TikTok as an Information Hodgepodge: Evaluation of the Quality and Reliability of Urinary Tumors Related Content (Preprint)

2021 ◽  
Author(s):  
Xiaoqiang Xue ◽  
Xinyi Yang ◽  
Weifeng Xu ◽  
Guanghua Liu ◽  
Yi Xie ◽  
...  
Keyword(s):  
Video Quality ◽  
Univariate Analysis ◽  
Assessment Instruments ◽  
Public Attention ◽  
Medical Practitioners ◽  
Significant Difference ◽  
Medium Quality ◽  
Code Scale ◽  
Quality And Reliability ◽  
Search For Information

BACKGROUND With 1.6 billion users in 2021, TikTok has become the world's fastest-growing social media application ever since its first launch. Because of the explosion of information on it during the COVID-19 pandemic, more and more patients search for information on urinary tumors on TikTok. OBJECTIVE We aim to evaluate the quality and reliability of urinary tumor-related videos on TikTok by using robust assessing scales and share our thoughts based on the results for better public health promotion. METHODS We retrieved videos on bladder, prostate, and kidney cancer from TikTok. Each video's length and descriptions, hashtags, number of views/likes/comments, forms of expression, and the uploader's profile were included. Three validated assessment instruments: the Hexagonal Radar Schema, the Health on the Net Code scale, and the DISCERN instrument, were used for evaluating the quality and reliability of the information. All misinformation was counted and categorized. Univariate analysis of variance was performed for analyzing the results. The Post-Hoc least significant difference test was conducted to explore further explanation. RESULTS Out of 167 retrieved videos, only 61 (36.53%) met the inclusion criteria. Amongst them, 36.07% were misinformative, and the most common type was using outdated data. More than half of the videos could provide good (> 1 point) content on the diseases' symptoms and examinations. However, the definition and outcomes were poorly addressed (tied at 21.31 %). The HONcode scale and the DISCERN instrument revealed a consistent conclusion that most videos on TikTok were of poor to mediocre quality. Videos published by media agencies were statistically better than those posted by others in terms of reliability and overall score (P = .003 and .008, respectively). 86.89% of videos had at least two unexplained medical terms. Among them, healthcare professionals like to use professional terms most (mean = 5.28 words). CONCLUSIONS Most videos on urinary tumors on TikTok are of poor to medium quality and reliability. However, videos posted by media agencies enjoyed great public attention and interaction. Medical practitioners could improve the video quality by cooperating with media agencies and avoiding unexplained terminologies.

scholarly journals Cohort study of the overall survival of patients with pancreatic cancer in a hospital of specialties of Quito-Ecuador in the period 2007–2017

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andrés Moreno Roca ◽  
Luciana Armijos Acurio ◽  
Ruth Jimbo Sotomayor ◽  
Carlos Céspedes Rivadeneira ◽  
Carlos Rosero Reyes ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cohort Study ◽  
Survival Time ◽  
Univariate Analysis ◽  
Rank Test ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Icd 10 ◽  
The Difference ◽  
Clinical Records

Abstract Objectives Pancreatic cancers in most patients in Ecuador are diagnosed at an advanced stage of the disease, which is associated with lower survival. To determine the characteristics and global survival of pancreatic cancer patients in a social security hospital in Ecuador between 2007 and 2017. Methods A retrospective cohort study and a survival analysis were performed using all the available data in the electronic clinical records of patients with a diagnosis of pancreatic cancer in a Hospital of Specialties of Quito-Ecuador between 2007 and 2017. The included patients were those coded according to the ICD 10 between C25.0 and C25.9. Our univariate analysis calculated frequencies, measures of central tendency and dispersion. Through the Kaplan-Meier method we estimated the median time of survival and analyzed the difference in survival time among the different categories of our included variables. These differences were shown through the log rank test. Results A total of 357 patients diagnosed with pancreatic cancer between 2007 and 2017 were included in the study. More than two-thirds (69.9%) of the patients were diagnosed in late stages of the disease. The median survival time for all patients was of 4 months (P25: 2, P75: 8). Conclusions The statistically significant difference of survival time between types of treatment is the most relevant finding in this study, when comparing to all other types of treatments.

scholarly journals 387. Markers for Mortality in COVID-19 Patients with Atrial Fibrillation or Flutter

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S262-S262
Author(s):  
Kok Hoe Chan ◽  
Bhavik Patel ◽  
Iyad Farouji ◽  
Addi Suleiman ◽  
Jihad Slim
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Prognostic Markers ◽  
Univariate Analysis ◽  
Laboratory Data ◽  
Significant Difference ◽  
New Onset

Abstract Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can lead to many different cardiovascular complications, we were interested in studying prognostic markers in patients with atrial fibrillation/flutter (A. Fib/Flutter). Methods A retrospective cohort study of patients with confirmed COVID-19 and either with existing or new onset A. Fib/Flutter who were admitted to our hospital between March 15 and May 20, 2020. Demographic, outcome and laboratory data were extracted from the electronic medical record and compared between survivors and non-survivors. Univariate and multivariate logistic regression were employed to identify the prognostic markers associated with mortality in patients with A. Fib/Flutter Results The total number of confirmed COVID-19 patients during the study period was 350; 37 of them had existing or new onset A. Fib/Flutter. Twenty one (57%) expired, and 16 (43%) were discharged alive. The median age was 72 years old, ranged from 19 to 100 years old. Comorbidities were present in 33 (89%) patients, with hypertension (82%) being the most common, followed by diabetes (46%) and coronary artery disease (30%). New onset of atrial fibrillation was identified in 23 patients (70%), of whom 13 (57%) expired; 29 patients (78%) presented with atrial fibrillation with rapid ventricular response, and 2 patients (5%) with atrial flutter. Mechanical ventilation was required for 8 patients, of whom 6 expired. In univariate analysis, we found a significant difference in baseline ferritin (p=0.04), LDH (p=0.02), neutrophil-lymphocyte ratio (NLR) (p=0.05), neutrophil-monocyte ratio (NMR) (p=0.03) and platelet (p=0.015) between survivors and non-survivors. With multivariable logistic regression analysis, the only value that had an odds of survival was a low NLR (odds ratio 0.74; 95% confidence interval 0.53–0.93). Conclusion This retrospective cohort study of hospitalized patients with COVID-19 demonstrated an association of increase NLR as risk factors for death in COVID-19 patients with A. Fib/Flutter. A high NLR has been associated with increased incidence, severity and risk for stroke in atrial fibrillation patients but to our knowledge, we are first to demonstrate the utilization in mortality predictions in COVID-19 patients with A. Fib/Flutter. Disclosures Jihad Slim, MD, Abbvie (Speaker’s Bureau)Gilead (Speaker’s Bureau)Jansen (Speaker’s Bureau)Merck (Speaker’s Bureau)ViiV (Speaker’s Bureau)

scholarly journals AB0132 THE STUDY OF SUBCLINICAL SYNOVITIS DETECTED BY ULTRASONOGRAPHY AND MRI IN RA PATIENTS AFTER REACHING CLINICAL REMISSION ON PATIENT’S SUBJECTIVE SYMPTOMS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1094.2-1094
Author(s):  
M. Nawata ◽  
K. Someya ◽  
T. Aritomi ◽  
M. Funada ◽  
K. Nakamura ◽  
...  
Keyword(s):  
Clinical Remission ◽  
Research Funding ◽  
Morning Stiffness ◽  
Univariate Analysis ◽  
P Value ◽  
Research Support ◽  
Residual Symptoms ◽  
Logistic Analysis ◽  
Significant Difference ◽  
Multivariate Logistic Analysis

Background:The goal of treatment in rheumatoid arthritis (RA) is to achieve remission. There is the patient with residual symptoms in the Japanese RA patient who achieved clinical remission. There are not many studies to examine the relation between everyday life, social activity and evaluation of disease activities using high-sensitivity image examinations (musculoskeletal ultrasound (MSKUS) and MRI).Objectives:To examine the relationship between subjective residual symptoms and imaging examinations in RA patients who have achieved clinical remission.Methods:30 RA patients who achieved SDAI remission during RA treatment. Age, sex, disease duration, physical findings, serological markers, disease activity, HAQ, EQ-5D-5L, FACIT-F, Patient Reported Outcomes (PROs), EGA and medications were evaluated. 44 joints were assessed by MSKUS with gray scale (GS) and power doppler (PD) and contrast-enhanced bilateral joint MRI scoring with OMERACT-RAMRIS scoring.Results:1. The mean SDAI of the 30 RA patients was 1.3. 2.In the analysis of the presence or absence of subjective residual symptoms that led to remission of SDAI (Table 1).Table 1.Subjective residual symptoms/presence (N=17)Subjective residual symptoms/absence (N=13)Univariate analysisp valueMultivariate logistic analysisp valueTJC0.0±0.00.3±0.50.0173HAQ0.4±0.40.05±0.10.00950.00181EQ5D-5L0.8±0.10.9±0.00.0001FACIT-F14.5±9.84.6±4.30.0233Morning stiffness (min)256.5±564.80.0±0.00.0210Pain (VAS) (mm)9.2±9.50.9±1.50.00440.0455PGA (mm)7.7±9.00.5±1.10.0013(1). In the univariate analysis, the number of tender joints, HAQ, EQ-5D-5L, FACIT-F, morning stiffness, and pain VAS were extracted with significant differences.(2). In multivariate logistic analysis, HAQ and pain VAS were extracted as independent factors with significant differences. 3.In univariate analysis of the association between HAQ and pain VAS extracted in multivariate logistic analysis and imaging examinations (MSKUS/MRI), MRI-synovitis was extracted with a significant difference in HAQ.Conclusion:1. It was suggested that Pain VAS and HAQ due to RA could be identified in patients reaching SDAI remission. 2. In patients reaching SDAI remission, Pain VAS ≤10 or HAQ ≤0.5 suggested that subjective residual symptoms may be eliminated. 3. HAQ ≤ 0.5 suggests that synovitis is less likely to be detected on MRI. 4. In patients who have reached SDAI remission, little residual inflammation was observed on US, suggesting that induction of remission is important not only to prevent joint destruction, but also to improve and maintain long-term QoL.Disclosure of Interests:MASAO NAWATA Grant/research support from: I have received research funding from Eli Lilly Japan K.K., Kazuki Someya: None declared, Takafumi Aritomi: None declared, Masashi funada: None declared, Katsumi Nakamura: None declared, SAITO KAZUYOSHI Grant/research support from: I have received research funding from Eli Lilly Japan K.K., Yoshiya Tanaka Speakers bureau: I have received speaking fees from Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen, Consultant of: I have received consulting fees from Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen, Grant/research support from: I have received research grants from Mitsubishi-Tanabe, Takeda, Chugai, Astellas, Eisai, Taisho-Toyama, Kyowa-Kirin, Abbvie, and Bristol-Myers

scholarly journals A Survey of Marine Coastal Litters around Zhoushan Island, China and Their Impacts

2021 ◽  
Vol 9 (2) ◽  
pp. 183
Author(s):  
Xuehua Ma ◽  
Yi Zhou ◽  
Luyi Yang ◽  
Jianfeng Tong
Keyword(s):  
Rapid Development ◽  
Univariate Analysis ◽  
Local Environment ◽  
Marine Litter ◽  
Social Ecological ◽  
The Social ◽  
Significant Difference ◽  
Valuable Method ◽  
Beach Litter ◽  
The Impact

Rapid development of the economy increased marine litter around Zhoushan Island. Social-ecological scenario studies can help to develop strategies to adapt to such change. To investigate the present situation of marine litter pollution, a stratified random sampling (StRS) method was applied to survey the distribution of marine coastal litters around Zhoushan Island. A univariate analysis of variance was conducted to access the amount of litter in different landforms that include mudflats, artificial and rocky beaches. In addition, two questionnaires were designed for local fishermen and tourists to provide social scenarios. The results showed that the distribution of litter in different landforms was significantly different, while the distribution of litter in different sampling points had no significant difference. The StRS survey showed to be a valuable method for giving a relative overview of beach litter around Zhoushan Island with less effort in a future survey. The questionnaire feedbacks helped to understand the source of marine litter and showed the impact on the local environment and economy. Based on the social-ecological scenarios, governance recommendations were provided in this paper.

scholarly journals P7: ACUTE KIDNEY INJURY AFTER ELECTIVE COLORECTAL SURGERY: RESULTS OF A NATIONAL CLOSED-LOOP AUDIT

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
Keyword(s):  
Acute Kidney Injury ◽  
Quality Improvement ◽  
Colorectal Surgery ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Elective Colorectal Surgery ◽  
National Quality ◽  
Significant Difference ◽  
The Uk

Abstract Introduction The aim of this study was to re-audit the rates of acute kidney injury (AKI) after elective colorectal surgery, following local presentations of results. Method Outcomes After Kidney injury in Surgery (OAKS) and Ileus Management International (IMAGINE), were prospective multicentre audits on consecutive elective colorectal resections, in the UK and Ireland. These were performed over 3-month periods in 2015 and 2018 respectively. During the interim period, results were presented at participating centres to stimulate local quality improvement initiatives. Risk-adjusted 7-day postoperative AKI rates were calculated through multilevel logistic regression based on the OAKS prognostic score. Result Of the 4,917 patients included, 3,133 (63.7%) originated from OAKS and 1,784 (36.3%) from IMAGINE. On univariate analysis, there was no significant difference (p=0.737) in the 7-day AKI rate between OAKS (n=346, 11.8%) and IMAGINE (n=205, 11.5%). However, the risk-adjusted AKI rate in IMAGINE was significantly lower compared to OAKS (-1.8%, 95% CI: -2.3% to -1.3%, p<0.001). Of 47 centres (40.1%) with a recorded local presentation, there was no significant difference in the subsequent AKI rate in IMAGINE (-0.7%, -2.0% to 0.6%, p=0.278). Conclusion Rates of AKI after elective colorectal surgery significantly reduced on re-audit. However, this may be related to increased awareness from participation or national quality improvement initiatives, rather than local presentation of results. Abbrev. AKI - Acute Kidney Injury, OAKS - Outcomes After Kidney injury in Surgery, IMAGINE - Ileus Management International Take-home message Risk-adjusted AKI rates significantly reduced on re-audit, however, this was most likely due to factors separate from the local presentation of initial results.

Evaluation of the Quality, Educational Value and Utility of the Videos on YouTube for Laparoscopic Low Anterior Resection

2021 ◽  
pp. 000313482110111
Author(s):  
Erol Piskin ◽  
Muhammet Kadri Çolakoğlu ◽  
Ali Bal ◽  
Volkan Oter ◽  
Erdal Birol Bostanci
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Video Quality ◽  
Relevant Information ◽  
Teaching Quality ◽  
Educational Value ◽  
Laparoscopic Low Anterior Resection ◽  
Significant Difference ◽  
October 17

Background Minimally invasive surgery is a rising trend in colorectal surgery and is on its way to becoming the gold standard due to the benefits it provides for patients. This study aims to test the efficacy for educational purposes by evaluating the videos published on YouTube ( www.youtube.com ) channel for low anterior resection procedure in rectum surgery. Methods We searched YouTube on October 17, 2020 to choose video clips that included relevant information about laparoscopic low anterior resection (LAR) for rectal cancer. Results We included 25 academics and 75 individual videos in this study. The teaching quality of the videos was evaluated according to academic and individual videos, and it was seen that the teaching quality scores of academic videos were higher and this result was statistically significant ( P = .03). The modified Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) criteria were found that the score was higher in individual videos ( P = .014). The median Video Power Index (VPI) value was 1.50 (range .05-347) and the mean ratio was 7.01 ± 3.52. There was no statistically significant difference between the 2 groups ( P = .443). Discussion Video-based surgical learning is an effective method for surgical education. Our study showed that the video quality and educational content of most of the videos about the low anterior resection procedure on YouTube were low. The videos of academic origin seem more valuable than individual videos. As far as video popularity is concerned, YouTube viewers are not selective. For this reason, training videos to be used for educational purposes must be passed through a standardized evaluation filter.

scholarly journals POS1189 THE IMPACT OF TELEMEDICINE AND COVID-19 ON A TERTIARY RHEUMATOLOGY SERVICE: A RETROSPECTIVE AUDIT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 876-877
Author(s):  
W. Zhu ◽  
T. De Silva ◽  
L. Eades ◽  
S. Morton ◽  
S. Ayoub ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Univariate Analysis ◽  
Diagnostic Delay ◽  
Cohort Differences ◽  
Phone Calls ◽  
Retrospective Audit ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Background:Telemedicine was widely utilised to complement face-to-face (F2F) care in 2020 during the COVID-19 pandemic, but the impact of this on patient care is poorly understood.Objectives:To investigate the impact of telemedicine during COVID-19 on outpatient rheumatology services.Methods:We retrospectively audited patient electronic medical records from rheumatology outpatient clinics in an urban tertiary rheumatology centre between April-May 2020 (telemedicine cohort) and April-May 2019 (comparator cohort). Differences in age, sex, primary diagnosis, medications, and proportion of new/review appointments were assessed using Mann-Whitney U and Chi-square tests. Univariate analysis was used to estimate associations between telemedicine usage and the ability to assign a diagnosis in patients without a prior rheumatological diagnosis, the frequency of changes to immunosuppression, subsequent F2F review, planned admissions or procedures, follow-up phone calls, and time to next appointment.Results:3,040 outpatient appointments were audited: 1,443 from 2019 and 1,597 from 2020. There was no statistically significant difference in the age, sex, proportion of new/review appointments, or frequency of immunosuppression use between the cohorts. Inflammatory arthritis (IA) was a more common diagnosis in the 2020 cohort (35.1% vs 31%, p=0.024). 96.7% (n=1,444) of patients seen in the 2020 cohort were reviewed via telemedicine. In patients without an existing rheumatological diagnosis, the odds of making a diagnosis at the appointment were significantly lower in 2020 (28.6% vs 57.4%; OR 0.30 [95% CI 0.16-0.53]; p<0.001). Clinicians were also less likely to change immunosuppressive therapy in 2020 (22.6% vs 27.4%; OR 0.78 [95% CI 0.65-0.92]; p=0.004). This was mostly driven by less de-escalation in therapy (10% vs 12.6%; OR 0.75 [95% CI 0.59-0.95]; p=0.019) as there was no statistically significant difference in the escalation or switching of immunosuppressive therapies. There was no significant difference in frequency of follow-up phone calls, however, patients seen in 2020 required earlier follow-up appointments (p<0.001). There was also no difference in unplanned rheumatological presentations but significantly fewer planned admissions and procedures in 2020 (1% vs 2.6%, p=0.002). Appointment non-attendance reduced in 2020 to 6.5% from 10.9% in 2019 (OR 0.57 [95% CI 0.44-0.74]; p<0.001), however the odds of discharging a patient from care were significantly lower in 2020 (3.9% vs 6%; OR 0.64 [95% CI 0.46-0.89]; p=0.008), although there was no significance when patients who failed to attend were excluded. Amongst patients seen via telemedicine in 2020, a subsequent F2F appointment was required in 9.4%. The predictors of needing a F2F review were being a new patient (OR 6.28 [95% CI 4.10-9.64]; p<0.001), not having a prior rheumatological diagnosis (OR 18.43 [95% CI: 2.35-144.63]; p=0.006), or having a diagnosis of IA (OR 2.85 [95% CI: 1.40-5.80]; p=0.004) or connective tissue disease (OR 3.22 [95% CI: 1.11-9.32]; p=0.031).Conclusion:Most patients in the 2020 cohort were seen via telemedicine. Telemedicine use during the COVID-19 pandemic was associated with reduced clinic non-attendance, but with diagnostic delay, reduced likelihood of changing existing immunosuppressive therapy, earlier requirement for review, and lower likelihood of discharge. While the effects of telemedicine cannot be differentiated from changes in practice related to other aspects of the pandemic, they suggest that telemedicine may have a negative impact on the timeliness of management of rheumatology patients.Disclosure of Interests:None declared.

scholarly journals Physical Activity of Serbian Children in Daycare

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 161
Author(s):  
Milenko Janković ◽  
Maja Batez ◽  
Dušan Stupar ◽  
Jelena Obradović ◽  
Nebojša Trajković
Keyword(s):  
Physical Activity ◽  
Early Childhood ◽  
Urban Environment ◽  
Educational Institution ◽  
Univariate Analysis ◽  
Age Groups ◽  
Preschool Age ◽  
Variance Test ◽  
Significant Difference ◽  
Novi Sad

Background: Monitoring of physical activity within the educational institution is of great importance, primarily because of the orientation and content implemented in the daycare. This research aimed to examine the number of steps children took during their stay in daycare with regards to age, gender and the frequency of going out. Methods: The research was conducted in four daycares in the urban environment of Novi Sad (Republic of Serbia), where 231 children, aged 5 to 7, were monitored (129 boys and 102 girls). Data on the number of steps were obtained using the pedometers. Results: The result of the univariate analysis of the variance test confirmed a statistically significant difference in the number of steps in relation to the age of children (p = 0.04). Boys were more active than girls in both age groups (p = 0.001). Children who were going to the daycare yard three to five times a week took drastically more steps than children who went up to twice a week (p = 0.001). Conclusion: The results of the current study show that age, gender, and time spent outdoors are significant determinants of physical activity in preschool age. Therefore, interventions regarding physical activity should be made during early childhood in order to promote health and prevent disease.

scholarly journals 1611. Evaluating Clinical Outcomes and Efficacy of Daptomycin in Combination with a Beta-Lactam for the Treatment of Vancomycin-Resistant Enterococcus (VRE) Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S799-S800
Author(s):  
Nerea Irusta ◽  
Ana Vega ◽  
Yoichiro Natori ◽  
Lilian M Abbo ◽  
Lilian M Abbo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Primary Outcome ◽  
Small Sample Size ◽  
Univariate Analysis ◽  
Small Sample ◽  
Significant Difference ◽  
Vancomycin Resistant ◽  
Secondary Outcomes ◽  
Related Mortality

Abstract Background In-vitro studies have shown synergistic bactericidal activity with daptomycin (DAP) plus β-lactam antimicrobials against vancomycin resistant enterococci (VRE). There is a paucity of data regarding clinical outcomes with this combination in VRE bloodstream infections (BSI). The purpose of this study was to assess the efficacy of DAP plus a β-lactam with in-vitro activity vs. other therapies for treatment of VRE BSI. Methods IRB-approved, single-center, retrospective study of patients with VRE BSI from 01/2018-09/2019. Patients were excluded if &lt; 18 years old, pregnant, or incarcerated. The primary outcome was time-to-microbiological clearance. Secondary outcomes included infection-related mortality, 30-day all-cause mortality, and incidence of recurrent BSI within 30 days of index culture. Targeted DAP doses were ≥ 8mg/kg and based on MIC. Factors associated with significance for outcomes, via univariate analysis, were evaluated with multivariable logistic regression (MLR), removed in a backward-step approach. Results A total of 85 patients were included, 23 of which received DAP plus a β-lactam. The comparator arm included linezolid or DAP monotherapy. Patients with combination therapy had significantly higher Charlson Comorbidity Index (CCI) (p=0.013) and numerically higher Pitt Bacteremia scores (PBS) (p=0.087) (Table 1). There was no difference seen in the primary outcome (Table 2). Secondary outcomes are provided in Table 2. The presence of polymicrobial infection and higher PBS were significantly associated with infection-related mortality (p=0.008 and p=0.005, respectively) by MLR. A Mann Whitney U test indicated that presence of infection-related mortality was greater for patients with higher MICS (U=20.5, p=0.06). The presence of an underlying source may be related to recurrence of BSI (p=0.075). Table 1: Patient Characteristics Table 2. Primary and Secondary Outcomes Conclusion We did not find a significant difference in time-to-microbiological clearance, although patients treated with DAP and a β-lactam had higher CCI and PBS. These results are limited by retrospective design, small sample size, and potential selection bias. Prospective randomized studies are needed to further validate these findings. Disclosures All Authors: No reported disclosures

Chemoradiotherapy is an Alternative Choice for Patients with Primary Mediastinal Seminoma

2021 ◽  
Author(s):  
Yirui Zhai ◽  
Bo Chen ◽  
Xiaoli Feng ◽  
Kan Liu ◽  
Shulian Wang ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Progression Free Survival ◽  
Poor Performance ◽  
Rank Test ◽  
Clinicopathologic Characteristics ◽  
Cancer Specific Survival ◽  
Adjacent Structures ◽  
Significant Difference ◽  
Mediastinal Seminoma ◽  
Alternative Choice

Abstract Background: The low incidence of primary mediastinal seminomas has precluded the development of clinical trials on mediastinal seminomas. We investigated the clinicopathologic characteristics, prognosis of patients with primary mediastinal seminomas as well as the efficiency of nonsurgical treatments compared with treatments containing surgery.Methods: We retrospectively collected data on the clinicopathologic characteristics, treatments, toxicities, and survival of 27 patients from a single center between 2000 and 2018. Patients were divided into two groups according to whether they received operation. Survivals were assessed using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test.Results: The median age was 28 (13-63) years. The most common symptoms were chest pain (29.6%), cough (25.9%), and dyspnea (22.2%). There were 13 and 14 patients in surgery and non-surgery group. Patients in the non-surgical group were more likely to be with poor performance scores (100% vs.76.9%) and disease invaded to adjacent structures(100% vs.76.9%) especially great vessels(100% vs.46.2%).The median follow-up period was 32.23 (2.7-198.2) months. There was no significant difference of overall survival (5-year 100% vs 100%), cancer-specific survival (5-year 100% vs.100%), local regional survival (5-year 91.7% vs.90.0%, p=0.948) , distant metastasis survival (5-year 100.0% vs. 90.9%, p=0.340) and progression-free survival (82.5% vs.90.0%, p=0.245) between patients with and without surgery. Conclusions: Primary mediastinal seminoma was with favorable prognosis, even though frequently invasion into adjacent structures brings difficulties to surgery administration. Chemoradiotherapy is an alternative treatment with both efficacy and safety.

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