Prognosis For Life Expectancy Research Articles

The role of modified Glasgow prognostic score in prognosing the life expectancy figures of osteosarcoma patient at general hospital H. Adam Malik

Introduction: Osteosarcoma is a malignant neoplasm originating from poorly differentiated cells in the metaphyseal area long bones of children, with a 5-year survival rate below 20%. The evaluation of patient?s prognosis with osteosarcoma using the modified Glasgow Prognostic Score (mGPS) determine the albumin and C-Reactive Protein values to assess inflammation of a tissue. The mGPS scores are 0,1,2 with the higher the score the worse the prognosis. Researchers want to know the role of mGPS in osteosarcoma patients and the prognosis of life expectancy in a general hospital. Material and Method: A retrospective cohort study with a population of osteosarcoma patients at General Hospital H. Adam Malik Medan, which was examined for albumin and C-Reactive Protein (CRP). Using the total sampling method, patients? data was obtained through hospital medical records from January 2012 to December 2017 and a mGPS assessment (0,1,2) was recorded. Then a follow-up was carried out recording patients who were found to survive at >2 years and >5 years. Results: There were 34 patients, of which 26(76%) were male and 8(24%) were female. With the highest age group in the 2nd decade (n=20, 59%) followed by the 3rd decade (n=6, 17%) and the 1st decade (n=5, 15%). The predilection for tumor location was often the same in the distal femur and proximal tibia (n=12, 35%) followed by the proximal humerus (n=5, 15%), and proximal femur (n=4, 12%). Meanwhile, the number of patients based on the mGPS 0-2 value was overal the same (n=11-12, 32-36%). In the 2-year survival rate group (p=0.033), there were 9 (45.0%), 7 (35.0%), and 4 (20.0%) patients with mGPS scores of 0, 1, and 2. Meanwhile, there were 5 (71.4%), 2 (28.6%), and 0 (0.0%) patients with mGPS scores of 0, 1 and 2 in the 5-year survival rate group (p=0.009). Conclusion: Based on the results of data analysis, it was found that there was a significant relationship (p <0.05) between the mGPS assessment and the patient's life expectancy in 2 years and 5 years.

Surgical treatment of patients with chest wall metastases

To evaluate postoperative outcomes in patients with chest wall metastases. We analyzed 40 patients who underwent surgery for chest wall metastatic lesions. Fourteen (35%) patients had sternal lesion, 26 (65%) ones - rib metastases. We used implants for chest wall defect closure in 15 (37.5%) patients. Chest wall repair with autologous tissues was performed in 19 (47.5%) patients. Median survival was 17 months. Most patients (n=30, 75%) showed improvement in the quality of life according to Karnofsky and EGOG scale after surgery. Continued tumor growth occurred in 4 (10%) patients within 8-16 months after surgery. There were 2 patients who suffered from tumor recurrence accompanied by other metastatic foci (progression). Complications were diagnosed in 5 (12.5%) patients. Tactical errors were identified in 4 (10%) patients and they were associated with progression of cancer in the form of new metastatic foci within 6 months after surgery. Active surgical approach for bone metastases in patients with favorable cancer-related prognosis can improve quality of life and survival at least in case of solitary lesions. New program for treatment strategy selection based on prognosis of life expectancy and algorithms of surgical treatment will reduce the risk of erroneous management and increase its effectiveness.

Personalised follow-ups for patients curatively treated for squamous cell carcinoma in the oral cavity

As a result of an increase in the incidence of oral cancer and improving survival rates, the number of patients needing follow-up care will increase in the Netherlands. At present, these patients enroll in a 5-year follow-up programme aiming for early detection of recurrences or second primary tumors and improving their prognosis of life expectancy, among other things. Recurrences mostly occur in the first 2 years after treatment, whereas patients have a lifelong elevated risk of second primary tumors. 75% of second primary tumors occur outside the oral cavity and over 50% outside the head and neck area, places not routinely checked. There is no convincing evidence this 5-year follow-up programme yields survival benefits. It would therefore be better to limit follow-up care to 2 years and choose a subsequent follow-up programme better tailored to the individual patient's needs. This does not necessarily require the lead of a head and neck oncologist.

Practice Patterns, Attitudes, and Barriers to Palliative Care Consultation by Gynecologic Oncologists.

We sought to describe practice patterns, attitudes, and barriers to the integration of palliative care services by gynecologic oncologists. Members of the Society of Gynecologic Oncology were electronically surveyed regarding their practice of incorporating palliative care services and to identify barriers for consultation. Descriptive statistics were used, and two-sample z-tests of proportions were performed to compare responses to related questions. Of the 145 respondents, 71% were attending physicians and 58% worked at an academic medical center. The vast majority (92%) had palliative care services available for consultation at their hospital; 48% thought that palliative care services were appropriately used, 51% thought they were underused, and 1% thought they were overused. Thirty percent of respondents thought that palliative care services should be incorporated at first recurrence, whereas 42% thought palliative care should be incorporated when prognosis for life expectancy is ≤ 6 months. Most participants (75%) responded that palliative care consultation is reasonable for symptom control at any stage of disease. Respondents were most likely to consult palliative care services for pain control (53%) and other symptoms (63%). Eighty-three percent of respondents thought that communicating prognosis is the primary team's responsibility, whereas the responsibilities for pain and symptom control, resuscitation status, and goals of care discussions were split between the primary team only and both teams. The main barrier for consulting palliative care services was the concern that patients and families would feel abandoned by the primary oncologist (73%). Ninety-seven percent of respondents answered that palliative care services are useful to improve patient care. The majority of gynecologic oncologists perceived palliative care as a useful collaboration that is underused. Fear of perceived abandonment by the patient and family members was identified as a significant barrier to palliative care consult.

Formal description of adaptation of intelligent JSM-systems for clinical and laboratory data analysis

This paper presents a formalized description of the adaptation of intelligent JSM systems (IntJSM) for the following medical tasks: prediction of highly pathogenic types of human papilloma virus (HPV) by the cytological results of smear tests; diagnostics of two eye diseases: degenerative retinoschisis and hereditary vitreoretinal dystrophies; diagnostics of systemic lupus erythematosus; and total life-expectancy prognosis based on the analysis of clinical and laboratory data.

An epidemiological analysis of monitoring of the immune status of chernobyl nuclear accident liquidators for early detection of risk groups and diagnosis of cancer diseases. Communication 2. Dependence of the rate and changes in the immune status on radiation accident risk factors

It was demonstrated that malignant neoplasms (MNs) most frequently develop in the liquidators involved in the cleanup activities after the Chernobyl nuclear accident (ChNA) in 1986 (43.75%) and the liquidators involved in long-term activities, one-quarter of whom also participated in the cleanup in 1986. The specific features of the immune status (IS) depending on the period and year of the cleanup activities in the ChNA area were determined. In the cohort with a confirmed MN diagnosis, the observed deviations in the people who participated in these activities only in 1986 and on a permanent basis, including 1986, coincided in their pattern but differed in the magnitude of changes in immunological characteristics. Long-term participation during the extreme period and, correspondingly, higher exposure caused an increase in the contents of CD8+ T cells, CD16+ lymphocytes, and activated T lymphocytes, as well as decreases in the total immunoregulatory index, percentage of CD3-16/56+ (NK), and total IgE and a more pronounced deficiency in B lymphocytes. Differences between the groups of liquidators who participated in the cleanup activities in 1986 and 1987 were detected. The liquidators-1987 display the most pronounced deviations in the IS characteristics. Permanent presence in the ChNA area in 1986 and 1987 caused a similar effect but the magnitude of changes in the content of CD4+ T lymphocytes (↓), content of CD8+ T lymphocytes (↑), and immunoregulatory index (↓) was considerably higher in liquidators-1987. The permanent cleanup activities in Chernobyl in 1987 caused a deficiency in CD4+ T lymphocytes; more pronounced increase in the content of CD8+ T lymphocytes; decrease in CD4+/CD8+ index; change in the ratio of NK-T to NK cells; elevation in the counts of CD95+, HLA-DR+, and activated T lymphocytes; and decrease in the level of total IgE. Any increase in the expression of cell activation markers was undetectable in the liquidators-1986 involved in the cleanup activities on a long-term basis. The specific features of the IS changes depending on the dose of external γ-irradiation were determined. It was shown that the MN rate in liquidators increases with age relative to the number of examined people in each age cohort. The differences in the IS age-related dynamics in liquidators with and without MNs were detectable in stable contents of CD3+, CD4+, and CD8+ T lymphocytes; immunoregulatory index; and contents of CD95+ cells and serum IgA at ages of 40 to 70 years old with a subsequent decrease in these parameters and elevation in the content of CD8+ T lymphocytes with age in the absence of MNs; continuous increase in CD3-16/56+ (NK) cells in the presence of MNs; and decreases in these values after 70 years in the absence of MNs. In both groups of liquidators older than 70 years (with and without MNs), a deficiency in the T-cell component (CD3+ and CD4+ T lymphocytes and CD4+/CD8+ ratio) and an increase in the counts of CD8+ T lymphocytes are characteristic of the IS. A growing deficiency in CD4+ T lymphocytes during the monitoring on the background of increasing content of CD8+ T lymphocytes, which additionally contributes to the weakening of immune regulation due to progressing abnormalities in the ratio of regulatory T-lymphocyte subpopulations, can be regarded as one of the characteristics that suggest an adverse life expectancy prognosis for people with MNs.

Combining prevention, treatment and care: lessons from South Africa

Over one million people in sub-Saharan Africa now access HIV treatment, and as the prognosis of life expectancy on antiretroviral therapy (ART) improves, the central question that arises for governments, civil society and the private sector must be: how will we pay for the healthcare costs?This paper critically evaluates the need to provide effective treatment, prevention and care for HIV over the long term. Compelling evidence and moral argument suggest that the right combination of treatment and prevention policies, bolstered by grassroots mobilization and effective treatment literacy campaigns, can prevent new infections, save lives and mitigate the impact of HIV/AIDS. South Africa's HIV epidemic and its antiretroviral roll-out provide instructive global templates. The scale of the epidemic, the political responses, the epidemiological evidence and the outcomes data are lessons for countries where there is only a low-level epidemic at present. The investment needed to provide universal ART in South Africa will be substantial, but the economic rationale to act now is compelling. Brazil and to a lesser extent Thailand have responded with increased urgency and foresight. When compared with South Africa, their successes lend further credence to the importance of augmenting HIV prevention efforts with widespread access to treatment and care. Despite the obstacles, important gains have been made in South Africa, with community level health facilities documenting noteworthy treatment and adherence results. Our example suggests that even after tragic mistakes have been made, collective action, evidence-informed programmes, and sustained investment can still save lives and mitigate the epidemic.

Diagnosis and prognosis of chest pain with normal coronary arteriograms.

Ninety-eight patients previously investigated for suspected angina but shown to have normal coronary arteriograms were reviewed. The prognosis for like expectancy was excellent but 76% were still symptomatic after average follow up of three years. 41% of those re-evaluated were still thought to be describing cardiac-like pain. Full re-investigation showed coronary artery spasm or other causes of myocardial ischemia to be rare whereas oesophageal spasm was a common cause of the pain.

Wear Rate Prognosis Through Particle Size Distribution

Diagnosis of wear regime can be made by examination of the wear particles in terms of the number or weight fraction in each size range. Consideration of the alternatives lends to the conclusion that a Weibull plot by weight (Rosin-Rammler) is the most useful. Application of this diagnosis to simplified wear rate equations can result in more meaningful prognosis of life expectancy. The relations to the more familiar SOAP, Ferrograph and chip detector methods are explored. Presented at the 35th Annual Meeting in Anaheim, California, May 5–8, 1980

Complete removal of gliomas affecting the optic nerve.

Gliomas, or so-called low-grade astrocytomas, affecting the optic nerves have for some years been of great interest to ophthalmologists and ophthalmic surgeons. Excellent contributions to the literature have been made by many authors concerning the pertinent pathologic aspects, classification, peculiarities of growth, and methods of treating these tumors.* Opinion has varied greatly as to the methods of treatment and the prognosis for life expectancy among patients harboring these tumors. The undeniable relationship of this tumorous growth with von Recklinghausen's disease in certain cases has tended to add confusion rather than to clarify the concepts of prognosis and necessary surgical approach and treatment. Reflection on the subject, however, and a review of the writings of others make it evident that the prognosis in cases of glioma of the optic nerve depends on the extent and type of growth.† Obviously, a tumor involving the optic chiasm or the neighboring structures of the