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Outcome Predictors (outcome + predictor)

Distribution by Scientific Domains

Medical Sciences	88%
Psychology	11%

Distribution within Medical Sciences

Neurology	25%
Oncology & Radiotherapy	12%

Selected Abstracts

MMPI Profile as an Outcome "Predictor" in the Treatment of Noncancer Pain Patients Utilizing Intraspinal Opioid Therapy

NEUROMODULATION, Issue 3 2001
Daniel M. Doleys PhD
Objective. To evaluate changes in Minnesota Multiphasic Personality Inventory (MMPI) profiles pre- and post-treatment involving intrathecal opioid therapy. Patients and Methods. This study reports on 30 patients that were evaluated pre- and post-intraspinal opioid therapy. Treatment duration was slightly more than four years. Each patient experienced chronic non-cancer pain deemed suitable for trialing and subsequent implantation of a drug administration system (DAS). On average the patients had experienced pain for 8.4 years and had a mean of 3.2 pain-related surgeries. Results. The patients could be divided into "positive change group" and "negative change group" based upon pre- and post-treatment MMPI profiles. Those patients in the negative change group had more "normal profiles" pretreatment. This group evidenced less reduction in pain and was found to be using slightly higher levels of intraspinal opioids. Conclusions. These results would suggest that the MMPI profile may not be a good "predictor" of long-term outcome utilizing intraspinal opioid therapy. Indeed, patients with the more normal profile pretreatment did not fare as well as those with the more elevated profile. A positive change in MMPI profile from pre- to post-treatment was associated with a higher level of pain reduction. Patient selection therefore should be based not on a single test such as the MMPI, but on consistency across multiple sources of information including physical examination, complaints of pain and disability, behavioral observations, and psychological testing. [source]

Outcome Predictors of Pneumonia in Elderly Patients: Importance of Functional Assessment

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2004
Olga H. Torres MD
Objectives: To evaluate the outcome of elderly patients with community-acquired pneumonia (CAP) seen at an acute-care hospital, analyzing the importance of CAP severity, functional status, comorbidity, and frailty. Design: Prospective observational study. Setting: Emergency department and geriatric medical day hospital of a university teaching hospital. Participants: Ninety-nine patients aged 65 and older seen for CAP over a 6-month recruitment period. Measurements: Clinical data were used to calculate Pneumonia Severity Index (PSI), Barthel Index (BI), Charlson Comorbidity Index, and Hospital Admission Risk Profile (HARP). Patients were then assessed 15 days later to determine functional decline and 30 days and 18 months later for mortality and readmission. Multiple logistic regression was used to analyze outcomes. Results: Functional decline was observed in 23% of the 93 survivors. Within the 30-day period, case-fatality rate was 6% and readmission rate 11%; 18-month rates were 24% and 59%, respectively. Higher BI was a protective factor for 30-day and 18-month mortality (odds ratio (OR)=0.96, 95% confidence interval (CI)=0.94,0.98 and OR=0.97, 95% CI=0.95,0.99, respectively; P<.01), and PSI was the only predictor for functional decline (OR=1.03, 95% CI=1.01,1.05; P=.01). Indices did not predict readmission. Analyses were repeated for the 74 inpatients and indicated similar results except for 18-month mortality, which HARP predicted (OR=1.73; 95% CI=1.16,2.57; P<.01). Conclusion: Functional status was an independent predictor for short- and long-term mortality in hospitalized patients whereas CAP severity predicted functional decline. Severity indices for CAP should possibly thus be adjusted in the elderly population, taking functional status assessment into account. [source]

Clinicopathologic Features and Outcome Predictors of Leptospira interrogans Australis Serogroup Infection in Dogs: A Retrospective Study of 20 Cases (2001,2004)

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2007
Cinzia Mastrorilli
Background and Hypothesis: We retrospectively evaluated the Clinicopathologic findings and outcome predictors in dogs with Leptospira interrogans Australis serogroup infections. Animals and Methods: The medical records of 159 dogs that had a leptospiral microscopic agglutination test (MAT) performed between 2001 and 2004 were reviewed. Results: Twenty dogs met serologic criteria for either symptomatic (16 dogs) or asymptomatic (4 dogs) infection caused by Leptospira interrogans Australis serogroup. Seven of 16 symptomatic dogs died or were euthanized and 9/16 recovered. Systemic inflammatory response syndrome (SIRS) was observed in 9/16 dogs. The presence of SIRS did not affect prognosis (P= .357). C-reactive protein (CRP) and haptoglobin (Hpt) concentrations were altered in all symptomatic dogs, but results did not differ significantly between survivors and nonsurvivors (P= .08 and P= .055, respectively). Conversely, the CRP to Hpt ratio (CRP/Hpt) was significantly increased in nonsurvivors. Disseminated intravascular coagulation (DIC) was diagnosed in 7/16 dogs. DIC did not significantly affect outcome (P= .126). Multiple organ involvement was present with renal failure in 16/16, liver damage in 12/16, cardiac damage in 11/16, and muscular damage in 8/16 dogs. Conclusions and Clinical Importance: Among the evaluated Clinicopathologic biomarkers, serum albumin, cardiac troponin I, CRP/Hpt, urinary albumin, and urinary total protein to creatinine ratio were found to predict outcome and warrant evaluation in larger prospective studies. [source]

P53 and Ki-67 as Outcome Predictors for Advanced Squamous Cell Cancers of the Head and Neck Treated With Chemoradiotherapy,

THE LARYNGOSCOPE, Issue 11 2001
Pierre Lavertu MD
Abstract Hypothesis P53 and Ki-67 status will predict response to treatment, organ preservation, and survival in patients with advanced squamous cell cancers of the head and neck treated with chemoradiotherapy (CRT). Study Design Retrospective analysis of p53 and Ki-67 status from the CRT arm of a randomized, controlled trial (n = 50) and from patients receiving the same treatment but not enrolled in the trial (n = 55). Methods P53 and Ki-67 status were established from archived tissue samples using immunohistochemical (IHC) staining. Tumors were positive for p53 (p53+) when more than 2% of cells stained for p53 and were positive for Ki-67 (Ki-67+) when any cell stained for Ki-67. End points were tumor response, tumor recurrence, survival status, and organ preservation at last follow-up, and time to events. Predictive models were calculated for each outcome. Results Neither marker predicted tumor response to treatment. P53+ status was associated with tumor recurrence (P = .003) and locoregional recurrence (P = .003). Adjusting for time to event, p53+ status was significantly related to a lower recurrence-free survival (P = .004), lower disease-specific survival (P = .04), lower overall survival with primary site preservation (P = .03), and lower disease-specific survival with primary site preservation (P = .003). Multivariate analysis revealed that p53+ status was significantly related to a lower recurrence-free survival (P = .01, risk ratio [RR] = 3.65) and lower disease-specific survival with organ preservation (P = .02, RR = 3.41). Ki-67+ status was not related to any variables. However, multivariate analysis revealed that Ki-67+ was significantly related to a lower overall survival (P = .05, RR = 2.03). The combination of both markers negative (p53-/Ki-67-) was associated with a lower incidence of tumor recurrence (P = .02), lower locoregional recurrence (P = .01), and fewer second primary lesions (P = .04). Adjusting for time to event, p53-/Ki-67- status was significantly related to a higher recurrence-free survival (P = .02), higher disease-specific survival with primary site preservation (P = .02), and higher overall survival with primary site preservation (P = .02). Multivariate analysis revealed that p53-/Ki-67- status was significantly related to a higher overall survival with site preservation (P = .01, RR = 2.78). Conclusions P53 and Ki-67 status appear to be related to the various survival end points considered in this study. However, this relation does not seem to be sufficient to warrant treatment modifications. Closer follow-up may be justified in both p53+ and Ki67+ patients to detect recurrence or a second primary at an earlier stage, possibly improving survival. [source]

Outcome predictors, efficacy and safety of Botox and Dysport in the long-term treatment of hemifacial spasm

EUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2009
A. R. Bentivoglio
Background and purpose:, To review the clinical characteristics and the long-term outcome of patients with hemifacial spasm (HFS) who received botulinum neurotoxin (BoNT) over the past 10 years. Results:, A total of 108 patients received 665 treatments. Mean latency of clinical effect was 5.4 ± 5.3 days for Botox and 4.9 ± 4.6 days for Dysport (P > 0.05). Mean duration of clinical improvement was higher after the injection of Dysport than Botox: 105.9 ± 54.2 and 85.4 ± 41.6 days respectively (P < 0.01). The percentage of treatment failures was 6.5% for Botox and 4.6% for Dysport (P > 0.05). The doses of Botox significantly increased over time (, = 0.35, P < 0. 001) whilst Dysport dose remained unchanged (, = 0.16, n.s.). The duration of clinical benefit slightly increased with Botox (, = 0.12; P < 0.01), but remained constant for Dysport. Side effects occurred in 17.4% of treatments: 16.7% of patients who had received Botox, and in 19.7% who had received Dysport (P > 0.05). The most common side effects were palpebral ptosis and lacrimation; ptosis and lagophtalmos was more common in Dysport treatments (P < 0.005). Conclusions:, Both brands are effective and safe in treating HFS; efficacy is long-lasting. The differences in outcome and side effects confirm that, albeit the active drug is the same, Botox and Dysport should be considered as two different drugs. [source]

Specificity and reliability of prognostic indexes in intensive care evaluation: the spontaneous cerebral haemorrhage case

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2009
Alberto Barbieri PhD MD
Abstract Objective, To determine the reliability of a generic index such as Simplified Acute Physiology Score II (SAPSII), compared with a specific one Intra Cerebral Haemorrhage score (ICH score), as an intensive care unit (ICU) outcome predictor when evaluating a general facility that frequently treats a specific type of patients , those with spontaneous cerebral haemorrhage. Methods, The study cohort consisted of a random sample of patients (81) admitted to Modena's Policlinico Teaching Hospital's ICU with spontaneous ICH over a 24-month period. Main outcome measure, SAPSII, ICH score, overall mortality. Results, The mean ICH score for the 32 surviving patients was 3.41 ± 1.012 while for the 49 deceased patients was of 4.24 ± 0.855 (P = 0.000). The mean SAPSII value for the 32 surviving patients was 49.09 ± 16.58 while for the 49 deceased patients was 49.51 ± 15.93. SAPSII, ICH scores were analysed for mortality, by receiver operating characteristic curves: the area under the curve was significant for ICH, not-significant for SAPSII. Conclusions, Regional quality controls use generic prognostic indexes (SAPSII) in relation to mortality and outcome to assess ICUs, which is appropriate when dealing with a general facility when there is not a predominant type of patient, but it may bias the evaluation if the population with specific pathologies (ICH), not included in the general index, is statistically considerable, leading to an incorrect criticality assessment, an inappropriate strategic plan and the subsequent inefficient resource allocation. [source]

Brugada Syndrome: Current Clinical Aspects and Risk Stratification

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2002
Ph.D., Takanori Ikeda M.D.
Brugada syndrome is a primary electrical disease of the heart that causes sudden cardiac death or life-threatening ventricular arrhythmias, especially in younger men. Genetic analysis supports that this syndrome is a cardiac ion channel disease. A typical electrocardiographic finding consists of a right bundle branch block pattern and ST-segment elevation in the right precordial leads. The higher intercostal space V1 to V3 lead electrocardiogram could be helpful in detecting Brugada patients. Although two types of the ST-segment elevation are present, the coved type is more relevant to the syndrome than the saddle-back type. These patterns can be present permanently or intermittently. Recent data suggest that the Brugada-type electrocardiogram is more prevalent than the manifest Brugada syndrome. Asymptomatic individuals have a much lower incidence of future cardiac events than the symptomatic patients. Although risk stratification for the Brugada syndrome is still incomplete, the inducibility of sustained ventricular arrhythmias has been proposed as a good outcome predictor in this syndrome. In noninvasive techniques, some clinical evidence supports that late potentials detected by signal-averaged electrocardiography are a useful index for identifying patients at risk. The available data recommend prophylactic implantation of an imptantabie cardioverter defibrillator to prevent sudden cardiac death. This review summarizes recent information of the syndrome by reviewing most of new clinical reports and speculates on its risk stratification. A.N.E. 2002;7(3):251,262 [source]

Mucosal melanoma of the nose and paranasal sinuses, a contemporary experience from the M. D. Anderson Cancer Center

CANCER, Issue 9 2010
Mauricio A. Moreno MD
Abstract BACKGROUND: Sinonasal mucosal melanoma is a rare disease associated with a very poor prognosis. Because most of the series extend retrospectively several decades, we sought to determine prognostic factors and outcomes with recent treatment modalities. METHODS: A retrospective chart review of 58 patients treated for sinonasal melanoma at a tertiary cancer center between 1993 and 2004. The patients were retrospectively staged according to the sinonasal American Joint Committee on Cancer (AJCC) staging system. Demographic, clinical and pathological parameters were identified and correlated with outcomes. RESULTS: There were 35 males and 23 females with a median age of 63 years; 56 patients were treated surgically and 33 received radiation therapy. According to Ballantyne's clinical staging system, 88% of the patients presented with stage I (local) disease. Classification by the AJCC staging classified yielded 27% of the patients with T1, 33% with T2, 21% with T3, and 19% with T4. T-stage and the degree of tumor pigmentation were associated with a worse survival (P = .0096 and P = .018, respectively), while pseudopapillary architecture was associated with a higher locoregional failure (P = .0144). Postoperative radiation therapy improved locoregional control when a total dose greater than 54 Gy was used (P = .0215), but did not affect overall survival. CONCLUSIONS: Tumor stage according to sinonasal AJCC staging system is an effective outcome predictor and should be the staging system of choice. Postoperative radiation therapy improves locoregional control when a higher dose and standard fractionations are used. Histological features such as pigmentation and pseudopapillary architecture are associated with worse outcome. Cancer 2010. © 2010 American Cancer Society. [source]

Combined counseling and bupropion therapy for smoking cessation: identification of outcome predictors

DRUG DEVELOPMENT RESEARCH, Issue 3 2006
Maria Caterina Grassi
Abstract Because some smoking-induced pathologies improve upon discontinuation, strategies have been developed to help smokers quit. The aim of this study was to measure the rate of smokers still abstinent one year after one cycle of a six-week group counseling given alone or in combination with a seven-week period of daily administration of bupropion. We also evaluated the predictor validity of nicotine dependence intensity at enrollment, administering both the Fageström Tolerance Questionnaire (FTQ) and the Severity of Dependence Scale (SDS). Visual Analogue Scale (VAS), to measure the intensity of "smoke craving," was also administered. Two hundred twenty-nine subjects trying to quit smoking were enrolled. Bupropion therapy was accepted by 110 subjects, but only 50 completed the 7-week cycle of therapy. Abstinence rates at one year were 68.0 and 56.6%, respectively, in the group that used bupropion for the scheduled 7 weeks and in the group that discontinued bupropion, and 35.3% in the group with counseling therapy alone. SDS (but not FTQ) scores at enrollment, VAS values for craving at the end of the program, and bupropion therapy were the variables selected by Linear Discriminant Analysis to assign subjects to the Smoker or Non-smoker group, with a global correctness of 70.9%. In conclusion, the efficacy of bupropion largely depends upon its interaction with psychological factors, such as the level of nicotine dependence, craving for nicotine, and the subject's commitment to quit smoking. Drug Dev. Res. 67:271,279, 2006. © 2006 Wiley-Liss, Inc. [source]

Old enough for a beer?

ADDICTION, Issue 9 2008
Compliance with minimum legal age for alcohol purchases in monopoly, Norway, other off-premise outlets in Finland
ABSTRACT Aim To assess whether government monopoly outlets comply better with minimum legal age for purchase of alcohol compared to other off-premise outlets for alcohol sales. Methods Under-age-appearing 18-year-olds attempted to purchase alcohol in off-premise outlets applying identical procedures in Finland (n = 290) and Norway (n = 170). Outcomes were measured as whether or not the buyers were asked to present an identity (ID) card and whether or not they succeeded in purchasing alcohol. Results The buyers were asked to present an ID card in slightly more than half the attempts, and they succeeded in purchasing alcohol in 48% of the cases. The buyers were more likely to be requested to present an ID card and less likely to succeed in purchasing alcohol in monopoly outlets compared to other types of outlets, and also when other outcome predictors, such as age and gender of salesperson and crowdedness in the outlet, were taken into account. Conclusion Monopoly outlets may facilitate compliance with minimum legal age for purchase of alcohol. [source]

Comprehensive Inpatient Treatment of Refractory Chronic Daily Headache

HEADACHE, Issue 4 2009
Alvin E. Lake III PhD
Objective., (1) To assess outcome at discharge for a consecutive series of admissions to a comprehensive, multidisciplinary inpatient headache unit; (2) To identify outcome predictors. Background., An evidence-based assessment (2004) concluded that many refractory headache patients appear to benefit from inpatient treatment, underscoring the need for more research, including outcome predictors. Methods., The authors completed a retrospective chart review of 283 consecutive admissions over 6 months. The inpatient program (mean length of stay = 13.0 days) included intravenous and oral medication protocols, drug withdrawal when indicated, cognitive-behavior therapy, and other services when needed, including anesthesiological intervention. Patient-reported pain levels and consensus of medical staff determined outcome status. Results., The 267 completers (94%) included 212 women and 55 men (mean age = 40.3 years, range = 13-74) from 43 states and Canada. The modal diagnosis was intractable, chronic daily headache (85%), predominantly migraine. Most (59%) had medication overuse headache (MOH), involving opioids (48%), triptans (16%), or butalbital-containing analgesics (10%). Psychiatric diagnoses included stress-related headache (82%), mood disorders (70%), anxiety disorders (49%), and personality disorders (PD, 26%). More patients with a PD (62%) had opioid-related MOH than those with no PD (38%), P < .005. Of the completers, 78% had moderate to significant pain reduction, with comparable improvement in mood, function, and behavior. Clinical factors predicting moderate-significant headache improvement were limited to MOH (84% vs 69%, P < .007) and presence of a PD (68% vs 81%, P < .03). Conclusions., Most patients (78%) improved following aggressive, comprehensive inpatient treatment. Maintenance of improvement is likely to depend on multiple post-discharge factors, including continuity of care, compliance, and home or work environment. [source]

Twelve-year course and outcome predictors of anorexia nervosa

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2006
Dipl-Psych, Manfred M. Fichter MD
Abstract Objective The current study presents the long-term course of anorexia nervosa (AN) over 12 years in a large sample of 103 patients diagnosed according to criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Method Assessments were made at the beginning of therapy, at the end of therapy, at the 2-year follow-up, at the 6-year follow-up, and at the 12-year follow-up. Self-rating and an expert-rating interview data were obtained. Results The participation rate at the 12-year follow-up was 88% of those alive. There was substantial improvement during therapy, a moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 12 years posttreatment. Based on a global 12-year outcome score, 27.5% had a good outcome, 25.3% an intermediate outcome, 39.6% had a poor outcome, and 7 (7.7%) were deceased. At the 12-year follow-up 19.0% had AN, 9.5% had bulimia nervosa-purging type (BN-P), 19.0% were classified as eating disorder not otherwise specified (EDNOS). A total of 52.4% showed no major DSM-IV eating disorder and 0% had binge eating disorder (BED). Systematic,strictly empirically based,model building resulted in a parsimonious model including four predictors of unfavorable 12-year outcome explaining 45% of the variance, that is, sexual problems, impulsivity, long duration of inpatient treatment, and long duration of an eating disorder. Conclusion Mortality was high and symptomatic recovery protracted. Impulsivity, symptom severity, and chronicity were the important factors for predicting the 12-year outcome. © 2005 by Wiley Periodicals, Inc. [source]

Capillary permeability and extracellular volume fraction in uterine cervical cancer as patient outcome predictors: Measurements by using dynamic MRI spin-lattice relaxometry

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2008
Véronique Dedieu PhD
Abstract Purpose To improve the outcome prediction of uterine cervical carcinoma by measuring the vascular permeability (kep) and the extracellular volume fraction (ve) of the tumor from Dynamic T1 - IRM Relaxometry. Materials and Methods Twenty-six patients with proven cervical carcinoma were divided into good outcome and poor outcome groups. Classic tumor prognostic factors, the longest diameter L and the volume V of the tumor, were measured from morphologic MR images. The tumor parameters kep and ve were determined from the relaxometry time-curve acquired during the contrast uptake after a bolus intravenous injection of an extracellular contrast agent. Results All "small" tumors (L<35 mm or V<11 cm3) were good outcome with 100% sensitivity but a rather low specificity (36% and 43% for L and V, respectively). With regard to the physiopathological parameter kep, "large" tumors (L , 35mm) can also be classified as good outcome on the condition that kep , 2.2 min,1 with 100% sensitivity and 89% specificity. Regarding the extracellular volume fraction (ve), no significant difference was observed between the two groups. Conclusion Measurement of the tumor vascular permeability might be useful to predict prognostic, to evaluate the treatment efficacy, and to adapt a proper therapy schedule. J. Magn. Reson. Imaging 2008;27:846,853. © 2008 Wiley-Liss, Inc. [source]

Dihydropyrimidine dehydrogenases and cytidine-deaminase gene polymorphisms as outcome predictors in resected gastric cancer patients treated with fluoropyrimidine adjuvant chemotherapy

JOURNAL OF SURGICAL ONCOLOGY, Issue 2 2008
Juan J. Grau MD
Abstract Background and Objectives Single nucleotide polymorphisms of dihydropyrimidine dehydrogenases gene (DPYD) induces dihydropyrimidine dehydrogenase enzyme (DPD) deficiency resulting in increased activity of 5-fluorouracil derivatives. Cytidine-deaminase gene (CDA) polymorphisms have been involved in prognosis in experimental tumours. Methods Analysis of 50 consecutive resected gastric cancer patients who received adjuvant chemotherapy with Tegafur for polymorphisms of genes DPYD1 (A/G; Ile543Val), DPYD2 (C/T; Arg29Cys) and CDA (A/C; Lys27Gin). The status of alleles (wild-type or at least one polymorphism) was correlated with outcome and toxicity. Results Polymorphisms frequencies wild-type/non-wild-type were 36/14 in DPYD1 (A/G; Ile543Val); 26/24 in DPYD2 (C/T; Arg29Cys); and 17/23 in CDA (A/C; Lys27Gin) or between homozygous/heterozygous were 39/11 in DPYD1; 33/17 in DPYD2 and 26/24 in CDA respectively. After 77 months of median follow-up (SD,=,26.3), 18 patients died of tumour relapse. Better survival was observed in DPYD1 patients only, for non-wild-type over wild-type (P,=,0.0214); and in patients with one or more heterozygous polymorphisms in any of the three genes tested (P,=,0.0017). In 10 pts (20%) total dose was reduced by toxicity, only 3 of them were homozygous. Conclusions Gene polymorphisms of DPYD and CDA predict survival of gastric cancer patients treated with 5-fluorouracil-based adjuvant chemotherapy. J. Surg. Oncol. 2008;98:130,134. © 2008 Wiley-Liss, Inc. [source]

Clinicopathologic Features and Outcome Predictors of Leptospira interrogans Australis Serogroup Infection in Dogs: A Retrospective Study of 20 Cases (2001,2004)

Copeptin: A novel, independent prognostic marker in patients with ischemic stroke,

ANNALS OF NEUROLOGY, Issue 6 2009
Mira Katan MD
Objective Early prediction of outcome in patients with ischemic stroke is important. Vasopressin is a stress hormone. Its production rate is mirrored in circulating levels of copeptin, a fragment of provasopressin. We evaluated the prognostic value of copeptin in acute stroke patients. Methods In a prospective observational study, copeptin was measured using a new sandwich immunoassay on admission in plasma of 362 consecutive patients with an acute ischemic stroke. The prognostic value of copeptin to predict the functional outcome (defined as a modified Rankin Scale score of ,2 or ,3), mortality within 90 days, was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors. Results Patients with an unfavorable outcomes and nonsurvivors had significantly increased copeptin levels on admission (p <0.0001 and p <0.0001). Receiver operating characteristics to predict functional outcome and mortality demonstrated areas under the curve of copeptin of 0.73 (95% confidence interval [CI], 0.67,0.78) and 0.82 (95% CI, 0.76,0.89), which was comparable with the National Institutes of Health Stroke Scale score but superior to C-reactive protein and glucose (p <0.01). In multivariate logistic regression analysis, copeptin was an independent predictor of functional outcome and mortality, and improved the prognostic accuracy of the National Institutes of Health Stroke Scale to predict functional outcome (combined areas under the curve, 0.79; 95% CI, 0.74,0.84; p <0.01) and mortality (combined areas under the curve, 0.89; 95% CI, 0.84,0.94; p <0.01). Interpretation Copeptin is a novel, independent prognostic marker improving currently used risk stratification of stroke patients. Ann Neurol 2009;66:799,808 [source]

Development and growth in very preterm infants in relation to NIDCAP in a Dutch NICU: two years of follow-up

ACTA PAEDIATRICA, Issue 2 2009
JM Wielenga
Abstract Aim: To study development and growth in relation to newborn individualized developmental and assessment program (NIDCAP®) for infants born with a gestational age of less than 30 weeks. Methods: Developmental outcome of surviving infants, 25 in the NIDCAP group and 24 in the conventional care group, in a prospective phase-lag cohort study performed in a Dutch level III neonatal intensive care unit (NICU) was compared. Main outcome measure was the Bayley scales of infant development-II (BSID-II) at 24 months corrected age. Secondary outcomes were neurobehavioral and developmental outcome and growth at term, 6, 12 and 24 months. Results: Accounting for group differences and known outcome predictors no significant differences were seen between both care groups in BSID-II at 24 months. At term age NIDCAP infants scored statistically significant lower on neurobehavioral competence; motor system (median [IQR] 4.8 [2.9,5.0] vs. 5.2 [4.3,5.7], p = 0.021) and autonomic stability (median [IQR] 5.7 [4.8,6.7] vs. 7.0 [6.0,7.7], p = 0.001). No differences were seen in other developmental outcomes. After adjustment for background differences, growth parameters were comparable between groups during the first 24 months of life. Conclusion: At present, the strength of conclusions to be drawn about the effect of NIDCAP on developmental outcome or growth at 24 months of age is restricted. Further studies employing standardized assessment approaches including choice of measurement instruments and time points are needed. [source]

Adolescent life events and adult mental health 5,9 years after referral for acute psychiatric outpatient treatment

CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2004
T. Skarbø
Knowledge is needed of mental health in relation to life events of former acute child and adolescent outpatients at risk of suicide. The present study describes the long-term mental health outcome of young adults who as children or adolescents were referred to outpatient psychiatry for mental health problems, and identifies putative mental health statistical outcome predictors at follow-up, with focus on life events. One hundred patients referred to treatment at child and adolescent outpatient clinics in Nordland County, Norway, during 1990,1994 were interviewed face to face, 5,9 years after referral. At follow-up, life events at young age were associated with the mental health status in spite of referral and acute psychotherapeutic intervention. There was a general effect of life events at young age, affecting a large number of mental health variables. Childhood and adolescence difficulties were highly correlated, indicating a possible continuation of effects from childhood to adolescence.,Copyright © 2004 John Wiley & Sons, Ltd. [source]