Retrospective evaluation of the success rate and factors associated with the stability of alveolar ridge orthodontic miniscrews: Pilot study.

BACKGROUND: An uncommon location for placing miniscrews, used to provide anchorage control in various tooth movements, is the alveolar ridge. This study aimed to provide an evaluation of the success rate of alveolar ridge miniscrews and examine variables that might impact their success. METHODS: Charts for 295 patients who had miniscrews were screened. Twenty patients (5 male and 15 female: average age = 38.15 ± 15.10 years) with a total of 50 alveolar ridge miniscrews were analyzed. A customized data form was used to collect patients' and miniscrews' related variables. Kaplan-Meier estimator was used for the survival function, whereas Cox proportional hazards regression models were used to associate collected variables with alveolar ridge miniscrew survival. RESULTS: In total, 31 (62.0%) miniscrews were stable and 19 (38.0%) failed. The survival time for those that failed was 6.03 ± 7.08 months. The follow-up period for those that survived was 35.84 ± 19.47 months. Male gender versus female (hazard ratio [HR] 2.46; 95% confidence interval [CI] 1.35-4.48; P = 0.003), and if the miniscrew was a replacement versus non-replacement (HR 0.27; 95% CI 0.07-0.99; P = 0.048) influenced the survival. Additionally, miniscrews that were used for both indirect and direct or indirect anchorage alone plus those with evidence of splinting showed a 100% survival rate, which led to an HR 0 (P < 0.001). When the previously mentioned variables were modeled, none seemed to have a significant effect on failure except for splinting and type of anchorage (P < 0.001), because none of the splinted miniscrews failed. CONCLUSIONS: The failure rate of alveolar ridge miniscrews was (38.0%) over 6.03 ± 7.08 months. The survival rate was (62.0%) over 35.84 ± 19.47 months. The evidence of splinting and the type of anchorage had a significant effect on survival probability.

OHCCPredictor: an online risk stratification model for predicting survival duration of older patients with hepatocellular carcinoma.

BACKGROUND: Although the elderly constitute more than a third of hepatocellular carcinoma (HCC) patients, they have not been adequately represented in treatment and prognosis studies. Thus, there is not enough evidence to guide the treatment of such patients. The objective of this study is to identify the prognostic factors of older patients with HCC and to construct a new prognostic model for predicting their overall survival (OS). METHODS: 2,721 HCC patients aged ≥ 65 were extracted from the public database-Surveillance, Epidemiology, and End Results (SEER) and randomly divided into a training set and an internal validation set with a ratio of 7:3. 101 patients diagnosed from 2008 to 2017 in the First Affiliated Hospital of Zhejiang University School of Medicine were identified as the external validation set. Univariate cox regression analyses and multivariate cox regression analyses were adopted to identify these independent prognostic factors. A predictive nomogram-based risk stratification model was proposed and evaluated using area under the receiver operating characteristic curve (AUC), calibration curves, and a decision curve analysis (DCA). RESULTS: These attributes including age, sex, marital status, T stage, N stage, surgery, chemotherapy, tumor size, alpha-fetoprotein level, fibrosis score, bone metastasis, lung metastasis, and grade were the independent prognostic factors for older patients with HCC while predicting survival duration. We found that the nomogram provided a good assessment of OS at 1, 3, and 5 years in older patients with HCC (1-year OS: (training set: AUC = 0.823 (95%CI 0.803-0.845); internal validation set: AUC = 0.847 (95%CI 0.818-0.876); external validation set: AUC = 0.732 (95%CI 0.521-0.943)); 3-year OS: (training set: AUC = 0.813 (95%CI 0.790-0.837); internal validation set: AUC = 0.844 (95%CI 0.812-0.876); external validation set: AUC = 0.780 (95%CI 0.674-0.887)); 5-year OS: (training set: AUC = 0.839 (95%CI 0.806-0.872); internal validation set: AUC = 0.800 (95%CI 0.751-0.849); external validation set: AUC = 0.821 (95%CI 0.727-0.914)). The calibration curves showed that the nomogram was with strong calibration. The DCA indicated that the nomogram can be used as an effective tool in clinical practice. The risk stratification of all subgroups was statistically significant (p < 0.05). In the stratification analysis of surgery, larger resection (LR) achieved a better survival curve than local destruction (LD), but a worse one than segmental resection (SR) and liver transplantation (LT) (p < 0.0001). With the consideration of the friendship to clinicians, we further developed an online interface (OHCCPredictor) for such a predictive function ( https://juntaotan.shinyapps.io/dynnomapp_hcc/ ). With such an easily obtained online tool, clinicians will be provided helpful assistance in formulating personalized therapy to assess the prognosis of older patients with HCC. CONCLUSIONS: Age, sex, marital status, T stage, N stage, surgery, chemotherapy, tumor size, AFP level, fibrosis score, bone metastasis, lung metastasis, and grade were independent prognostic factors for elderly patients with HCC. The constructed nomogram model based on the above factors could accurately predict the prognosis of such patients. Besides, the developed online web interface of the predictive model provide easily obtained access for clinicians.

GC-MS/MS analysis of chlorpyrifos in forensic samples with varied survival time.

Organophosphorus pesticides are extensively used in the agricultural sector to kill insects, worms, and other pests. Many people may be poisoned by chlorpyrifos either accidentally or intentionally, including accidental, suicidal, and homicidal poisoning cases in India. The effect of chlorpyrifos on human health depends on factors such as the time, amount and frequency of exposure, the individual's health, and certain environmental conditions. The main objective of this investigation is to identify the post-mortem biological sample that shows the longest detection window, enabling precise chlorpyrifos detection in cases of acute poisoning with varying survival durations. Our research focuses on the detection and distribution of chlorpyrifos in cases of acute poisoning using a simple liquid-liquid extraction and GC-MS/MS analysis. We validated the method, which proved to be effective and reliable. Upon examining various organs, we detected the presence of chlorpyrifos in the stomach tissue, liver tissue, kidney tissue, and blood samples of individuals who consumed chlorpyrifos and passed away immediately, as well as in those who survived for the first 3 days following ingestion. Analysing urine, blood, and liver tissue from individuals who survived for 3 days provided more precise results compared to stomach tissue. Additionally, urine samples played a crucial role in detecting chlorpyrifos in individuals who survived for 4 and 5 days. A blood sample is the most suitable post-mortem biological sample for detecting chlorpyrifos in individuals who survived for a duration of 2 to 4 days. This finding highlights the significance of analysing urine as a valuable sample type, particularly in determining the presence of chlorpyrifos in cases where individuals have survived for a long period of time before their demise. The experimental data and information provided in this study will serve as a valuable resource for forensic toxicologists.

Survival of cervical cancer patients in Brunei Darussalam: 2002-2017.

Objective: Cervical cancer is the fourth leading cause of cancer deaths among Bruneian women. This study aims to investigate the survival rate of cervical cancer patients in Brunei Darussalam between 2002 and 2017, to compare survival of cervical cancer patients between two periods: 2002-2009 and 2010-2017 and to identify prognostic factors of cervical cancer. Methods: A retrospective cohort study on cervical cancer patients registered in Brunei Darussalam Cancer Registry between 2002 and 2017. De-identified data from the registry was extracted and survival analysis was performed using Kaplan-Meier estimator, log-rank test and multiple Cox regression analysis. Results: The 1-, 3- and 5-year survival rates of cervical cancer patients in Brunei Darussalam were 87.3%, 77.4% and 72.5% respectively from 2002 to 2017. The 5-year survival rate for 2002-2009 and 2010-2017 were 77.3% and 69.1% respectively. The risk of mortality was significantly higher in 2010-2017 compared to 2002-2009 after adjusting for variables (Adjusted HR = 1.59; 95% CI: 1.08, 2.40; p = 0.019). Patients with distant cancer (Adjusted HR = 11.21; 95% CI: 6.18, 20.30; p < 0.001) had the highest risk of mortality. Conclusion: The 5-year survival rate of cervical cancer patients in Brunei Darussalam was 72.5%, which ranks relatively high globally. However, increased mortality among elderly patients, and patients diagnosed with cervical cancers at the later stages, calls for public health efforts to raise awareness, early detection, and disease management.

A cat with myelodysplastic syndrome by administration of the methylation inhibitor Azacytidine.

A 5-year-old female cat with nonregenerative anemia and thrombocytopenia was diagnosed with myelodysplastic syndromes (MDS), since peripheral blood and bone marrow (BM) examination revealed various dysplasias and a blast ratio of 19%. Chemotherapy with azacytidine (AZA; 70-35 mg/m2, 3-5 days, three cycles) and treatment with prednisolone, antibiotics, and vitamin K2, and blood transfusion were performed. On day 106, blast cells and dysplasia had decreased in the BM, and the cat remained alive for at least 1,474 days. This report is the first on feline MDS treated with AZA, suggesting appropriate drug dosage, interval and effective combination should be investigated and the pharmacological and cell biological mechanisms needs to be elucidated in the future.

Cochlear Implantation in Elderly Patients: Survival Duration, Hearing Outcomes, Complication Rates, and Cost Utility.

INTRODUCTION: The prevalence of hearing loss and its consequences is increasing as the elderly population grows. As the guidelines for cochlear implantation (CI) expand, the number of elderly CI recipients is also increasing. We report complication rates, survival duration, and audiological outcomes for CI recipients aged 80 years and over and discuss the cost utility of CI in this age group. METHODS: A retrospective cohort study was undertaken of all CI recipients (126 cases), aged 80 years and over at the time of their surgery, implanted at our institution (Cambridge University Hospitals) during a period from January 1, 2001, to March 31, 2019. Data on survival at 1, 3, and 5 years post-implantation, post-operative complications and functional hearing outcomes including audiometric and speech discrimination outcomes (Bamford-Kowal-Bench sentence test) have been reported. RESULTS: The mean age at implantation was 84 years. The mean audiometric score improved from 108 dB HL to 28 dB HL post-implantation. The mean Bamford-Kowal-Bench score improved from 14% to 66% and 73% at 2 and 12 months post-implantation, respectively. The complication rate was 15.3%. The survival probability at 1 year post-implantation was 0.95 for females and 0.93 for males, at 3 years was 0.89 for females and 0.81 for males, and at 5 years was 0.74 for females and 0.54 for males. CONCLUSION: CI is safe and well-tolerated in this age group and elderly patients gain similar audiometric and functional benefit as found for younger age groups.

Severity of Downgaze Palsy in the Context of Disease Duration Could Estimate Survival Duration in Patients With Progressive Supranuclear Palsy.

It is an unmet need to estimate survival duration for patients with progressive supranuclear palsy (PSP). The objective of this study was to identify factors associated with the survival duration in patients with PSP. We followed up 23 patients with probable PSP-RS (Richardson syndrome) or PSP-P (parkinsonism) in our PSP center until death from 2011 to 2019. We prospectively and quantitatively rated their downgaze palsy whenever first noticed in our clinic. This was utilized along with the disease duration, motor function, medication use for parkinsonism, sex, age at onset of PSP, comorbid pulmonary and cardiovascular diseases, and the total survival duration from the onset of PSP to death for prediction analysis. A well-fitted linear regression model and a multivariant Cox model were applied to identify predicting factors for total survival duration. All patients had the specific hummingbird sign on brain MRI for PSP when downgaze palsy was documented. We found that the severity of downgaze palsy and the disease duration at the assessment were consistently correlated with the total survival duration in both models. The total survival duration could be further estimated by a formed regression equation. We conclude that severity and time to develop downgaze palsy could help to estimate the total survival duration in patients with probable PSP-RS and PSP-P, the major forms of PSP, which has significant clinical applications in clinical counseling and trial enrollment.

Rapid shortening of survival duration in early fatal cases of COVID-19, Wuhan, China.

Severe COVID-19 cases place immediate pressure on hospital resources. To assess this, we analysed survival duration in the first 39 fatal cases in Wuhan, China. Time from onset and hospitalization to death declined rapidly, from ~40 to 7 days, and ~25 to 4 days, respectively, in the outbreak's first month.

Associative Increases in Amyotrophic Lateral Sclerosis Survival Duration With Non-invasive Ventilation Initiation and Usage Protocols.

Objective: It is hypothesized earlier non-invasive (NIV) ventilation benefits Amyotrophic Lateral Sclerosis (ALS) patients. NIV typically consists of the removable bi-level positive airway pressure (Bi-PAP) for adjunctive respiratory support and/or the cough assist intervention for secretion clearance. Historical international standards and current USA insurance standards often delay NIV until percent predicted forced vital capacity (FVC %predict) is <50. We identify the optimal point for Bi-PAP initiation and the synergistic benefit of daily Bi-PAP and cough assist on associative increases in survival duration. Methods: Study population consisted of a retrospective ALS cohort (Emory University, Atlanta, GA, USA). Primary analysis included 474 patients (403 Bi-PAP users, 71 non-users). Survival duration (time elapsed from baseline onset until death) is compared on the basis of Bi-PAP initiation threshold (FVC %predict); daily Bi-PAP usage protocol (hours/day); daily cough assist usage (users or non-users); ALS onset type; ALSFRS-R score; and time elapsed from baseline onset until Bi-PAP initiation, using Kruskal-Wallis one-way analysis of variance and Kaplan Meier. Results: Bi-PAP users' median survival (21.03 months, IQR = 23.97, N = 403) is significantly longer (p < 0.001) than non-users (13.84 months, IQR = 11.97, N = 71). Survival consistently increases (p < 0.01) with FVC %predict Bi-PAP initiation threshold: <50% (20.3 months); ≥50% (23.60 months); ≥80% (25.36 months). Bi-PAP usage >8 hours/day (23.20 months) or any daily Bi-PAP usage with cough assist (25.73 months) significantly (p < 0.001) extends survival compared to Bi-PAP alone (15.0 months). Cough assist without Bi-PAP has insignificant impact (14.17 months) over no intervention (13.68 months). Except for bulbar onset Bi-PAP users, higher ALSFRS-R total scores at Bi-PAP initiation significantly correlate with higher initiation FVC %predict and longer survival duration. Time elapsed since ALS onset is not a good predictor of when NIV should be initiated. Conclusions: The "optimized" NIV protocol (Bi-PAP initiation while FVC %predict ≥80, Bi-PAP usage >8 h/day, daily cough assist usage) has a 30. 8 month survival median, which is double that of a "standard" NIV protocol (initiation FVC %predict <50, usage >4 h/day, no cough assist). Earlier access to Bi-PAP and cough assist, prior to precipitous respiratory decline, is needed to maximize NIV synergy and associative survival benefit.

Immediate and late outcomes of stenting for severe extracranial internal carotid artery stenosis in octogenarian patients.

Background: Multiple studies suggest that internal carotid artery stenting can be performed safely in octogenarians with low periprocedural complication rates. However, great concern still exists as to whether these patients will gain long-term benefits from this procedure given their advanced age and uncertain life expectancy. We decided to conduct a retrospective study to determine short-and long-term clinical outcomes and to analyze survival duration in this population. Methods and Results: Sixty-nine consecutive elderly patients with either symptomatic or asymptomatic stenosis ≥70% underwent 86 procedures. Immediate and late outcomes, as well as survival data, were analyzed retrospectively. Mean age was 83.1 ± 2.7 years. Mean survival was 49.3 ± 10.1 months. A complete neurological assessment was obtained at 1 and 2 years in 100% of patients, at 3 years in 90.7% of patients and at 5 years in 84.8% of patients. Two major and one minor ischemic strokes occurred during the periprocedural period. No death, myocardial infarction or intracranial hemorrhage was recorded. The mean follow-up period was 55.4 ± 24.6 months. Four patients experienced a minimum of 1 year of follow-up, and the longest is 8 years. Among the patients with the longest follow-up time, 6 had ischemic strokes, of which 2 were fatal. In total, 17 deaths occurred. Four patients experienced dementia without stroke. Survival at 3 and 5 years was estimated to be 90% and 73%, respectively. Conclusion: This study demonstrated that stenting in octogenarians was safe and effective during the periprocedural period. Long-term follow-up showed a low rate of fatal and nonfatal stroke, and patients survived long enough to benefit from the procedure. However, it was associated with a relatively high rate of long-term event. Though carotid artery stenting is a minimally invasive procedure, it should still be performed with great caution and only in carefully selected patients. The present study suggested that in this age population, carotid artery stenting might be considered as a revascularization option.

Expression and Action Mechanism of miR-98 in Colon Cancer Tissues / 中国医科大学学报

Objective To investigate the expression and action mechanism of miR-98 in colon cancer tissues. Methods Tumor tissues and adjacent tissues were collected from 40 patients with colorectal cancer. The expression of miR-98 in tumor tissues and adjacent tissues was detected by real-time PCR. miR-98 was overexpressed or silenced in cells,and the effects on proliferation,cell cycle,and apoptosis were analyzed using MTT,flow cytometry,and Hoechst 33258 assays. Results Real-time PCR showed that the expression of miR-98 in tumor tissues was lower than that in adjacent tissues (P = 0.022). The survival rate of patients with lower miR-98 expression was shorter than that of patients with higher miR-98 expression. The MTT assay showed that miR-98 overexpression inhibited the proliferation of HCT116 cells. Hoechst 33258 staining showed that the overexpression of miR-98 could inhibit the cell cycle and promote the apoptosis of HCT116 cells. Conclusion miR-98 can inhibit the proliferation and promote the apoptosis of colon cancer cells. The expression of miR-98 is closely related to the survival of patients with colon cancer.

Survival of primary lung cancer patients in Brunei Darussalam, 1987-2012.

BACKGROUND: In 2009 to 2011, the commonest cause of death was by cancer in Brunei Darussalam, and 16.5% and 19.5% of cancer deaths were due to lung cancer in 2004 and 2011 respectively. This study was to investigate the survival of lung cancer patients in Brunei Darussalam. METHODS: This retrospective cohort study was conducted in 2013 & 2014 for those who were diagnosed as primary lung cancer in the period of 1987 to 2012. Data were retrieved from patients' medical records and death certificates using pretested data collection form. Survival analyses namely Kaplan-Meier method, and log-rank test to compare survival between groups. RESULTS: We retrieved 630 primary lung cancer records. Majority was diagnosed at the late stages, 42.5% at Stage IV & 33.4% at Stage III. The overall median survival time was 6.1 months whereas 2.6 and 79.1 months for Stage IV and Stage I respectively. The overall 6-month, 1-, 3- and 5-year survival rates were 50.2%, 32.1%, 14.5% and 8.8% respectively. Survival duration had significantly improved from 1987-1999 to 2000-2012 (P=0.001) although significant higher proportion of Stage IV was diagnosed in the second period (P=0.008). CONCLUSIONS: Overall survival rates and duration of primary lung cancer in Brunei Darussalam were comparable with some developed countries. However, through effective public intervention such as increase awareness, early case detection, and effective anti-smoking strategies, survival of lung cancer patients can certainly be improved and the burden of disease can be reduced.

Effect of Korean Red Ginseng intake on the survival duration of human immunodeficiency virus type 1 patients.

BACKGROUND: Long-term ginseng intake can increase longevity in healthy individuals. Here, we examined if long-term treatment with Panax ginseng Meyer (Korean Red Ginseng, KRG) can also enhance survival duration (SD) in patients with human immunodeficiency virus type 1 (HIV-1) infection. METHODS: We retrospectively analyzed 252 HIV-1 patients diagnosed from 1986 to 2013 prior to the initiation of antiretroviral therapy. Overall, 162 patients were treated with KRG (3,947 ± 4,943 g) for 86 ± 63 mo. The effects of KRG on SD were analyzed according to the KRG intake level and the length of the follow-up period. RESULTS: There were significant correlations between the total amount of KRG and SD in the KRG intake group (r = 0.64, p < 0.0001) as well as between total amount of KRG and mean annual decrease in CD4+ T-cell count in all 252 patients (r = -0.17, p < 0.01). The annual decrease in CD4+ T-cell count (change in cells/µL) was significantly slower in KRG-treated patients than in patients receiving no KRG (48 ± 40 vs. 106 ± 162; p < 0.001). The SD (in months) was also significantly longer in the KRG group than in the no-KRG group (101 ± 64 vs. 59 ± 40, p < 0.01). CONCLUSION: KRG prolongs survival in HIV-1 patients, possibly by slowing the decrease in CD4+ T-cell count.

Clinical significance of plasma fibrinogen level in patients with lung cancer / 中国综合临床

Objective To investigate the relationship among the plasma levels of fibrinogen and the lung cancer,and its clinical significance.Methods From 2011 to 2013,121 cases newly diagnosed lung cancer patients(lung cancer group) and 37 cases healthy individuals(control group) were evaluated.The patients had no history of coagulation system disorders or anticoagulant therapy.Plasma prothrombin time (PT), activated partial thromboplastin time(APTT), thrombin time (TT), fibrin original (FIB), platelet (PLT) of the patients were obtained.The relationship between the plasma levels of fibrinogen and clinical characteristics, therapy modalities (surgery, chemotherapy and radiotherapy), therapy outcomes and survival durations of the patients were analyzed.Results (1) Serum levels of fibrinogen at stage Ⅱ A, stage Ⅱ B, stage Ⅲ A, stage Ⅲ B, stage Ⅳ were (2.001±0.813) g/L, (2.191±0.827) g/L, (3.121 ±2.016) g/L, (4.174±0.595) g/L, (4.332 ± 1.534) g/L, a significant difference was observed between the fibrinogen levels of patients with stage Ⅱ A and those with stage Ⅳ disease (P＜0.001), and there were no significant differences among other stages (P＞0.05).(2)The mean fibrinogen level was significantly higher in the patient group with ECOG performance status 2 than in the other groups(r=0.613,P＜0.05).The mean fibrinogen level was (3.780±1.731) g/L (95％CI,3.122-4.439,P＜0.001) in the group with ECOG 0, (4.182 ± 1.661) g/L(95％CI 3.583-4.781 ,P＜0.001) in the group with ECOG 1 ,and (4.725±2.153) g/L(95％CI,4.007-5.443,P＜0.001) in the group with ECOG 2.(3) The treatment responses of 81 patients who received chemotherapy and/or radiotherapy without surgical intervention were evaluated, serum levels of fibrinogen in 39 patients with partial remission (PR) were (4.005 ±1.177) g,/L,42 patients with stable disease(SD) were (3.192±0.479) g/L, 17 patients with progressive disease(PD) were (7.530± 1.885) g/L,fibrinogen levels were found to be significantly higher in cases with progression,and the difference was significant(P =0.015).(4)Correlation analysis on fibrinogen and chnical indicator: clinical stage (r =0.529, P =0.008), ECOG score (r =0.273, P =0.031), therapy response (r =0.529, P=0.012) were positively correlated with fibrinogen levels.(5)Fibrinogen levels in patients with lung cancer were higher than those of the control group ((2.891 ± 0.484) g/L vs.(3.586± 1.692) g/L, t =-4.620, P ＜0.05), and the difference was statistically significant (P＜0.01).(6)The survival duration was significantly longer in patients with lower fibrinogen levels(321 d vs.435 d,P＜0.05).The mean fibrinogen concentration in patients who were still alive at the end of a 2-year follow-up was (3.531 ± 1.482) g/L, whereas the meanfibrinogen level of patients who died was (3.725± 2.063) g/L, and the difference between the two groups was significant(P =0.015).Conclusion The results suggest that Fibrinogen plasma levels might be useful to predict the clinical outcome and survival of patients with lung cancer.

Analysis of 32 cases of Krukenberg Tumors / 대한산부인과학회잡지

OBJECTIVE: The Krukenberg tumor is a metastatic or primary malignant ovarian tumor of the signet-ring cell type. The incidence of this tumor is higher in Korea than in western, among relatively young age group with poor prognosis. We evaluated the clinical characteristics of the Krukenberg tumor (metastasized from stomach cancer) and the relationship between the survival and clinical characteristics (including treatment modalities). METHODS: We analyzed 32 cases of the Krukenberg tumor metastasized from stomach cancer at the Department of Obstetrics and Gynecology, Kosin University Gospel Hospital. RESULTS: Among the 32 cases of the Krukenberg tumor, the age distribution ranged from 22 to 58 years, and the mean age was 38.8 years. The most common chief complaint was lower abdominal pain(11 cases). The majority of the stomach cancer showed serosal invasion and was signet-ring cell type in histology. The mean survival was 20 months. In patients with ascites(22 cases), the mean survival was 16 months in contrast to 25 months in ascites-free patients(10 cases). In the chemotherpy group, the mean survival was 23 months in contrast to 16 months in chemotherpy-free group. Also, longer mean survival(25months) was shown in cases with optimal surgery group than non-optimal surgery group. CONCLUSIONS: The survival of krukenberg tumor was shown to be related to the surigcal resectability and chemotherpy modalities.