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Content available remote The role of genetic and other biomarkers in NSCLC prognosis
The development of non-small-cell lung cancer (NSCLC) is a multistep process, which is triggered and maintained by various factors. Many steps of non-small-cell lung carcinogenesis, risk factors and biomarkers have been identified; however no consistent model has been established of personalized medicine for these patients. Distinct various gene expression, products of mutated genes and other markers such as circulating nucleic acids or tumor cells has been proven to be potential biomarkers of non-small cell lung cancer as well as potential targets for new treatment strategies. This article will highlight promising biomarkers in non-small cell lung cancer prognosis.
Content available remote Serum neopterin as a prognostic indicator in patients with breast carcinoma
Neopterin is a useful indicator of the activation state of the cellular immune system, and an elevated level predicts prognosis in different types of tumors. The aim of this study was to evaluate serum neopterin levels if it is viable predictor for prognosis in breast carcinoma patients. Serum neopterin was investigated in 56 breast carcinoma patients, 16 patients with benign breast lesions and 16 healthy women as controls. Neopterin was measured by ELISA (Enzyme-linked immunosorbent assay). The clinicopathological parameters were determined by reviewing both medical charts and pathological records. All patients had been followed-up until September 2009 or death.The mean serum neopterin concentrations were 8.5 ± 5.2 nmol/L in patients with breast carcinoma, 6.5±3.1 nmol/L in patients with benign breast lesion and 8.1 ± 1.9 nmol/L in healthy volunteers (p>0.05). Elevated neopterin levels were significantly correlated with age, elevated serum CRP level, advanced stage and presence of the distant metastases (p<0.05). Overall survival was significantly shorter in patients with a serum neopterin level >10 nmol/L than patients with neopterin <10 nmol/L level (56 months vs. 76 months, p=0.011). Increased preoperative serum neopterin concentrations are associated with a poor prognosis in patients with breast carcinoma.
Content available remote Significance of extremely elevated ferritin level in medical inpatients
The diagnostic and prognostic utility of extremely elevated ferritin values in hospitalized medical patients is lacking. We aimed to determine the clinical significance of ferritin levels ≥ 1000 ng/mL in adults hospitalized in the general medical service. We scanned the hospital laboratory database for ferritin values ≥ 1000 ng/mL, and evaluated the medical history, diagnoses, and survival of patients hospitalized in the general medical service. We compared the characteristics and outcomes of patients with values up-to versus above 2,999 ng/mL. Ferritin samples ranging from 1,003 to 12,170 ng/mL from 422 patients in the lower and 94 in the higher ferritin groups were included. Malignancy, repeat blood transfusions and recent chemotherapy were more prevalent in the higher ferritin group (p=0.003, p=0.002, and p<0.001, respectively). Infection (58.7%), chronic kidney disease (22.0%), and solid or hematological malignancies (21.6% and 17.1%, respectively) were the leading conditions associated with elevated ferritin. One-year survival was low, and significantly lower in patients in the higher ferritin group (10.8% vs. 16.9%, p=0.004). In conclusion, extremely elevated ferritin values in patients admitted to the general medical service are associated with multiplicity of clinical conditions and poor outcome.
Content available remote Prognosis of elderly patients hospitalized in the cardiac ward
Introduction Cardiovascular diseases affect nearly 80% of the elderly, and they are the major cause of death in this population. The aim was to evaluate the clinical profile and prognostic factors for patients aged 80 years and more who have been hospitalized for cardiologic reasons. Material and Methods The study included 100 patients aged 80–91 years (46% men) referred to the Department of Cardiology. We analyzed the reasons and length of hospitalization, clinical factors, results of basic laboratory tests, echocardiography, angiography, comorbidities and number of deaths during the hospitalization and in one year of follow-up. Patients were divided and analyzed, depending on the total mortality rate.Results The most common causes of hospitalization were myocardial infarction (67%) and heart failure (10%). Coronary angiography was performed in 72% of patients and percutaneous coronary intervention in 81%. The most common cause of hospital deaths was myocardial infarction (67%). The proportion of deaths in hospital was 8%, and during a year of observation it was 26%. Deaths were found to be related to ventricular conduction blocks (OR=4.0; P=0.03) and atrial fibrillation (OR=11.15; P=0.04). Conclusions In the elderly hospitalized in cardiac wards, myocardial infarction was the most common cause of hospitalization and hospital death. The mortality rate was high and associated with ventricular conduction blocks and atrial fibrillation.
Idiopathic thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. In 20% of cases, this condition is classified as chronic when the thrombocytopenia is persistent 6 months after diagnosis. The aim of the present study is to identify the potential factors correlating with a favorable outcome in patients with chronic ITP. Some 71 patients affected by ITP were retrospectively analyzed. Results show a higher rate of spontaneous recovery that is statistically significant for patients with platelet count at diagnosis <20,000/µL. These observations suggest the possibility to delay or avoid aggressive surgical treatment for these patients.
Content available Przyszłe wojny. Zarys problemu
Artykuł poświęcony jest zidentyfikowaniu kluczowych aspektów dotyczących przyszłych wojen i konfliktów zbrojnych oraz usystematyzowaniu istniejącej wiedzy w tym obszarze. W związku z tym przyjęto założenie, że należy chociażby w ogólnym zarysie nakreślić prognozy najbardziej prawdopodobnych rodzajów wojen i konfliktów, a nie jednej uniwersalnej wizji wojny oraz konfliktu zbrojnego. Użycie liczby mnogiej w tym wypadku jest w pełni uzasadnione, ponieważ wypracowanie jednej wizji wojny byłoby podejściem zbyt uproszczonym, mogącym negatywnie wpłynąć nie tylko na rozwój teorii wojen i konfliktów, lecz także na ich praktykę. Rozwiązanie zatem tego problemu wymagało udzielenia odpowiedzi na pytanie: jakie będą przyszłe wojny i konflikty w stosunku do przewidywanych uwarunkowań geopolitycznych, rozwoju technologii wojskowych, walki informacyjnej oraz regulacji prawnych? W przygotowaniu niniejszego opracowania niezbędne okazały się teoretyczne metody badawcze, takie jak: synteza, analiza, uogólnienie i porównanie. Jednakże ze względu na specyficzny obszar badawczy kluczowe znaczenie miała jakościowa metoda prognozowania, czyli metoda scenariuszowa.
The following article is devoted to identification of key aspects concerning future wars and armed conflicts, and to systematisation of the existing knowledge on this extremally interesting topic. The conducted analysis is based upon an assumption that it is necessary to, at least generally, outline prognoses of most probable types of wars and conflicts, and not just the single one and universal vision of the war and armed conflict. Use of the plural here is therefore fully justified, since elaboration of the single vision would be too much simplified an attempt that could negatively influence, not only the development of the theory of war and conflicts, but also their practice. A solution, thereby, to this problem required answering the following question: what will the future wars look like in relation to prognosed geopolitical conditions, development of the military technology, information warfare and the law? While realising this study, theoretical research methods were employed, such as: synthesis, analysis, generalisation and comparison. However, due to the characteristics of the research field, a qualitative method, the scenario-based approach was crucial in realising the following study.
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