Factors Affecting Long-Term Prognosis and Maintenance Treatment Outcomes

2019 ◽  
pp. 327-338
Keyword(s):  
Treatment Outcomes ◽  
Maintenance Treatment ◽  
Factors Affecting ◽  
Long Term Prognosis

64 STATISTICAL ANALYSIS OF PROGNOSTIC FACTORS AFFECTING LONG-TERM PROGNOSIS AFTER ENDOSCOPIC TREATMENT OF ESOPHAGEAL VARICES

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
T Nishimura
Keyword(s):  
Prognostic Factors ◽  
Esophageal Varices ◽  
Endoscopic Treatment ◽  
Survival Period ◽  
Term Survival ◽  
Gastroesophageal Varices ◽  
Long Term Survival ◽  
Factors Affecting ◽  
Long Term Prognosis

Abstract   Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 260 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and June 2019. Among them, 160 successfully followed up. The patients’ characteristics were: mean age, 65.4 years (29–85); 109 men and 51 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The long-term/non-long-term survival group had a preoperative Child-Pugh score of 6.2 ± 1.1/7.4 ± 2.0 (p < 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.4%/55.9% (p < 0.01), significantly higher in the non-long-term group. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, p < 0.05], total bilirubin value≧ 2 [HR:2.5573, p < 0.05], and presence of HCC [HR:2.2450, p < 0.01] were noted as significant factors. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio:0.3463, p < 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices.

scholarly journals Anti-NMDAR encephalitis

2019 ◽  
Vol 7 (1) ◽  
pp. e633 ◽  
Author(s):  
Xiaolu Xu ◽  
Qiang Lu ◽  
Yan Huang ◽  
Siyuan Fan ◽  
Lixin Zhou ◽  
...  
Keyword(s):  
Ovarian Teratoma ◽  
Long Term Outcomes ◽  
First Line ◽  
Factors Affecting ◽  
First Line Therapy ◽  
Nmdar Encephalitis ◽  
Clinical Presentations ◽  
Long Term Prognosis

ObjectiveTo describe the detailed clinical characteristics, immunotherapy, and long-term outcomes of patients with anti-NMDA receptor (NMDAR) encephalitis in China.MethodsA single-center, prospective study. Patients who met the diagnostic criteria were enrolled from 2011 to 2017 and followed up. The clinical features, treatment, and long-term outcomes were collected prospectively. Factors affecting the long-term prognosis were analyzed.ResultsThe study included 220 patients. The most common clinical presentations were psychosis (82.7%) and seizures (80.9%). Of the patients, 19.5% had an underlying neoplasm; of which ovarian teratoma was 100% of tumors in females and only one male had lung cancer. Most patients (99.5%) received first-line therapy (glucocorticoids, IV immunoglobulin, or plasmapheresis alone or combined), and only 7.3% received second-line immunotherapy (rituximab, cyclophosphamide alone, or combined). Long-term immunotherapy (mycophenolate mofetil or azathioprine >1 year) was administered to 53.2% of patients. During the first 12 months, 207 (94.1%) patients experienced improvement, and 5 (2.3%) died, whereas 38 (17.3%) experienced relapses. At 12-month follow-up, 92.7% had favorable clinical outcomes (modified Rankin Scale score ≤2).ConclusionsPatients in China present with psychosis and seizure frequently but have a low percentage of underlying neoplasms. Re-enforced first-line immunotherapy is effective in managing anti-NMDAR encephalitis in the acute phase. Although relapse is relatively common, with combined first-line and long-term immunotherapy, most patients reached favorable outcomes.

scholarly journals The Influence of Different Treatment Strategies on the Long-Term Prognosis of T1 Stage Esophageal Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Liang Pan ◽  
Xingyu Liu ◽  
Weidong Wang ◽  
Linhai Zhu ◽  
Wenfeng Yu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Tumor Size ◽  
Factors Affecting ◽  
Ajcc Stage ◽  
Size Grade ◽  
T1 Stage ◽  
Long Term Prognosis ◽  
Better Than

ObjectiveTo compare the long-term prognosis effects of non-esophagectomy and esophagectomy on patients with T1 stage esophageal cancer.MethodsAll esophageal cancer patients in the study were included from the National Surveillance Epidemiology and End Results (SEER) database between 2005-2015. These patients were classified into non-esophagectomy group and esophagectomy group according to therapy methods and were compared in terms of esophagus cancer specific survival (ECSS) and overall survival (OS) rates.ResultsA total of 591 patients with T1 stage esophageal cancer were enrolled in this study, including 212 non-esophagectomy patients and 111 esophagectomy patients in the T1a subgroup and 37 non-esophagectomy patients and 140 esophagectomy patients in the T1b subgroup. In all T1 stage esophageal cancer patients, there was no difference in the effect of non-esophagectomy and esophagectomy on postoperative OS, but postoperative ECSS in patients treated with non-esophagectomy was significantly better than those treated with esophagectomy. Cox proportional hazards regression model analysis showed that the risk factors affecting ECSS included race, primary site, tumor size, grade, and AJCC stage but factors affecting OS only include tumor size, grade, and AJCC stage in T1 stage patients. In the subgroup analysis, there was no difference in either ECSS or OS between the non-esophagectomy group and the esophagectomy group in T1a patients. However, in T1b patients, the OS after esophagectomy was considerably better than that of non-esophagectomy.ConclusionsNon-esophagectomy, including a variety of non-invasive procedures, is a safe and available option for patients with T1a stage esophageal cancer. For some T1b esophageal cancer patients, esophagectomy cannot be replaced at present due to its diagnostic and therapeutic effect on lymph node metastasis.

scholarly journals Factors Affecting the Absorption of Subcutaneously Administered Insulin: Effect on Variability

2018 ◽  
Vol 2018 ◽  
pp. 1-17 ◽  
Author(s):  
A. K. J. Gradel ◽  
T. Porsgaard ◽  
J. Lykkesfeldt ◽  
T. Seested ◽  
S. Gram-Nielsen ◽  
...  
Keyword(s):  
Injection Site ◽  
Subcutaneous Tissue ◽  
Injection Technique ◽  
Insulin Absorption ◽  
Physiological Factors ◽  
Insulin Effect ◽  
Factors Affecting ◽  
Glucose Levels ◽  
Long Term Prognosis

Variability in the effect of subcutaneously administered insulin represents a major challenge in insulin therapy where precise dosing is required in order to achieve targeted glucose levels. Since this variability is largely influenced by the absorption of insulin, a deeper understanding of the factors affecting the absorption of insulin from the subcutaneous tissue is necessary in order to improve glycaemic control and the long-term prognosis in people with diabetes. These factors can be related to either the insulin preparation, the injection site/patient, or the injection technique. This review highlights the factors affecting insulin absorption with special attention on the physiological factors at the injection site. In addition, it also provides a detailed description of the insulin absorption process and the various modifications to this process that have been utilized by the different insulin preparations available.

Endoscopic versus surgical resection for mucosal esophageal squamous cell carcinoma: Treatment outcomes and factors affecting survival.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 368-368
Author(s):  
Ga Hee Kim ◽  
Ho June Song ◽  
Hee Kyong Na ◽  
Ji Yong Ahn ◽  
Jeong Hoon Lee ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Adverse Events ◽  
Esophageal Squamous Cell Carcinoma ◽  
Treatment Outcomes ◽  
Cancer Recurrence ◽  
Second Primary ◽  
Term Survival ◽  
Second Primary Cancers ◽  
Factors Affecting

368 Background: Mucosal esophageal squamous cell carcinoma (T1a EC) is treated with endoscopic (ER) or surgical resection (SR). The data regarding prognosis of T1a EC and the associated factors are still lacking. This study aimed to compare the treatment outcomes of T1a EC in ER and SR groups, and to investigate the factors affecting long-term survival. Methods: We retrieved data for 263 patients with T1a EC who underwent ER (n = 200) or SR (n = 63). Relevant clinical and tumor-specific parameters were reviewed. Underlying comorbidity was scored using Charlson co-morbidity index (CCI). Significant factors affecting survival were determined by Cox regression analysis. Results: The mean age of the patients was 64.5±8.0 years. During a mean follow-up of 54.4±20.4 months, the 5-year overall survival (OS) of all T1a EC patients was 85.7% (86.8% in ER and 82.4% in SR group; p = 0.631). In multivariate analysis, CCI was a significant factor affecting survival (p < 0.001). The 5-year OS was 60.2% in patients with CCI > 2 and 88.2% in patients with CCI ≤2 (p < 0.001). The 5-year cumulative incidence of primary EC recurrence was 1.9% and metachronous EC recurrence was 15.1% in ER group (0% in SR group). Incidence of subsequent second primary cancers was 9% in ER and 9.5% in SR. The 5-year cumulative incidences of all cases of cancer recurrence in ER and SR groups were 27.5% and 10.8%, respectively (p = 0.037). The procedure-related adverse events occurred in 10.0% in ER and 41.3% in SR (p < 0.001). Among the 24 (12.0%) and 10 (15.9%) deaths in ER and SR group, respectively, primary EC-specific death was not reported. The major causes of death were second primary cancers in ER group (75%), and post-operative complications or organ failure in SR group (70%). Conclusions: Long-term survival was excellent in patients undergoing ER or SR for T1a EC. The prognosis of T1a EC was significantly associated with underlying comorbidity. Attention should be paid to metachronous cancer recurrence in ER group and operation-related adverse events in SR group.

Renovascular reconstruction: Factors affecting long-term prognosis in 919 patients followed up to 31 years

1989 ◽  
Vol 63 (15) ◽  
pp. 1085-1092 ◽  
Author(s):  
Gerald M. Lawrie ◽  
George C. Morris ◽  
Donald H. Glaeser ◽  
Michael E. DeBakey
Keyword(s):  
Factors Affecting ◽  
Long Term Prognosis

Long-Term Prognosis of Tinnitus Associated with Idiopathic Sudden Sensorineural Hearing Loss

2021 ◽  
pp. 1-9
Author(s):  
Tongxiang Diao ◽  
Xin Ma ◽  
Jingjing Li ◽  
Jen-Tsung Lai ◽  
Lisheng Yu ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Recovery Time ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Factors Affecting ◽  
Hearing Recovery ◽  
Long Term Prognosis

<b><i>Objective:</i></b> To analyze the factors affecting the long-term prognosis of tinnitus accompanied by unilateral idiopathic sudden sensorineural hearing loss (SSNHL). <b><i>Methods:</i></b> A total of 161 patients with sudden hearing loss (HL) accompanied by tinnitus were enrolled. All patients had two separate telephone follow-ups and were asked about changes in tinnitus. The severity of tinnitus at admission and the outcome at discharge were assessed in terms of the patients’ sex, age, level of HL, type of audiogram, etc. <b><i>Results:</i></b> The prognosis of tinnitus after SSNHL had no relationship with grades of HL or hearing recovery. Initial tinnitus level was remarkably associated with tinnitus improvement at discharge and was an independent risk factor for the long-term prognosis of residual tinnitus after SSNHL (odds ratio 0.722, 95% confidence interval 0.550–0.949, <i>p</i> = 0.019), and the median recovery time was 23.00 ± 3.80 months. <b><i>Conclusions:</i></b> Residual tinnitus after SSNHL has a tendency of self-recovery. The short-term prognosis of tinnitus may be related to psychological changes caused by hearing recovery, while the long-term prognosis of residual tinnitus after SSNHL is related only to the initial tinnitus level, with a median recovery time of approximately 2 years.

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