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Giancarlo Agnelli Melina Verso Mario Mandalà Silvano Gallus Claudio Cimminiello Giovanni Apolone Giovanni Di Minno Evaristo Maiello Paolo Prandoni Armando Santoro Lucio Crinò Roberto Labianca 《Internal and emergency medicine》2014,9(5):559-567
Retrospective population-based studies showed that in cancer patients venous thromboembolism (VTE) is associated with reduced survival. Master Oncology is a multicenter study in patients with solid advanced cancer aimed at assessing (1) risk factors for VTE using a case–control design, and (2) survival in cases (patients with VTE) and controls (patients without VTE). Survival data were prospectively collected for at least 10 months. Overall, 237 cases and 339 controls were included in the analysis. The following factors were found to be associated with an increased risk of VTE: body mass index (BMI; OR 2.02; 95 % CI 1.31–3.12 for ≥26 vs. <23 kg/m2), ECOG score (OR 2.14; 95 % CI 1.47–3.11 for grade 1, and 3.32; 95 % CI 1.64–6.00 for grade 2–3, compared to grade 0) and recent diagnosis of cancer (OR 1.90; 95 % CI 1.33–2.71 for <12 vs. ≥12 months). After an average prospective observation of 8.3 months, 136 cases (57.4 %) and 127 controls (37.5 %) died with a median survival of 8.7 (95 % CI 7.5–10.9) and 14.3 months (95 % CI 12.2–18.7), respectively, (Wilcoxon = 27.72, p < 0.001; multivariate hazard ratio 1.55; 95 % CI 1.21–2.00). Median survival time was reduced for both patients with symptomatic (Wilcoxon = 35.22, p < 0.001) and asymptomatic VTE (Wilcoxon = 4.63, p = 0.031). Patients with advanced solid cancer, high BMI, high ECOG score, and recent diagnosis of cancer are associated with an increased risk for VTE. Patients with both symptomatic and asymptomatic VTE have a reduced survival compared to those without VTE. 相似文献
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Steckman DA Schneider PM Schuller JL Aleong RG Nguyen DT Sinagra G Vitrella G Brun F Cova MA Pagnan L Mestroni L Varosy PD Sauer WH 《The American journal of cardiology》2012,110(4):575-579
Some patients diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC) are eventually found to have cardiac sarcoidosis (CS). Accurate differentiation between these 2 conditions has implications for immunosuppressive therapy and familial screening. We sought to determine whether cardiac magnetic resonance imaging (MRI) could be used to identify the characteristic findings to accurately differentiate between CS and ARVC. Consecutive patients with a diagnostic MRI scan indicating CS and/or ARVC constituted the cohort. All patients diagnosed with CS had histologic confirmation of sarcoidosis, and all patients with ARVC met the diagnostic task force criteria. The cardiac MRI data were retrospectively analyzed to identify possible differentiating characteristics. Of the patients, 40 had CS and 21 had ARVC. Those with CS were older and had more left ventricular scar. The presence of mediastinal lymphadenopathy or left ventricular septal involvement was seen exclusively in the patients with CS (p <0.001). A family history of sudden cardiac death was seen only in the ARVC group (p = 0.012). The right ventricular ejection fraction and ventricular volumes were also significantly different between the 2 groups. In conclusion, patients with CS have significantly different cardiac MRI characteristics than patients with ARVC. The cardiac volume, in addition to the degree and location of cardiac involvement, can be used to distinguish between these 2 disease entities. The presence of mediastinal lymphadenopathy and left ventricular septal scar favors a diagnosis of CS and not ARVC. Consideration of CS should be given if these MRI findings are observed during the evaluation for possible ARVC. 相似文献
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Park KL Budaj A Goldberg RJ Anderson FA Agnelli G Kennelly BM Gurfinkel EP Fitzgerald G Gore JM;Grace Investigators 《The American journal of cardiology》2012,110(5):628-635
The risk of stroke in patients hospitalized with an acute coronary syndrome (ACS) ranges from <1% to ≥2.5%. The aim of this study was to develop a simple predictive tool for bedside risk estimation of in-hospital ischemic stroke in patients with ACS to help guide clinicians in the acute management of these high-risk patients. Data were obtained from 63,118 patients enrolled from April 1999 to December 2007 in the Global Registry of Acute Coronary Events (GRACE), a multinational registry involving 126 hospitals in 14 countries. A regression model was developed to predict the occurrence of in-hospital ischemic stroke in patients hospitalized with an ACS. The main study outcome was the development of ischemic stroke during the index hospitalization for an ACS. Eight risk factors for stroke were identified: older age, atrial fibrillation on index electrocardiogram, positive initial cardiac biomarkers, presenting systolic blood pressure ≥160 mm Hg, ST-segment change on index electrocardiogram, no history of smoking, higher Killip class, and lower body weight (c-statistic 0.7). The addition of coronary artery bypass graft surgery and percutaneous coronary intervention into the model increased the prediction of stroke risk. In conclusion, the GRACE stroke risk score is a simple tool for predicting in-hospital ischemic stroke risk in patients admitted for the entire spectrum of ACS, which is widely applicable to patients in various hospital settings and will assist in the management of high-risk patients with ACS. 相似文献
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Cozzi F Parisi G Ciprian L Bullo A Cardarelli S Rizzo M Sfriso P Punzi L 《Rheumatology international》2012,32(5):1219-1223
Gastric involvement appears quite commonly in systemic sclerosis (SSc). The aim of this study was to evaluate gastric wall
motility using ultrasonography, a noninvasive method able to track both filling and emptying of fundus and antrum. The study
was performed in 20 SSc patients and 20 healthy control subjects. Gastric filling and emptying were evaluated by transabdominal
ultrasonography, measuring changes in fundus and antral areas over a 1-h period after ingestion of a liquid bolus (500 ml
of mineral water). Areas of both gastric fundus and antrum at basal evaluation were found to be smaller in SSc patients than
in healthy controls. Gastric filling was significantly reduced after ingestion of liquid bolus. Gastric emptying was delayed
both in fundus and antrum. No significant differences of gastric wall motility have been observed in different subsets of
SSc patients. Our findings show that gastric dysmotility is frequent and severe in SSc patients, contributing to the gastrointestinal
disturbances which are very common in this disease. 相似文献
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