C.G was evaluated. The patient had received antibiotics, antiplatelet medications, antiemetics, antacids, and analgesics. The patient had received antibiotics, antiplatelet drugs, antiemetics, antacids, and painkillers. The patient has been advised to undergo cortico-cavernous fistula embolization surgery.

Treatment of Scabies in A Persian Mixed Cat at UPTD. Puskeswan, Bukittinggi City

Background: Sarcoptes scabiei is one of the ectoparasites that usually attack cats. This parasitic disease can be transmitted through direct contact with other animals affected by scabies or by the presence of a source of scabies in the area where the cat lives. Purposes: This study aimed to determine the handling of cases of scabies in a Persian mixed-breed cat (Pobo) at UPTD. Puskeswan, Bukittinggi City. Methods: Handling began with anamnesis and continued by examining the patient's physical condition and observing the body parts infected with scabies. A deep skin scraping was performed on the facial area, followed by microscopic and hematological examination. Results: Examination showed Sarcoptes scabiei infestation in the scraped skin layer and the cat was anemic. The cat patient with scabiosis received Ivomec® as an antiparasitic. Symptomatic treatment was also carried out by giving Vet-oxy SB® and Vetadryl® injections as antibiotics because a secondary infection was suspected. Conclusions: The therapy administered showed positive progressive results in the patient.

Activité Physique Adaptée et cancer métastatique : quels besoins et quelles attentes ?

Between October 2019 and March 2020, 60 medical oncologists and 305 patients with metastatic cancer were asked to fill in a self-completed questionnaire. The benefits of physical activity are recognised by most oncologists and patients. These benefits were perceived more by oncologists in prevention (78%) or in the early stage (72%) of the disease than in the metastatic stage (55%) (P=0.01). Patient's physical condition (45%) and age (37%) but also the lack of time during the consultation to explain supportive care (35%) are the main obstacles identified by the oncologist to the integration of physical activity into patient care. Furthermore, lack of knowledge of adapted programmes is the main reason given by the physicians who have never prescribed physical activity (51%). On the patient side, while 88% of them had heard of the benefits of physical activity, only 11% had received a prescription. Most oncologists and patients were very interested in receiving information on where and what types of activities to practice, as well as what to avoid. Efforts in terms of information for both oncologists and patients seem necessary to increase the level of physical activity prescription and practice for patients followed for metastatic cancer.

Stand-Up Assistive Devices Allowing Patients to Perform Voluntary Movements Within the Safety Movement Tolerance

This paper proposes a novel standing assistance robot, which realizes voluntary movements of the patient within a safety motion range. In previous studies, conventional assistive robots did not require patients to use their own physical strength to stand, which leads to decreased strength in the elderly. Such general assistive robots helped patients by using a fixed motion reference pathway in spite of their original intention, and as a result, these robots failed to use the physical strength of the patients. Therefore, this study proposes a novel method for assisting the patient to stand up safely while using their physical abilities, by determining the range of movements that can be safely performed from the patient's physical condition, and allowing the patient to move freely within this range. The standing motion is a set of different movements: inclining the trunk forward, lifting the trunk and extending the trunk. In this study, the range of movements in which the patient can safely stand in each movement was determined in terms of body stability and the muscle output that the patient can generate. Furthermore, this study proposes a robot control method that allows movements based on the patient's free will if the patient's posture is within the safety tolerance, and corrects the movements when the patient's posture is estimated to fall outside of it. Proposed idea is implemented to our new prototype and its effectiveness is verified by experimental results with elderly subjects who lives in the nursing care house.

Effects of Dexmedetomidine on Postoperative Pain and Recovery Time in Obese Patients.

Objective The objective of this study is to investigate the effect of dexmedetomidine on postoperative pain and recovery time in obese patients. Methods A total of 100 obese patients with body mass index (BMI) ≥ 30 kg/m2 who underwent laparoscopic sleeve gastrectomy under general anesthesia in our hospital from January 2019 to December 2021 were included and assigned into DEX group (dexmedetomidine group) and NS group (normal saline group). The bariatric surgery patients who were given normal saline pump were the NS group (n = 50), and the bariatric surgery patients who were given the dexmedetomidine pump were the DEX group (n = 50). The patients in the DEX group were given continuous intravenous infusion of dexmedetomidine before, during, and after induction of anesthesia at a dose of 0.4 μg. kg-1. h-1, 0.4 μg·kg-1. h-1, 0.2 μg·kg-1. h-1, respectively. The NS group was infused with the same volume of normal saline for the same time. The two groups of patients were treated with the same anesthesia induction and maintenance program. By comparing the operation, anesthesia, postoperative extubation, and recovery time of the two groups of patients, the effect of dexmedetomidine on the postoperative recovery time of obese patients was analyzed. Visual analogue scale (VAS) and adverse reactions were compared to analyze the effect of dexmedetomidine on postoperative pain in obese patients. Results The operation, anesthesia, postoperative extubation, and recovery time of the DEX group were significantly lower than those of the NS group, whereas the VAS and adverse reactions were significantly lower than those in the NS group (P < 0.05). Conclusion An appropriate dose of dexmedetomidine in bariatric surgery for morbidly obese patients can effectively shorten the recovery time and extubation time of patients, reduce postoperative pain and the incidence of adverse reactions, and is worthy of clinical application. Dexmedetomidine 2 μg/kg has promising anesthesia benefits in bariatric surgery of obese patients, can provide favorable analgesia and quality of recovery, help reduce the degree of stress response of patients, and does not increase the risk of adverse events. However, this study has certain limitations, so physicians should tailor the dosage according to the patient's physical condition in clinical practice.

Effect of the preoperative physical status on postoperative nausea and vomiting risk: a matched cohort study

BackgroundThe American Society of Anesthesiologists Physical Status Classification System is commonly used for preoperative assessment. Patient physical status before surgery can play an important role in postoperative nausea and vomiting. However, the relationship between the physical status classification and postoperative nausea and vomiting has not been well defined.MethodsAdults aged ≥ 18 years who underwent procedures under anesthesia between 2015 and 2020 were included in the study. We analyzed the relationship of postoperative nausea and vomiting with physical status classification score using propensity score matching and Cox hazard regression. Differences in intraoperative use of vasopressor and inotropes and invasive monitoring were investigated according to the classification.ResultsA total of 163,500 patients were included in the study. After matching, classification 1 versus 2 included 43,400 patients; 1 versus ≤ 3, 13,287 patients; 2 versus ≤ 3, 23,530 patients (absolute standardized difference, 0–0.06). Patients with physical status classification ≤ 3 had a significantly lower postoperative nausea and vomiting risk than those with classification 1–2 (physical status classification 1 vs. ≤ 3, hazard ratio 0.76 [0.71–0.82], P < 0.001; 2 versus ≤ 3, hazard ratio 0.86 [0.82–0.91], P < 0.001). Intraoperative use of vasopressor or inotrope and invasive monitoring were noted more in the high physical status classification than the low physical status classification (absolute standardized difference [0.19–1.25]).ConclusionThere were differences in intraoperative invasive monitoring and use of vasopressor or inotrope among the classifications, and a score of 3 or higher reduced the risk of postoperative nausea and vomiting more than a score of 1–2.

1568P Physical condition in patients with a recent diagnosis of colorectal cancer

Assessment of physical condition (PC) is of utmost interest for physicians and specifically for medical oncologists, since it is highly informative for the process of therapeutic decision-making. PC is the ability to carry out daily tasks with vigour and alertness, without undue fatigue and with ample energy to engage in leisure time pursuits and to meet the above-average physical stresses encountered in emergency situations. The concept of PC includes different components: (a) body composition, (b) cardiorespiratory component, (c) muscular component (muscular strength and muscular endurance), and (d) motor component (balance, flexibility, speed).

Differentiation and prediction of pneumoconiosis stage by computed tomography texture analysis based on U-Net neural network

Background and ObjectiveThe progressive worsening of pneumoconiosis will ensue a hazardous physical condition in patients. This study details the differential diagnosis of the pneumoconiosis stage, by employing computed tomography (CT) texture analysis, based on U-Net neural network. MethodsThe pneumoconiosis location from 92 patients at various stages was extracted by U-Net neural network. Mazda software was employed to analyze the texture features. Three dimensionality reduction methods set the best texture parameters. We applied four methods of the B11 module to analyze the selected texture parameters and calculate the misclassified rate (MCR). Finally, the receiver operating characteristic curve (ROC) of the texture parameters was analyzed, and the texture parameters with diagnostic efficiency were evaluated by calculating the area under curve (AUC). ResultsThe original film was processed by Gaussian and Laplace filters for a better display of the segmented area of pneumoconiosis in all stages. The MCR value obtained by the NDA analysis method under the MI dimension reduction method was the lowest, at 10.87%. In the filtered texture feature parameters, the best AUC was 0.821. ConclusionsCT texture analysis based on the U-Net neural network can be used to identify the staging of pneumoconiosis.

Airway Foreign Bodies in Patients that Underwent Bronchoscopies with General Anesthesia in Dr. Soetomo General Academic Hospital Surabaya

Introduction: Airway foreign body (AFBs) is the most common emergency for ENT-HN (Ear, Nose, Throat-Head Neck) that requires immediate treatment. The gold standard management for AFBs is a bronchoscopy performed under general anesthesia (GA). Objective: This study aims to determine the profile of AFBs patients who underwent bronchoscopies with GA at Dr. Soetomo General Hospital Surabaya from January 2018 – December 2019. Methods and Materials: This is a descriptive, retrospective study that uses data from medical records. Microsoft Excel was used to analyze the data. 22 patients met the inclusion criteria. Results: The most common ages were 11 to 20-year-olds (73%), 55% were female, and 45% were male. The patients were from outside (73%) and inside (27%) Surabaya. As much as 67% of the sampled patients had coughs and 23% were symptomless. The foreign bodies found were pins (67%), clipboard nails (14%), and nuts (9%). These AFBs were located in the left main bronchus (45%), trachea (32%), and right main bronchus (18%), and in 5% of these cases, the AFBs could not be located. The duration between the event and the bronchoscopy was mostly less than 1 day (54%), 2 days (32%), and 3 days (14%). Most cases (90%) were without AFBs complications, but some had obstruction (5%), and hemoptysis (5%). Most patients also had an uncomplicated bronchoscopy (81%), however, some suffered lesions (14%) and bleeding (5%). A majority of the patients were also ASA I (68%), and the remainder were classified as ASA II (18%), and III (14%). The premedication drugs administered were fentanyl (41%), and a combination of fentanyl and midazolam (41%). Meanwhile, the most frequently maintained anesthetic agent was Isoflurane+O2 (27%). Most patients also did not have any comorbid factors (85%), but some had anemia (5%), obstruction (5%), as well as obesity followed by sputum retention and hypernatremia (5%). Conclusion: Most AFB patients who underwent bronchoscopy under GA were 11-20 years old, female, and had a cough as a clinical symptom. Most AFBs were pins at the left main bronchus. The duration between the incident and the bronchoscopy was less than 1 day. There were also mostly no complications of AFBs and bronchoscopies. The most common physical status in patients was ASA I, with fentanyl only or fentanyl and midazolam as a premedication drug. The most common agent used to maintain the anesthesia was a combination of isoflurane and O2. Most patients also had no comorbid factors for GA.

Chemotherapy drug potency assessment method of ovarian cancer cells by digital holography microscopy

Drug potency assessment plays a crucial role in cancer chemotherapy. The selection of appropriate chemotherapy drugs can reduce the impact on the patient's physical condition and achieve a better therapeutic effect. Various methods have been used to achieve in vitro drug susceptibility assays, but there are few studies on calculating morphology and texture parameters quantitatively based on phase imaging for drug potency assessment. In this study, digital holography microscopy was used to get phase imaging of ovarian cancer cells after adding three different drugs, namely, Cisplatin, Adriamycin, and 5-fluorouracil. Based on the reconstructed phase imaging, four parameters of ovarian cancer cells changed with time, such as the average height, projected area, cluster shade, and entropy, were calculated. And the half-inhibitory concentration of cells under the effect of different drugs was calculated according to these four parameters. The half-inhibitory concentration, which can directly reflect the drug potency, is associated with the morphological and texture features extracted from phase images by numerical fitting. So, a new method for calculating the half-inhibitory concentration was proposed. The result shows that the morphological and texture feature parameters can be used to evaluate the sensitivity of ovarian cancer cells to different drugs by fitting the half-inhibitory concentration numerically. And the result provides a new idea for drug potency assessment methods before chemotherapy for ovarian cancer.

Using mHealth Technologies to Promote Public Health and Well-Being in Urban Areas with Blue-Green Solutions.

European and International cities face crucial global geopolitical, economic, environmental, and other changes. All these intensify threats to and inequalities in citizens' health. The implementation of Blue-Green Solutions in urban and rural areas have been broadly used to tackle the above challenges. The Mobile health (mHealth) technologies contribution in people's well-being has found to be significant. In addition, several mHealth applications have been used to support patients with mental health or cardiovascular diseases with very promising results. The patients' remote monitoring can be a valuable asset in chronic diseases management for patients suffering from diabetes, hypertension or arrhythmia, depression, asthma, allergies and others. The scope of this paper is to present the specifications, the design and the development of a mobile application which collects health-related and location data of users visiting areas with Blue-Green Solutions. The mobile application has been developed to record the citizens' and patients' physical activity and vital signs using wearable devices. The proposed application can also monitor patients physical, physiological, and emotional status as well as motivate them to engage in social and self-caring activities. Additional features include the analysis of the patients' behavior to improve self-management. The "HEART by BioAsssist" application could be used as a health and other data collection tool as well as an "intelligent assistant" to monitor and promote patient's physical activity.

Physical rehabilitation for fractures of the lower extremities in mature men

Features of physical rehabilitation at fractures of the lower extremities in men, which are one of the most dangerous and serious traumatic conditions, are considered. The program of physical rehabilitation, which allows the most economical and rational approach to solving the problem of rehabilitation of patients with diaphysis and fragmentary fractures of the tubular bones of the lower extremities. he effectiveness of this program, which included exercise therapy; physiotherapy; massage and hydromassage, gave positive results and the recovery process took less time. The program will help restore walking skills and improve the physical condition of patients through methods, principles, objectives of physical therapy.

Effects of Exercise in People with Severe Mental Illness and Recommendations for its Implementation as Add-on Therapy

There are many reasons for people with (and without) severe mental illness to exercise regularly. In people with schizophrenia, major depression and bipolar disorder, it has already been shown that regular physical activity as an add-on therapy can improve quality of life and symptom severity. This is particularly important in domains that standard therapy is currently not able to treat sufficiently, such as cognitive deficits. Postulated underlying neurobiological effects include increased volume in hippocampal areas as demonstrated by data of a current clinical trial in people with schizophrenia.Furthermore, regular exercise is essential to counteract the increased cardiovascular morbidity and mortality of people with severe mental illness. However, most people with severe mental illness do not achieve the recommended amount of physical activity and the potential of exercise as an add-on therapy is currently not even close to being fully realized. On the one hand, it is important that mental health staff also considers the physical condition of patients with mental illnesses and counsels them on their health behavior. On the other hand, there is a need for individually adapted training programs delivered by qualified exercise professionals that incorporate motivational and adherence strategies. Examples of barriers and facilitators for the implementation of exercise as an add-on therapy are discussed on the basis of current local projects.DisclosureNo significant relationships.

A phase I study of anlotinib with concurrent chemoradiotherapy for limited-stage small cell lung cancer.

8579 Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment for limited-stage small-cell lung cancer (LS-SCLC). However, LS-SCLC remains an area of high unmet medical need. Anlotinib is an antiangiogenic multi-target tyrosine kinase inhibitor. In the phase II ALTER-1202 trial, anlotinib significantly improved clinical outcomes in advanced small-cell lung cancer. We report here a phase 1 trial of anlotinib with CCRT for LS-SCLC. Methods: This is a prospective, single-arm, phase I clinical trial using a 3+3 design. Patients aged between 18 and 75 with previously untreated LS-SCLC, PS 0-1 and adequate organ function are eligible. Patients received anlotinib (12mg, qd, d1-14, q3w) and chemotherapy (etoposide, 100 mg/m2, d1-3, q3w and cisplatin, 25 mg/m2, d1-3, q3w) for cycle 1, then anlotinib [dose escalation at 3 levels (DL1-3) 8mg, 10mg and 12mg, qd, d1-14, q3w], chemotherapy (etoposide, 50 mg/m2, d1-5, q4w and cisplatin, 25 mg/m2, d1-3, q4w) and thoracic radiotherapy (60-66 Gy in 30-33 daily 2-Gy fractions starting on day 1 of cycle 2) for cycles 2–3, then anlotinib (12mg, qd, d1-14, q3w) and chemotherapy (etoposide, 100 mg/m2, d1-3, q3w and cisplatin, 25 mg/m2, d1-3, q3w) for cycles 4-6. Cycles 5-6 were given as appropriate according to the patient's physical condition. Prophylactic cranial radiation was given according to the judgment of the investigator after CCRT. The purpose of this study is to determine the maximum tolerated dose (MTD) of anlotinib when combination with CCRT. Results: Twelve patients were enrolled from May 2020 to September 2021. No DLTs were observed in DL1 (3 patients) or DL2 (3 patients). At DL3 (6 patients), 1 patient had a DLT of grade 3 pulmonary embolism. Grade 3 adverse events were white blood cell count decreased, neutrophil count decreased, lymphocyte count decreased, hypertension, albumin decreased and pulmonary embolism. One patient had grade 3 pulmonary embolism and grade 4 neutrophil count decreased in DL3 at cycle 1. One patient had grade 2 radiation pneumonitis after cycle 5 and grade 1 radiation esophagitis at cycle 3 in DL3. One patient had grade 2 radiation esophagitis at cycle 3 in DL2. The MTD was not reached. Conclusions: Combined treatment with anlotinib and CCRT for limited-stage small cell lung cancer is well tolerated and further clinical investigation is warranted. Clinical trial information: NCT04882033.

The Effectiveness of Acupuncture in The Treatment of Post COVID-19 Condition: A Retrospective Study

Objective: To demonstrate the effectiveness and safety of acupuncture in the treatment of post COVID-19 condition (also called long COVID) in 85 cases in eastern Canada. Method: The condition of 85 patients with long COVID was analyzed retrospectively based on their clinical symptoms, diagnosis and classification. 85 cases were divided into 4 categories according to the main symptoms. The number and percentage of clinical symptoms were shortness of breath and general fatigue (35 cases, 41%); body pain (26 cases, 31%); brain fog (17 cases, 20%); and irregular menstrual cycle (7 cases, 8%). 85 patients received acupuncture weekly for 8 to 12 consecutive weeks (from June 2020 to Dec 2021), to tonify lung and kidney qi and strengthen spleen and stomach qi. The acupuncture points used were on the meridians of lung, kidney, spleen, stomach, bladder, the Ren (Conception) and the Du (Governing). Results: Of the 85 patients, 72 cases were clinically cured, and 13 cases were ineffective. The rate of overall effectiveness was 85%. Conclusions: Acupuncture restored the healthy functioning of the lungs, kidney, spleen and brain; significantly decreased the symptoms of post COVID-19 condition; improved the patient's physical condition and quality of life; and enabled patients to go back to work.

Computed tomography of traumatic brain injury in infants and young children (a literature review)

Objective . To analyze recent studies related to the use of computed tomography in traumatic brain injury in young children. Results . Traumatic brain injury (TBI) is one of the most common causes of death and disability in children. Pediatric TBI has a number of characteristics different of adults. This is due to age-related anatomical and physiological differences depending on patient's physical condition and on problems with his/her neurological assessment. Young children demonstrate specific pathological reactions to TBI with clear concomitant neurological manifestations. The authors present an important information on current aspects of CT application for all types of isolated blunt TBI in children aged from birth to 3 years with consideration of age-appropriate characteristics and emergency condition. Although TBI mechanisms are similar in young children and adults, visual manifestations of head injury in children have their own specific features due to the developing brain and cranial vault. Radiologist's primary role is to identify and characterize the type and severity of head injury so as to assist the correct management of the patient. Using the information obtained from CT examination and knowing TBI mechanisms in infants and young children, a radiologist can play a key role both in diagnostics and in selection of effective care, thus improving clinical outcomes. Conclusion . Head CT with multifaceted and 3D reconstructions has now replaced X-ray examination of the skull in suspected TBI and has become the most important diagnostic technique in patients with TBI at emergency settings. Radiographs do not provide with additional diagnostic information and may be excluded from the examination, if CT with 3D reconstruction are planned to perform or has already been performed.

Latissimus dorsi myocutaneous flap repair is effective after neoadjuvant chemotherapy for locally advanced breast cancer

ObjectiveTo describe the clinical outcome and physical condition of patients with locally advanced breast cancer (LABC) who received neoadjuvant chemotherapy followed by mastectomy and latissimus dorsi myocutaneous flap repair.MethodsA retrospective review of 142 patients with locally advanced breast cancer was selected from 1156 breast cancer patients in the South and North areas of The Affiliated Calmette Hospital of Kunming Medical University between May 2008 and December 2018.ResultsAll participants (n = 142) were women aged 40–55 years (average age 47.35 ± 0.43 years) who received neoadjuvant chemotherapy followed by mastectomy and latissimus dorsi flap repair. The median follow-up period was 16 months (range 12–24 months). For stage of disease, there were 19 cases (13%) in stage IIB, 31 cases (22%) in stage IIIA, 39 cases (28%) in stage IIIB, and 53 cases (37%) in stage IIIC, which were statistically significant with the physical condition of patients (≤ 0.001). Neoadjuvant chemotherapy was administered to shrink the tumors, and an average tumor size decrease from 10.05 ± 1.59 cm × (8.07 ± 1.54) cm to 6.11 ± 1.72 cm × (3.91 ± 1.52) cm (P < 0.001) was considered statistically significant. A t test was used for the ECOG score statistics, and the results showed that the scores were statistically significant (≤ 0.001) before and after neoadjuvant chemotherapy and after surgery.ConclusionsNeoadjuvant chemotherapy is an accepted treatment option for patients with locally advanced breast cancer, and the use of a latissimus dorsi musculocutaneous flap for post-mastectomy reconstruction may improve the patients’ physical condition. Our results indicated that this strategy was safe and feasible.

Higher Body Mass Index Is a Simple Favorable Non-cancer Prognostic Marker for Japanese Elderly Colorectal Cancer Patients after Curative Resection.

Objectives: In elderly colorectal cancer (CRC) patients, preoperative surgical indications can be controversial in some cases depending on the patient's physical condition. In comparison with younger patients, both cancer-specific survival (CSS) and non-CCS (NCSS) have an impact on the prognosis and both CSS and NCSS should be considered in the preoperative assessment. We aimed to investigate the impact of body mass index (BMI) on CSS and NCSS in Japanese elderly CRC patients.Methods: We retrospectively collected data from 471 Japanese elderly patients (≥80 years) with stage I-III CRC who underwent curative surgery from 1998 to 2017. A Kaplan-Meier survival analysis with propensity score matching (PSM) and a multivariate Cox regression analysis were performed. Results: After PSM, 123 higher BMI (≥23) and 123 lower BMI (<23) cases were matched. The higher BMI group had significantly better survival than the lower BMI group regarding NCSS and overall survival (OS; P < .001 and P < .001, respectively). The multivariate survival analysis further confirmed that the higher BMI group had significantly better survival than the lower BMI group regarding CSS, NCSS, and OS (P = .027, P < .001, and P < .001, respectively).Conclusions: In Japanese elderly patients with stage I-III CRC who underwent curative surgery, preoperative higher BMI was a significant and simple favorable prognostic predictor, especially for NCSS and OS.

Inflammatory burden as a prognostic biomarker for cancer

Systemic inflammation is the most representative host-tumor interaction in cancer. This study aimed to develop a novel inflammatory burden index (IBI) to assess the inflammatory burden of different cancers and predict the prognosis of patients with cancer. A total of 6359 cancer patients admitted to multiple centers from 2012 through 2019 were included in this study. The IBI was formulated as C-reaction protein×neutrophil/lymphocyte. Survival differences between the groups were compared using the Kaplan-Meier method. Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) and 95% confidence interval (CI). Logistic regression analysis was used to assess the association between the inflammatory burden index and outcomes. Cancers assessed by the IBI could be classified as high, moderate, or low inflammatory burden and had different prognostic stratification effects (46.5% vs 61.0% vs 83.0%; P<.001). Compared with other systemic inflammation biomarkers, the IBI had the highest accuracy in predicting survival. Patients with a high IBI had significantly lower survival rates than those with a low IBI (45.7% vs 69.1%; P<.001). For every standard deviation increase in the IBI, the risk of poor prognosis for patients with cancer increased by 10.3% (HR, 1.103; 95% CI, 1.072-1.136; P<.001). The IBI could be used as a useful prognostic supplement in the pathological stage. A high IBI was an independent high-risk factor that affected patient's physical condition, malnutrition, cachexia, and short-term outcomes and an independent risk factor for patients with cancer in both validation cohorts a (hazard ratio, 1.114; 95% confidence interval, 1.072-1.157; P<.001) and b (hazard ratio, 1.125; 95% confidence interval, 1.060-1.193; P<.001). The IBI, as a novel indicator of systemic inflammation, is a feasible and promising predictive biomarker in patients with cancer and can be used to assess the inflammatory burden of different cancers.

Використання прогностичної моделі післяопераційних ускладнень та протокол оцінки ефективності анестезії під час реконструктивних та естетичних хірургічних втручань на молочних залозах

при розробці рекомендацій стосовно вибору методу обезболення при реконструктивних та естетичних хірургічних втручаннях на молочних залозах важливою є оцінка ефективності та безпеки анестезіологічного забезпечення. Окрім впливу на центральну нервову систему, загальна анестезія чинить комплексний вплив на організм, у тому числі викликаючи зміни у різних ланках метаболізму. Метаболічні зміни, пов’язані з хірургічним стресом, включають активацію катаболічних процесів і збільшення протеолізу. Метою даної роботи було розробити модель оцінки ефективності анестезії під час реконструктивних та естетичних хірургічних втручань на молочних залозах, а також розробити відповідний протокол. В роботі проведено покрокову оцінку ефективності анестезіологічного забезпечення при реконструктивних операціях на молочних залозах. Інструментом оцінки ефективності для створенням прогностичної моделі ризику в нашій роботі був категоріальний аналіз частоти хірургічних ускладнень, а також гемодинамічних та метоболічних змін залежно від фізичного статусу пацієнтів за ASA. Для створення прогностичної моделі ризику в нашій роботі використовувався метод бінарної логістичної регресії з використанням пакету спеціального призначення SPSS. За дихотомічну перемінну прийнято вірогідність післяопераційних ускладнень у відповідності до незалежних перемінних. Серед незалежних перемінних в модель були включені такі числові параметри як вік, індекс маси тіла, вміст глюкози, креатиніну, BIS внутрішньоопераційний, внутрішньоопераційний систолічний артеріальних тиск, тривалість втручання, больовий синдром через 24 години після втручання, когнітивні порушення через 24 години після втручання. Серед категоріальних перемінних відібрані вид анестезії, клас пацієнта за ASA. У запропонованому протоколі оцінки ефективності анестезії під час реконструктивних та естетичних хірургічних втручань на молочних залозах за досягнення порогової суми коефіцієнтів з використанням шкали визначено групу ризику: якщо сума прогностичних коефіцієнтів дорівнює або нижча, ніж -19,8, ризик мінімальний; більша -19,8 і нижча 19,8, ризик невизначений; якщо дорівнює або вища, ніж 19,8, ризик високий. Чутливість протоколу склала 95,7%, специфічність — 93,5%, позитивна прогностична цінність — 91,8%, негативна прогностична цінність — 92,9%. Факторний аналіз клініко-анамнестичних, апаратних та лабораторних показників у пацієнтів, яким було проведено реконструктивні та естетичні хірургічні втручання на молочних залозах, дозволив встановити групи факторів, які визначають варіативність ознак. Розроблений протокол оцінки ефективності анестезії під час реконструктивних та естетичних хірургічних втручань на молочних залозах характеризується параметрами клінічної цінності, достатніми для застосування у анестезіологічному забезпеченні реконструктивних та естетичних хірургічних втручань на молочних залозах.