In patients with venous thromboembolism (VTE), 15-20% will have prevalent cancer when VTE is diagnosed but little is known about such patients' long-term risk, time course and predictors of new ...cancer.
We studied an inception cohort of patients with a first VTE who were not diagnosed with cancer within 3 months after VTE and who had follow-up for up to 120 months. We determined the annual risk for a new cancer number of events and 95% confidence interval (CI) per 100 person-years in all patients and in those with unprovoked VTE and identified predictors for new cancer.
We studied 1852 patients with VTE who received anticoagulant therapy for 12 months (mean) and were followed for 4.2 years (mean). During follow-up, there were 105 (5.7%) patients diagnosed with new cancer during the period after the initial 3 months from diagnosis, for an annual risk of 1.32 (CI, 1.09-1.60) per 100 person-years. The risk for new cancer appeared uniform over time. The annual risk for new cancer was more than 2-fold higher in patients presenting with unprovoked compared with those with provoked VTE 1.76 (CI, 1.39-2.20) vs. 0.83 (CI, 0.58-1.16) per 100 person-years; P<0.001. Clinical predictors for new cancer were increasing age hazard ratio (HR), 1.23; CI, 1.05-1.44 and unprovoked VTE (HR, 1.86; CI, 1.21-2.87).
In patients with a first VTE and without prevalent cancer, the risk for new cancer is about 1-2% per year, appears to be uniform over time, and is higher in patients with unprovoked VTE and those with advanced age.
A capillary electrophoresis method was developed to analyse same food dyes in ice-cream.
Sunset yellow (E110), carmoisine (E122), Ponceau 4 R (E124), are permitted in ice-cream by directive 95/45/ce ...of Commission 26-7-95, but their maximum amount (50 μg/kg) is lower of the limit for the other permitted (150 μg/kg).
In this paper we propose a separation on a capillary column (
50
cm×70
μ
m I.D.) with photodiode array detection: each peak is identified from absorbance spectra and then quantified by external standard.
The electrophoresis buffer used was a mixture of 25 mM sodium phosphate and 25 mM sodium borate (1:1) pH 8.
The three dyes are separated in a short time, <6 min the standard deviations of the migration times of the peaks range between 0.3% and 0.7%.
The limit of detection with a 3:1 signal-to-noise ratio was 5 μg/kg. This capillary zone electrophoresis procedure resulted rapid and sensitive.
Abstract A completely automated system for the identification of pleural nodules in low-dose and thin-slice computed tomography (CT) of the lung has been developed. The directional-gradient ...concentration method has been applied to the pleura surface and combined with a morphological opening -based procedure to generate a list of nodule candidates. Each nodule candidate is characterized by 12 morphological and textural features, which are analyzed by a rule-based filter and a neural classifier. This detection system has been developed and validated on a dataset of 42 annotated CT scans. The k -fold cross validation has been used to evaluate the neural classifier performance. The system performance variability due to different ground truth agreement levels is discussed. In particular, the poor 44% sensitivity obtained on the ground truth with agreement level 1 (nodules annotated by only one radiologist) with six FP per scan grows up to the 72% if the underlying ground truth is changed to the agreement level 2 (nodules annotated by two radiologists).
Cancer and venous thromboembolism Prandoni, Paolo; Falanga, Anna; Piccioli, Andrea
The lancet oncology,
06/2005, Letnik:
6, Številka:
6
Journal Article
Recenzirano
Venous thromboembolism occurs commonly in patients with cancer. The pathogenetic mechanisms of thrombosis involve a complex interaction between tumour cells, the haemostatic system, and ...characteristics of the patient. Among risk factors for thromboembolism are long-term immobilisation, especially in hospital, surgery, and chemotherapy with or without adjuvant hormone therapy. Although prophylaxis and treatment of thromboembolism in patients with cancer draw on the agents that are commonly used in those without cancer, there are many special features of patients with cancer that make use of these drugs more challenging. Low-molecular-weight heparins are the cornerstone of prophylaxis and treatment of venous thromboembolism in patients with cancer. These drugs have the potential to increase survival, at least in patients with more favourable outlook. About 10% of patients with idiopathic venous thromboembolism have an underlying malignant disorder that can be detected by extensive diagnostic investigation. However, the issue of whether screening for occult malignant disease ultimately improves prognosis and survival remains to be resolved.
The SOMIT trial randomized patients with idiopathic venous thromboembolism (IVTE) and without signs of cancer at routine medical examination, to extensive screening for cancer plus 2 years of ...follow-up or to just 2-year follow-up.
The data of the SOMIT-trial were used to perform a decision analysis. The screening tests were divided in several possible strategies. The number of detected cancer patients and the number of patients investigated further for an eventually benign condition were calculated for each strategy. The total costs for the screening strategy and for each detected cancer patient were determined. Based on the tumor type, stage, age and gender of the individual cancer patient, the difference in live years gained (LYG) was calculated between the two study groups.
Computed tomography (CT) of the abdomen combined with sputum cytology and mammography detected 12 of the 14 patients with cancer and had one false-positive result. In general, screening strategies including abdominal/pelvic ultrasonography (US) or tumor markers yielded a higher number of patients needed to screen in comparison with those using abdominal/pelvic CT. Furthermore, the strategies which included colonoscopy, tumor markers, and abdominal/pelvic US were significantly more costly, had inferior LYG and higher costs per LYG, when compared with strategies using abdominal/pelvic CT.
Despite the limitations of this analysis, the screening for cancer with a strategy including abdominal/pelvic CT with or without mammography and/or sputum cytology appears potentially useful for cancer screening in patients with IVTE. The cost-effectiveness analysis of this strategy needs confirmation in a large trial.
Curettage is one of the most common method for surgical treatment of bone metastasis. Local adjuvant improve most commonly used for improving the effect of curettage in local cancer surgery may ...exerted their effects either chemically either physically; in Orthopedic Oncology the most common are phenol, liquid nitrogen, laser, and cement. This article reviewed the main characteristics of the most common chemical and physical agents used in bone oncology, emphasizing the toxic effects of some of them, especially phenol and liquid nitrogen.
Screening for cancer in patients with unprovoked venous thromboembolism (VTE) often is considered, but clinicians need precise data on cancer prevalence, risk factors, and the effect of different ...types of screening strategies.
To estimate the prevalence of occult cancer in patients with unprovoked VTE, including in subgroups of different ages or those that have had different types of screening.
MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to 19 January 2016.
Prospective studies evaluating cancer screening strategies in adults with unprovoked VTE that began enrolling patients after 1 January 2000 and had at least 12 months of follow-up.
2 investigators independently reviewed abstracts and full-text articles and independently assessed risk of bias.
10 eligible studies were identified. Individual data were obtained for all 2316 patients. Mean age was 60 years; 58% of patients received extensive screening. The 12-month period prevalence of cancer after VTE diagnosis was 5.2% (95% CI, 4.1% to 6.5%). The point prevalence of cancer was higher in patients who had extensive screening than in those who had more limited screening initially (odds ratio OR, 2.0 CI, 1.2 to 3.4) but not at 12 months (OR, 1.4 CI, 0.89 to 2.1). Cancer prevalence increased linearly with age and was 7-fold higher in patients aged 50 years or older than in younger patients (OR, 7.1 CI, 3.1 to 16).
Variation in patient characteristics and extensive screening strategies; unavailability of long-term mortality data.
Occult cancer is detected in 1 in 20 patients within a year of receiving a diagnosis of unprovoked VTE. Older age is associated with a higher cancer prevalence. Although an extensive screening strategy initially may detect more cancer cases than limited screening, whether this translates into improved patient outcomes remains unclear.
None. (PROSPERO: CRD42016033371).
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