scholarly journals Haptoglobin Genotype and Outcome after Subarachnoid Haemorrhage: New Insights from a Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Ben Gaastra ◽  
James Glazier ◽  
Diederik Bulters ◽  
Ian Galea
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Genetic Variants ◽  
Meta Analysis ◽  
Delayed Cerebral Ischemia ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short Term Outcome ◽  
Haptoglobin Genotype

Haptoglobin (Hp) is a plasma protein involved in clearing extracellular haemoglobin and regulating inflammation; it exists as two genetic variants (Hp1 and Hp2). In a meta-analysis of six published studies, we confirm that Hp genotype affects short-term outcome (cerebral vasospasm and/or delayed cerebral ischemia) after subarachnoid haemorrhage (SAH) but not long-term outcome (Glasgow Outcome Score and modified Rankin Scale between one and three months). A closer examination of the heterozygous group revealed that the short-term outcome of Hp2-1 individuals clustered with that of Hp1-1 and not Hp2-2, suggesting that the presence of one Hp1 allele was sufficient to confer protection. Since the presence of the Hp dimer is the only common feature between Hp1-1 and Hp2-1 individuals, the absence of this Hp moiety is most likely to underlie vasospasm in Hp2-2 individuals. These results have implications for prognosis after SAH and will inform further research into Hp-based mechanism of action and treatment.

scholarly journals Low Levels of Immunoglobulins and Mannose-Binding Lectin Are Not Associated With Etiology, Severity, or Outcome in Community-Acquired Pneumonia

2018 ◽  
Vol 5 (2) ◽  
Author(s):  
William W Siljan ◽  
Jan C Holter ◽  
Ståle H Nymo ◽  
Einar Husebye ◽  
Thor Ueland ◽  
...  
Keyword(s):  
Disease Severity ◽  
Community Acquired Pneumonia ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short Term Outcome ◽  
Mannose Binding ◽  
Microbial Etiology ◽  
Low Levels

Abstract Background Disease severity and outcome in community-acquired pneumonia (CAP) depend on the host and on the challenge of the causal microorganism(s). We measured levels of immunoglobulins (Igs) and complement in 257 hospitalized adults with CAP and examined the association of low levels of Igs or complement to microbial etiology, disease severity, and short-term and long-term outcome. Methods Serum Igs were analyzed in blood samples obtained at admission and at 6 weeks postdischarge if admission levels were low. Serum complement deficiencies were screened with a total complement activity enzyme-linked immunosorbent assay (ELISA), with further analyzes performed if justified. Disease severity was assessed by the CURB-65 severity score. Short-term outcome was defined as a composite end point of intensive care unit (ICU) admission and 30-day mortality, and long-term outcome as 5-year all-cause mortality. Results At admission, 87 (34%) patients had low levels of at least 1 Ig, with low IgG2 as the most prevalent finding (55/21%). IgG levels were lower in bacterial than viral CAP (8.48 vs 9.97 g/L, P = .023), but low Igs were not associated with microbial etiology. Fifty-five (21%) patients had low lectin pathway activity, of which 33 (13%) were mannose-binding lectin (MBL) deficient. Low admission levels of any Ig or MBL were not associated with disease severity, short-term outcome, or long-term outcome. Excluding patients defined as immunocompromised from analysis did not substantially affect these results. Conclusion In hospitalized adults with CAP, low admission levels of Igs or complement were in general not associated with microbial etiology, disease severity, short-term outcome, or long-term outcome.

scholarly journals Haptoglobin genotype and outcome after aneurysmal subarachnoid haemorrhage

2020 ◽  
Vol 91 (3) ◽  
pp. 305-313 ◽  
Author(s):  
Matthew J Morton ◽  
Isabel C Hostettler ◽  
Nabila Kazmi ◽  
Varinder S Alg ◽  
Stephen Bonner ◽  
...  
Keyword(s):  
Subarachnoid Haemorrhage ◽  
High Volume ◽  
Expression Level ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fisher Grade ◽  
Haptoglobin Genotype ◽  
Low Volume

ObjectiveAfter aneurysmal subarachnoid haemorrhage (aSAH), extracellular haemoglobin (Hb) in the subarachnoid space is bound by haptoglobin, neutralising Hb toxicity and helping its clearance. Two exons in the HP gene (encoding haptoglobin) exhibit copy number variation (CNV), giving rise to HP1 and HP2 alleles, which influence haptoglobin expression level and possibly haptoglobin function. We hypothesised that the HP CNV associates with long-term outcome beyond the first year after aSAH.MethodsThe HP CNV was typed using quantitative PCR in 1299 aSAH survivors in the Genetics and Observational Subarachnoid Haemorrhage (GOSH) Study, a retrospective multicentre cohort study with a median follow-up of 18 months. To investigate mediation of the HP CNV effect by haptoglobin expression level, as opposed to functional differences, we used rs2000999, a single nucleotide polymorphism associated with haptoglobin expression independent of the HP CNV. Outcome was assessed using modified Rankin and Glasgow Outcome Scores. SAH volume was dichotomised on the Fisher grade. Haemoglobin-haptoglobin complexes were measured in cerebrospinal fluid (CSF) of 44 patients with aSAH and related to the HP CNV.ResultsThe HP2 allele associated with a favourable long-term outcome after high-volume but not low-volume aSAH (multivariable logistic regression). However rs2000999 did not predict outcome. The HP2 allele associated with lower CSF haemoglobin-haptoglobin complex levels. The CSF Hb concentration after high-volume and low-volume aSAH was, respectively, higher and lower than the Hb-binding capacity of CSF haptoglobin.ConclusionThe HP2 allele carries a favourable long-term prognosis after high-volume aSAH. Haptoglobin and the Hb clearance pathway are therapeutic targets after aSAH.

Renal abscesses in cats: six cases

2016 ◽  
Vol 19 (4) ◽  
pp. 484-492 ◽  
Author(s):  
Mathieu R Faucher ◽  
Marie-Laure Theron ◽  
Brice S Reynolds
Keyword(s):  
Case Series ◽  
Clinical Findings ◽  
Renal Abscess ◽  
Short Term ◽  
Cytological Examination ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short Term Outcome ◽  
Case Basis

Case series summary Six cats were diagnosed with renal abscesses. Common clinical findings were lethargy, dehydration, abdominal pain and nephromegaly. Fever was noted in half of the cases. Diagnosis was established by ultrasonography, cytological examination and bacterial culture of abscess aspirates. At least one possible contributing factor could be identified in all cases. Antibiotics were consistently used and in two cats the abscess was surgically drained. The short-term outcome was fair but the long-term outcome was dependent on the underlying condition. Relevance and novel information The results of this small case series suggest that renal abscess should be considered when nephromegaly and/or abdominal discomfort are noted. Diagnosis of renal abscess is straightforward when ultrasonography and fine-needle aspirate analysis can be performed. Medical treatment is assumed to be preferable but surgical treatment may be warranted on a case-by-case basis. Given that almost every affected cat was diagnosed with at least one comorbidity, a thorough evaluation is recommended for all cats with renal abscesses.

Outcome after arthroscopic treatment of lateral femoral trochlear ridge osteochondrosis in sport horses

2013 ◽  
Vol 26 (02) ◽  
pp. 105-109 ◽  
Author(s):  
K. UpRichard ◽  
P. Piat ◽  
G. Beauchamp ◽  
S. Laverty ◽  
Y. A. Elce
Keyword(s):  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Stifle Joint ◽  
Short Term Outcome ◽  
Short And Long Term ◽  
Worse Prognosis

SummaryObjectives: To determine the short- and long-term outcome for sport horses after arthroscopic treatment of osteochondrosis of the lateral trochlear ridge of the femur.Methods: A retrospective study was performed using the medical records of horses intended for use as English sport horses. Outcome was obtained through telephone questionnaire.Results: Thirty-seven horses, mainly Warmbloods, underwent arthroscopic surgery for treatment of lateral femoral trochlear ridge osteochondrosis. Short-term outcome revealed that 27 of 37 horses had no complications. Seven horses had postoperative lameness and effusion which eventually resolved in four horses. Long-term outcome was available for 29 horses, of which 19 were performing to full expectations. Five horses were athletic but at a lower level than expected, and five horses were unable to be used. The depth of the lesion was significantly associated with short-term complications of effusion and lameness. The depth and length of the lesion were not associated with the long-term outcome, but involvement of structures other than the lateral trochlear ridge (patella, medial trochlear ridge) was associated with a worse prognosis.Clinical significance: The prognosis for sport horses following stifle arthroscopy for lateral trochlear ridge is similar to that reported in other studies and lesions at other sites within the stifle joint.

Outcome of ventriculoperitoneal shunt placement in Grade IV tubercular meningitis with hydrocephalus: a retrospective analysis in 95 patients

2009 ◽  
Vol 4 (2) ◽  
pp. 176-183 ◽  
Author(s):  
Umesh Srikantha ◽  
Jagadeesh V. Morab ◽  
Savitr Sastry ◽  
Rojin Abraham ◽  
Anandh Balasubramaniam ◽  
...  
Keyword(s):  
Long Term Outcomes ◽  
Short Term ◽  
Tubercular Meningitis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vp Shunt ◽  
Shunt Placement ◽  
Short Term Outcome ◽  
Short And Long Term

Object Hydrocephalus is the most common complication of tubercular meningitis (TBM). Relieving hydrocephalus by ventriculoperitoneal (VP) shunt placement has been considered beneficial in patients in Palur Grade II or III. The role of VP shunt placement in those of Grade IV is controversial and the general tendency is to avoid its use. Some authors have suggested that patients in Grade IV should receive a shunt only if their condition improves with a trial placement of an external ventricular drain (EVD). In the present study, the authors assessed the outcome of VP shunt placement in patients in Grade IV TBM with hydrocephalus to examine the factors predicting outcome and to determine whether a trial with an EVD is absolutely necessary prior to shunt placement. Methods Ninety-five consecutive cases of TBM with hydrocephalus in which the patients underwent VP shunt placement were retrospectively analyzed, and direct VP shunts were placed whenever possible. An EVD was placed first only in the presence of deranged blood parameters. Outcomes were assessed both in the short and long term. Results The mean patient age was 17.5 years (range 1–55 years). Fifty-two patients underwent direct VP shunt placement, and the remaining 43 received EVDs first. Overall, 33 and 45% of patients had favorable short- and long-term outcomes, respectively. Age older than 3 years and duration of altered sensorium ≤ 3 days were predictive of a favorable short-term outcome. Glasgow Coma Scale score at presentation was predictive of long-term outcome. Of the patients who did not improve with placement of an EVD prior to VP shunt insertion, 24 and 18% had favorable short- and long-term outcomes, respectively; this was not significantly different from the outcome in the patients who underwent direct VP shunt placement. Conclusions Direct VP shunt placement is an effective option in patients with Grade IV TBM with hydrocephalus. Age and duration of altered sensorium are predictive of short-term outcome, while Glasgow Coma Scale score at presentation predicts long-term outcome. Ventriculoperitoneal shunts should be considered even in patients who do not improve with an EVD.

scholarly journals The Association Between Genetic Variants in lncRNA-p53 Regulatory Network and Ischemic Stroke Prognosis

2020 ◽  
Author(s):  
Xu Liu ◽  
qianwen wang ◽  
jingjing zhao ◽  
hongtao chang ◽  
ruixia zhu
Keyword(s):  
Ischemic Stroke ◽  
Genetic Variants ◽  
Regulatory Network ◽  
Regulatory Pathway ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Risk Alleles ◽  
Short Term Outcome ◽  
Increased Risk

Abstract Objective Recently, lncRNAs have been demonstrated to be associated with the p53 regulatory pathway,which serve as regulators or effectors. LncRNA-p53 regulatory network play important role in ischemia induced apoptosis and be importance for post-stroke recovery.Method Eight genetic variants in p53 related lncRNA were genotype in 940 patients to explore the association of SNPs in p53 regulatory pathway genes with ischemic stroke prognosis in a northern Chinese population. Long-term outcome and short-term outcome were respectively assessed by the stroke recurrence and modified Rankin Scale score at 3 months after stroke.Results We first identified for that p53 rs1042522 and LINC-ROR rs2027701 may be associated with the risk of IS recurrence. In our further cumulative effect analysis, we found that these two polymorphisms may jointly be associated with IS recurrence. Patients carrying 2-4 risk alleles had significantly increased risk of IS recurrence compared with those carrying 0–1 risk alleles. In contrast to rs2027701 and rs1042522, other SNP was found to be not associated with IS recurrence. Subsequently, we also found that TUG1 rs2240183 CC genotype was associated with favorable outcome of ischemic stroke after adjusting confound factors. However, the other seven genetic variants in p53 related lncRNA were not associated with functional outcome after stroke. Conclusion P53 rs1042522 and LINC-ROR rs2027701 may have combined effects on IS recurrence and TUG1 rs2240183 may be new biomarker to predict the short-term outcome of ischemic stroke through modulating p53-mediated apoptosis.

Prognosis of Schizophrenia Before and After Pharmacotherapy: I. Short Term Outcome

1967 ◽  
Vol 113 (505) ◽  
pp. 1345-1352 ◽  
Author(s):  
Michael Pritchard
Keyword(s):  
Mental Hospital ◽  
Short Term ◽  
Short Term Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short Term Outcome ◽  
Number Of Patients ◽  
Before And After ◽  
Hospital Statistics

This study, in two parts, compares the immediate and more long-term outcome of two groups of schizophrenic patients admitted to hospital before and after the introduction of pharmacotherapy in the form of reserpine and the phenothiazines. There have been differences of opinion as to whether the undoubted improvement which has occurred in the prognosis of schizophrenia, at least in the short term, since the introduction of chemotherapy has been due to the use of these drugs, to changes of administrative treatment, or to both. There has been evidence from mental hospital statistics (Shepherd et al., 1961) that changes in outcome began before the introduction of the drugs and were almost certainly related to the changes of administrative treatment or institutional management which have occurred in the mental hospitals over the same period. It may well be that the use of drugs has facilitated these changes as well as having a more direct effect oh prognosis, but the relative importance of these two factors is difficult to assess from mental hospital statistics. Comparison between results obtained in different hospitals is also of limited value because of the number of uncontrolled variables. There would seem, therefore, to be an advantage in the more detailed examination and comparison of a smaller number of patients admitted to the same hospital, and the present investigation is of this type. The material consists of two groups, of 50 patients each, admitted to the Professorial Unit at the Maudsley Hospital in the years 1952/53 and 1956/57 respectively. Since the policy throughout has been to admit only non-compulsory patients for relatively short-term treatment, administrative changes in this hospital between the two periods are likely to have been minimal. The aim was to compare both immediate and long-term outcome in the two groups and to examine the effect of a number of variables on this. The short-term outcome will be considered in the first and the long-term outcome in the second paper.

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