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Impact of perioperative treatment on survival of resectable gastric cancer patients after D2 lymphadenectomy: a single European centre propensity score matching analysis

) chemotherapy. Therefore, we conducted an analysis with propensity score matched patients to determine the role of perioperative and adjuvant chemotherapy in patients after D2 lymphadenectomy. Patients and methods Patients Since 1991, 1563 patients were operated for gastric cancer in the department for Abdominal and General Surgery at the University Clinical Centre Maribor, Slovenia. The demographic characteristics of patients, the characteristics of the surgical procedures, and the pathological characteristics of tumours were prospectively stored on a computer

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Integrated ST Segment Elevation Scores and In-hospital Mortality in STEMI Patients Undergoing Primary PCI

Abstract

The objective of this study was to study the integrated score of ST-segment resolution (ISSTE) and in-hospital death in patients undergoing primary percutaneous intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI).

Material and Methods: This prospective study included 586 consecutive patients admitted with STEMI to the Cardiology Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș, between January 1st, 2013 and December 31, 2014, who underwent pPCI in less than twelve hours after the onset of symptoms. Clinical and demographic data were analyzed in 539 (91.9%) survivors (Group 1) and 47 (8.1%) nonsurvivors (Group 2). The Integrated Score of ST elevation (ISSTE) was calculated by summing the amplitude of the ST segment elevation in all the 12 leads, before and at 2 hours after revascularization.

Results: The ISSTE score calculated at baseline, immediately before the primary percutaneous coronary intervention, was significantly higher in Group 2 as compared to Group 1 (13.9 ± 1.2 vs. 11.0 ± 0.2, p = 0.026). At the same time, the ISSTE score calculated at 2 hours after the coronary intervention was significantly higher for patients in Group 2 (7.36 ± 1.12 vs. 2.9 ± 0.1, p <0.0001). Analysis of the dynamics of the ISSTE score indicated that patients who survived presented a more expressed reduction in the ISSTE score following pPCI, as compared to those who subsequently died (73.5% reduction in Group 1 compared to 47.2% reduction in Group 2, p <0.0001). In-hospital mortality was significantly higher in the group of patients with >50% reduction in the ISSTE score. The in-hospital death rate was 5.4% in patients with >50% reduction in the ISSTE score, compared to 19.4% for those who presented less than 50% reduction in the ISSTE score following pPCI (p <0.0001). The rate of successful reperfusion rate, expressed by the reduction in ISSTE score, was 83.8% in Group 1, compared to 55.3% in Group 2 (p <0.0001), indicating that the absence of an efficient reperfusion after pPCI is associated with a higher mortality in STEMI patients, and could be evaluated using regression of the ISSTE score, which proved to be directly associated with mortality.

Conclusion: The ISSTE score is shown to be an effective ECG-derived marker of myocardial damage in STEMI patients. A high ISSTE score is associated with higher mortality, while a reduction in the ISSTE score after pPCI may indicate an efficient reperfusion and a decrease in mortality in the first days after infarction.

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Doppler ultrasound for diagnosis of soft tissue sarcoma: efficacy of ultrasound-based screening score

Abstract

Background. The utility of ultrasound imaging in the screening of soft-part tumours (SPTs) has been reported. We classified SPTs according to their blood flow pattern on Doppler ultrasound and re-evaluated the efficacy of this imaging modality as a screening method. Additionally, we combined Doppler ultrasound with several values to improve the diagnostic efficacy and to establish a new diagnostic tool.

Patients and methods. This study included 189 cases of pathologically confirmed SPTs (122 cases of benign disease including SPTs and tumour-like lesions and 67 cases of malignant SPTs). Ultrasound imaging included evaluation of vascularity by colour Doppler. We established a scoring system to more effectively differentiate malignant from benign SPTs (ultrasound-based sarcoma screening [USS] score).

Results. The mean scores in the benign and malignant groups were 1.47 ± 0.93 and 3.42 ± 1.30, respectively. Patients with malignant masses showed significantly higher USS scores than did those with benign masses (p < 1 × 10-10). The area under the curve was 0.88 by receiver operating characteristic (ROC) analysis. Based on the cut-off value (3 points) calculated by ROC curve analysis, the sensitivity and specificity for a diagnosis of malignant SPT was 85.1% and 86.9%, respectively.

Conclusions. Assessment of vascularity by Doppler ultrasound alone is insufficient for differentiation between benign and malignant SPTs. Preoperative diagnosis of most SPTs is possible by combining our USS score with characteristic clinical and magnetic resonance imaging findings.

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Carotid artery stiffness, digital endothelial function, and coronary calcium in patients with essential thrombocytosis, free of overt atherosclerotic disease

plaques, which were defined as focal lesions exceeding the intima-media thickness by at least 50% or reaching an absolute thickness of at least 1.5 mm in two orthogonal projections. Scoring of atherosclerotic plaques was performed by a modification of the methodology used in the Rotterdam Study. 24 The extracranial carotid arteries were divided into three sectors on each side: the common carotid artery and its bulb, the internal carotid artery, and the external carotid artery. At least one plaque in any sector was scored 1 point, while the absence of plaques was scored

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Inter-relation between Altered Nutritional Status and Clinical Outcomes in Patients with Acute Myocardial Infarction Admitted in a Tertiary Intensive Cardiac Care Unit

-0959.2004.17603.x. 15. Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20:38-45. 16. Iwakami N, Nagai T, Furukawa TA, et al. Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure. Int J Cardiol. 2017;230:529-536. doi: 10.1016/j.ijcard.2016.12.064. 17. Toyokawa T, Kubo N, Tamura T, et al. The pretreatment Controlling Nutritional Status (CONUT) score is

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Health-related quality of life in Croatian general population and multiple myeloma patients assessed by the EORTC QLQ-C30 and EORTC QLQ-MY20 questionnaires

loss of appetite, constipation, diarrhoea, dyspnoea, financial impact and sleep disturbance. For general quality of life and functional scale, higher scores mean better quality of life while higher scores for symptom scale and single items mean lower quality of life. 18 In addition to EORTC QLQ-C30 all the participants also responded to a questionnaire on their demographic data including age, gender and place of residence. The EORTC QLQ-MY20 is specific questionnaire adjusted for patients with multiple myeloma. The official Croatian translation of the

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Factors affecting voice quality in early glottic cancer before and after radiotherapy

irradiation. Subjective phoniatrician’s and patient’s evaluation A perceptive analysis of voice quality during spontaneous speech by a phoniatrician was performed using the GRB score (grade [G], roughness [R], breathiness [B]; graded from 0 to 3 [0 = not present, 3 = severe disorder]) before and three months after the treatment. Patients assessed their voice quality according to the visual analogue scale (VAS, from 0 to 100%). They also completed the Voice Handicap Index questionnaire (VHI), which is showing the influence of the patients’ voice on their lives. 12 A

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Factors affecting the morbidity and mortality of diverting stoma closure: retrospective cohort analysis of twelve-year period

. Gastrografin enema or colonoscopy were performed in all patients prior to stoma closure. Patients had routine mechanical preparation of the proximal and distal bowel with the cessation of oral feeding the day before surgery. All patients underwent single-shot parenteral antibiotic treatment (cefuroxime and metronidazole) one hour prior to operation. Elementary data included age, sex, American Society of Anaesthesiologists (ASA) score at primary and stoma closure operation, and time from the primary operation to closure. Operative and postoperative data included type of

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Multigene expression signatures in early hormone receptor positive HER 2 negative breast cancer

expression signatures have been developed to better prognosticate disease outcome. Several of these signatures are commercially available and accepted by international guidelines, including the Oncotype DX recurrence score (Genomic Health), PAM50 Prosigna risk of recurrence (NanoString), Breast Cancer Index (BCI) (bioTheranostics), EndoPredict (MyriadGenetics), and MammaPrint (Agendia BV). Oncotype DX and MammaPrint have been most extensively validated, including in prospective randomized trials, TAILOR x and MINDACT and are therefore most commonly used. They are

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Total neoadjuvant treatment of locally advanced rectal cancer with high risk factors in Slovenia

after completion of CRT. Surgery was scheduled 8–10 weeks after the end of CRT. The choice between abdominoperineal and sphincter preserving surgery was at the surgeon’s discretion. No additional treatment was administered after surgery. Endpoints The primary endpoint was pCR. The secondary endpoints included clinical and pathological downstaging, neoadjuvant rectal (NAR) score, toxicity profile, time to stoma closure and compliance during treatment. Pathologic stage was recorded according to the American Joint Committee on Cancer (AJCC) 7th edition. 12 Tumor

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