Search results for " Prospective Studies"

showing 10 items of 189 documents

Intraperitoneal drain placement and outcomes after elective colorectal surgery: International matched, prospective, cohort study

2022

Abstract Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and tim…

AdultElective Surgical ProcedureAdult; Aged; Cohort Studies; Drainage; Elective Surgical Procedures; Female; Humans; Postoperative Complications; Prospective Studies; Surgical Wound Infection; Colorectal Surgerydrain; intrabdominaldrainAdult Aged Cohort Studies Colorectal Surgery Drainage Elective Surgical Procedures Female Humans Postoperative Complications Prospective Studies Surgical Wound InfectionSettore MED/18Cohort StudiesSettore MED/18 - Chirurgia GeneraleProspective StudiePostoperative ComplicationsElective Surgical ProceduresintrabdominalDrainageHumansSurgical Wound InfectionSurgeryFemalePostoperative ComplicationProspective StudiesCohort Studiedrain intrabdominalColorectal SurgeryHumanAged
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Prospective comparison of Fibroscan, King's score and liver biopsy for the assessment of cirrhosis in chronic hepatitis C infection

2010

Historically, liver biopsy (LB) was the sole method to evaluate the severity of hepatic fibrosis in patients with chronic hepatitis C infection. However, LB is expensive and associated with a risk of severe complications. Therefore, noninvasive tests have been developed to assess the severity of liver fibrosis. The accuracy of Fibroscan (FS) and King's score (KS) was evaluated individually and in combination using liver histology as the reference standard. One hundred and eighty-seven patients were identified who had undergone a biopsy with a diagnosis of chronic hepatitis C virus (HCV) mono-infection (HCV RNA-positive by RT-PCR), attending King's College Hospital (n = 88) or the Royal Free…

AdultLiver CirrhosisMaleKing's scoreHepacivirusPredictive Value of TestsVirologyfibrosis; hepatitis C; King's score; transient elastography; Adult; Alanine Transaminase; Alkaline Phosphatase; Area Under Curve; Aspartate Aminotransferases; Bilirubin; Elasticity Imaging Techniques; Female; Hepacivirus; Hepatitis C Chronic; Histocytochemistry; Humans; Liver Cirrhosis; Male; Middle Aged; Platelet Count; Predictive Value of Tests; Prospective Studies; ROC Curve; gamma-Glutamyltransferase; Hepatology; Infectious Diseases; Virology; Medicine (all)Humansfibrosis hepatitis C King s score transient elastographyAspartate AminotransferasesProspective StudiesChronicHepatologyHistocytochemistryPlatelet CountMedicine (all)fibrosisAlanine TransaminaseBilirubingamma-GlutamyltransferaseHepatitis C ChronicMiddle AgedAlkaline Phosphatasetransient elastographyHepatitis CInfectious DiseasesROC CurveArea Under CurveElasticity Imaging TechniquesFemale
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Computer-assisted image analysis of liver collagen: relationship to Ishak scoring and hepatic venous pressure gradient.

2009

Histopathological scoring of disease stage uses descriptive categories without measuring the amount of fibrosis. Collagen, the major component of fibrous tissue, can be quantified by computer-assisted digital image analysis (DIA) using histological sections. We determined relationships between DIA, Ishak stage, and hepatic venous pressure gradient (HVPG) reflecting severity of fibrosis. One hundred fifteen patients with hepatitis C virus (HCV) who had undergone transplantation had 250 consecutive transjugular liver biopsies combined with HVPG (median length, 22 mm; median total portal tracts, 12), evaluated using the Ishak system and stained with Sirus red for DIA. Liver collagen was expres…

AdultLiver CirrhosisMalemedicine.medical_specialtyCirrhosismedicine.medical_treatmentPortal venous pressureImage ProcessingBiopsyLiver transplantationHepatic VeinsGastroenterologyComputer-AssistedInternal medicineBiopsymedicineImage Processing Computer-AssistedHumansProspective StudiesAgedHepatologymedicine.diagnostic_testbusiness.industryHepatologyMiddle Agedmedicine.diseaseHepatitis CConfidence intervalSurgeryLiver TransplantationTransplantationLogistic ModelsLiverAdult; Aged; Biopsy; Collagen; Female; Hepatic Veins; Hepatitis C; Humans; Liver; Liver Cirrhosis; Liver Transplantation; Logistic Models; Male; Middle Aged; Prospective Studies; Venous Pressure; Image Processing Computer-AssistedFemaleCollagenTransient elastographybusinessVenous Pressurecollagen proportionate area HVPG liver fibrosisHepatology (Baltimore, Md.)
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Mortality risk according to different clinical characteristics of first episode of liver decompensation in cirrhotic patients: a nationwide, prospect…

2013

Abstract OBJECTIVES: The occurrence of decompensation marks a crucial turning point in the course of cirrhosis. The purpose of this study was to assess the risk of mortality according to the clinical characteristics of first decompensation, considering also the impact of acute-on-chronic liver failure (AoCLF). METHODS: We conducted a prospective nationwide inception cohort study in Italy. Decompensation was defined by the presence of ascites, either overt or detected by ultrasonography (UD), gastroesophageal variceal bleeding (GEVB), and hepatic encephalopathy (HE). AoCLF was defined according to the Asian Pacific Association for the Study of the Liver criteria. Multivariable Cox proportion…

AdultLiver CirrhosisMalemedicine.medical_specialtyPediatricsCarcinoma HepatocellularCirrhosisAdolescentmedicine.medical_treatmentCirrhosis Mortality Liver decompensation CohortLiver transplantationEsophageal and Gastric VaricesSeverity of Illness IndexYoung AdultSeverity of illnessmedicineHumansProspective StudiesYoung adultIntensive care medicineProspective cohort studyHepatic encephalopathyAgedProportional Hazards ModelsAged 80 and overFirst episodeHepatologybusiness.industryLiver NeoplasmsGastroenterologyAscitesMiddle Agedmedicine.diseaseLiver TransplantationAdolescent; Adult; Aged; Aged 80 and over; Ascites; Carcinoma Hepatocellular; Esophageal and Gastric Varices; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Hepatic Encephalopathy; Humans; Italy; Liver Cirrhosis; Liver Failure; Liver Neoplasms; Liver Transplantation; Male; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Prospective Studies; Severity of Illness Index; Young AdultItalyCirrhosisHepatic EncephalopathyMultivariate AnalysisCohortFemaleGastrointestinal HemorrhagebusinessLiver FailureFollow-Up Studies
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Neoangiogenesis-related genes are hallmarks of fast-growing hepatocellular carcinomas and worst survival. Results from a prospective study

2016

Objective The biological heterogeneity of hepatocellular carcinoma (HCC) makes prognosis difficult. We translate the results of a genome-wide high-throughput analysis into a tool that accurately predicts at presentation tumour growth and survival of patients with HCC.Design Ultrasound surveillance identified HCC in 78 (training set) and 54 (validation set) consecutive patients with cirrhosis. Patients underwent two CT scans 6 weeks apart (no treatment in-between) to determine tumour volumes (V-0 and V-1) and calculate HCC doubling time. Baseline-paired HCC and surrounding tissue biopsies for microarray study (Agilent Whole Human Genome Oligo Microarrays) were also obtained. Predictors of su…

AdultMale0301 basic medicinemedicine.medical_specialtyTime FactorsCarcinoma HepatocellularTime FactorMicroarrayHepatocellular carcinomamolecular carcinogenesisGastroenterologyliver imagingHEPATOCELLULAR CARCINOMA; LIVER IMAGING; MOLECULAR CARCINOGENESIS; MOLECULAR ONCOLOGY; Adult; Aged; Aged 80 and over; Carcinoma Hepatocellular; Disease Progression; Female; Humans; Liver Neoplasms; Male; Middle Aged; Neovascularization Pathologic; Prospective Studies; Survival Rate; Time Factors; Tumor Burden; Medicine (all); Gastroenterology03 medical and health sciencesmolecular oncology0302 clinical medicineHepatocellular carcinoma liver imaging molecular carcinogenesis molecular oncologyInternal medicinemedicineCarcinomaHumansDoubling timeProspective StudiesProspective cohort studySurvival rateAgedAged 80 and overNeovascularization Pathologicbusiness.industryProportional hazards modelLiver NeoplasmsGastroenterologyMiddle Agedmedicine.diseaseTumor BurdenSurvival RateProspective Studie030104 developmental biologyQuartileLiver Neoplasm030220 oncology & carcinogenesisHepatocellular carcinomaDisease ProgressionFemalebusinessHumanGut
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Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis o…

2018

Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF…

AdultMaleDiabetes mellituLUNG SAFEOrgan Dysfunction Scoreshumanoslnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]Socio-culturaleOrgan Dysfunction ScoreDiabetes ComplicationsDiabetes mellituspuntuaciones de disfunción orgánicaRisk FactorsDiabetes Complicationestudios prospectivosHumansfactores de riesgoProspective StudiesHospital MortalityHypoxiamediana edadAcute hypoxemic respiratory failureAgedRespiratory Distress SyndromeancianoAcute respiratory distress syndromeResearchRespirationrespiraciónRespiratory Distress Syndrome Adultlcsh:Medical emergencies. Critical care. Intensive care. First aidlcsh:RC86-88.9Middle AgedRespiration Artificialinsuficiencia respiratoriaAcute hypoxemic respiratory failure; Acute respiratory distress syndrome; Diabetes mellitus; LUNG SAFEProspective StudieArtificialAcute hypoxemic respiratory failure; Acute respiratory distress syndrome; Diabetes mellitus; LUNG SAFE; Aged; Diabetes Complications; Diabetes Mellitus; Female; Hospital Mortality; Humans; Hypoxia; Male; Middle Aged; Organ Dysfunction Scores; Prospective Studies; Respiration Artificial; Respiratory Distress Syndrome Adult; Respiratory Insufficiency; Risk FactorsFemaleRespiratory Insufficiencymortalidad hospitalariacomplicaciones de la diabetesHuman
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Evaluation of erlotinib treatment response in non-small cell lung cancer using metabolic and anatomic criteria

2016

BACKGROUND: In this paper the clinical value of PET for early prediction of tumor response to erlotinib in patients with advanced or metastatic non-small cell lung cancer (NSCLC) after failure of at least one prior chemotherapy regimen is evaluated. The aim was to compare the early metabolic treatment response using European Organization for Research and Treatment of Cancer (EORTC) 1999 recommendations and PET Response Criteria in Solid Tumors (PERCIST), and the standard treatment response using Response Evaluation Criteria in Solid Tumors (RECIST). METHODS: Twenty patients with stage IV NSCLCwere enrolled prospectively. PET/CT studies were performed before, then 48 hours, and 45 days after…

AdultMaleLung NeoplasmsTime FactorsAntineoplastic AgentsKaplan-Meier EstimateAdult; Aged; Antineoplastic Agents; Carcinoma Non-Small-Cell Lung; Disease-Free Survival; Erlotinib Hydrochloride; Female; Humans; Kaplan-Meier Estimate; Lung Neoplasms; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Prospective Studies; Time Factors; Treatment OutcomeResponse evaluation criteria in solid tumorDisease-Free SurvivalErlotinib Hydrochloridenon–small cell lung cancerPositron Emission Tomography Computed TomographyHumansProspective StudiesNon-Small-Cell LungAgedCarcinomaMiddle AgedCarcinoma non-small-cell lungEORTCTreatment OutcomeRECISTResponse evaluation criteria in solid tumorsFemalePositron-emission tomographyPERCISTDiagnosi18F-FDG PET
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Palliative Sedation in Patients With Advanced Cancer Followed at Home: A Prospective Study

2014

Abstract Context Home care programs in Italy. Objectives The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. Methods A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. Results A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P = 0.012). The principal reasons to start PS were agitated delirium (n = 20) and dyspnea (n = 4).…

AdultMaleend of lifemedicine.medical_specialtyPalliative careContext (language use)Settore MED/42 - Igiene Generale E ApplicataPalliative sedationend of life; midazolam; palliative care; Palliative sedation; Adult; Aged; Aged 80 and over; Delirium; Dyspnea; Family; Feasibility Studies; Female; Humans; Hypnotics and Sedatives; Italy; Male; Midazolam; Middle Aged; Neoplasms; Palliative Care; Patient Care Team; Prospective Studies; Terminal Care; Young Adult; Home Care Services; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous); Medicine (all)Young AdultPalliative sedationNeoplasms80 and overmedicineHumansHypnotics and SedativesFamilyIn patientProspective StudiesIntensive care medicineProspective cohort studyNursing (all)2901 Nursing (miscellaneous)General NursingAgedAged 80 and overPatient Care TeamTerminal Carepalliative carebusiness.industryMedicine (all)DeliriumMiddle AgedHome Care ServicesAdvanced cancerDistressDyspneaAnesthesiology and Pain MedicinePalliative sedation; end of life; midazolam; palliative careItalymidazolamEmergency medicineFeasibility StudiesMidazolamFemaleNeurology (clinical)businessmedicine.drugJournal of Pain and Symptom Management
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Advancement flap in the management of chronic anal fissure: A prospective study

2012

Lateral internal sphincterotomy is the surgical treatment of choice of chronic anal fissure after failure of conservative measures. Several randomized trials identified an overall risk of incontinence of 10 % mostly for flatus. Fissurectomy is the most commonly used procedure to preserve the integrity of the anal sphincters. However, a possible complication is keyhole defect that may lead to faecal soiling. In this study, chronic anal fissure (CAF) was treated by fissurectomy and anal advancement flap to preserve the anatomo-functional integrity of sphincters and to reduce healing time and the risk of anal stenosis. In patients with hypertonia, surgical treatment was combined with chemical …

AdultMalemedicine.medical_specialtyAdolescentmedicine.medical_treatmentInjections IntramuscularSurgical FlapsFissurectomyFollow-Up StudieInternal anal sphincterAnal stenosismedicineDeformityHumansReconstructive Surgical ProcedureProspective StudiesKeyhole defectBotulinum Toxins Type ADigestive System Surgical ProceduresAdvancement flapAgedNeuromuscular Agentbusiness.industryUrinary retentionDigestive System Surgical ProcedureRecovery of FunctionPlastic Surgery ProceduresMiddle AgedSurgerySurgical FlapProspective StudieSettore MED/18 - Chirurgia GeneraleTreatment OutcomeNeuromuscular AgentsAnesthesiaChronic DiseaseDefecationHypertoniaFemaleSurgeryFissure in AnoAdvancement flap; Chronic anal fissure; Fissurectomy; Adolescent; Adult; Aged; Botulinum Toxins Type A; Chronic Disease; Digestive System Surgical Procedures; Female; Fissure in Ano; Follow-Up Studies; Humans; Injections Intramuscular; Male; Middle Aged; Neuromuscular Agents; Prospective Studies; Reconstructive Surgical Procedures; Recovery of Function; Treatment Outcome; Surgical Flaps; Surgerymedicine.symptombusinessLateral internal sphincterotomyChronic anal fissureFollow-Up StudiesHuman
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Treatment of relapsing-remitting multiple sclerosis after 24 doses of natalizumab: evidence from an Italian spontaneous, prospective, and observation…

2014

Importance The evaluation of therapeutic choices is needed after 24 doses of natalizumab in patients with multiple sclerosis (MS). Objective To evaluate the effect of therapeutic choices on the mean annualized relapse rate and on magnetic resonance imaging MS activity after 24 doses of natalizumab in patients with relapsing-remitting MS. Design, Setting, and Participants The TY-STOP study, which recruited participants between October 22, 2010, and October 22, 2012, at 8 Italian MS centers (secondary care outpatient clinics) among 124 adult patients who demonstrated no clinical or magnetic resonance imaging MS activity after 24 doses of natalizumab. Interventions Natalizumab, no treatment, i…

AdultMalemedicine.medical_specialtyAdult; Antibodies Monoclonal Humanized; Humans; Italy; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis Relapsing-Remitting; Natalizumab; Prospective Studies; Recurrence; Treatment OutcomeAntibodies Monoclonal HumanizedNatalizumabMultiple Sclerosis Relapsing-RemittingRecurrenceInternal medicineClinical endpointmedicineOutpatient clinicHumansProspective StudiesGlatiramer acetateMultiple Sclerosis Ty-STOP Natalizumabbusiness.industryProgressive multifocal leukoencephalopathyNatalizumabMiddle Agedmedicine.diseaseFingolimodMagnetic Resonance ImagingSurgeryDiscontinuationClinical trialTreatment OutcomeItalySettore MED/26 - NeurologiaNeurology (clinical)businessmedicine.drugJAMA neurology
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