Supervivencia en pacientes con fibrosis quística

Introducción: La fibrosis quística ha dejado de ser una enfermedad pediátrica para ser una enfermedad crónica del adulto. Existen múltiples factores que condicionan la supervivencia de estos enfermos. Objetivo: Determinar la sobrevida de pacientes pediátricos con fibrosis quística hospitalizados en un centro especializado. Métodos: Estudio retrospectivo de cohorte cuyo universo lo conformaron 27 pacientes incluidos en el Registro Provincial de Fibrosis Quística de Granma, 2003-2018. Se analizaron variables: edad actual y sexo, variante genética, presencia de gérmenes, formas clínicas, y supervivencia a partir del diagnóstico y tratamiento. Se utilizó el método de Kaplan-Meier y Log-Rank Test, para un nivel de significación de 95 %. Resultados: El 40,7 % de los pacientes declaró tener actualmente más de 15 años, predominó el sexo masculino (63 %), y la mutación F508del en su variante genética heterocigótica (44,4 %). El promedio de supervivencia resultó en 21,4 años, no existieron diferencias significativas según sexo, formas clínicas y tipos de gérmenes. Conclusiones: Los pacientes con fibrosis quística en Granma, Cuba mostraron un promedio de supervivencia de 21,4 años, inferior a lo documentado en países desarrollados. El Estado cubano garantiza recursos para la atención de estos pacientes, a pesar de las dificultades económicas del país.

Introduction: Cystic fibrosis is no longer a pediatric disease but a chronic adult disease. There are multiple factors that condition the survival of these patients. Objective: To determine the survival of pediatric patients with cystic fibrosis hospitalized in a specialized center. Methods: Retrospective cohort study whose universe consisted of 27 patients included in the Granma provincial cystic fibrosis registry, 2003-2018. Variables were analyzed: current age and gender, genetic variant, presence of germs, clinical forms and survival after diagnosis and treatment. The Kaplan-Meier method and Log-Rank Test were used, for a significance level of 95%. Results: 40.7% of patients are currently over 15 years of age, male sex predominates (63%) and the F508del mutation in its heterozygous genetic variant (44.4%). The average survival is 21.4 years, there were no significant differences according to gender, clinical forms and types of germs. Conclusions: The average survival rate of patients with cystic fibrosis in Granma, Cuba, is 21.4 years, lower than that documented in developed countries. The Cuban State guarantees resources for the care of these patients, despite the country's economic difficulties.

What is the best method for long?term survival analysis?

In the Cox proportional hazards regression model, which is the most commonly used model in survival analysis, the effects of independent variables on survival may not be constant over time and proportionality cannot be achieved, especially when long-term follow-up is required. When this occurs, it would be better to use alternative methods that are more powerful for the evaluation of various effective independent variables, such as milestone survival analysis, restricted mean survival time analysis (RMST), area under the survival curve (AUSC) method, parametric accelerated failure time (AFT), machine learning, nomograms, and offset variable in logistic regression. The aim

Application of restricted mean survival time in clinical follow-up study / 中华流行病学杂志

In clinical follow-up studies,hazard ratio (HR) is routinely used to quantify the differences between-groups,however,it is being estimated by the Cox procedure.HR,the ratio of two hazard functions has abstract meaning only and is in lack of the context to give an intuitive explanation of the survival of patients and the assumption of proportional hazards (PH) must be satisfied.Under this context,the restricted mean survival time (RMST) can be used as a relatively effective measure or index of statistics.This paper introduces the RMST-based statistical analysis methods,including estimation of RMST and its difference,hypothesis testing and regression analysis.The application of RMST in data analysis is also introduced.All the evidence demonstrates that RMST can be used as an effective analytical tool with straightforward interpretation.RMST is also more effective than HR in comparing differences between groups,when non-PH is observed.Therefore,RMST is suggested to be stated along with HR in the process of disease efficacy evaluation and prognosis analysis.Cooperation and complement of the two,a precise reflection on the characteristics of data can be expected.

Application of restricted mean survival time in clinical follow-up study / 中华流行病学杂志

In clinical follow-up studies,hazard ratio (HR) is routinely used to quantify the differences between-groups,however,it is being estimated by the Cox procedure.HR,the ratio of two hazard functions has abstract meaning only and is in lack of the context to give an intuitive explanation of the survival of patients and the assumption of proportional hazards (PH) must be satisfied.Under this context,the restricted mean survival time (RMST) can be used as a relatively effective measure or index of statistics.This paper introduces the RMST-based statistical analysis methods,including estimation of RMST and its difference,hypothesis testing and regression analysis.The application of RMST in data analysis is also introduced.All the evidence demonstrates that RMST can be used as an effective analytical tool with straightforward interpretation.RMST is also more effective than HR in comparing differences between groups,when non-PH is observed.Therefore,RMST is suggested to be stated along with HR in the process of disease efficacy evaluation and prognosis analysis.Cooperation and complement of the two,a precise reflection on the characteristics of data can be expected.

Antiproliferative role of Indigofera aspalathoides on 20 methylcholanthrene induced fibrosarcoma in rats

Objective: To find out the anticancer effect of Indigofera aspalathoides (I. aspalathoides) on 20-methylcholanthrene induced fibrosarcoma in rats. Methods:Fibrosarcoma was induced in Wistar strain male albino rats by 20-methylcholanthrene. Intraperitoneous (i.p.) administration of 250 mg/kg body weight/day of aqueous extract of I. aspalathoides for 30 d effectively suppressed chemically induced tumors. Parameters such as body weight, liver and kidney weight, tumor weight, mean survival time, behavioral changes, blood glucose, blood glycogen and marker enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), acid phosphatase (ACP) and 5'-nucleiotidase (5'-NT) in serum, liver and kidney and lipid profiles such as total cholesterol, phospholipids, free fatty acids in liver and kidney of control and experimental animals were studied. Results:Fibrosarcoma bearing animals were ferocious and anxious. The mean survival time was found to increase after the treatment. The body weights were significantly decreased (P<0.001) in group II fibrosarcoma animals which steadily increased after the treatment with I. aspalathoides. The liver and kidney weights were significantly increased whereas the tumor weights decreased as compared to the weights in untreated fibrosarcoma bearing rats. The blood glucose and the liver and kidney glycogen levels were found to decrease significantly (P<0.001) in group II animals. Elevated activities of marker enzymes were observed in serum, liver and kidney of fibrosarcoma bearing Group II animals which were normalize after I. aspalathoides treatment. In the liver and kidney of Group II animals the total cholesterol increased whereas the phospholipids and free fatty acid levels decreased (P<0.001) which were normalized after treatment. Conclusions:The treatment by I. aspalathoides on fibrosarcoma bearing rats has improved the levels of various parameters indicating its antiproliferative and anticancer activity.

Antiproliferative role of Indigofera aspalathoides on 20 methylcholanthrene induced fibrosarcoma in rats

<p><b>OBJECTIVE</b>To find out the anticancer effect of Indigofera aspalathoides (I. aspalathoides) on 20-methylcholanthrene induced fibrosarcoma in rats.</p><p><b>METHODS</b>Fibrosarcoma was induced in Wistar strain male albino rats by 20-methylcholanthrene. Intraperitoneous (i.p.) administration of 250 mg/kg body weight/day of aqueous extract of I. aspalathoides for 30 d effectively suppressed chemically induced tumors. Parameters such as body weight, liver and kidney weight, tumor weight, mean survival time, behavioral changes, blood glucose, blood glycogen and marker enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), acid phosphatase (ACP) and 5'-nucleiotidase (5'-NT) in serum, liver and kidney and lipid profiles such as total cholesterol, phospholipids, free fatty acids in liver and kidney of control and experimental animals were studied.</p><p><b>RESULTS</b>Fibrosarcoma bearing animals were ferocious and anxious. The mean survival time was found to increase after the treatment. The body weights were significantly decreased (P<0.001) in group II fibrosarcoma animals which steadily increased after the treatment with I. aspalathoides. The liver and kidney weights were significantly increased whereas the tumor weights decreased as compared to the weights in untreated fibrosarcoma bearing rats. The blood glucose and the liver and kidney glycogen levels were found to decrease significantly (P<0.001) in group II animals. Elevated activities of marker enzymes were observed in serum, liver and kidney of fibrosarcoma bearing Group II animals which were normalize after I. aspalathoides treatment. In the liver and kidney of Group II animals the total cholesterol increased whereas the phospholipids and free fatty acid levels decreased (P<0.001) which were normalized after treatment.</p><p><b>CONCLUSIONS</b>The treatment by I. aspalathoides on fibrosarcoma bearing rats has improved the levels of various parameters indicating its antiproliferative and anticancer activity.</p>

Anti-Tumor Effect of AG60 against Ehrlich Tumor

BACKGROUND: AG60 is a complex of acriflavine and guanosine. Our previous study revealed that AG60 had not only in vitro antitumor activities in several human cancer cell lines, but also strong antitumor effects in animal experiments using p388 or S180 cells-implanted mice. METHODS: Antitumor effects of AG60 were compared with those of Adriamycin, acriflavine, guanosine or control group. Body weight, tumor weight change, and survival time were measured in Ehrlich carcinoma cells implanted ICR mice. RESULTS: Body weights in AG60, acriflavine, or Adriamycin treated groups were significantly lower than those in control group during 30 day observation period(p<0.05). The percent tumor growth inhibition of AG60, Adriamycin, acriflavine, or guanosine two weeks after last treatment was respectively 86% (T/C%=14), 83% (T/C%=17), 68%(T/C%=32), 41% (T/C%=59). According to above data, tumor growth inhibition in AG60 treated group was significantly stronger than that in control, acriflavine or guanosine treated group(p<0.01), but there was no significant difference between AG60 and Adriamycin treated group. Mean survival time in control, AG60, Adriamycin, acriflavine, or guanosine treated group was respectively 33+/-3.9 days, 68+/-4.2 days, 54+/-5.8 days, 36+/-3.8 days, 50+/-8.1 days. CONCLUSIONS: The anti-tumor effect of AG60 against Ehrlich tumor was significantly stronger than that of control, acriflavine or guanosine, and comparable with Adriamycin. Mean survival time in AG60 treated group was significantly longer than that in control, acrifavine, guanosine or Adriamysin treated group.

A study on prolonging survival time of rats following 90% hepatectomy / 中国普通外科杂志

Objective To observe the effects of atorvastatin and cytokine signaling inhibitor AG490 on the residual liver function and the survival time of 90% hepatectomy rats. Methods Rats were divided randomly into three groups after surgery: control group without treatment; Ato group administrated with atorvastatin (20 mg?kg -1?d -1) through NG tube one day before and three days after the surgery and AG490 group, intraperitoneally given AG490 (1 mg?kg -1?12h -1) beginning intraoperatively for 4 times. The health status and liver regeneration were observed and recorded. Results All rats in control group died within 24 hours. Both atorvastatin and AG490 significantly prolonged the survival time of rats after surgery (25.6 h & 30.6 h vs. 10.7 h,P