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Influence Survival (influence + survival)
Selected AbstractsGender-Related Differences in Modulation of Heart Rate in Patients with Congestive Heart FailureJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2000DORON ARONSON M.D. Gender and HRV in Heart Failure Introduction. The prognosis of women with congestive heart failure (CHF) is better than that for men, but the mechanisms underlying the female survival advantage are not well understood. CHF is characterized by profound abnormalities in cardiac autonomic control that contribute to progressive circulatory failure and influence survival. Methods and Results. Time- and frequency-domain heart rate variability (HRV) indexes were obtained from 24-hour Holter recordings and compared to assess the role of gender in 131 men and 68 women with CHF (mean age 60 ± 13.6 years, range 21 to 87; New York Heart Association Functional Class III [66%] and IV [34%]). Gender-related differences in HRV were observed only in the subset of patients with nonischemic heart failure (55 men and 39 women). Among the time-domain indexes, the SD of the RR intervals (76 ± 5.3 msec vs 55.3 ± 3.2 msec, P < 0.0001) and indexes denoting parasympathetic modulation, the percentage of RR intervals with >50 msec variation (4.0%± 1.0% vs 6.5%± 1.3%, P = 0.02), and the square root of mean squared differences of successive RR intervals (19.1 ± 3.3 vs 28.4 ± 3.8, P = 0.004) were higher in women. Among the frequency-domain indexes, the total power (7.5 ± 0.13 In-msec2 vs 8.3 ± 0.14 In-msec2, P = 0.0002), the ultralow-frequency power (7.2 ± 0.11 In-msec2 vs 8.0 ± 0.14 In-msec2, P < 0.0001), the low-frequency power (3.8 ± 0.25 In-msec2 vs 4.8 ± 0.28 In-msec2, P = 0.006), and the high-frequency power (3.8 ± 0.24 In-msec2, vs 4.6 ± 0.26 In-msec2, P = 0.003) were greater in women than in men. Conclusion. Women with nonischemic CHF have an attenuated sympathetic activation and parasympathetic withdrawal compared with men. Gender-based differences in autonomic responses in the setting of CHF may be related to the female survival advantage. (J Cardiovasc Electrophysiol, Vol. 11, pp. 1071-1077, October 2000) [source] The survival outcome and prognostic factors for middle and distal bile duct cancer following surgical resectionJOURNAL OF SURGICAL ONCOLOGY, Issue 6 2009Sae Byeol Choi MD Abstract Background and Objectives The objective of this study was to analyze the survival outcome and the clinicopathological factors that influence survival and recurrence of middle and distal bile duct cancer after surgical resection. Methods From January 2000 to June 2007, 125 patients underwent surgical resection for middle and distal bile duct cancer. The clinicopathological characteristics and survival outcomes were reviewed retrospectively. Results Of the 125 patients, 31 patients underwent segmental resection of the bile duct, and 94 patients underwent pancreaticoduodenectomy (PD). Overall survival rates were 85.8% at 1 year and 38.3% at 5 years. Lymph node metastasis, noncurative resection, poorly differentiated tumor, and preoperative bilirubin level greater than 5.0 mg/dl were significant independent predictors of poor prognosis by multivariate analysis. The number of metastatic lymph nodes did not significantly affect survival. Recurrence occurred in 72 patients (61.0%). Disease-free survival rates were 74.1% at 1 year and 42.0% at 3 years. Lymph node and distant metastases and poorly differentiated tumors were found to be significant independent predictors of recurrence by multivariate analysis. Conclusions R0 resection confers a survival benefit, thus the surgeon should make an effort to achieve R0 resection. The presence of lymph node metastasis was a significant prognostic factor. J. Surg. Oncol. 2009;99:335,342. © 2009 Wiley-Liss, Inc. [source] Breast-Conservation Treatment Outcomes: A Community Hospital's ExperienceTHE BREAST JOURNAL, Issue 1 2009Barbara D. Florentine MD Abstract:, In the United States, the majority of early breast cancer patients choose breast-conserving treatment in the community setting, yet there is a paucity of literature describing outcomes. In this paper, we describe our experience with breast-conserving treatment in a small community hospital. Our hospital tumor registry was used to identify breast cancer cases diagnosed at our hospital between 1997 and 2003. We limited our study to those women with initial attempts at breast-conserving surgery (BCS) who had follow-up oncology treatment at on-campus affiliated oncological services. We looked at factors that influence survival for early stage 0,II disease such as tumor and patient characteristics, completeness of local surgical tumor excision, and adjuvant treatment. We also evaluated the percentage of cases in which the initial BCS did not achieve adequate surgical oncological results and the number and type of subsequent surgeries that were required to achieve this goal. There were 185 cases with a median patient age of 55 and a median follow-up time of 53 months. Most tumors were stage 0,I (68%) or stage II (23%). A single surgery was deemed sufficient to achieve the desired oncological outcome in 54% of cases; the remaining cases (46%) required additional surgeries. A final margin of 5 mm or greater was successfully achieved in 81% of cases. Ninety-two percent of the patients underwent radiotherapy, 65% received hormonal therapy, and 49% underwent chemotherapy. One hundred and sixty one patients had successful breast-conserving surgeries (87%) and 24 patients (13%) ultimately required mastectomy. There were four loco-regional recurrences and 19 deaths during the study period. Our disease-free survival rate for early-stage cancer (stage 0,II) was 91% at 5 years. Our study shows that high-quality patient outcomes for breast-conserving treatment can be achieved in the community setting. [source] Sex of the first hatched chick influences survival of the brood in the herring gull (Larus argentatus)JOURNAL OF ZOOLOGY, Issue 1 2006S.-Y. Kim Abstract Differences in the growth rate of male and female offspring can result in different parental rearing costs for sons and daughters. Such differences may also influence the survival chances of male and female offspring when conditions are unfavourable. In birds, hatching asynchrony leads to hierarchical competition for food between siblings. Therefore, the sex of the chick in the first hatched position in the brood may influence breeding success by affecting the extent to which the later hatched chicks can compete for resources. The interaction between brood sex composition and chick performance in the herring gull Larus argentatus was examined under different environmental conditions. When environmental conditions were relatively good, chick survival within broods was better when a female was first to hatch, an effect that was most obvious later in the season. When conditions were poorer however, sex of the first hatched chicks was not related to brood survival. In neither situation did the overall primary sex ratio differ from equality. However in the year of relatively good food availability, the first chick in the brood was more likely to be male early in the season, which was when the disadvantageous effects on brood survival of males being in this position are weakest. [source] MDM2 SNP309 genotype influences survival of metastatic but not of localized neuroblastoma,PEDIATRIC BLOOD & CANCER, Issue 4 2009Chiara Perfumo PhD Abstract Background MDM2 is a major negative regulator of p53 function and is directly regulated by MYCN in neuroblastoma (NB) cells. MDM2 SNP309, a T-to-G substitution in the MDM2 promoter associated with higher gene expression compared to wild-type, may attenuate the p53 pathway in NB, in which p53 mutations are rare. We investigated its impact on NB development and survival in relation with major clinical and biological characteristics. Procedure A consecutive cohort of 497 NB children, diagnosed in Italy between 1995 and 2005, and a healthy control population of 471 adults were genotyped for MDM2 SNP309. NB patients were followed up until June 30, 2008. Results Patients and controls showed similar distribution of MDM2 SNP309 genotypes. In patients, the polymorphism was not associated with any characteristic at diagnosis. In localized stages no effect of the polymorphism on survival was evident. In stage 4 patients overall survival (OS), event free survival (EFS) and survival after relapse (SAR) were significantly poorer for TG/GG than for TT patients (P,=,0.008; P,=,0.013; P,=,0.046, respectively). In this group, such an effect was more evident in patients with MYCN amplification (OS: P,<,0.001; EFS: P,=,0.028; SAR: P,<,0.001). Conclusions While MDM2 SNP309 status does not affect the risk of developing NB nor disease outcome for localized cancer cases, it significantly correlates with survival in stage 4 NB patients, particularly in the presence of MYCN amplification. The impact of small molecule inhibitors of MDM2 activity in the management of such patients could be usefully considered. Pediatr Blood Cancer 2009;53:576,583. © 2009 Wiley-Liss, Inc. [source] | ||||||||||