Value of ISS for predicting mortality in multiple trauma patients / 中华创伤杂志

Objective To investigate the value of ISS in predicting mortality after multiple trauma.Methods A total of 550 patients with multiple trauma treated from March 2007 to May 2011 were divided into survivor group (n =473) and death group (n =77) according to the outcome.ISS and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ]) were used to predict patients' risk of death.Receiver operation characteristic curve (ROC) was developped to compare the area under the curve (AUC),optimal cut-off point,and prediction index for the two scoring systems.Results ISS and APACHE Ⅱ score were higher in death group than in survivor group (P ＜ 0.05).ISS showed the diagnostic cut-off point of ≥20,with a sensitivity of 76.7％,specificity of 83.7％,concordance rate of 82.7％,and AUC of 0.835.With regard to APACHE Ⅱ,the diagnostic cut-off point was ≥20,with a sensitivity of 80.5％,specificity of 89.2％,concordance rate of 88.0％,and AUC of 0.922.ISS and APACHE Ⅱ were equivalent in predicting mortality (P ＞ 0.05).Conclusion ISS presents a moderate value for predicting the mortality of multiple trauma patients and it is more rational to set ISS≥20 points as the criteria for severe multiple trauma.

The role of pretreatment FDG standard uptake value in predicting for clinical outcome in locally advanced nasopharyngeal carcinoma / 中华放射肿瘤学杂志

ObjectiveTo explore the prognostic value of pretreated maximum standardized uptake value (SUVmax) using 18-fluorodeoxyglucose positron emission tomography with computed tomography (18FDG PET/CT) in locally-advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).MethodsOne hundred and forty previously untreated stage Ⅲ - Ⅳb ( UICC/AJCC 6th) patients with biopsy-proven nasopharyngeal carcinoma were examined.All of the enrolled patients accepted whole body/head-neck 18FDG PET/CT before radical IMRT. 18FDG uptakes were recorded as SUVmax of primary tumor (SUVmax-P) and SUVmax of cervical lymph nodes (SUVmax-N).The relationships between SUVmax and long-term clinical outcomes were analyzed.ResultsThe median SUVmax-P was 10.4,and the median SUVmax-N was 6.2.The SUVmax-P was weakly correlated with T-stage ( R =0.279,P =0.001 ).The SUVmax-N was weakly correlated with N stage ( R =0.334,P =0.000 ).There were no difference of the median SUVmax-P (9.2 vs.10.4,U =560.50,P =0.805 ) and the median SUVmax-N (4.0vs.5.0,U =576.00,P =0.908) between patients with and without local recurrence.The median SUVmax-P of patients with distant metastasis was significantly higher than those without metastasis (11.9 vs.9.8,U =987.50,P =0.014).The SUV of 10.2 was taken as a cut-off for high and low uptake tumors.For patients with SUVmax-P ＞ 10.2,the 5-year distant metastasis-free survival (DMFS) and 5-year overall survival (OS)were significantly higher than those with SUVmax-P ≤ 10.2 (69.1％ vs.95.5％,x2 =15.88,P =0.000;68.4％ vs.94.0％,x2 =15.56,P =0.000,respectively).Multivariate analysis showed that SUVmax-P was the only independent risk factor of 5-year DMFS and OS ( HR =7.87,P =0.001 and HR =5.14,P =0.003). Conclusion SUVmax-P is a useful biomarker predicting long-term clinical outcomes in newly diagnosed locally-advanced NPC patients.

Capacidad predictiva de algunos indicadores en el rendimiento docente de la asignatura Fisiología Médica / Predictive capacity of some indicators in the teaching performance of the Medical Physiology subject

Estimar la capacidad predictiva de algunos indicadores respecto a los resultados del examen final de la asignatura. Como predictores se utilizaron la vía de ingreso, los resultados de algunas de las asignaturas del primer semestre y los resultados del corte de la décima semana de la asignatura Fisiología Médica, todos en relación con la nota de su examen final en 548 estudiantes de los cursos 2005-2006 y 2006-2007. Se utilizaron estadísticas descriptivas simples y se ajustó un modelo de regresión con escalamiento óptimo para la recodificación. Los valores estimados por este modelo se convirtieron a una escala ordinal con fines de predicción. Se llevó a cabo un análisis de componentes principales para una mejor comprensión de la estructura de asociaciones entre las variables. Los predictores en su conjunto son capaces de explicar 54 por ciento de la variabilidad de la nota final de la asignatura y el modelo de regresión con escalamiento óptimo con estos predictores proporciona un ajuste satisfactorio, el corte de la décima semana es el mejor predictor. Otros predictores relevantes son la vía de ingreso y la historia académica previa. Los indicadores vía de ingreso, notas de las asignaturas del primer semestre del primer año de la carrera de Medicina y corte de la décima semana integrados en un modelo de predicción, logran un modelo satisfactorio de predicción del rendimiento docente en la asignatura Fisiología Médica. El corte de la décima semana resulta el mejor predictor debido a que es más cercano y específico a los resultados de la asignatura. La vía de ingreso puede constituir un elemento útil a la hora de identificar estudiantes en pronóstico de éxito-fracaso docente.

To estimate the prediction capacity of some indicators regarding the results of final examinations of this subject. The admission via, the results of some of subjects in the first semester, and the results of the cut-off on the tenth week of the Medical Physiology subject were used as predictors. All of them were related to the mark obtained in the final examination of 548 students in the courses 2005-2006 and 2006-2007. Simple descriptive statistics were used and a regression model with optimal scaling up was adjusted for recoding. The values estimated for this model were converted into an ordinal scale for prediction. An analysis of the main components for a better understanding of the structure of the associations among variables was carried out.Predictors as a whole are capable to explain 54 percent of the variability in the final mark of the subject, whereas the regression model with an optimal scaling up with these predictors allows a satisfactory adjustment. The cut-off on the tenth week is the best predictor. The admission via, the qualifications obtained in the first semester of first year of the medical career, and the cut-off on the tenth week integrated in a prediction model are a satisfactory prediction model of academic performance in the Medical Physiology subject. The cut-off on the tenth week is the best predictor, since it is more specific and closer to the results of the subject. The admission via may be a useful element at the time of identifying students in the prognosis of teaching success-failure.

A study on the preorthodontic prediction values versus the actual postorthodontic values in Class III surgery patients / 대한치과교정학회지

The purpose of this study was to find out and evaluate discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to it in 45 patients(17 male, 28 female) who were diagnosed as skeletal Class III malocclusion and received presurgical orthodontic treatment and orthognathic surgery at Yonsei university dental hospital. Lateral cephalograms were analyzed at pretreatment(T1), orthodontic prediction(T2), immediately before surgery(T3) and designated the landmark as coordinates of X and Y axes. The samples were divided according to ALD, upper and lower incisor inclination(U1 to SN, IMPA), COS, extraction, the position of extracted teeth and the statistical significance was tested to find out the factors contributing to the prediction. The results were as follows : 1. Differences between preorthodontic prediction values and actual postorthodontic values(T2-T3) were statistically significant(p<0.05) in the x coordinates of U6mbc, L1x and in y coordinates of U1i, U1x, U6me, U6mbc, L6mbc 2. The accuracy of prediction is relatively higher in horizontal changes compared to vertical changes. 3. The statistical significance(p<0.05) between prediction and actual values is observed more in the landmarks of the maxilla than the mandible. 4. Differences between prediction and actual values of incisor and first molar were statistically significant(p<0.05) according to extraction vs non-extraction, extraction type, ALD in the maxilla and according to ALD, IMPA in the mandible. Discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to the prediction must be considered in treatment planning of Cl III surgical patients to increase the accuracy of prediction. Furthermore future investigations are needed on the prediction of vertical changes.

The Effect of Hypertension History on the Application of a Computer Program for the Prediction of Perioperative Myocardiac Infarction and Cardiac Mortality to Non-cardiac Surgical Patients / 대한마취과학회지

To evaluate whether the perioperative myocardiac infarction or cardiac mortality can be predicted in non-cardiac surgery, a computer program for the prediction value was applicated 70 normotensive and 93 hypertensive patients. The eight questions which are required a answer either "yes" or "no" for emergency surgery, experience of anginal attacks, ischemia on electrocardiography, history of myocardiac infarction, age over 70 years, laparotomy and/or thoracotomy, surgery involving great vessels and serum potassium less than 3.5 mEq/L are employed in this program. The prediction values were higher in the normotensive group(10.2+/-15.3%) than the hypertensive group(7.9+/-6.9%), and two cases of perioperative myocardiac infarction occurred in the normotensive group. Histories of myocardiac infarction in the normotensive patients(14.3%) were significantly more frequent than in the hypertensive group(3.3%). The authors suggested that the patients history of hypertension seems not to be directily related to the prediction value of perioperative myocardiac infarction and cardiac mortality.