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At least 19 recordsLinked to original sources
PubMed2026

Analysis of the Relationship between Early Clinical Factors and Glasgow Outcome Scale in Patients With Traumatic Brain Injury.

OBJECTIVE: This study aimed to evaluate the association between early clinical factors and the Glasgow outcome scale (GOS) in patients with traumatic brain injury (TBI). METHODS: We conducted a retrospective analysis of 98 TBI patients who underwent emergency surgery between January 2021 and January 2024. Based on GOS scores at 6 months post-surgery, patients were classified into a favorable outcome group (GOS&#xa0;&#x2265;&#xa0;4, defined as moderate disability or good recovery,&#xa0;n = 58) and an unfavorable outcome group (GOS < 4, i.e., death, persistent vegetative state, or severe disability,&#xa0;n = 40). Baseline and early clinical parameters were compared between groups. Statistically significant variables from univariate analysis were entered into a multivariate logistic regression model to identify independent prognostic factors. RESULTS: Significant intergroup differences were observed in age, time from injury to surgery, bleeding site, midline shift, Glasgow coma scale (GCS) score at admission, blood glucose level, and D-dimer level (all p < 0.05). Multivariate analysis confirmed that age, time from injury to surgery, GCS score, blood glucose, and D-dimer level were independent predictors of GOS (all p < 0.05). CONCLUSION: Early clinical factors, including age, time to surgery, GCS score, blood glucose, and D-dimer level, independently influence GOS in TBI patients. Time from injury to surgery&#xa0;emerged as a potentially modifiable factor in this cohort, suggesting that minimizing delays may improve outcomes.

Humans↗
PubMed2025

A clinically applicable method for early interstitial lung disease detection in incident rheumatoid arthritis cases: integration of protein biomarkers and clinical factors.

BACKGROUND: This study aimed to develop an early diagnostic method integrating proteomic biomarkers and clinical parameters for screening interstitial lung disease (ILD) in patients with newly diagnosed rheumatoid arthritis (RA) through a multi-phase research strategy. METHODS: A three-phase study was conducted: (1) Discovery: Tandem mass tag (TMT)-labeled quantitative proteomics with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyzed serum protein profiles in 5 RA-ILD and 5 RA-non-ILD patients, identifying candidates via bioinformatics. (2) Verification: Enzyme-linked immunosorbent assay (ELISA) validated candidates in an independent cohort (13 RA-ILD vs 14 RA-non-ILD). (3) Application: Biomarkers combined with clinical indicators (Krebs von den Lungen-6 [KL-6], age, sex) were evaluated in 110 patients (51 RA-ILD vs 59 RA-non-ILD) to build a predictive model. RESULTS: Proteomic analysis identified matrix metalloproteinase-3 (MMP3), von Willebrand factor (VWF), and other significantly differentially expressed proteins. ELISA validation confirmed that serum MMP3 and VWF levels were significantly higher in the RA-ILD group than in the RA-non-ILD group (p&#x2009;=&#x2009;0.025 and 0.027, respectively). Expanded validation demonstrated superior diagnostic performance when combining MMP3 and VWF with KL-6 (area under the curve [AUC]&#x2009;=&#x2009;0.90). The nomogram prediction model based on univariate analysis exhibited excellent discrimination (AUC = 0.89) and calibration. CONCLUSION: This systematic study from discovery to validation identified MMP3 and VWF as potential biomarkers for RA-ILD. The integrated predictive model combining these biomarkers with clinical parameters (KL-6, age, sex) provides a potential tool for early ILD screening in RA patients, offering novel strategies for early diagnosis and intervention of RA-ILD.

Humans↗
PubMed1979

Septic endarteritis due to intra-arterial catheters for cancer chemotherapy. I. Evaluation of an outbreak. II. Risk factors, clinical features and management, III. Guidelines for prevention.

A cluster of three cases of staphylococcal septic endarteritis originating from percutaneously inserted brachial artery catheters for regional cancer chemotherapy prompted an epidemiologic and clinical study of bacteremic infections associated with this therapeutic modality. Nine cases were identified over a 3 1/2-year period (1.6% of all catheterizations), all caused by Staphylococcus aureus. The cluster followed discontinuation of hexachlorophene for scrub of the extremity prior to cannulation; phage-typing suggested the three cases were caused by the patients' own strains of Staphylococcus. These infections produced a distinctive clinical syndrome which facilitates implicating the catheter in the genesis of fever occurring in a patient receiving intra-arterial chemotherapy: early localized pain (89%) and hemorrhage (78%), and Osler's nodes distally (44%), later followed by local inflammation (78%), purulence (56%) and signs of systemic sepsis (100%) (each factor, p less than or equal to .005). Duration of cannulation did not influence susceptibility to infection. However, difficult cannulations or need for repositioning the catheter (p = .0096), prior radiation therapy (p = .033), leukopenia (p less than .05) and hypoalbuminemia (p less than .05) were all associated with septicemia. In the 25 months since implementation of specific control measures, there have been no further catheter-related septicemia in 310 catheterization (p less than .001). Guide-lines for prevention and management of these infections are provided.

Adult↗
PubMed1978

Fracture of the femur in old age: A two-centre study of associated clinical factors and the cause of the fall.

All patients with fractured neck of the femur admitted to hospitals in two areas (North London and Manchester) in a period of one year have been examined--a total of 384 patients. Compared to control groups of similar age, the older fracture patients showed a higher prevalence of chronic brain syndrome, they were in poorer physical state and their skinfold thickness was less. They also had more unrecognized visual disorders. Those who were younger had a higher prevalence of stroke than comparable controls. The type of fall leading to the fracture varied with age--tripping was the commonest cause in the younger patients the 'drop attacks' in the older. Both stroke and partial sightedness were associated with falls due to loss of balance. The older patients had a very high prevalence of pyramidal tract abnormality associated with chronic brain syndrome--and it appears that these demented patients fall not because of mental confusion but because of associated motor abnormalities. Extra-capsular fractures occur in older patients. They are more likely to have a history of falls but previous fracture is equally common at this age in the fracture and control series.

Accidents↗
PubMed1977

Ascorbic acid metabolism and the clinical factors which affect tissue saturation with ascorbic acid.

The factors which give rise to tissue desaturation of ascorbic acid are classified and discussed. Nutritional deprivation, normal physiological factors and metabolic factors, and pathophysiological factors may all give rise to acute and continuing ascorbic acid tissue desaturation while the factors continue to operate. Nutritional desaturation can easily be rectified by providing supplementary Vitamin C in adequate dosage. The other factors can only be rectified when the causative mechanism is arrested. Iatrogenic desaturation may be produced by aspirin and several other drugs. While causative factors excluding that of nutrition are operating, it is very difficult if not impossible to restore normal tissue values of ascorbic acid. In consequence side effects which arise from supplementary Vitamin C administration do not arise in these circumstances. The supplementary Vitamin C administration is defined as compensatory administration of Vitamin C. In healthy individuals administration of supplementary Vitamin C can be defined as (large doses). Such large doses may give rise to side effects. The mechanism by which ascorbic acid is involved in the inflammatory response is discussed.

Ascorbic Acid↗
PubMed1978

Glottic cancer: clinical factors affecting irradiation control.

An analysis of the results of 252 patients with glottic larynx cancer treated in the RRTI between January 1965 and December 1971 is given. The patients were treated by orthovoltage radiotherapy and classified according to the UICC/AJC staging system of 1972. The 3-year recurrence-free rates for T1, T2 and T3 are 83, 62, and 60%, respectively. The present series suggest a reduction in disease-free survival for T2 patients from 70% with extraglottic extension or partial immobility to 52% with both extraglottic extension and partial immobility.

Carcinoma, Squamous Cell↗
PubMed2025

Polygenic Risk Scores for Preeclampsia Prediction Beyond Gold-Standard Clinical Models in Multiethnic Populations.

BACKGROUND: Preeclampsia is a major cause of maternal and fetal mortality and morbidity. Early risk stratification enables timely preventative therapy in high-risk women. Polygenic risk scores (PGS) improve prediction in complex diseases, but their added value for preeclampsia remains unclear, particularly in comparison to gold-standard first-trimester prediction models and across non-European ancestries. METHODS: We evaluated the performance of both a preeclampsia and systolic blood pressure PGS in 2 prospective pregnancy cohorts with detailed phenotyping: the Fetal Medicine Foundation study (n=5207; 2127 cases) and the Pregnancy Outcome Prediction study (n=3659; 228 cases). Risk models included (1) clinical factors; (2) clinical factors plus PGS; (3) advanced model including first-trimester mean arterial pressure, PAPP-A (pregnancy-associated plasma protein-A), and uterine artery pulsatility index; and (4) advanced model plus PGS. Discriminative performance, measured by the area under the receiver operating characteristic curve, was assessed overall and by ancestry. RESULTS: The preeclampsia PGS was independently associated with preeclampsia (odds ratio per SD, 1.24 [95% CI, 1.17-1.31]; P<0.001). It modestly improved prediction over clinical models (area under the receiver operating characteristic curve 0.746 versus 0.750; P=0.017) but not over the advanced model (area under the receiver operating characteristic curve 0.817 versus 0.818; P=0.326). The systolic blood pressure PGS showed stronger performance, improving prediction over both models in women of European ancestry. No improvement was observed with either score in women of African ancestry. CONCLUSIONS: PGSs for preeclampsia and SBP provide modest added predictive value beyond clinical risk factors in European ancestry women. Limited utility in African ancestry women reflects underrepresentation in the genome-wide association studies used to develop current scores. As cohort sizes grow and models are refined, PGSs may become important tools for equitable risk stratification in maternal health.

Adult↗
PubMed1978

Clinical prognostic factors in osteosarcoma.

Clinical characteristics thought to be of prognostic importance for patients with osteosarcoma are reviewed. The importance of considering prognostic factors in the evaluation of new therapies when no concurrent control group is available is emphasized.

Adult↗
PubMed1976

[Clinical and statistical study of 100 vitiligo patients. I. Etiologic factors and clinical study].

A study of the etiological factors in 100 cases of vitiligo showed female predominance (59%) variable age of onset, absence of radial factor, moderate influence of psychological, physical or endocrine factors, the large number of subjects belonging to group B, a family history in 18% of cases. The morphology site and course of the lesions were also studied. There was no significant correlation between the course of the disease and the various etiological and clinical parameters studied.

Adolescent↗
PubMed1979

Physician awareness of economic factors in clinical decision-making.

Physicians' awareness of economic factors in clinical decision-making at one large urban university medical center was studied by a 50-item questionnaire. Their dollar estimates were considered correct if within +/- 20 per cent of the true October 1976 figure. Eighty-one per cent of the house staff and all of the attendings correctly estimated the daily semi-private room rate, but only 15 per cent of each group correctly estimated the charge for a serum potassium. Roughly half of the questions concerning various third-party benefit plans were answered correctly. These results are consistent with those of the few previous studies. If the findings are generally applicable, they may suggest that a directed teaching program in simple economic facts and principles may be useful at all levels of physician training.

Attitude of Health Personnel↗
PubMed1977

[Clinical prognostic factors in breast cancer].

Five year survival of 683 mammary carcinomas would confirm the prognostic value of T.N.M. classification (UICC), of tumor particular characteristics (size, fixation to neighbouring structures) and presence or absence of clinical nodes. A clinical-histological relationship was studied for axillary nodes: in our experience, clinical determination is more reliable for estimation of N0 and N2 than N1. Three groups of age were considered; the age, T and N corrected five year survival show a higher mortality for patients older than 60 years with T3-T4, N greater than 0 carcinomas. The study of this prospective computerised register confirms the prognostic value of developping growth tumors (PEV) described by P. Denoix. In fact, inflammatory carcinomas (PEV 2-PEV 3) show a poor 5 year survival and PEV 1 is an intermediate pronostic group between stable and inflammatory carcinomas. PEV 1 was showed to be an independant clinical factor from T and N characteristics.

Adult↗
PubMed1979

Factors influencing clinical response to psychotropic drugs. Imipramine in depression.

Numerous factors are involved in determining the efficacy of tricyclic antidepressant agents in the treatment of depression. The list includes diagnosis and patient selection; pharmacodynamics, bioavailability and tissue sensitivity; natural history; placebo response, nonspecific factors; compliance and adverse effects; the effects of concurrent life events, illness and treatment, and the bias in evaluating the outcome of treatment. Physicians should be aware of the factors that influence clinical response so they can maximize therapeutic effects and utilize the agents properly.

Biological Availability↗