Ruizshapiro0550

BACKGROUND The serum marker CA 125 is still the most widely used biomarker for ovarian cancer (OC) diagnosis in gynecological and oncological setting, but its predictive role in early-stage OC is still debated. The aim of this study was to explore the value of CA 125 in distinguishing between early-stage OC and borderline ovarian tumor (BOT) and to evaluate the accuracy of CA 125 in the detection of early stage OC. METHODS A retrospective cohort study was performed at the University Hospital of Bologna (Italy) on 1296 consecutive women suffering from OC or BOT (diagnosed at histology) between 1988-2017. Patients for whom CA 125 level was determined preoperatively were included. The positive cut-off level used was >35 U/mL. RESULTS Of 910 patients, 192 (21.1%) were diagnosed with BOT and 718 (78.9%) with OC. The sensitivity of CA 125 for stage I OC was 54.4 (95% CI 45.3-63.3) (51.5 for IA, 54.6 for IB, 58.3 for IC), but it increased to 78.0 (95% CI 63.7-88.0) for stage II. Interestingly, in stage I OC, CA 125 presented a significantly higher sensitivity for the endometrioid histotype [72.4 (95% CI 52.5-86.5) vs. 49.0 (95% CI 38.6-59.4), P=0.026]. The positive likelihood ratio of CA 125 for early-stage OC compared to BOT was 1.29 (95% CI 1.06-1.58). CONCLUSIONS Despite its limited sensitivity for early-stage OCs, CA 125 still represents a useful serum marker to early differentiate between OCs and BOTs. Its sensitivity for stage I OC increases in endometrioid histotype.BACKGROUND The aim of this study was to describe the population of patients arriving in several Italian Emergency Departments (EDs) complaining of chest pain suggestive of acute coronary syndrome (ACS) in order to evaluate the incidence of ACS in this cohort and the association between ACS and different clinical parameters and risk factors. METHODS This is an observational prospective study, conducted from the 1st January to the 31st December 2014 in 11 EDs in Italy. Patients presenting to ED with chest pain, suggestive of ACS, were consecutively enrolled. RESULTS Patients with a diagnosis of ACS (N.=1800) resulted to be statistically significant older than those without ACS (NO ACS; N.=4630) (median age 70 vs. 59, P less then 0.001), and with a higher prevalence of males (66.1% in ACS vs. 57.5% in NO ACS, P less then 0.001). ECG evaluation, obtained at ED admission, showed new onset alterations in 6.2% of NO ACS and 67.4% of ACS patients. Multiple logistic regression analysis showed that the following parameters were predictive for ACS age, gender, to be on therapy for cardio-vascular disease (CVD), current smoke, hypertension, hypercholesterolemia, heart rate, ECG alterations, increased BMI, reduced SaO2. CONCLUSIONS Results from this observational study strengthen the importance of the role of the EDs in ruling in and out chest pain patients for the diagnosis of ACS. The analysis put in light important clinical and risk factors that, if promptly recognized, can help Emergency Physicians to identify patients who are more likely to be suffering from ACS.INTRODUCTION Prognosis of patients with newly diagnosed multiple myeloma (MM), a third most common hematological cancer, is dependent on baseline cytogenetics. However, less is known about the prognostic significance of cytogenetic evolution (CE) between MM diagnosis and relapse. OBJECTIVES Here, we retrospectively analyzed the prognostic impact of CE detected in a routine interphase fluorescent in situ hybridization (FISH) test in a cohort of MM patients. PATIENTS AND METHODS Among 650 patients evaluated with FISH MM panel at our center between 2014 and 2019 we identified 29 MM patients who had been tested twice, at diagnosis and relapse. CE was defined as the acquisition or loss of at least one cytogenetic abnormality at relapse (FISH2) as compared to baseline test. RESULTS CE was seen in 14 (48%) patients while 15 patients had stable cytogenetics. Most common type of CE was acquired chromosome 17p deletion (del[17p]) found in 7 patients (24%). In univariable analysis, stable cytogenetics predicted longer overall survival (OS) (median, not reached [NR] with a median follow-up of 3.1 years vs. 3.8 years; hazard ratio [HR], 0.15, p=0.04) and OS after FISH2 (median, NR with a median follow-up of 0.6 years vs. 0.8 years; HR, 0.13, p=0.002). In multivariable analysis, acquired del(17p) predicted shorter progression-free survival and OS after FISH2 (HR, 9.3 and 18.8, p=0.005 and p=0.004, respectively). CONCLUSIONS Presence of CE and, especially, the acquisition of new del(17p) at relapse, negatively affects MM outcome. Therefore, re-evaluation of FISH at MM relapse should be included in routine clinical practice.Aim This study is aimed at assessing the prevalence and associates of vitamin D deficiency amongst stroke survivors with fatigue and the impact of vitamin D supplementation on fatigue symptoms. Methods This was a retrospective observational study in which records of 58 consecutive stroke survivors with fatigue who had their vitamin D levels checked at presentation were reviewed and analysed. Comparison between groups was assessed using Pearson Chi Square and Fishers Exact tests. Results A total of 58 survivors (mean age 75.8, range 37-94 years) were included, the majority of which were females (56.9%), aged over 75 years (65.5%), lived with a partner (72.4%), were ambulant at presentation (53.4%) and had modified rankin scores (MRS) of less then 4(79.3%). The over-all prevalence of vitamin D insufficiency was 74.5% while the prevalence amongst ambulant survivors was 77.4%. There was significant improvement in fatigue symptoms in 100%of those treated. Conclusion Our results indicate a high prevalence of vitamin D deficiency especially amongst ambulant survivors where such deficiencies are unexpected; as well as improvement in symptoms following correction. If replicated in a longitudinal randomised study, this can open treatment options and possibly improve the quality of life of stroke survivors with fatigue. Keywords Stroke, fatigue, survivors, vitamin D deficiency.OBJECTIVE To identify determinants of oral health-quality of life (OHRQoL) and its association with overall quality of life (QoL). BASIC RESEARCH DESIGN Cross-sectional analytic study. Predictors variables were selected based on Wilson and Cleary's model for patient outcomes including individual factors and socioeconomic status (SES) to represent environmental and clinical/biological factors. PARTICIPANTS 444 children aged 11 to 14 years. Selleckchem 5-aza-2'-deoxycytidine MAIN OUTCOME MEASURES OHRQoL and overall QoL. Data were analysed using univariate correlation coefficients and structural equation modelling. The initial path was analysed for the goodness-of-fit. The level of significance adjusted at 5% and 95% confidence intervals. RESULTS In the final model, sense of coherence (SOC) and dental coping behaviour displayed direct and indirect effects on OHRQoL and QoL. Gingival condition and metabolic disease control displayed bidirectional effects on overall QoL. SES was directly and indirectly associated with OHRQoL. The fit of final model indicators was CFI = 0.