Evaluation of prognostic factors for patients with eosinophilic granulomatosis with polyangiitis recruited at the pneumonological centre and mainly ANCA negativity: A retrospective analysis of a single cohort in Poland.

OBJECTIVES: The aim was to investigate the risk factors for relapse and death in patients with eosinophilic granulomatosis with polyangiitis (EGPA) recruited at the pneumonological centre and mainly antineutrophil cytoplasmic antibody negativity. METHODS: We retrospectively recruited 86 patients. Relapse was defined as the recurrence or appearance of new organ symptoms. The study end-point included the final examination. RESULTS: Relapses occurred in 34.9% of the patients, while 9.3% died. Immunosuppressive therapy (P = 0.042), prolonged low-dose corticosteroid treatments (mainly for asthma) (P = 0.006), and longer follow-up duration (P = 0.004) were associated with a higher relapse risk, while advanced EGPA severity (P = 0.0015) and activity (P = 0.044), older age of onset (P = 0.030), symptomatic cardiac involvement (P = 0.007), and postinflammatory cardiac fibrosis (P = 0.038) were associated with a higher risk of death. Sinusitis (P = 0.028) and prolonged low-dose corticosteroid treatments (P = 0.025) correlated with a better prognosis. Relapses did not have an impact on the mortality (P = 0.693). CONCLUSIONS: Relapses in EGPA remain frequent, although they do not impact mortality. Cardiac involvement is common, but clinically symptomatic cardiomyopathy is associated with a higher risk of death. Asthma requiring chronic corticosteroid treatments is associated with a lower risk of death, although the risk of EGPA recurrence is significantly higher.

Use of the expanded Apgar score for the assessment of intraventricular and intraparenchymal haemorrhage risk in neonates.

OBJECTIVES: Preterm birth is a key factor contributing to haemorrhage incidence in neonates. This study focused on defining relevant parameters for the assessment of intraventricular and intraparenchymal haemorrhage risks in neonates. MATERIAL AND METHODS: Chi-square automatic interaction detection was used to analyse the Apgar score (AS), the Apgar max score, and the course of resuscitation documented according to the expanded AS in 696 infants born between 2009 and 2011 in the Neonatal and Intensive Care Department of the Medical University of Warsaw. RESULTS: Gestational age was the most relevant discriminating variable for the prediction of intraventricular III degree and intraparenchymal haemorrhage incidences. Infants born before the 31st week of pregnancy made up 80% of the intraventricular or intraparenchymal haemorrhage cases. Additionally, a fraction of inspired oxygen > 0.8 at ten minutes after birth was a better discriminating variable in the youngest neonates than an Apgar max score ≤ 5, identifying 31.6% and 20.6% of infants with intraventricular and intraparenchymal haemorrhage, respectively. CONCLUSIONS: Consideration of the oxygen concentration supplied during resuscitation significantly improves the prognosis of intraventricular and intraparenchymal haemorrhages in preemies compared to the use of the classical AS.

Cooperation in aspiration-based N -person prisoner's dilemmas.

We propose a mathematical model of the N -person prisoner's dilemma game played by a continuous population of agents with a time-dependent aspiration level. The model-a system of differential equations-takes into account the evolution of the aspiration level and of the mean frequency of the cooperators in the population. The dependence of the asymptotic level of cooperation on the individual payoffs and on the transition rates determining the agent's reaction to the received payoffs is studied. In general the existence and the magnitude of the asymptotic level of cooperation depends on N , the payoffs and the transition rates, and decreases with increasing N .