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Author (down) Roh, T.H.; Park, H.H.; Kang, S.-G.; Moon, J.H.; Kim, E.H.; Hong, C.-K.; Ahn, S.S.; Choi, H.J.; Cho, J.; Kim, S.H.; Lee, S.K.; Kim, D.S.; Kim, S.H.; Suh, C.-O.; Lee, K.S.; Chang, J.H.
Title Long-term outcomes of concomitant chemoradiotherapy with temozolomide for newly diagnosed glioblastoma patients: A single-center analysis Type Journal Article
Year 2017 Publication Medicine Abbreviated Journal Medicine (Baltimore)
Volume 96 Issue 27 Pages e7422
Keywords Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Alkylating/*therapeutic use; Brain Neoplasms/diagnosis/genetics/metabolism/*therapy; *Chemoradiotherapy; DNA Methylation; DNA Modification Methylases/genetics/metabolism; DNA Repair Enzymes/genetics/metabolism; Dacarbazine/*analogs & derivatives/therapeutic use; Disease-Free Survival; Female; Follow-Up Studies; Glioblastoma/diagnosis/genetics/metabolism/*therapy; Humans; Male; Middle Aged; Prognosis; Promoter Regions, Genetic; Retrospective Studies; Treatment Outcome; Tumor Suppressor Proteins/genetics/metabolism; Young Adult
Abstract The present study analyzed outcomes of surgery followed by concomitant chemoradiotherapy (CCRT) with temozolomide (TMZ) in patients with newly diagnosed glioblastoma (GBM) at a single institution. Outcomes were retrospectively reviewed in 252 consecutive patients with newly diagnosed GBM who underwent surgery followed by CCRT with TMZ at the authors' institution between 2005 and 2013. At initial operation, 126 (50.0%), 55 (21.8%), 45 (17.9%), and 26 (10.3%) patients underwent gross total resection (GTR), subtotal resection, partial resection (PR), and biopsy, respectively. Their median overall survival (OS) was 20.8 months (95% confidence interval [CI] 17.7-23.9 months) and their median progression-free survival was 12.7 months (95% CI 11.2-14.2 months). The O-methylguanine-DNA methyltransferase (MGMT) promoter was methylated in 78 (34.1%) of the 229 patients assayed, and an isocitrate dehydrogenase 1 mutation was detected in 7 (6.6%) of the 106 patients analyzed. Univariate analyses showed that patient age, involvement of eloquent areas, involvement of the subventricular zone, presence of leptomeningeal seeding, Karnofsky Performance Status, extent of resection (EOR), MGMT promoter methylation, and presence of an oligodendroglioma component were prognostic of OS. Multivariate analysis showed that age, involvement of eloquent areas, presence of leptomeningeal seeding, EOR, and MGMT promoter methylation were significantly predictive of survival. OS in patients with GBM who undergo surgery followed by CCRT with TMZ is enhanced by complete resection. Other factors significantly prognostic of OS include that age, involvement of eloquent areas, presence of leptomeningeal seeding, and MGMT promoter methylation.
Address aYonsei University Graduate School, Seoul bDepartment of Neurosurgery, Ajou University Hospital, Ajou University School of Medicine, Suwon cDepartment of Neurosurgery dDepartment of Radiology eDepartment of Medical Oncology fDepartment of Radiation Oncology gDepartment of Pathology, Yonsei University College of Medicine hBrain Tumor Center, Severance Hospital, Yonsei University Health System iBrain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0025-7974 ISBN Medium
Area Expedition Conference
Notes PMID:28682902 Approved no
Call Number ref @ user @ Serial 96578
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Author (down) Rogers, A.E.J.; Eisenman, K.M.; Dolan, S.A.; Belderson, K.M.; Zauche, J.R.; Tong, S.; Gralla, J.; Hilden, J.M.; Wang, M.; Maloney, K.W.; Dominguez, S.R.
Title Risk factors for bacteremia and central line-associated blood stream infections in children with acute myelogenous leukemia: A single-institution report Type Journal Article
Year 2017 Publication Pediatric Blood & Cancer Abbreviated Journal Pediatr Blood Cancer
Volume 64 Issue 3 Pages
Keywords Adolescent; Bacteremia/*etiology; Bacteria/isolation & purification; Case-Control Studies; Catheter-Related Infections/*etiology; Catheterization, Central Venous/*adverse effects; Child; Child, Preschool; Cross Infection/*etiology; Female; Follow-Up Studies; Humans; Infant; Intensive Care Units, Pediatric; Leukemia, Myeloid, Acute/*complications/microbiology; Male; Prognosis; Retrospective Studies; Risk Factors; Clabsi; acute myelogenous leukemia; bacteremia; pediatric oncology
Abstract BACKGROUND: Central line-associated blood stream infections (CLABSIs) are a source of high morbidity and mortality in children with acute myelogenous leukemia (AML). PROCEDURE: To understand the epidemiology and risk factors associated with the development of CLABSI in children with AML. METHODS: We retrospectively reviewed all patients with AML over a 5-year period between 2007 and 2011 at the Children's Hospital Colorado. Cases and controls were classified on the basis of the presence of a CLABSI as defined by the National Healthcare Safety Network. RESULTS: Of 40 patients in the study, 25 (62.5%) developed at least one CLABSI during therapy. The majority of CLABSIs were due to oral or gastrointestinal organisms (83.0%). Skin organisms accounted for 8.5%. In a multivariable analysis, the strongest risk factors associated with CLABSI were diarrhea (odds ratio [OR] 6.7, 95% confidence interval [CI] 1.6-28.7), receipt of blood products in the preceding 4-7 days (OR 10.0, 95%CI 3.2-31.0), not receiving antibiotics (OR 8.3, 95%CI 2.8-25.0), and chemotherapy cycle (OR 3.5, 95%CI 1.4-8.9). CLABSIs led to increased morbidity, with 13 cases (32.5%) versus two controls (1.9%) requiring transfer to the pediatric intensive care unit (P < 0.001). Three (7.5%) of 40 CLABSI events resulted in or contributed to death. CONCLUSIONS: Intensified line care efforts cannot eliminate all CLABSIs in the patients with AML. Exploring the role of mucosal barrier breakdown and/or the use of antibiotic prophylaxis may be effective strategies for further prevention of CLABSIs, supporting ongoing trials in this patient population.
Address Department of Infectious Disease, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, Colorado
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1545-5009 ISBN Medium
Area Expedition Conference
Notes PMID:27616655 Approved no
Call Number ref @ user @ Serial 99291
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Author (down) Rogers, A.E.J.; Eisenman, K.M.; Dolan, S.A.; Belderson, K.M.; Zauche, J.R.; Tong, S.; Gralla, J.; Hilden, J.M.; Wang, M.; Maloney, K.W.; Dominguez, S.R.
Title Risk factors for bacteremia and central line-associated blood stream infections in children with acute myelogenous leukemia: A single-institution report Type Journal Article
Year 2017 Publication Pediatric Blood & Cancer Abbreviated Journal Pediatr Blood Cancer
Volume 64 Issue 3 Pages
Keywords Adolescent; Bacteremia/*etiology; Bacteria/isolation & purification; Case-Control Studies; Catheter-Related Infections/*etiology; Catheterization, Central Venous/*adverse effects; Child; Child, Preschool; Cross Infection/*etiology; Female; Follow-Up Studies; Humans; Infant; Intensive Care Units, Pediatric; Leukemia, Myeloid, Acute/*complications/microbiology; Male; Prognosis; Retrospective Studies; Risk Factors; Clabsi; acute myelogenous leukemia; bacteremia; pediatric oncology
Abstract BACKGROUND: Central line-associated blood stream infections (CLABSIs) are a source of high morbidity and mortality in children with acute myelogenous leukemia (AML). PROCEDURE: To understand the epidemiology and risk factors associated with the development of CLABSI in children with AML. METHODS: We retrospectively reviewed all patients with AML over a 5-year period between 2007 and 2011 at the Children's Hospital Colorado. Cases and controls were classified on the basis of the presence of a CLABSI as defined by the National Healthcare Safety Network. RESULTS: Of 40 patients in the study, 25 (62.5%) developed at least one CLABSI during therapy. The majority of CLABSIs were due to oral or gastrointestinal organisms (83.0%). Skin organisms accounted for 8.5%. In a multivariable analysis, the strongest risk factors associated with CLABSI were diarrhea (odds ratio [OR] 6.7, 95% confidence interval [CI] 1.6-28.7), receipt of blood products in the preceding 4-7 days (OR 10.0, 95%CI 3.2-31.0), not receiving antibiotics (OR 8.3, 95%CI 2.8-25.0), and chemotherapy cycle (OR 3.5, 95%CI 1.4-8.9). CLABSIs led to increased morbidity, with 13 cases (32.5%) versus two controls (1.9%) requiring transfer to the pediatric intensive care unit (P < 0.001). Three (7.5%) of 40 CLABSI events resulted in or contributed to death. CONCLUSIONS: Intensified line care efforts cannot eliminate all CLABSIs in the patients with AML. Exploring the role of mucosal barrier breakdown and/or the use of antibiotic prophylaxis may be effective strategies for further prevention of CLABSIs, supporting ongoing trials in this patient population.
Address Department of Infectious Disease, University of Colorado Denver School of Medicine and Children's Hospital Colorado, Aurora, Colorado
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1545-5009 ISBN Medium
Area Expedition Conference
Notes PMID:27616655 Approved no
Call Number ref @ user @ Serial 100321
Permanent link to this record
 

 
Author (down) Rocha, G. da S.; Mello Jorge, M.H.P. de; Grembek, O.
Title After-effects and disabilities in traffic crash victims in northern Brazil Type Journal Article
Year 2017 Publication Traffic Injury Prevention Abbreviated Journal Traffic Inj Prev
Volume 18 Issue 4 Pages 412-419
Keywords Accidents, Traffic/*statistics & numerical data; Adolescent; Adult; Aged; Brazil/epidemiology; Child; Cities; Cross-Sectional Studies; *Disabled Persons; Facial Injuries/epidemiology/mortality/pathology; Female; Humans; Injury Severity Score; Logistic Models; Male; Middle Aged; Motorcycles; Odds Ratio; Risk Factors; Wounds and Injuries/*epidemiology/mortality/pathology; Young Adult; Crashes; after-effects; severity of trauma; traffic; victims
Abstract OBJECTIVES: The objective of this study was to identify the characteristics related to crash and victim, as well as the after-effects/disabilities and consequences arising from traffic crashes occurring in the city of Rio Branco-Acre. METHODS: This is an analytical descriptive cross-sectional study conducted in the City of Rio Branco-Acre. The study population consisted of 405 residents of the city who were victims of traffic crashes, of all age groups and genders, who were hospitalized for the first time as a result of the crash in public hospitals and the health system network, as recorded in the Hospital Information System, and who were discharged between January 1 and December 31, 2010. The data sources included hospital record consultations and active searches for the victims. Hierarchical logistic regression was performed to evaluate the factors associated with the after-effects. RESULTS: The majority of the study population was motorcycle victims (68.6%), male, and young (20-39 years). Concerning the after-effects, the following were significantly associated: factors related to the presence of a postcrash activity limitation (odds ratio [OR] = 2.39; 95% confidence interval [CI], 2.39-6.76), length of hospital stay in days (OR = 1 03; 95% CI, 1.01-1.06), and surgical treatment (OR = 1.82; 95% CI, 1.03-3.21). Those who suffered damage to soft tissue and nerves or facial injury showed an odds ratio of 2 to 4 times of having an after-effect/disability, independent of the victim's personal attributes. CONCLUSION: The mechanism, such as the origin of the pattern of injuries, explains the exposure factors shown by each attribute of the victim and their characteristics. Many of the injuries were precursors to after-effects/disabilities, which, due to their nature and extent, result in the modification of the apparently healthy living standards of young victims who are routinely injured in traffic crashes. Therefore, public policies for prevention should be formulated, reformulated, and implemented, taking into account each attribute of the victims and their social conditions, because these are closely related to their habits and customs. This is a starting point for promoting changes to the current reality that traffic crashes present in the morbidity and mortality of the population.
Address c University of California , Berkeley , Safe Transportation Research and Education Center , Berkeley , California
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1538-9588 ISBN Medium
Area Expedition Conference
Notes PMID:27575383 Approved no
Call Number ref @ user @ Serial 97666
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Author (down) Ribeiro, A.P.; Souza, E.R. de; Sousa, C.A.M. de
Title Injuries caused by firearms treated at Brazilian urgent and emergency healthcare services Type Journal Article
Year 2017 Publication Ciencia & Saude Coletiva Abbreviated Journal Cien Saude Colet
Volume 22 Issue 9 Pages 2851-2860
Keywords
Abstract This paper analyzes the medical care given at Brazilian urgent and emergency healthcare services to people injured by firearms in 2014. A cross-sectional study was carried out on care given to patients with firearms injuries in 24 capital cities of Brazilian states and in the Brazilian Federal District, included in the VIVA Survey. Simple and relative frequencies of the variables related to the patients and to the event were calculated, and a logistic model for complex samples was applied adopting care for firearms injuries patients as outcome. The results show the following percentages of care events as caused by firearms: 0.7% for the category 'other accidents (other than transport-related accidents)', 1.5% for self-inflicted injuries, 15.9% for injuries due to assault, and 65.1% of cases arising from legal intervention. The care given was predominantly to young male adults (age 20-39), of mixed race and with a low level of schooling. The most common injuries were: to arms and legs; and to multiple organs. The paper concludes by discussing the efforts to control firearms held by the public in Brazil, and how they can lead to severe and lethal outcomes in quarrels and interpersonal disputes.
Address Departamento de Estudos sobre Violencia e Saude Jorge Careli/Claves, Escola Nacional de Saude Publica, Fiocruz. Av. Brasil 4036/7 masculine, Manguinhos. 21040-210 Rio de Janeiro RJ Brasil. adalpeixoto@yahoo.com.br
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title Lesoes provocadas por armas de fogo atendidas em servicos de urgencia e emergencia brasileiros
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1413-8123 ISBN Medium
Area Expedition Conference
Notes PMID:28954136 Approved no
Call Number ref @ user @ Serial 97503
Permanent link to this record