Were Trump to be elected, there's a poor prognosis for US markets and our economy.
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A majority of AML patients relapse or present with refractory disease and have overall poor prognosis.
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The disease, called idiopathic pulmonary fibrosis, is a chronic, progressive lung disease with a poor prognosis.
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The doctor overseeing it told me that so far four previously poor-prognosis IVF patients have gotten pregnant.
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It leads to weakened muscles and organ dysfunction, among other symptoms, with a poor prognosis for most patients.
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Mitochondrial DNA depletion has a poor prognosis and leads to weakened muscles and organ dysfunction, among other symptoms.
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Given the poor prognosis many of these cancer patients must have had, that number might not seem so surprising.
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The disease accounts for about 15 percent of all lung cancers and is very hard to treat, with a poor prognosis.
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People facing a poor prognosis may not want to squander their limited energy on traveling, undergoing invasive scans or inhabiting hospital environments.
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She asked that if she gets sick and has a poor prognosis, to play recordings of the voice of Josie, her daughter.
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People diagnosed with squamous cell lung cancer typically have a poor prognosis since the disease is often first diagnosed after it has spread.
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Caused by a genetic mutation, it leads to weakened muscles and organ dysfunction, among other symptoms, with a poor prognosis for most patients.
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The scans showed the majority of babies had brain damage that was "extremely severe", the researchers said, "indicating a poor prognosis for neurological function".
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Doctors leading Novartis's study said it confirms a potential new avenue to take on an aggressive lung cancer, whose patients have a poor prognosis.
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Caused by a genetic mutation, the disease leads to weakened muscles and organ dysfunction, among other symptoms, with a poor prognosis for most patients.
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Living With Cancer Toward the end of another unexpected year of existence, outliving a poor prognosis of late-stage cancer rouses me in the dark.
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" Dr. Ko, who is among the few American scientists to have reviewed brain scans of microcephalic infants in Brazil, fears that many have a "poor prognosis.
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Juno's drug is being evaluated in adults with relapsed or refractory B-cell acute lymphoblastic leukemia, a type of blood cancer with a very poor prognosis.
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"Until very recently, people infected with highly drug-resistant TB had poor treatment options and a poor prognosis," said Dr. Francesca Conradie, principal investigator of the trial.
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The Rock Island, Illinois, couple was initially given a poor prognosis, warned that their son could be "brain dead and a vegetable" with extremely low quality of life.
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J's grandmother had a very poor prognosis 403 months ago, and I know I'm not the only family member who expected our next gathering would be for her funeral.
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Nineteen of the 30 most over-active genes were already associated with a poor prognosis, but 11 were new genes for which such a link had not been suspected.
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Philip Wolfson, a San Francisco-area psychiatrist who'd used MDMA in hundreds of therapy sessions, testified that the drug had helped patients in severe emotional distress with a poor prognosis.
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Immuno-oncology remains another major business area for Roche, which also released positive results on using its Tecentriq drug in a group of breast cancer patients with a particularly poor prognosis.
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" In an interview with CBS' 60 Minutes on Sunday, McCain opened up about his diagnosis of glioblastoma, an aggressive form of brain cancer, saying doctors have told him "it's a very poor prognosis.
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One cause of severe heart failure that currently has a poor prognosis is a leaky valve, particularly the leakage of the mitral valve, which control's blood flow in the left part of the heart.
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Researchers were particularly encouraged by the significant tumor shrinkage seen in 38% of patients whose bladder cancer had spread to the liver, as they tend to be among the most difficult to treat with a very poor prognosis.
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"Male breast cancer has a poor prognosis and has not benefited from same improvements in mortality as women in the past 13 years, so improved study of how to improve male breast cancer survival is desirable," Seely said.
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It was here that fate stepped in through the guise of a total stranger: Oscar winner Winslet, who had been researching the same clinics in response to "a very poor prognosis" for her mother, Sally, who died in May 2017.
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Before she was diagnosed, all Evie's parents knew was that she suffered from 'global developmental delay': a vague umbrella term for a set of symptoms with myriad potential causes—some, but not all of them, associated with a heartbreakingly poor prognosis.
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The paper, which involved reviewing 44 previously published studies on heart disease, found that anger and hostility were linked with increased coronary heart disease events, such as heart attack, in healthy people and poor prognosis in those who already had a history of heart disease.
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"And just like medicine anywhere else, I get to walk through life with people in the midst sometimes of their most difficult and challenging circumstances they've faced — a terminal diagnosis, bad news, poor prognosis and also the most joyful times with people — like the birth of a new baby."
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Every person seeking euthanasia must meet criteria set by Dutch law, which include ensuring that the request is voluntary, that the person is in unbearable suffering with a poor prognosis that shows no improvement, and that he or she is mentally able to understand the process and its consequences.
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A few years ago, one of the paper's authors — Jason Sheltzer, a research fellow in cancer biology at Cold Spring Harbor Laboratory — and his colleagues became interested in a gene called MELK, which is supposed to serve as a biomarker for aggressive breast cancer in patients with a poor prognosis.
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When she finally got an appointment in June, four months after she first discovered the lump in February 2014, Kudirka learned that she not only had breast cancer — it was a "very aggressive, fast-growing, triple positive stage 4 breast cancer with a very poor prognosis," she explains — a median life expectancy of two to three years and a five year survival rate of less than 20 percent.
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Generally, there is a good prognosis for low-grade tumors, and a poor prognosis for high-grade tumors, however recent research have found reoccurring low grade tumors also have a poor prognosis.
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Pleural carcinosis is associated with malignant pleural effusion and poor prognosis.
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The perturbed expression was associated with disease progression and poor prognosis.
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Non-occlusive disease has a poor prognosis with survival rate between 40-50%.
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Primary squamous cell thyroid carcinoma shows an aggressive biological phenotype resulting in poor prognosis for patients.
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They often appear late in the progression of the disease but are associated with a poor prognosis.
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H3K23ac and the oncoprotein TRIM24 are higher in HER2-positive breast cancer patients and is a poor prognosis.
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While transfusion- dependent anemia has a poor prognosis, advancement in iron chelation therapy may help increase survival rates.
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Increased NLR is associated with poor prognosis of various cancers, such as esophageal cancer or advanced pancreatic cancer.
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Cases refractory to these regimens have a poor prognosis with average overall 3 year survival rates of ~7%.
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Both situations requires emergency surgery to prevent death, and often still has a poor prognosis for survival with surgical correction.
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ACTL6A is amplified in head and squamous cancers and confers poor prognosis in patients. In hepatocellular carcinomas, it promotes metastasis.
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Furthermore, aberrant expression of RGMs was indicated in breast cancer. The perturbed expression was associated with disease progression and poor prognosis.
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This type of injury has a poor prognosis if the patient is comatose, even with no apparent causes for the coma.
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Deletions, too, in the NH2-terminal domain of merlin proteins have been associated with early tumor onset and poor prognosis in affected people.
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Bas-LCLC are considered to have a particularly poor prognosis, even compared to other forms of lung cancer. However, not all studies have confirmed this.
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Because MCB tumors are typically triple-negative, hormone therapy is not usually an option for treatment. This is directly related to its relatively poor prognosis.
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The tooth is often able to be saved by a simple restoration. In contrast, reparative dentin is secreted when the tooth has a poor prognosis.
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Patient response to treatment will vary based on age, health, and the tolerance to medications and therapies. Metastasis occurs in about 39% of patients, most commonly to the lung. Features associated with poor prognosis include a large primary tumor (over 5 cm across), high grade disease, co-existent neurofibromatosis, and the presence of metastases. It is a rare tumor type, with a relatively poor prognosis in children.
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One study has shown that a factor V level less than 10% of normal indicated a poor prognosis (91% mortality), whereas a ratio of factor VIII to factor V of less than 30 indicated a good prognosis (100% survival). Patients with a poor prognosis are usually identified for likely liver transplantation. Patients that do not die are expected to fully recover and have a normal life expectancy and quality of life.
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Cases with rapid progression of clinical signs, uncontrollable encephalopathy, haemorrhage or haemolysis have a poor prognosis. Horses that display clinical signs have a mortality rate of 50–90%.
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351–356 However the majority of ovarian cancer patients are diagnosed with stage III and stage IV cancer, which are associated with poor prognosis, even with aggressive therapy.
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This has been identified as a significant independent risk factor for poor prognosis of colorectal cancer. It is also frequently observed in liver metastases of colorectal cancer specimens.
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This term has not been included in any version of the DSM. In modern terms, catastrophic schizophrenia would likely be defined as 'acute-onset chronic schizophrenia with poor prognosis'.
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For patients with poor prognosis for bowel control, a Malone procedure can be utilised during the colostomy. Alternatively, in cases of renal duplication, the Mitrofanoff procedure is performed instead.
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Previous beliefs that tumors in the groin or perineum carried a worse prognosis have been discounted. Tumors that have spread to the lymph nodes or other parts of the body have a poor prognosis. Any dog showing symptoms of mastocytosis or with a grade III tumor has a poor prognosis. Dogs of the Boxer breed have a better than average prognosis because of the relatively benign behavior of their mast cell tumors.
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The poor prognosis of this disease has been significantly improved by rituximab or similar immunochemotherapy drugs but significant proportions of these responding cases relapse, often with central nervous system involvement.
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Many malignant cancers with poor prognosis have shown overexpression of ubiquitous mitochondrial creatine kinase; this may be related to high energy turnover and failure to eliminate cancer cells via apoptosis.
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Older patients and those with poorer Hunt and Hess grades on admission have a poor prognosis. Generally, about two-thirds of patients have a poor outcome, death, or permanent disability.
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Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis.
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Photomutilation and transfusion-dependent anemia are common complications. Liver disease is also observed in some cases. It has been reported that early childhood-onset haematological manifestations is a poor prognosis factor.
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Currently the ocular SGc is commonly treated with wide surgical resection or Moh's micrographic surgery. This type of cancer usually has a poor prognosis because of a high rate of metastasis.
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PDPN has been studied extensively in the cancer field. It is a specific lymphatic vessel marker, and since lymphangiogenesis levels are correlated with poor prognosis in cancer patients, it can be used as a diagnostic marker. It is often upregulated in certain types of cancer, including several types of squamous cell carcinomas, malignant mesothelioma and brain tumors. Moreover, it can be upregulated by cancer-associated fibroblasts (CAFs) in the tumor stroma, where it has been associated with poor prognosis.
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For patients that have a poor prognosis and are expected to die regardless of the medical treatment available, palliative care such as painkillers may be given to ease suffering before they die.
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Treatment is by excisional biopsy, wide local excision and possibly sentinel node biopsy. Spread of disease to local lymph nodes or distant sites (typically brain, bone, skin and lung) marks a decidedly poor prognosis.
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Craniopharyngiomas are generally benign, but are known to recur after resection. Recent research has demonstrated a malignant (but rare) tendency of craniopharyngiomas. These malignant craniopharyngiomas are very rare, but are associated with poor prognosis.
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LEF1 is highly overexpressed and associated with disease progression and poor prognosis in B-cell chronic lymphocytic leukemia and other kinds of malignancies like colorectal cancer. It is also a promising potential drug target.
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It is caused by damage to the medulla oblongata due to strokes or trauma. It generally indicates a poor prognosis, and usually progresses to complete apnea. The term is sometimes used interchangeably with Biot's Respirations.
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Kichang et al. reported BAE for hemoptysis in 84 lung cancer patients, and demonstrated that massive hemoptysis and cavity formation were significantly poor prognosis factors; re-hemoptysis rate was 23.8% in their follow-up period.
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Despite the seriousness of the condition, the majority of patients survive if treatment is given in time, however, patients with a core body temperature over 40 °C at presentation tend to have a poor prognosis.
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Most mammary tumors in mice are adenocarcinomas. They can be caused by viral infection. Recurrence rates are high, and therefore there is a poor prognosis. There is frequently local tissue invasion and metastasis to the lungs.
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Primary ovarian squamous cell carcinomas are rare and have a poor prognosis when advanced. More typically, ovarian squamous cell carcinomas are cervical metastases, areas of differentiation in an endometrioid tumor, or derived from a mature teratoma.
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Fever and headache are the cardinal features; confusion is a late feature and coma bears a poor prognosis. Meningism is absent in a fifth of patients with TB meningitis. Patients may also have focal neurological deficits.
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This is likely, at least in part, a reason for the widespread hemorrhaging and minimal vascular development in EVI1 deleted embryos, and has potential to indicate yet another reason for poor prognosis of EVI1 positive cancers.
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Lympoid cells at the bite site may also express the EBV1 viral gene, BZLF1; this gene promotes the lyses of its infected cell host and when detected in bite sites is a marker of a poor prognosis.
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A clinical severity score has been developed to assess chronic venous ulcers. It is based on the CEAP (clinical, etiology, anatomy, and pathophysiology) classification system developed by an expert panel. A high score gives a poor prognosis.
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CBR1 has been reported to relate to tumor progression. Suppression of CBR1 expression was associated with poor prognosis in uterine endometrial cancer and uterine cervical squamous cell carcinoma. Previous studies showed that decreased CBR1 expression is associated with lymph node metastasis and poor prognosis in ovarian cancer, and induction of CBR1 expression in ovarian tumors leads to a spontaneous decrease in tumor size. Recent study demonstrates that CBR1 attenuates apoptosis and promotes cell survival in pancreatic β cell lines under glucotoxic and glucolipotoxic conditions via reducing ROS generation.
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The treatment for mediastinal nonseminomatous germ cell tumors should follow guidelines for poor-prognosis testicular cancer. Initial treatment with four courses of bleomycin, etoposide, and cisplatin, followed by surgical resection of any residual disease, is considered standard therapy.
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Abnormal and unfavorable karyotypes (e.g., loss of the long arm of chromosome 5 (5q-) and 7q-) and higher expression of the multidrug resistance glycoprotein (p170) are frequent. In general, minimally differentiated acute myeloblastic leukemia has a poor prognosis.
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May manifest basophil and mast cell granules by EM. Cytogenetically heterogeneous but frequently associated with Philadelphia chromosome. There is no clinically distinguishing features but may be more common in children and young adults and carry a poor prognosis.
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H3K9ac is an important acetylation and connected with active promoters. This is also a mark for liver cancer through a defect in the H3K9ac/H3K9me3 transition. Also, lower acetylation at this mark shows a poor prognosis in oral cancer.
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Observation of monosomy 7 within the marrow is well correlated with an increased risk of developing AML and with a very poor prognosis, death generally ensuing within 2 years (unless prompt allogeneic hematopoietic progenitor cell transplant is an option).
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After the war, Lanctin and his wife returned to Canada. He became a Protestant pastor in Lac Long, then in Connors, New Brunswick. In 1931, he contracted tuberculosis. Hospitalized in Saint John, New Brunswick, Lanctin had a poor prognosis.
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Mutations in this gene have been associated with early-onset severe retinal dystrophy. LRAT was overexpressed in colorectal cancer cells compared to normal colonic epithelium. Strong LRAT expression was associated with a poor prognosis in patients with colorectal cancer.
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Golph 3 expression is associated with poor prognosis of various cancers of gastrointestinal tract, such as gastric and esophageal squamous cell carcinoma. Higher expression of GOLPH3 is reported to be associated with greater sensitivity of colorectal cancer to Fluorouracil therapy.
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Evidence also indicates that MAP4K4 is a major contributor to the elevated growth and migratory properties of tumour cells. Poor prognosis and clinical progression of hepatocellular carcinoma, pancreatic adenocarcinoma, and colorectal cancer are all closely correlated with MAP4K4 expression levels.
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Histologically, the tumour is a well-differentiated squamous cell carcinoma. This carcinoma is aggressive in nature, spreads locally and is associated with a poor prognosis. The cancer has a 18-38% rate of metastasis.Motley, T., White, K. and Clyde, J. (2014).
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Complications of analgesic nephropathy include pyelonephritis and end-stage kidney disease. Risk factors for poor prognosis include recurrent urinary tract infection and persistently elevated blood pressure. Analgesic nephropathy also appears to increase the risk of developing cancers of the urinary system.
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Amplification, also known as the over-expression of the ERBB2 gene, occurs in approximately 15-30% of breast cancers. It is strongly associated with increased disease recurrence and a poor prognosis; however, drug agents targeting HER2 in breast cancer have significantly positively altered the otherwise poor-prognosis natural history of HER2-positive breast cancer. Over-expression is also known to occur in ovarian, stomach, adenocarcinoma of the lung and aggressive forms of uterine cancer, such as uterine serous endometrial carcinoma, e.g. HER2 is over- expressed in approximately 7-34% of patients with gastric cancer and in 30% of salivary duct carcinomas.
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The family created the Huljich Foundation, a charitable trust that supports seriously ill children. The trust provides a memorable experience for children with a poor prognosis. The experience is to be chosen by the child to share the experience with their family.
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CEL associated with a mutation in PDGFRA is treatable with imatinib and has an excellent prognosis. On the other hand, CEL associated with FGFR1 mutations has a very poor prognosis. Progression can occur from CEL to AEL or AML in rare cases.
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CT scan of subcutaneous emphysema. Subcutaneous emphysema is found in the deepest layer of the skin. Emphysematous cystitis is a condition of gas in the bladder wall. On occasion this may give rise to secondary subcutaneous emphysema which has a poor prognosis.
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The left ventricle is involved in 50–67% of individuals. If the left ventricle is involved, it is usually late in the course of disease, and confers a poor prognosis. There are two pathological patterns seen in ACM, Fatty infiltration and fibro-fatty infiltration.
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Northern Afleet was euthanized on June 1, 2018 due to severe gastrointestinal disease. He had experienced an episode of acute abdominal pain and was taken to Rood and Riddle Equine Hospital, where veterinarians determined that he had a poor prognosis and subsequently euthanized him.
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The stroma of the prostate is characteristically muscular. Due to this muscularity, detecting the myofibroblastic phenotypic change indicative of reactive stroma is difficult in an examination of patient pathologic slides. A diagnosis of reactive stroma associated with prostate cancer is one of poor prognosis.
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Six genes whose expression in leukemic blasts was associated with prognosis were identified:three genes predicting poor prognosis (AK022211, FASTKD1 and STARD4) and three genes associated with a favorable outcome (CAMSAP1, PCGF6 and SH3RF3). Thus it appears that FASTKD1 may also play a role in ALL.
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The impact of serious illness on patient's families. Journal of the American Medical Association. 1994;272(23):1839-1844. Yet, studies indicate that 70-95% of people would rather refuse aggressive medical treatment than have their lives medically prolonged in incompetent or other poor prognosis states.
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Type A Niemann–Pick disease (about 85% of cases) has an extremely poor prognosis, with most cases being fatal by the age of 18 months. Type B (adult onset) and type C (mutation affecting a different molecule) Niemann–Pick diseases have a better prognosis.
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Salivary duct carcinoma (SDC) is a rare type of aggressive cancer that arises from the salivary glands. It is predominantly seen in men and, generally, has a poor prognosis. Other high grade carcinomas can mimic SDC. About 40-60% of SDC arise in pleomorphic adenomas.
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Critical green inclusions are a rare finding, and when found they are suggestive of a poor prognosis, hence the colloquial term death crystals. A 2018 review found that 56% of patients died shortly after the inclusions were first identified (usually within two weeks). However, critical green inclusions are of limited utility for predicting mortality because they are usually found in severely ill patients whose poor prognosis is already evident for other reasons by the time the crystals are detected. The inclusions are strongly associated with damage to liver tissue: they are most frequently seen in cases of acute hypoxic and ischaemic hepatitis and have been observed after uncomplicated liver transplantation.
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This region includes a brain-specific snRNA that targets the serotonin-2C receptor mRNA. Medulloblastoma – The U1 snRNA is mutated in a subset of these brain tumors, and leads to altered RNA splicing. The mutations predominantly occur in adult tumors, and are associated with poor prognosis.
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Although most people with juvenile ALS live longer than those with adult-onset ALS, some of them have specific mutations in FUS and SOD1 that are associated with a poor prognosis. Late onset (after age 65) is associated with a more rapid functional decline and shorter survival.
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LPL expression has been shown to be a prognostic predictor in Chronic lymphocytic leukemia. In this haematological disorder, LPL appears to provide fatty acids as an energy source to malignant cells. Thus, elevated levels of LPL mRNA or protein are considered to be indicators of poor prognosis.
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Thyroxine is given to replace the hormones lost and to suppress TSH production, as TSH may stimulate recurrence. With the exception of the rare anaplastic thyroid cancer, which carries a very poor prognosis, most thyroid cancers carry an excellent prognosis and can even be considered curable.
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Erbin's C-terminal PDZ domain is able to bind to ErbB2, a protein tyrosine kinase which is often associated with poor prognosis in epidermal oncogenesis. Erbin's N-terminal region has been shown to disrupt Ras to Raf binding and may be, through this action, a tumor suppressing protein.
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Children living near the Chernobyl nuclear power plant during the catastrophe of 1986 have experienced a 60-fold increase in the incidence of thyroid cancer. Thyroid cancer arising in the background of radiation is often multifocal with a high incidence of lymph node metastasis and has a poor prognosis.
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The prognosis for DSRCT remains poor. Prognosis depends upon the stage of the cancer. Because the disease can be misdiagnosed or remain undetected, tumors frequently grow large within the abdomen and metastasize or seed to other parts of the body. There is no known organ or area of origin.
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Asystole is different from very fine occurrences of ventricular fibrillation, though both have a poor prognosis, and untreated fine VF will lead to asystole. Faulty wiring, disconnection of electrodes and leads, and power disruptions should be ruled out. Asystolic patients (as opposed to those with a "shockable rhythm" such as ventricular fibrillation or ventricular tachycardia, which can potentially be treated with defibrillation) usually present with a very poor prognosis. Asystole is found initially in only about 28% of cardiac arrest cases in hospitalized patients, but only 15% of these survive, even with the benefit of an intensive care unit, with the rate being lower (6%) for those already prescribed drugs for high blood pressure.
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People who suffer from neurotmesis often face a poor prognosis. They will more than likely never regain full functionality of the affected nerve, but surgical techniques do give people a better chance at regaining some function. Current research is focused on new ways to regenerate nerves and advance surgical techniques.
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Patients with aHUS have an extremely poor prognosis. Among those with the most commonly identified aHUS genetic mutation, the proportion of patients experiencing negative outcomes (e.g., need for dialysis, permanent kidney damage, death) within the first year rises to 70%. However, sudden morbidity and mortality can occur regardless of mutational status.
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Information on prognosis is limited by the rarity of the condition. Prognosis appears to be no different from AML in general, taking into account other risk factors. Acute erythroid leukemia (M6) has a relatively poor prognosis. A 2010 study of 124 patients found a median overall survival of 8 months.
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Most cases of cerebral venous sinus thrombosis are due to hypercoagulability. It is possible for the clot to break off and migrate (embolise) to the lungs, causing a pulmonary embolism. An analysis of earlier case reports concludes that this occurs in about 10% of cases, but has a very poor prognosis.
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This rare translocation has a poor prognosis compared to the t(8;21) because 70% of t(6;9) acute myeloid leukemia patients have the FLT3-ITD mutation (Schwartz et al., 1983, Kottaridis, 2001). The FLT- ITD mutation is one of the most lethal mutations in acute myeloid leukemia (Chi et al.
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Talaromyces marneffei demonstrates in vitro susceptibility to multiple antifungal agents including ketoconazole, itraconazole, miconazole, flucytosine, and amphotericin B. Without treatment patients have a poor prognosis; death occur by liver failure as the fungus releases toxins in the bloodstream. The elevation of liver enzyme in the blood helps to establish a diagnosis.
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CTC clusters are two or more individual CTCs bound together. The CTC cluster may contain traditional, small or CK- CTCs. These clusters have cancer-specific biomarkers that identify them as CTCs. Several studies have reported that the presence of these clusters is associated with increased metastatic risk and poor prognosis.
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Disability-adjusted life year for RA per 100,000 inhabitants in 2004. The course of the disease varies greatly. Some people have mild short-term symptoms, but in most the disease is progressive for life. Around 25% will have subcutaneous nodules (known as rheumatoid nodules); this is associated with a poor prognosis.
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The presence of tumour cells in the peripheral blood of a cancer patient was first described in an 1869 case report in the Medical Journal of Australia. The term carcinocythemia was first used in 1976 by Robert Carey. In 1984, a review of 10 cases was published, noting the condition's poor prognosis.
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Fukuyama congenital muscular dystrophy has a poor prognosis. Most children with FCMD reach a maximum mobility at sitting upright and sliding. Due to the compounded effects of continually worsening heart problems, impaired mental development, problems swallowing and additional complications, children with FCMD rarely live through adolescence, the disorder proves fatal by age 20.
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Undifferentiated cancers - those where the cell type cannot be determined - make up about 10% of epithelial ovarian cancers and have a comparatively poor prognosis. When examined under the microscope, these tumors have very abnormal cells that are arranged in clumps or sheets. Usually there are recognizable clumps of serous cells inside the tumor.
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Involvement of the airway can present with shortness of breath, fever, cough, coughing up blood or chest pain, or as an incidental finding on chest x-ray. The diagnosis is usually confirmed by bronchoscopy, when the lesions are directly seen and often biopsied. Kaposi's sarcoma of the lung has a poor prognosis.
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The concept of legal consent combined with the non-legal consent (assent) of the child when considering treatment options, especially in the face of conditions with poor prognosis or complicated and painful procedures/surgeries, means the pediatrician must take into account the desires of many people, in addition to those of the patient.
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ACC, generally, carries a poor prognosis, Free Full Text. with an overall 5-year survival rate of about 50%. Five-year disease- free survival for a complete resection of a stage I–III ACC is about 30%. The most important prognostic factors are age of the patient and stage of the tumor.
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MTA1 regulates gene expression by functioning as a coregulator to integrate DNA-interacting factors to gene activity. MTA1 participates in physiological functions in the normal and cancer cells. MTA1 is one of the most upregulated proteins in human cancer and associates with cancer progression, aggressive phenotypes, and poor prognosis of cancer patients.
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Newer approaches are able to identify more cells out 7.5 ml of blood, like IsofFux or Maintrac. In very rare cases, CTCs are present in large enough quantities to be visible on routine blood smear examination. This is referred to as carcinocythemia or carcinoma cell leukemia and is associated with a poor prognosis.
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Macrophages have been shown to infiltrate a number of tumors. Their number correlates with poor prognosis in certain cancers including cancers of breast, cervix, bladder, brain and prostate.Bingle L, Brown NJ, Lewis CE. The role of tumour-associated macrophages in tumour progression: implications for new anticancer therapies. J Pathol 2002; 196:254–65.
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Elevated cytoplasmic localization of p27 has been observed in a number of cancers and has been associated with a poor prognosis. This mislocalization could potentially explain how p27 could simultaneously promote cell cycle progression and increased motility in cancers. A similar model could also be equally true of other CIP/KIP proteins.
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In oncology, metastasectomy is the surgical removal of metastases, which are secondary cancerous growths that have spread from cancer originating in another organ in the body. In many cases, metastases are not treated surgically. There are two common reasons for this. Often, even with a successful surgery the patient would have a poor prognosis.
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No cure or treatment option for individuals with HLS currently exist. Due to the severity of the foetal defects and the poor prognosis for those with HLS, the pregnancy is often terminated. Certain prevention can only be achieved by avoiding conception if genetic testing indicates both prospective parents as carriers of the defective HYLS1 gene.
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Pancreatic cancer has a poor prognosis, with a five-year survival rate of less than 5%. By the time the cancer is diagnosed, it is usually at an advanced, inoperable stage. Only one in about fifteen to twenty patients is curative surgery attempted. Pancreatic cancer tends to be aggressive, and it resists radiotherapy and chemotherapy.
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A laparoscope may be used post-surgery to look for and break down adhesions, however there is risk of additional adhesions forming post- procedure. Encouraging motility post-surgery can also be useful, as it decreases the contact time between tissues. Adhesion-induced colic has a poor prognosis, with a 16% survival rate in one study.
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Therefore, the main causes of RVH are pathologies of systems related to the right ventricle such as the pulmonary artery, the tricuspid valve or the airways. RVH can be benign and have little impact on day-to-day life or it can lead to conditions such as heart failure, which has a poor prognosis.
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The prognosis of this developmental disorder is highly based on the underlying disorder. Cerebellar hypoplasia may be progressive or static in nature. Some cerebellar hypoplasia resulting from congenital brain abnormalities/malformations are not progressive. Progressive cerebellar hypoplasia is known for having poor prognosis, but in cases where this disorder is static, prognosis is better.
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This form of schizophrenia is typically associated with early onset (often between the ages of 15 and 25 years) and is thought to have a poor prognosis because of the rapid development of negative symptoms and decline in social functioning. Use of electroconvulsive therapy has been proposed; however, the effectiveness after treatment is in question.
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The factors of poor prognosis for people with thyroid lymphoma are advanced stage of the tumor, large size (>10 cm) as well as spreading to mediastinum. The overall survival for primary thyroid lymphoma is 50% to 70%, ranging from 80% in stage IE to less than 36% in stage IIE and IVE in 5 years.
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Tumor size also affects the prognosis, in that dogs with tumors greater than five centimeters have a greater chance of lymph node metastasis. Tumor type is also important. Sarcomas and carcinosarcomas carry an average survival time of nine to twelve months. Inflammatory carcinomas have a very poor prognosis, and have usually metastasized by the time of diagnosis.
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Syndecan1 is upregulated in multiple myeloma. High levels of shed syndecan1 in a patient's serum typically is correlated with poor prognosis. Syndecan 1 is the most studied of all the syndecans in cancer research. Many studies have shown that syndecan 1 plays an important role in cancer progression, and also can be used as cancer biomarker.
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This has a poor prognosis. Surgery to remove the tumor is often very difficult due to metastasis into arteries, the esophagus, or the windpipe. It may be possible to reduce the size of the tumor, thus relieving symptoms and allowing time for other treatments to work. About 10% of thyroid tumors are benign; these often cause few symptoms.
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Conversely, triple negative cancer (i.e. no positive receptors), lacking targeted treatments, now has a comparatively poor prognosis. Androgen receptor is expressed in 80-90% of ER+ breast cancers and 40% of "triple negative" breast cancers. Activation of androgen receptors appears to suppress breast cancer growth in ER+ cancer while in ER- breast it appears to act as growth promoter.
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Somatic mutations in genes such as ASXL1 and EZH2 are associated with a poor prognosis. CMML has a 20–30% chance of transformation to AML, a lower rate than other similar diseases. The CMML-2 subtype is associated with increased risk of transformation and ASXL1 and RUNX1 mutations also increase the risk of transition to AML.
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Choriocarcinoma can occur as a primary ovarian tumor developing from a germ cell, though it is usually a gestational disease that metastasizes to the ovary. Primary ovarian choriocarcinoma has a poor prognosis and can occur without a pregnancy. They produce high levels of hCG and can cause early puberty in children or menometrorrhagia (irregular, heavy menstruation) after menarche.
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Urinary symptoms can include blood in the urine, increased urinary frequency, urgency, occasional incontinence, difficulty voiding, and burning sensation. Emphysematous cystitis is often indicated in patients who have air in the urine. In some cases, emphysematous cystitis can cause thickening of the bladder wall. Clinical subcutaneous emphysema is a rare complication of emphysematous cystitis that has a poor prognosis.
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Atelosteogenesis type I is a rare autosomal dominant condition.Sillence D, Worthington S, Dixon J, Osborn R, Kozlowski K (1997) Atelosteogenesis syndromes: a review, with comments on their pathogenesis. Pediatr Radiol 27(5):388-396 This condition is evident at birth and is associated with a very poor prognosis for the baby. It may be diagnosed antenatally.
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Mutations in the SLC25A12 gene cause early infantile epileptic encephalopathy 39(EIEE39), characterized by refractory seizures, neurodevelopmental impairment, and poor prognosis. Development is normal prior to seizure onset, after which cognitive and motor delays become apparent. EIEE39 is characterized by global hypomyelination of the central nervous system, with the gray matter appearing relatively unaffected. Inheritance is autosomal recessive.
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FOXJ1 expression has been shown to be elevated in clear cell renal carcinoma patients and indicative of tumor stage, histological grade and tumor size. High expression of FOXJ1 in CRCC patients was associated with poor prognosis. There is potential for FOXJ1 to act as an oncogene marker for CRCC patients and has value as a therapeutic target.
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It is caused by damage to the pons or upper medulla caused by strokes or trauma. Specifically, concurrent removal of input from the vagus nerve and the pneumotaxic center causes this pattern of breathing. It is an ominous sign, with a generally poor prognosis. It can also be temporarily caused by some drugs, such as ketamine.
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In 1990, while pruning a neighbour's tree with a chainsaw as a favour, Joye slipped and fell six metres onto brick paving below, striking his head and falling into a coma, as well as sustaining serious lower back and shoulder injuries. Initially given a poor prognosis, he eventually recovered to start performing and touring again in 1998.
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This gene encodes an RNA-binding protein that is a member of the Musashi protein family. The encoded protein is transcriptional regulator that targets genes involved in development and cell cycle regulation. Mutations in this gene are associated with poor prognosis in certain types of cancers. This gene has also been shown to be rearranged in certain cancer cells.
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A deficiency of tyrosine hydroxylase leads to impaired synthesis of dopamine as well as epinephrine and norepinephrine. It is represented by a progressive encephalopathy and poor prognosis. Clinical features include dystonia that is minimally or nonresponsive to levodopa, extrapyramidal symptoms, ptosis, miosis, and postural hypotension. This is a progressive and often lethal disorder, which can be improved but not cured by levodopa.
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Primary signet ring cell carcinoma of the colon and rectum (PSRCCR) is rare, with a reported incidence of less than 1 percent. It has a poor prognosis because symptoms often develop late and it is usually diagnosed at an advanced stage. Five-year survival rates in previous studies ranged from nine to 30 percent. Average survival was between 20 and 45 months.
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A clinician should remember that whilst a root fracture remains, bone around the tooth is continuing to be lost, compromising the success of any future potential implants. Anterior teeth with a vertical root fracture have a very poor prognosis and treatment is mainly extraction. Multi-rooted teeth can be successfully treated by removing the fractured root, either by root amputation or hemisection.
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Carcinocythemia, also known as carcinoma cell leukemia, is a condition in which cells from malignant tumours of non-hematopoietic origin are visible on the peripheral blood smear. It is an extremely rare condition, with 33 cases identified in the literature from 1960 to 2018. Carcinocythemia typically occurs secondary to infiltration of the bone marrow by metastatic cancer and carries a very poor prognosis.
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In the 1980s, only 20% of children with cancer survived. In society today, about 75% of children with cancer are cured. Investigations regarding the latest advanced treatments, long-term effects of diseases, psycho-social impacts on survivors, their quality of life post- treatment and patients undergoing treatment are on the rise. Malignant tumors with poor prognosis remain a challenge for research.
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Due to immune system suppression, neutropenic enterocolitis (typhlitis) is a "life-threatening gastrointestinal complication of chemotherapy." Typhlitis is an intestinal infection which may manifest itself through symptoms including nausea, vomiting, diarrhea, a distended abdomen, fever, chills, or abdominal pain and tenderness. Typhlitis is a medical emergency. It has a very poor prognosis and is often fatal unless promptly recognized and aggressively treated.
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Mixed carcinomas are those that have both Type I and Type II cells, with one making up at least 10% of the tumor. These include the malignant mixed Müllerian tumor, which derives from endometrial epithelium and has a poor prognosis. Undifferentiated endometrial carcinomas make up less than 1–2% of diagnosed endometrial cancers. They have a worse prognosis than grade III tumors.
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Surgical removal of the tumor, neoadjuvant chemotherapy prior to tumor removal, and liver transplantation have been used to treat these cancers. Primary liver transplantation provides high, long term, disease-free survival rate in the range of 80%, in cases of complete tumor removal and adjuvant chemotherapy survival rates approach 100%. The presence of metastases is the strongest predictor of a poor prognosis.
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As a result, he discovered that he had Bright's disease (or hypertension) with a dilated heart, a condition with a poor prognosis at the time. As a consequence he changed his diet, discontinued coffee and stopped smoking. His condition improved, he lost weight and his blood pressure fell. Over the next 4 years he developed a dietary system based on this experience.
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Cancer associated with a reactive stroma is typically diagnostic of poor prognosis. The tumor-induced stromal change hypothesis claims that tumor cells can dedifferentiate into fibroblasts and, themselves, secrete more collagen. This was observed in desmoplastic melanoma, in which the tumor cells are phenotypically fibroblastic and positively express genes associated with ECM production. However, benign desmoplasias do not exhibit dedifferentiation of tumor cells.
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Macrophages within tumor stroma, so called tumor-associated macrophages (TAMs) promote tumor growth and metastasis. Tumor-associated macrophage infiltration correlates with poor prognosis in patients with breast, cervix, bladder and brain cancers. Pathophysiological interaction between tumor-associated macrophages and surrounding cells, such as endothelial cells promote tumor progression. In 1971, Judah Folkman proposed that angiogenesis plays essential role in tumor growth.
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High expression of glycophorin C has been associated with a poor prognosis for acute lymphoblastic leukaemia in the Chinese. Glycophorin C is the receptor for the protein erythrocyte binding antigen 140 (EBA140) of Plasmodium falciparum. This interaction mediates a principal invasion pathway into the erythrocytes. The partial resistance of erythocytes lacking this protein to invasion by P. falciparum was first noted in 1982.
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The symptoms include shortness of breath, chronic chest pain, cough, and weight loss. Diagnosing mesothelioma is often difficult and can include physical examination, chest X-ray and lung function tests, followed by CT scan and MRI. A biopsy is needed to confirm a diagnosis of malignant mesothelioma. Mesothelioma has a poor prognosis, with most patients dying within 1 year of diagnosis.
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Most types of RPGN are characterized by severe and rapid loss of kidney function with marked hematuria; red blood cell casts in the urine; and proteinuria sometimes exceeding three grams in twenty-four hours, a range associated with nephrotic syndrome. Some patients also experience hypertension and edema. Severe disease is characterized by pronounced oliguria or anuria, which portends a poor prognosis.
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Cyclin B1 expression levels can be used as a tool to determine prognosis of patients with breast cancers. The intracellular concentration can have important implications for cancer prognosis. High levels of nuclear cyclin B1 is associated with high tumor grade, larger tumor size and higher metastasis probability, therefore a high level of cyclin B1 is a predictor of poor prognosis.
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Burkholderia gladioli in humans is an opportunistic pathogen that is an important agent for hospital-associated infections. It has recently appeared as a severe pathogen in patients with cystic fibrosis, causing severe pulmonary infections. Though it is still a fairly uncommon pathogen, its presence is associated with a poor prognosis. It has also colonized the respiratory tracts of patients with granulomatous disease.
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IL-6's role as an anti-inflammatory myokine is mediated through its inhibitory effects on TNF-alpha and IL-1, and activation of IL-1ra and IL-10. There is some early evidence that IL-6 can be used as an inflammatory marker for severe COVID-19 infection with poor prognosis, in the context of the wider coronavirus pandemic.
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FGF19 is also found in the liver of patients with cholestasis. It can be synthesised in the gall-bladder and secreted into bile. FGF19 is expressed in around half of hepatocellular carcinomas and was associated with larger size, early recurrence and poor prognosis. Patients with the metabolic syndrome, non-alcoholic fatty liver disease and insulin resistance have reduced levels of FGF19.
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SMC1A variants have been identified in blood, brain, bladder, and colon cancer. SMC1A plays a pivotal role in colorectal tumorigenesis. Indeed, colorectal tissue acquires extra- copies of SMC1A during cancer development and its expression is significantly stronger in carcinomas than in normal mucosa and early adenoma. Finally, the up-regulation of SMC1A is thought to be a predictor of poor prognosis in colorectal cancer.
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Pulmonary vein stenosis is a rare cardiovascular disorder. It is recognized as being the stenosis of one or more of the four pulmonary veins that return blood from the lungs to the left atrium of the heart. In congenital cases, it is associated with poor prognosis and high mortality rate. In some people, pulmonary vein stenosis occurs after pulmonary vein ablation for the treatment of atrial fibrillation.
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This is an intermediate neoplasm which affects the skin and mucous membranes; usually arising in patients with HIV. The stages of this type of pigmentation start from an early patch stage, to become plaque-like which then develop into larger nodules- known as the tumour stage. It is common to have oral involvement with this disease and frequently this is associated with a poor prognosis.
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Studies in both humans and animal models have implicated that high numbers of Tregs in the tumor microenvironment is indicative of a poor prognosis, and Tregs are thought to suppress tumor immunity, thus hindering the body's innate ability to control the growth of cancerous cells. Recent immunotherapy research is studying how regulation of T cells could possibly be utilized in the treatment of cancer.
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Grade 3 tumors often display chromosomal abnormalities, also an indication of poor prognosis. Tumor grade is the most important factor for relapse in immature teratomas. Vicus et al. (2011), reported that grade 2 or 3 tumors are associated with a greater chance of relapse that can be fatal, predominantly within 2 years of diagnosis. Among grade 3 patients, the stage was significantly associated with relapse.
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During the pandemic, the healthcare system is using triage, reserving ventilators for younger and healthier individuals because of the poor prognosis for survival. A critical care medical association released triage criteria that included the "life expectancy" and "social value" of the patient. More than 65% of fatalities have occurred in those 80 or older, compared to 50% in Italy and only 15% in China.
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The company is developing small molecule fibrosis inhibitors focusing on two targets: galectin-3 and LOXL2. Galectin-3 has been implicated in diseases of the lung, liver, eye and cardiovascular system amongst many others, where it can promote the development of tissue scarring (fibrosis) and inflammation. In addition, galectin expression and activity has been associated with the development and progression of cancer, often with a poor prognosis.
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CpG islands that are hypermethylated can play three roles in cancer: in diagnosis, prognosis and in monitoring. In diagnosis, one can identify the tumor type and tumor subtype, as well as its primary tumor when that is unknown. Hypermethylation increases with tumorigenicity, which is an indication of the prognosis of cancer. For example, high methylation is a marker for poor prognosis in lung cancer.
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Altered miRNA expression profiles in malignant cancers suggest a pivotal role of miRNA and thus dicer in cancer development and prognosis. miRNAs can function as tumor suppressors and therefore their altered expression may result in tumorigenesis. In analysis of lung and ovarian cancer, poor prognosis and decreased patient survival times correlate with decreased dicer and drosha expression. Decreased dicer mRNA levels correlate with advanced tumor stage.
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Neuropilin 2 expression in (A) blood vessels, (B) carcinoma tissue, (C and D) breast carcinoma tissue with co-localized staining for neuropilin 2 and CXCR4, a chemokine receptor. Neuropilin 2 is a known marker for venous blood vessels, indicating the vascularization of the tumour.Yasuoka et al. (2009). Neuropilin-2 expression in breast cancer: correlation with lymph node metastasis, poor prognosis, and regulation of CXCR4 expression.
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Patients with grade IV GvHD usually have a poor prognosis. If the GvHD is severe and requires intense immunosuppression involving steroids and additional agents to get under control, the patient may develop severe infections as a result of the immunosuppression and may die of infection. However, a 2016 study found that the prognosis for patients with grade IV GvHD has improved in recent years.
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Pancreatic cancer is the fifth most-common cause of death from cancer in the United Kingdom, and the third most-common in the United States. The disease occurs most often in the developed world, where about 70% of the new cases in 2012 originated. Pancreatic adenocarcinoma typically has a very poor prognosis; after diagnosis, 25% of people survive one year and 5% live for five years.
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Clomiphene citrate or letrozole may also be used to induce follicular development when endogenous estrogen levels are low. It has been found that teenagers with FHA who present as low responders to clomiphene do not necessarily face a poor prognosis with regards to future menses or fertility. Despite a growing body of research, leptin and kisspeptin therapies are not yet recommended for treating infertility.
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Calciphylaxis is one type of extraskeletal calcification. Similar extraskeletal calcifications are observed in some people with high levels of calcium in the blood, including people with milk-alkali syndrome, sarcoidosis, primary hyperparathyroidism, and hypervitaminosis D. Certain medications such as warfarin can also result in calciphylaxis in rare cases. The presence of calciphylaxis generally predicts a poor prognosis with a typical life expectancy of less than one year.
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While HIF1A serves as a pro-apoptotic factor, HIF2A interacts with cyclin D1. This leads to increased survival due to lower rates of apoptosis and increased proliferation due to the activation of cyclin D1.Maxwell, 2005 Recent genome wide analysis of HIF binding in kidney cancer showed that HIF1A binds upstream of majorly good prognosis genes, while HIF2A binds upstream to majorly poor prognosis genes.
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Radiotherapy is a well- established treatment modality for several cancer types. However, relapses after radiotherapy are often more aggressive and associated with poor prognosis. Cumulative evidence shows that the host response to radiotherapy is a contributing factor to this effect. Tumors implanted in pre-irradiated tissue grow with slower kinetics, however, paradoxically exhibit enhanced invasive and metastatic properties, a phenomenon known as the “tumor bed effect”.
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Aldolase A (ALDOA) is a highly expressed in multiple cancers, including lung squamous cell carcinoma (LSCC), renal cancer, and hepatocellular carcinoma. It is proposed that ALDOA overexpression enhances glycolysis in these tumor cells, promoting their growth. In LSCC, its upregulation correlates with metastasis and poor prognosis, while its downregulation reduces tumor cell motility and tumorigenesis. Thus, ALDOA could be a potential LSCC biomarker and therapeutic drug target.
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Neuroblastoma is a form of childhood cancer that can develop at any age but typically presents between the ages of 18 months and five years. It affects a little over 600 children per year in the United States. Most are diagnosed with stage IV disease, the most advanced form. Even with aggressive therapy, stage IV neuroblastoma carries a poor prognosis, with a three-year survival rate of 30–40%.
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These aggressive tumors are generally diagnosed at advanced stages and survival is generally shorter. The prognosis of SRCC and its chemosensitivity with specific regimens are still controversial as SRCC is not specifically identified in most studies and its poor prognosis may be due to its more advanced stage. One study suggests that its dismal prognosis seems to be caused by its intrinsic tumor biology, suggesting an area for further research.
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Histologic transformation to diffuse large B-cell lymphoma (DLBCL) can occur in up to 12% of cases. After transformation, neoplastic cells carry monoclonal immunoglobulin gene rearrangements. Histological transformation may lead to poor prognosis and therefore repeat biopsy is required at relapse. One study found a transformation rate of 7.6%, and suggested that prior exposure to chemotherapy and a presentation with splenic involvement were associated with increased risks of transformation.
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Myoepithelioma of the head and neck, also myoepithelioma, is a salivary gland tumour of the head and neck that is usually benign. When malignant, which is exceedingly rare, they are known as malignant myoepithelioma or Myoepithelial carcinoma, and they account for 1% of the salivary tumors with poor prognosis. As the name suggests, it consists of myoepithelial cells. Classically, they are found in the parotid gland or palate.
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Bacteremia secondary to periodontal infection is known to be one of the primary causes of infectious endocarditis, particularly in patient with heart valve disorders. Therefore, treatment of dental disease should be done prior to performing heart surgery. Periodontal treatment is advised in patients with advanced periodontitis, followed by root planing and ultrasound treatment. Those teeth not amenable to treatment and with poor prognosis should be removed as pre- surgical preventive measures.
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Phosphorylated FADD can induce G2/M cell cycle arrest, potentially by increasing the stability of p53. Therefore, drugs which can activate this pathway may have a therapeutic potential. However, high levels of phosphorylated FADD have been correlated with a poor prognosis in many cancers such as that of the head and neck. This is likely to be due to its activation of the NF-κB pathway, which is antiapoptotic.
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About half of hereditary breast–ovarian cancer syndromes involve unknown genes. Furthermore, certain latent viruses, may decrease the expression of the BRCA1 gene and increase the risk of breast tumors. GATA-3 directly controls the expression of estrogen receptor (ER) and other genes associated with epithelial differentiation, and the loss of GATA-3 leads to loss of differentiation and poor prognosis due to cancer cell invasion and metastasis.
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Clear cell carcinoma is a Type II endometrial tumor that makes up less than 5% of diagnosed endometrial cancer. Like serous cell carcinoma, it is usually aggressive and carries a poor prognosis. Histologically, it is characterized by the features common to all clear cells: the eponymous clear cytoplasm when H&E; stained and visible, distinct cell membranes. The p53 cell signaling system is not active in endometrial clear cell carcinoma.
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Relative five-year survival of invasive epithelial ovarian cancer by stage Ovarian cancer usually has a relatively poor prognosis. It is disproportionately deadly because it lacks any clear early detection or screening test, meaning most cases are not diagnosed until they have reached advanced stages. Ovarian cancer metastasizes early in its development, often before it has been diagnosed. High-grade tumors metastasize more readily than low-grade tumors.
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Core 2 glycans terminate in galactose or sialic acid, whereas core 1 is branched and has potential for large carbohydrate extensions. High levels of MUC-1 are associated with poor prognosis and increased potential of metastasis. This cancer-associated MUC-1 is a natural ligand for galectin-3. In normal cells, MUC-1 has distinct polarisation and acts as a protective barrier around the cell, reducing cell-cell interactions.
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The AP-1 complex has been implicated in transformation and progression of cancer. In osteosarcoma and endometrial carcinoma, c-Fos overexpression was associated with high-grade lesions and poor prognosis. Also, in a comparison between precancerous lesion of the cervix uteri and invasive cervical cancer, c-Fos expression was significantly lower in precancerous lesions. c-Fos has also been identified as independent predictor of decreased survival in breast cancer.
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Higher tTG expression also correlates with higher instances of metastasis, chemotherapy resistance, lower survival rates and generally poor prognosis. Cancer cells can be killed by increasing calcium levels through the activation of tTG transamidation activity. Preclinical trials have showed promise in using tTG inhibitors as anti-cancer therapeutic agents. However, other studies have noted that tTG transamidation activity could be linked to the inhibition of tumor cell invasiveness.
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L1CAM protein expression is normally restricted to neurons. However, it has been noticed there's L1CAM overexpression in all types of cancer cells, which has been associated with poor prognosis, tumor progression and metastasis. This up-regulation may not be necessarily associated with mutations in L1 transcription factors. It has been seen this protein plays a key role in inflammatory reactions as the one's taking place in the tissue surrounding a tumor.
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Tooth extraction is the major risk factor for development of MRONJ. Prevention including the maintenance of good oral hygiene, comprehensive dental examination and dental treatment including extraction of teeth of poor prognosis and dentoalveolar surgery should completed prior to commencing any medication which is likely to cause osteonecrosis (ONJ). Patients with removable prostheses should be examined for areas of mucosal irritation. Procedures which are likely to cause direct osseous trauma, e.g.
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Oligodendrogliomas show only rarely mutations in the p53 gene, which is in contrast to other gliomas. Epidermal growth factor receptor amplification and whole 1p/19q codeletion are mutually exclusive and predictive of completely different outcomes, with EGFR amplification predicting poor prognosis. There is a strong correlation between 1p/19q codeletion and the expression of proneural genes, suggesting that gliomas with a 1p19q codeletion represent a subgroup of proneural gliomas.
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Any remaining cancer cells post chemoradiation are surgically removed. Lymphadenectomy may also be done after treatment with chemoradiation if the cancer cells have infiltrated the cervical lymph nodes. Another method of treatment includes, first, surgical removal of tumor as well as cervical lymph nodes followed by chemoradiation or radiation to decrease the chances of recurrence. • Stage IVB: In this stage the cancer has already undergone distant metastasis, hence showing poor prognosis.
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However, there are contradicting scientific reports about the effects of VEGF-A treatments in CNS injury models. VEGF-A has been implicated with poor prognosis in breast cancer. Numerous studies show a decreased overall survival and disease-free survival in those tumors overexpressing VEGF. The overexpression of VEGF-A may be an early step in the process of metastasis, a step that is involved in the "angiogenic" switch.
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HER2 is overexpressed in 20-30% of breast cancers and is commonly associated with poor prognosis. It is therefore an oncogene whose differently spliced variants have been shown to have different functions. Knocking down hnRNP H1 was shown to increase the amount of an oncogenic variant Δ16HER2. HER2 is an upstream regulator of cyclin D1 and p27, and its overexpression leads to the deregulation of the G1/S checkpoint.
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Pancreatic cancer can arise following chronic pancreatitis or due to other reasons, and carries a very poor prognosis, as it is often identified when it has spread to other areas of the body. The word pancreas comes from the Greek πᾶν (pân, “all”) & κρέας (kréas, “flesh”). The function of the pancreas in diabetes has been known since at least 1889, with its role in insulin production identified in 1921.
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Absence of eosinophilia in an infection limited to the gastrointestinal tract may indicate poor prognosis. Eosinophilia is often absent in disseminated infection. Steroids will also suppress eosinophilia, while leading to dissemination and potential hyperinfection. Escalated disseminated infections caused by immunosuppression can result in a wide variety and variable degree of disparate symptoms depending on the condition and other biological aspects of the individual, that may emulate other diseases or diagnoses.
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Cardiac fibromas in infancy which are unable to be removed surgically due to size and extensive myocardial infiltration, have a poor prognosis. The is due to the high ratio of tumor-to- heart size that may produce low cardiac output and as a result lead to a poorer prognosis. As a result, defibrillator implantation or cardiac transplantation may be required. However, tumors that are able to be surgically removed even incompletely have a good prognosis.
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However, incompatibilities between the human and murine systems hamper clinical evaluation of these agents. Moreover, urokinase is used by normal cells for tissue remodeling and vessel growth, which necessitates distinguishing cancer-associated urokinase features for specific targeting. uPA breakdown of the extracellular matrix is crucial for initiating the angiogenesis which is associated with cancer growth. uPA antigen is elevated in breast cancer tissue, which correlates with poor prognosis in breast cancer patients.
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Symptoms may include headache, decreased level of consciousness and hemiparesis (weakness of one side of the body). SAH is a frequent occurrence in traumatic brain injury, and carries a poor prognosis if it is associated with deterioration in the level of consciousness. While thunderclap headache is the characteristic symptom of subarachnoid hemorrhage, less than 10% of those with concerning symptoms have SAH on investigations. A number of other causes may need to be considered.
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Anterior tibial stress fractures can have a particularly poor prognosis and can require surgery. On radiographic imaging, these stress fractures are referred to as the "dreaded black line." When compared to other stress fractures, anterior tibial fractures are more likely to progress to complete fracture of the tibia and displacement. Superior femoral neck stress fractures, if left untreated, can progress to become complete fractures with avascular necrosis, and should also be managed surgically.
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Hobnail cells seen in a clear cell carcinoma sample Clear-cell adenocarcinomas are histopathologically similar to other clear cell carcinomas, with clear cells and hobnail cells. They represent approximately 5–10% of epithelial ovarian cancers and are associated with endometriosis in the pelvic cavity. They are typically early-stage and therefore curable by surgery, but advanced clear-cell adenocarcinomas (approximately 20%) have a poor prognosis and are often resistant to platinum chemotherapy.
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The first mechanism is based on tryptophan depletion from the tumor microenvironment. The second mechanism is based on the production of catabolic products called kynurenins, that are cytotoxic for T lymphocytes and NK cells. Overexpression of human IDO (hIDO) is described in a variety of human tumor cell lineages and is often associated with poor prognosis. Tumors with increased production of IDO include prostate, ovarian, lung or pancreatic cancer or acute myeloid leukemia.
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2005 June 1;65(11):4471-4; Shachaf C.M., Gentles A, Elchuri S, Sahoo D, Gentles A, Soen Y, Sharpe O, Perez OD, Chang M, Mitchel D, Amati B, Dill D, Nolan GP, Plevritis SK and Felsher DW. Systematic molecular analysis of a MYC overexpressing tumor cell following MYC inactivation. Cancer Res. 2008 Jul 1;68(13):5132-42. The MYC protein in cancers correlates with poor prognosis and is a difficult therapeutic target.
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Sometimes removal of a large part of the liver called hepatectomy is required to completely remove the tumor. The bile duct if involved also needs to be removed. However, with gallbladder cancer's extremely poor prognosis, most patients will die within a year of surgery. If surgery is not possible, endoscopic stenting or percutaneous transhepatic biliary drainage (PTBD) of the biliary tree can reduce jaundice and a stent in stomach may relieve vomiting.
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The genetic events found in ductal adenocarcinoma have been well characterized, and complete exome sequencing has been done for the common types of tumor. Four genes have each been found to be mutated in the majority of adenocarcinomas: KRAS (in 95% of cases), CDKN2A (also in 95%), TP53 (75%), and SMAD4 (55%). The last of these is especially associated with a poor prognosis. SWI/SNF mutations/deletions occur in about 10–15% of the adenocarcinomas.
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Overexpression of Skp2 is frequently observed in human cancer progression and metastasis, and evidence suggests that Skp2 plays a proto-oncogenic role both in vitro and in vivo. Skp2 overexpression has been seen in: lymphomas, prostate cancer, melanoma, nasopharyngeal carcinoma, pancreatic cancer, and breast carcinomas. Additionally, overexpression of Skp2 is correlated with a poor prognosis in breast cancer. As one would expect, Skp2 overexpression promotes growth and tumorigenesis in a xenograft tumor model.
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Its expression is reduced in many types of cancer, thereby distinguishing the cancerous expression profile of the other proteins of the S100 group. It has been reported that S100A2 is downregulated in lung, kidney, prostate cancer and melanoma. Chromosomal rearrangements and altered expression of this gene have also been implicated in breast cancer. In addition, its decline is associated with poor prognosis, disease progression, increased occurrence of metastasis and increased patient mortality.
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Finally, c-myc gene expression is relatively high in neoplasms, and it is often linked to poor prognosis. Bilateral adrenocortical tumors are less common than unilateral. The majority of bilateral tumours can be distinguished according to size and aspect of the nodules: primary pigmented nodular adrenocortical disease, which can be sporadic or part of Carney complex, and primary bilateral macro nodular adrenal hyperplasia. Metastasis is most commonly to the liver and lung.
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The development of any of the cancers associated with PSC predicts a poor prognosis. Complications from PSC-associated cancers account for 40% of deaths from PSC. Primary sclerosing cholangitis is one of the major known risk factors for cholangiocarcinoma, a cancer of the biliary tree, for which the lifetime risk among patients with PSC is 10-15%. This represents a 400-fold greater risk of developing cholangiocarcinoma compared to the general population.
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He became leader of the clinic in 1940, appointed by the German-led occupation administration and confirmed by the legitimate Norwegian government in 1945. He published further studies on schizophrenia in 1937 and 1939, in which he developed a distinction between "typical schizophrenia" and "schizophreniform psychoses". While the former had a poor prognosis, he believed that the latter could include affective disorders and delusions but lacked several of the typical schizophrenic symptoms.
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Overall the disease has a poor prognosis, with treatment mainly focusing on palliation and comfort care. As the mechanism and clinical course of DSS remains unclear, definitive treatment is not available for patients. Bone marrow transplant may improve skeletal abnormalities, however it is improbable the transplant will ameliorate the unexplained neurological deteriorations. In addition, the surgery may not be suitable for every patients as the underlying genetic cause of the disease varies amongst patients.
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Although many patients have an underlying cancer, the prognosis is determined by the severity of the neurological symptoms produced by the encephalitis. Compared to other paraneoplastic encephalitides, anti-Hu associated encephalitis has an especially poor prognosis. Several studies reporting an average survival time of less than a year, from the time of diagnosis. Much of the prognosis depends on the efficacy of treatment, which is directed at the underlying cancer, if present.
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Severe alcoholic hepatitis has a poor prognosis and is notoriously difficult to treat. Without any treatment, 20-50% of patients may die within a month, but evidence shows treatment may extend life beyond one month (i.e., reduce short-term mortality). Available treatment options include pentoxifylline (PTX), which is a nonspecific TNF inhibitor, corticosteroids, such as prednisone or prednisolone (CS), corticosteroids with N-acetylcysteine (CS with NAC), and corticosteroids with pentoxifylline (CS with PTX).
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Surgery to remove the blockage is not generally recommended and comes with a poor prognosis. Some rabbits are more prone to GI stasis than others. The causes of GI stasis are not completely understood, but common contributing factors are thought to include stress, reduced food intake, low fiber in the diet, dehydration, reduction in exercise or blockage caused by excess fur or carpet ingestion. Stress factors can include changes in housing, transportation, or medical procedures under anesthesia.
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Neurocutaneous melanosis is a congenital disorder characterized by the presence of congenital melanocytic nevi on the skin and melanocytic tumors in the leptomeninges of the central nervous system. These lesions may occur in the amygdala, cerebellum, cerebrum, pons and spinal cord of patients. Although typically asymptomatic, malignancy occurs in the form of leptomeningeal melanoma in over half of patients. Regardless of the presence of malignancy, patients with symptomatic neurocutaneous melanosis generally have a poor prognosis with few treatment options.
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As an enzyme central to cell energetics, CKMT1A is often impaired in pathological situations. CKMT1A is known as a primary target of oxidative and radical-induced molecular damage; and the impairment of CKMT1A has been reported in ischaemia, cardiomyopathy, and neurodegenerative disorders due to the failure in maintaining metabolic homeostasis. Overexpression of uMtCK has been reported for several tumors with poor prognosis and this may be the adaption of cancer cells to maintain the high growth rate.
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In normal breast tissue, mRNA expression of SEMA7A is low or not expressed, but activation to re-express SEMA7A occurs in these adult tissues to cause pleiotropic effects which increase tumorigenesis. Tumor cell growth, EMT, lung metastasis and angiogenesis have been linked to increased Sema7a expression in murine models. Increased SEMA7A expression correlates with poor prognosis in breast cancer patients. Tumors increase SEMA7A expression in an involuting environment, but knockout of SEMA7a in mouse models undergoing involution decreases lymphangiogenesis.
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Gliomatosis peritonei, a rare condition often associated with immature ovarian teratoma, is characterized by the presence of mature glial implants in the peritoneum. Yoon et al. (2012), reported that immature ovarian teratoma patients with Gliomatosis peritonei have larger tumors, more frequent recurrence and higher CA-125 levels than immature ovarian teratoma patients without gliomatosis peritonei. A high degree of immaturity in the primary tumor, one that corresponds with a grade 3 diagnosis is a sign of poor prognosis.
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FOXA1 particularly is expressed in 90% of breast cancer metastases and 89% of metastic prostate cancers. In the breast cancer cell line, MCF-7, it was found that FoxA1 was bound to 50% of estrogen receptor binding sites independent of estrogen presence. High expression of pioneer factors is associated with poor prognosis with the exception of breast cancer where FoxA1 is associated with a stronger outcome. The correlation between pioneer factors and cancer has led to prospective therapeutic targeting.
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Non-metastatic squamous cell carcinoma and transitional cell carcinoma are very rare in the endometrium. Squamous cell carcinoma of the endometrium has a poor prognosis. It has been reported fewer than 100 times in the medical literature since its characterization in 1892. For primary squamous cell carcinoma of the endometrium (PSCCE) to be diagnosed, there must be no other primary cancer in the endometrium or cervix and it must not be connected to the cervical epithelium.
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Metastasis is the most common cause of brain cancer, with primary tumors that originate in the brain being less common. The most common sites of primary cancer which metastasize to the brain are lung, breast, colon, kidney, and skin cancer. Brain metastases can occur in patients months or even years after their original cancer is treated. Brain metastases have a poor prognosis for cure, but modern treatments are allowing patients to live months and sometimes years after the diagnosis.
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Factors such as elevated intracranial pressure, increased patients age, and abnormal GCS results lead to a poor prognosis. The mortality rate following a hematoma could be as high as 80% and survivors many not regain the same pre- injury function. Subdural and epidural hematomas are serious injuries and recovery varies widely depending on the severity of the hematoma. Severity depends on type and location of the injury, the size of the blood collection, and how quickly treatment is obtained.
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The main findings of the study were, that there are most likely four different subgroups of pelvic girdle pain. Then different groups have different incidence, and there is different clinical characteristics and pain pattern and different prognosis. Most important is the subgroups; Pelvic Girdle Syndrome, 5% of the pregnant women suffer from Pelvic Girdle Syndrome. Unfortunately, these women have a poor prognosis, hence 20% of the women still suffer from pain 2 years after delivery of the child.
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The pathology mostly affects persons of 30 to 50 years of age. Females are four times more likely to develop TAO than males. When males are affected, they tend to have a later onset and a poor prognosis. A study demonstrated that at the time of diagnosis, 90% of the patients with clinical orbitopathy were hyperthyroid according to thyroid function tests, while 3% had Hashimoto's thyroiditis, 1% were hypothyroid and 6% did not have any thyroid function tests abnormality.
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By contrast, ovarian cancer, the leading cause of reproductive organ cancer deaths, and the fifth commonest cause of cancer deaths in women in the United States, lacks an effective screening programme, and is predominantly a disease of women in industrialised countries. Because it is largely asymptomatic in its earliest stages, more than 50% of women have stage III or higher cancer (spread beyond the ovaries) by the time they are diagnosed, with a consequent poor prognosis.
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The half-life of cTnI in adult cardiomyocytes is estimated to be ~3.2 days and there is a pool of unassembled cardiac TnI in the cytoplasm. Cardiac TnI is exclusively expressed in the myocardium and is thus a highly specific diagnostic marker for cardiac muscle injuries, and cTnI has been universally used as indicator for myocardial infarction. An increased level of serum cTnI also independently predicts poor prognosis of critically ill patients in the absence of acute coronary syndrome.
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Cyclin levels can easily be determined through immunohistological analysis of tumor biopsies. The fact that cyclin B is often disregulated in cancer cells makes cyclin B an attractive biomarker. Many studies have been performed to examine cyclin levels in tumors, and it has been shown that levels of cyclin B is a strong indicator of prognosis in many types of cancer. Generally, elevated levels of cyclin B are indicative of more aggressive cancers and a poor prognosis.
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These rare patients can be identified through their elevated cyclin B levels. In addition high levels of cyclin B also indicate poor prognosis and lymph node metastasis in gastric cancers. However, not all cancers which overexpress cyclin B are more aggressive. A study in 2009 found that cyclin B overexpression in ovarian cancer indicates that the cancer is unlikely to be malignant while more aggressive ovarian cancers of epithelial cell origin do not show elevated cyclin B.
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Deletions and mutations of the TRG gene have been implicated in a variety of cancers. Specifically, γδ T cells may contribute to the immune response against several tumor types (lymphoma, myeloma, breast, colon, lung, ovary, and others). They act directly through mediation of cytotoxic activity and indirectly through the regulation of other cell types responsible for the anti-tumor response. The presence of γδ T cells in the tumor microenvironment has been associated with poor prognosis in some cancers.
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Posterior reversible encephalopathy syndrome (PRES) is a rare clinical disease characterized by cerebral edema. The exact pathophysiology, or cause, of the syndrome is still debated but is hypothesized to be related to the disruption of the blood-brain barrier. The syndrome features acute neurological symptoms and reversible subcortical vasogenic edema predominantly involving the parieto-occipital areas on MR imaging. PRES in general has a benign course, but PRES-related intracranial hemorrhage has been associated with a poor prognosis.
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The first cancer genome was sequenced in 2008. This study sequenced a typical acute myeloid leukaemia (AML) genome and its normal counterpart genome obtained from the same patient. The comparison revealed ten mutated genes. Two were already thought to contribute to tumor progression: an internal tandem duplication of the FLT3 receptor tyrosine kinase gene, which activates kinase signaling and is associated with a poor prognosis and a four base insertion in exon 12 of the NPM1 gene (NPMc).
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Rarely, it is associated with clear cell renal cell carcinoma and papillary renal cell carcinoma. If it develops in someone with BHD, renal cell carcinoma occurs later in life and has a poor prognosis. Though the types of tumor typically associated with BHD are considered less aggressive, cases of advanced or metastatic kidney cancer have been observed in people with the syndrome. Both benign and cancerous tumors can reduce kidney function over time as they grow larger.
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TroVax is a cancer vaccine that was developed by Oxford BioMedica. No cancer vaccines have been proven to cure cancer or extend life yet,National Cancer Institute, Cancer Vaccine Fact Sheet, Updated: 06/08/2006 TroVax has been studied in a number of trials for colon cancer. TroVax uses a tumor-associated antigen, 5T4, with a pox virus vector. 5T4 is found in a wide range of solid cancers and its presence is correlated with poor prognosis.
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Richter's syndrome (RS), also known as Richter's transformation, is a transformation of B cell chronic lymphocytic leukemia (CLL) or hairy cell leukemia into a fast-growing diffuse large B cell lymphoma, a variety of non- Hodgkin lymphoma which is refractory to treatment and carries a bad prognosis. There is also a less common variant in which the CLL changes into a Hodgkin's lymphoma. Rarely, transformations to a form of myeloid leukemia have been observed. These extraordinarily rare transformations carry a very poor prognosis.
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A poor prognosis is associated with amelanotic lesions, partially due to the difficulty in achieving a diagnosis; however, metastatic amelanotic melanoma has a worse prognosis than other subtypes. Survival after diagnosis of amelanotic melanoma was found in a 2014 seven-year study of 3,000 patients to be poorer than for pigmented melanoma, which was attributed to the more advanced stage at diagnosis due probably to difficulty of diagnosis. The study also suggested that amelanotic melanomas might grow faster than pigmented melanomas.
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Caused by a gammaherpes virus called Kaposi's sarcoma-associated herpes virus (KSHV), it often appears as purplish nodules on the skin, but can affect other organs, especially the mouth, gastrointestinal tract, and lungs. High-grade B cell lymphomas such as Burkitt's lymphoma, Burkitt's-like lymphoma, diffuse large B-cell lymphoma (DLBCL), and primary central nervous system lymphoma present more often in HIV-infected patients. These particular cancers often foreshadow a poor prognosis. Epstein-Barr virus (EBV) or KSHV cause many of these lymphomas.
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Pralatrexate (brand name Folotyn) is an anti-cancer therapy., Allos Therapeutics Press Release, “Allos Therapeutics' Pralatrexate Demonstrates Anticancer Activity in Multiple Cancer Cell Lines”. It is the first drug approved as a treatment for patients with relapsed or refractory peripheral T-cell lymphoma, or PTCL, Allos Therapeutics Press Release, “Allos Therapeutics' FOLOTYN(TM) First and Only FDA-Approved Therapy for Relapsed or Refractory Peripheral T-cell Lymphoma”. — a biologically diverse group of aggressive blood cancers that have a poor prognosis.
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Circulating concentrations of neurokinin A is an independent indicator of poor prognosis in certain cancers such as carcinoids. Patients presenting with neurokinin A plasma concentrations of >50 pmol/l showed a poorer 3 year survival rate than patients presenting with neurokinin A concentrations of less than 50 pmol/l. These types of studies show that measuring tachykinin levels in human patients may have clinical relevance. Patients with Midgut Carcinoid disease (MGC) commonly receive neurokinin A test to determine the progression of their disease.
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Male gender, proteinuria (especially > 2 g/day), hypertension, smoking, hyperlipidemia, older age, familial disease and elevated creatinine concentrations are markers of a poor outcome. Frank hematuria has shown discordant results with most studies showing a better prognosis, perhaps related to the early diagnosis, except for one group which reported a poorer prognosis. Proteinuria and hypertension are the most powerful prognostic factors in this group. There are certain other features on kidney biopsy such as interstitial scarring which are associated with a poor prognosis.
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Recurrences can be treated, but the disease-free interval tends to shorten and chemoresistance increases with each recurrence. When a dysgerminoma recurs, it is most likely to recur within a year of diagnosis, and other malignant germ cell tumors recur within 2 years 90% of the time. Germ cell tumors other than dysgerminomas have a poor prognosis when they relapse, with a 10% long-term survival rate. Low malignant potential tumors rarely relapse, even when fertility-sparing surgery is the treatment of choice.
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Chart from How to Always Be Well, William Howard Hay In 1905, Hay seems to have had an episode of acute heart failure following running for a train. As a result he discovered that he had Bright's disease (hypertension with nephritis) with a dilated heart, a condition with a poor prognosis at the time. Hay started looking for ways to improve his condition. He first turned to a vegetarian diet and restricted his eating to once a day in the evening.
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The most characteristic feature are elevated levels of gamma glutamyl transferase (100–300 IU/L), aspartate transaminase (>1000 IU/L) and sorbitol dehydrogenase, with AST levels > 4000 IU/L indicating a poor prognosis. High levels of unconjugated and total bilirubin, and serum bile acids, can be seen. Moderate to severe acidosis, leukocytosis, polycythaemia, increased creatine kinase and hyperammonemia may be present, and hemolysis can occur at the end stage. The prothrombin time (PT) and partial thromboplastin time (PTT) is often prolonged.
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As more and more Americans experienced the burdens and diminishing benefits of invasive and aggressive medical treatment in poor prognosis states – either directly (themselves) or through a loved one – pressure began to mount to devise ways to avoid the suffering and costs associated with treatments one did not want in personally untenable situations. The first formal response was the living will. In the United States, all states recognize some form of living wills or the designation of a health care proxy.
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Similarly, HER2 overexpression occurs in approximately a quarter of breast cancers and correlates with poor prognosis. Recent research revealed that IL-6 secretion induced by HER2 overexpression activated STAT3 and altered gene expression, resulting in an autocrine loop of IL-6/STAT3 expression. Both mouse and human in vivo models of HER2-overexpressing breast cancers relied critically on this HER2–IL-6–STAT3 signaling pathway. Another group found that high serum levels of IL-6 correlated with poor outcome in breast cancer tumors.
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BC200 RNA has been found to be a factor in numerous types of cancer. Although this type of RNA is normally expressed in neurons, it has been detected in cancers of the breast, cervix, esophagus, lungs, ovaries, parotid glands, tongue, and the colon. In certain cancers, expression of BC200 RNA is upregulated. This occurs in esophageal squamous cell carcinoma (ESCC) and higher expression is considered to be a predictor of poor prognosis and may serve as a predictive biomarker for the disease.
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Nonetheless, it is particularly important to diagnose them correctly because they can have very different prognoses and treatments than the lymphomas which they resemble. Plasmablastic lymphomas are aggressive and rare malignancies that usually respond poorly to chemotherapy and carry a very poor prognosis. They occur predominantly in males who have HIV/AIDS, had a solid organ transplant, or are immunosuppressed in other ways; ~5% of all individuals with PBL appear to be immunocompetent, i.e. to have no apparent defect in their immune system.
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In general, old age, reduced serum albumin concentration, end stage kidney failure, and sustained elevated SAA concentration are all associated with poor prognosis. There are currently no approved treatments for systemic AA amyloidosis. The current standard of care includes treatments for the underlying inflammatory disease with anti-inflammatory drugs, immunosuppressive agents or biologics. AA amyloidosis patients are also receiving treatments to slow down the decline of their renal function, such as angiotensin II receptor blockers or angiotensin converting enzyme inhibitors.
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Hepatorenal syndrome is one of the more serious complications in patients with an acute decompensation of cirrhosis and increased portal hypertension. It is characterized by hemodynamic changes in splanchnic, systemic and renal circulation. Splanchnic vasodilatation triggers the production of endogenous vasoactive substances that produce renal vasoconstriction and low glomerular filtration rate, leading to oliguria with a concomitant reduction in creatinine clearance. Renal insufficiency is always progressive with a very poor prognosis, with survival at 1 and 2 months of 20 and 10% respectively.
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The mortality rate from paracetamol overdose increases two days after the ingestion, reaches a maximum on day four, and then gradually decreases. Acidosis is the most important single indicator of probable mortality and the need for transplantation. A mortality rate of 95% without transplant was reported in patients who had a documented pH less than 7.30. Other indicators of poor prognosis include chronic kidney disease (stage 3 or worse), hepatic encephalopathy, a markedly elevated prothrombin time, or an elevated blood lactic acid level (lactic acidosis).
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Expression of egfl7 is endothelial cell- specific in physiological conditions, however it is aberrantly expressed by tumour cells in human cancers. In colorectal cancer, high levels of egfl7 correspond to tumours with higher pathologic stages and to the presence of lymph node metastases. Egfl7 is also over-expressed by tumour cells in human hepatocellular carcinoma and overexpression is significantly higher in tumours with multiple nodules, without capsules and with vein invasion. Levels of egfl7 are thus correlated with markers of metastasis and with poor prognosis.
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NF-2 may be inherited in an autosomal dominant fashion, as well as through random mutation. NF2 is caused by inactivating mutations in the NF2 gene located at 22q12.2 of chromosome 22, type of mutations vary and include protein- truncating alterations (frameshift deletions/insertions and nonsense mutations), splice-site mutations, missense mutations and others. Deletions, too, in the NH2-terminal domain of merlin proteins have been associated with early tumor onset and poor prognosis in people with NF2. Protein truncating mutations correlate with more severe phenotype.
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Cochliobolus lunatus is one of the main causative agents of phaeohyphomycosis. Initial infection via breaks to the epidermal barrier or the inhalation of spores can lead to disseminated infections, which are often associated with a poor prognosis. C. lunatus is an opportunistic pathogen, infecting immunocompromised patients and those on rigorous steroid drug regimens such as solid organ transplant recipients, advanced AIDS patients and cancer patients. Dematiaceous fungi such as C. lunatus can facilitate foreign body infections of catheters, heart valves and pacemakers, for example.
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It is for this reason that a post-operative full abdominal and chest x-ray will often be requested. In 2 to 3% of cases, hydatidiform moles may develop into choriocarcinoma, which is a malignant, rapidly growing, and metastatic (spreading) form of cancer. Despite these factors which normally indicate a poor prognosis, the rate of cure after treatment with chemotherapy is high. Over 90% of women with malignant, non-spreading cancer are able to survive and retain their ability to conceive and bear children.
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Cecil Woolf and John Bagguley,Authors take sides on Vietnam : two questions on the war in Vietnam answered by the authors of several nations London : Peter Owen, (p.108). In 1962 Frankau was diagnosed with breast cancer with a poor prognosis due to the remedial cancer treatments available at the time. After a 5 year battle with the disease, Frankau died aged 59 at the Hampstead, London home she had shared with Margaret Webster. She was buried in a Catholic service in Hampstead Cemetery.
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Mesothelioma often has a poor prognosis. Typical survival despite surgery is between 12 and 21 months depending on the stage of disease at diagnosis with about 7.5% of people surviving for 5 years. Women, young people, people with low-stage cancers, and people with epithelioid cancers have better prognoses. Negative prognostic factors include sarcomatoid or biphasic histology, high platelet counts (above 400,000), age over 50 years, white blood cell counts above 15.5, low glucose levels in the pleural fluid, low albumin levels, and high fibrinogen levels.
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In 1951, Irving Selikoff and , working out of Sea View Hospital on Staten Island, began clinical trials on two new anti- tuberculosis agents developed by Hoffman-LaRoche, isoniazid and iproniazid. Only patients with a poor prognosis were initially treated; nevertheless, their condition improved dramatically. Selikoff and Robitzek noted "a subtle general stimulation ... the patients exhibited renewed vigor and indeed this occasionally served to introduce disciplinary problems." The promise of a cure for tuberculosis in the Sea View Hospital trials was excitedly discussed in the mainstream press.
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Altered expression and activity levels of MMPs have been strongly implicated in the progression and metastasis of many forms of cancer. Increased MMP-2 activity has also been linked with a poor prognosis in multiple forms of cancer including colorectal, melanoma, breast, lung, ovarian, and prostate. Furthermore, changes in MMP-2 activity can come from alterations in levels of transcription, MMP secretion, MMP activation, or MMP inhibition. MMP production in many cancers may be upregulated in surrounding stromal tissue rather than simply in the tumor lesion.
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It is common for individuals with drugs use disorder to have other psychological problems. The terms “dual diagnosis” or “co-occurring disorders,” refer to having a mental health and substance use disorder at the same time. According to the British Association for Psychopharmacology (BAP), “symptoms of psychiatric disorders such as depression, anxiety and psychosis are the rule rather than the exception in patients misusing drugs and/or alcohol.” Individuals who have a comorbid psychological disorder often have a poor prognosis if either disorder is untreated.
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A systematic review and meta-analysis came to the result that assisted zona hatching is related to increased rates of clinical pregnancy and multiple pregnancy in women with previous repeated failure or frozen-thawed embryos. However, it is unlikely to increase clinical pregnancy rates when performed in fresh embryos transferred to unselected women, to those without poor prognosis or to women of advanced maternal age. Also, overall, there no evidence of a significant difference in live birth rate following assisted hatching compared with no assisted hatching.
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There was criticism that she had named abortion as a human right, but neither she nor the commission as a whole gave in to the pressure to remove it. In 1976 she was elected as a director on the Canadian Research Institute for the Advancement of Women. From 1977 to 1987, she served on the board of governors of the Canadian Council on Social Development. Taylor suffered a severe stroke in 1995, but recovered much of her lost speech and mobility, despite a poor prognosis initially.
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Barnes was then spotted and signed by Arsenal in September 1943. At and away from Highbury he played in virtually every position on the pitch for Arsenal in wartime matches including a match where he featured as a goalkeeper, but suffered a serious knee injury which was incurred in 1944. Despite a poor prognosis at the time, he recovered, and forced himself back in the Arsenal side after insisting on playing a reserves match against Cambridge University. He made his League debut for the Gunners against Preston North End on 9 November 1946.
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This may indicate that certain genetic features drives cellular changes which ultimately effect fluid movement which can be seen on MRI and these features are predominantly associated with poor prognosis. The combination of more dangerous genetic alterations, histology and clinical outcomes for patients with prostate tumours which are visible on mpMRI, has lead to suggestions that the definition of 'clinically significant cancer' should be at least in part based on mpMRI findings. The radiogenomic approach has been also successfully applied in breast cancer. In 2014, Mazurowski et al.
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He however noted that, unlike in Rheumatic Chorea, the tendon reflexes were brisk. Two days later after re-examining the child, Prof. Lamabadusuriya ordered a CT scan of the brain, since he could not exclude the possibility of a Space Occupying Lesion in the Brain. The CT Scan revealed a Brain Stem Glioma (BSG), which is a growth of certain nerve cells in the proximal part of the brain which houses most of the vital structures necessary for life - hence it is associated with a very poor prognosis .
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It has been found to be oncogenic and is implicated in cervical cancers. PIK3CA mutations are present in over one-third of breast cancers, with enrichment in the luminal and in human epidermal growth factor receptor 2-positive subtypes (HER2 +). The three hotspot mutation positions (GLU542, GLU545, and HIS1047) have been widely reported till date. While substantial preclinical data show an association with robust activation of the pathway and resistance to common therapies, clinical data do not indicate that such mutations are associated with high levels of pathway activation or with a poor prognosis.
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Activated expression of lactate dehydrogenase A (LDH-A), parallels with deactivation of pyruvate dehydrogenase mediated by pyruvate dehydrogenase kinase. Subsequent inactivation of pyruvate dehydrogenase following phosphorylation and increased expression of lactate dehydrogenase A shunts pyruvate away from the mitochondrial TCA cycle. In many different tumor types lactate dehydrogenase A is found at elevated levels and has even been linked to poor prognosis and a greater metastatic potential The high levels of lactate production surface the question of whether lactate has some influence on the aggressive behaviour shown in hypoxic tumors.
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In an international three-arm phase III study with 626 previously untreated, poor-prognosis patients, temsirolimus, interferon-α and the combination of both agents was compared. Median overall survival improved significantly in the temsirolimus group (10.9 months) compared with interferon-α group (7.3 months) and the combination group (8.4 months). Further studies are needed to determine the role of temsirolimus in the first-line treatment of patients with a more favorable prognosis, how it can be combined with other targeted agents and as sequential therapy with sunitinib or sorafenib.
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Aside from bone marrow suppression, frequent side effects included nerve injury caused by vincristine and allergic reactions to procarbazine. Long-term effects were also a concern, as patients were often cured and could expect long survival after chemotherapy. Infertility was a major long-term side effect, and even more seriously, the risk of developing treatment-related myelodysplasia or acute leukemia was increased up to 14-fold in patients who received MOPP. These treatment-related hematological malignancies peaked at 5 to 9 years after treatment for Hodgkin's lymphoma, and were associated with a dismally poor prognosis.
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While the group was able to identify these mutations they were unable to determine the underlying mechanisms resulting in them. The McDermott group in participation with other labs worked to find new treatment possibilities for Acute myeloid leukemia (AML), an aggressive cancer with a poor prognosis. They accomplished this by designing a CRISPR genome wide screening tool to locate areas in the genome that would be more susceptible to treatment in the AML cells. The research identified 492 essential genes to the function of the AML cells that would be accessible to being therapeutic targets.
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New treatments and clinical trial for breast cancer patients and non-small cell lung cancer patients with leptomeningeal disease are currently being explored. Diagnostics that improve early detection and chemotherapeutics tailored to the primary malignancy will likely be the most significant advances in improving survival. Patients with leptomeningeal metastasis are generally excluded from clinical trials, thereby limiting the systematic assessment of novel therapies in this subgroup of patients with poor prognosis. More patients with leptomeningeal metastasis should be enrolled into trials investigating novel agents with the potential to penetrate the blood–brain barrier.
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The peptide tumor-associated trypsin inhibitor (TATI) has been used as a marker of mucinous ovarian carcinoma, urothelial carcinoma, and renal cell carcinoma. TATI is metabolised by the kidneys and is, thus, elevated in patients with kidney failure. It may be elevated in non-neoplastic processes such as pancreatitis and can be used as a prognostic marker in this setting (levels above 70 micrograms/L are associated with poor prognosis). Fifty percent of stage I mucinous ovarian carcinomas are associated with elevated TATI, and nearly 100% of stage IV tumors show elevated TATI.
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MTDH has a dual role in promoting metastatic seeding and enhancing chemoresistance. MTDH is therefore a potential therapeutic target for enhancing chemotherapy and reducing metastasis. MTDH has been shown to be overexpressed in prostate cancer, where there is a shift towards a more cytoplasmic localisation, signalling a poor prognosis. In the nucleus of prostate cancer cells, MTDH has been shown to effect alternative splicing of genes such as CD44 which may also be associated with prostate cancer progression. LSF/TFCP2 plays multifaceted role in chemo resistance, EMT, allergic response, inflammation and Alzheimer’s disease.
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Using molecular biological techniques, it is possible to characterize the mutations, epimutations or chromosomal aberrations within a tumor, and rapid progress is being made in the field of predicting certain cancer patients' prognosis based on the spectrum of mutations. For example, up to half of all tumors have a defective p53 gene. This mutation is associated with poor prognosis, since those tumor cells are less likely to go into apoptosis or programmed cell death when damaged by therapy. Telomerase mutations remove additional barriers, extending the number of times a cell can divide.
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Incidence of cholangiocarcinoma and O. viverrini in Thailand from 1990–2001.Both experimental and epidemiological evidence strongly implicates Opisthorchis viverrini infections in the etiology of a malignant cancer of the bile ducts (cholangiocarcinoma) in humans which has a very poor prognosis. Clonorchis sinensis and Opisthorchis viverrini are both categorized by the International Agency for Research on Cancer (IARC) as Group 1 carcinogens. In humans, the onset of cholangiocarcinoma occurs with chronic opisthorchiasis, associated with hepatobiliary damage, inflammation, periductal fibrosis and/or cellular responses to antigens from the infecting fluke.
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Things get a twist when it is shown that Shamu is a married man with a kid. This makes Annie to meet him again and comes to know that his wife is in a mental hospital with a poor prognosis possibly due to post traumatic stress disorder due to rape she underwent during a tour. Annie and Shamu go for a trip but they consummate and Shamu gives word that he will marry her. On his return to his house he knows his wife who fell from height has her mental illness cured.
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Loss-of-function mutations in the STAT3 gene result in Hyperimmunoglobulin E syndrome, associated with recurrent infections as well as disordered bone and tooth development. Gain-of-function mutations in the STAT3 gene have been reported to cause multi-organ early onset auto- immune diseases; such as thyroid disease, diabetes, intestinal inflammation, and low blood counts, while constitutive STAT3 activation is associated with various human cancers and commonly suggests poor prognosis. It has anti- apoptotic as well as proliferative effects. STAT3 can promote oncogenesis by being constitutively active through various pathways as mentioned elsewhere.
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Patients with DLBCL, NOS who relapse or progress following first-line therapy have been treated wit "salvage regimens" consisting of high-dose (also termed high- intensity) chemotherapy conditioning drugs followed by autologous stem cell transplantation. This regimen has attained 3 year progression-free survival rates of 21-37%. Relapse following this treatment carries a very poor prognosis with median overall survival times of ~10 months. Patients who have failed or because of health issues are ineligible for autologous stem cell transplantation have been treated with low-dose (i.e.
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Patients exhibit rapid increases in lymphadenopathy, spleen size, and blood cell numbers, some cells of which take on the appearance of immature and/or malignant cells. Their disease soon thereafter escalates to an angioimmunoblastic T-cell lymphoma, peripheral T cell lymphoma, Anaplastic large-cell lymphoma (which unlike most lymphomas of this type is Anaplastic lymphoma kinase-negative), or Cutaneous T cell lymphoma. The malignantly transformed disease is aggressive and has a poor prognosis. Recommended treatment includes chemotherapy with Fludarabine, Cladribine, or the CHOP combination of drugs followed by bone marrow transplantation.
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A podcast on Alabama rot was published in April 2014 by the Royal Veterinary College. As of February 2015 the Forestry Commission England will only publish specific site location details if "cases are confirmed as CRGV and a scientific connection to the dogs walked on the site is made". A comprehensive report on CRGV was published in March 2015 by the British Veterinary Association, concluding that it is a disease of unknown cause "carrying a poor prognosis when azotaemia develops". However, an association has been linked to dogs walking on muddy ground.
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Wet gangrene of the foot Wet, or infected, gangrene is characterized by thriving bacteria and has a poor prognosis (compared to dry gangrene) due to sepsis resulting from the free communication between infected fluid and circulatory fluid. In wet gangrene, the tissue is infected by saprogenic microorganisms (Clostridium perfringens or Bacillus fusiformis, for example), which cause tissue to swell and emit a foul odor. Wet gangrene usually develops rapidly due to blockage of venous (mainly) or arterial blood flow. The affected part is saturated with stagnant blood, which promotes the rapid growth of bacteria.
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HSF1 is a promising drug target in cancer and proteopathy. The genes activated by HSF1 under heat shock conditions have been recently shown to differ from those activated in malignant cancer cells, and this cancer-specific HSF1 panel of genes has indicated poor prognosis in breast cancer. The ability of cancer cells to use HSF1 in a unique manner gives this protein significant clinical implications for therapies and prognoses. In the case of protein-folding diseases such as Huntington's disease (HD), however, induction of the heat shock response pathway would prove beneficial.
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Angiogenesis is essential for the supply of oxygen and nutrients to nourish the growing tumor. CYR61 is a powerful angiogenic inducer in vivo, and it can also promote cancer cell proliferation, invasion, survival, epithelial–mesenchymal transition, and metastasis. Accordingly, forced overexpression of CYR61 enhanced tumor growth in xenografts of breast cancer cells, prostate cancer cells, ovarian carcinoma cells, and squamous carcinoma cells. Clinically, CYR61 expression correlates with the tumor stage, tumor size, lymph node positivity, and poor prognosis in several cancers, including breast cancer, prostate cancer, glioma, gastric adenocarcinoma, and squamous cell carcinoma.
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Heightened expression of HMGA2 is found in a variety of human cancers, but the precise mechanism by which HMGA2 contributes to the formation of cancer is unknown. The same mutations that lead to pituitary adenomas in mice can be found in similar cancers in humans. Its presence is associated with poor prognosis for the patient, but also with sensitization of the cancer cells to certain forms of cancer therapy. To be specific, HMGA2-high cancers display an abnormally strong response to double strand breaks in DNA caused by radiation therapy and some forms of chemotherapy.
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This function is further supported by knockout studies in mice which reveal an essential role in podocyte morphogenesis and a role in the opening of vascular lumens and regulation of vascular permeability. Of note, this is the only cell surface sialomucin knockout known to display a lethal phenotype. Podocalyxin is also upregulated in a number of cancers and is frequently associated with poor prognosis. Sialylated, O-glycosylated glycoforms of podocalyxin expressed by colon carcinoma cells possess L-selectin and E-selectin binding activity, and may be pivotal to the metastatic spread of colon carcinoma cells.
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The course of the untreated disease is heavily dependent on its clinical stage at diagnosis. Patients presenting with highly localized stage I nasal disease usually have nasal but no other symptoms; these individuals commonly show no progression of their disease over long periods of time. Other patients with limited (i.e. stage I or II) disease involving other sites in the head area are more likely to suffer a relatively slow progression of their disease while patients with stage III or IV disease have a more rapidly progressive disease with a poor prognosis.
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In cells lacking TGF-β receptors, a deficiency that is characteristic of lung cancer, lysyl oxidase is found in high concentrations. LOX immunostaining has revealed that high LOX expression is associated with high extent of carcinoma invasion in samples obtained from surgically removed lung adenocarcinomas. Additionally, LOX expression is an indicator of 5-year survival in patients, with a 71% chance of survival for patients with low LOX levels, compared to 43% for patients with high LOX levels. Thus, upregulation of lysyl oxidase is a predictor of poor prognosis in early-stage adenocarcinoma patients.
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Also, active Wnt/beta-catenin pathway correlates with poor prognosis in breast cancer patients in the clinic. Similarly, TGF-β activates the expression of SNAIL and ZEB to regulate EMT in heart development, palatogenesis, and cancer. The breast cancer bone metastasis has activated TGF-β signaling, which contributes to the formation of these lesions. However, on the other hand, p53, a well-known tumor suppressor, represses EMT by activating the expression of various microRNAs – miR-200 and miR-34 that inhibit the production of protein ZEB and SNAIL, and thus maintain the epithelial phenotype.
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Obligatory hibernators such as the ground squirrels show resistance to ischemia/reperfusion (I/R) injury in liver, heart, and small intestine during the hibernation season when there is a switch from carbohydrate metabolism to lipid metabolism for cellular energy supply. This metabolic switch limits anaerobic metabolism and the formation of lactate, a herald of poor prognosis and multi-organ failure (MOF) after I/R injury. In addition, the increase in lipid metabolism generates ketone bodies and activates peroxisome proliferating-activated receptors (PPARs), both of which have been shown to be protective against I/R injury.
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In many of these cancers, SALL4 expression was compared in tumor cells to the normal tissue counterpart, e.g. it is expressed in nearly half of primary human endometrial cancer samples, but not in normal or hyperplastic endometrial tissue samples. Often, SALL4 expression is correlated with worse survival and poor prognosis such as in HCC, or with metastasis such as in endometrial cancer, colorectal carcinoma, and esophageal squamous cell carcinoma. It is unclear how SALL4 expression is de-regulated in malignant cells, but DNA hypomethylation in its intron 1 region has been observed in B-ALL.
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The gene that codes for FAS has been investigated as a possible oncogene. FAS is upregulated in breast and gastric cancers, as well as being an indicator of poor prognosis may also be worthwhile as a chemotherapeutic target. FAS inhibitors are therefore an active area of drug discovery research. FAS may also be involved in the production of an endogenous ligand for the nuclear receptor PPARalpha, the target of the fibrate drugs for hyperlipidemia, and is being investigated as a possible drug target for treating the metabolic syndrome.
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Survival is influenced by the presence of myometrial invasion, sarcomatous overgrowth, lymphovascular invasion, necrosis, and the presence of heterologous elements, which are features in the tumor not native to the tissue of origin such as rhabdomyoblastic differentiation Post-operative recurrence is common in uterine adenosarcomas. Recurrence usually occurs in the vagina, pelvis, and abdomen, and is seen in up to 30% of cases resulting in a poor prognosis. The presence and depth of the sarcoma’s myometrial invasion determines early staging diagnosis. The FIGO (International Federation of Gynecology and Obstetrics) staging is IA: no myometrial invasion, IB: inner myometrial half, IC: outer myometrial half.
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Cancer of unknown primary origin (CUP) is a cancer that is determined to be at the metastatic stage at the time of diagnosis, but a primary tumor cannot be identified. A diagnosis of CUP requires a clinical picture consistent with metastatic disease and one or more biopsy results inconsistent with a tumor cancer CUP is found in about 3 to 5% of all people diagnosed with invasive cancer, and carries a poor prognosis in most (80 to 85%) of those circumstances. The other 15 to 20% of patients, however, have a relatively long survival with appropriate treatment.
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Dostoevsky on his bier, drawing by Ivan Kramskoi, 1881 Dostoevsky's grave in Saint Petersburg On 25 January 1881, while searching for members of the terrorist organisation Narodnaya Volya ("The People's Will") who would soon assassinate Tsar Alexander II, the Tsar's secret police executed a search warrant in the apartment of one of Dostoevsky's neighbours. On the following day, Dostoevsky suffered a pulmonary haemorrhage. Anna denied that the search had caused it, saying that the haemorrhage had occurred after her husband had been looking for a dropped pen holder. After another haemorrhage, Anna called the doctors, who gave a poor prognosis.
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Additionally, a long-term study showed that the Cardiac Contractility Modulation was able to stop the common and prognostically unfavorable long-term prolongation of QRS duration in heart failure patients. This result was interpreted as signaling the safety of the treatment and as an indicator that patients could benefit from Cardiac contractility modulation therapy in the long term. If the QRS-stabilizing effect were to be confirmed in further studies, the Cardiac Contractility Modulation would become the first device-based treatment for heart failure with the potential to halt QRS prolongation, a factor associated with a poor prognosis.
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DCC has found to be a useful prognostic marker for late stage colorectal carcinoma in some studies, but unhelpful in others. Currently the American Society of Clinical Oncology does not recommend using DCC as a marker due to insufficient classification data. A recent review of over two dozen 18q LOH-survival studies concluded that there was a significant amount of inconsistency between the data sets. They concluded that loss of 18q remains a marker for poor prognosis, and that DCC status has the potential to define a group of patients who may benefit from specific treatment regimes.
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Hepatocyte growth factor/Scatter Factor (HGF/SF) and its splicing isoform (NK1, NK2) are the only known ligands of the MET receptor. MET is normally expressed by cells of epithelial origin, while expression of HGF/SF is restricted to cells of mesenchymal origin. When HGF/SF binds its cognate receptor MET it induces its dimerization through a not yet completely understood mechanism leading to its activation. Abnormal MET activation in cancer correlates with poor prognosis, where aberrantly active MET triggers tumor growth, formation of new blood vessels (angiogenesis) that supply the tumor with nutrients, and cancer spread to other organs (metastasis).
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Malignant mixed tumours have a poor prognosis that is deemed unpredictable due to its spread being lymphatic or blood-borne. As there have only been a limited number of cases that have been reported, prognostic points are challenging to confirm, however mainly "include size, histological type, lymph node involvement, and distant metastasis" (Garcia, Atun, and Fernando, 2016). The outcome of the prognosis is dependent on early diagnosis and complete resection. The standard duration between diagnosis and reappearance was "23 months, 50 months, and 66 months for local recurrence, nodal metastasis, and distant metastasis, [respectively]" (Watarai, Amoh, Aki, Takasu, Katsuoka, 2011).
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Despite the high mortality rate, the most important factor in improving survival probability is to detect and diagnose the lesion before birth using ultrasound and MRI scans. If undetected prenatally, the epignathus will be apparent immediately after birth, but prognosis will be poor due to lack of preparation and treatment plans. Most babies with epignathus have a poor prognosis due to late diagnosis and subsequently, complications of securing the airway. However, with early detection and multidisciplinary healthcare teams, an adequate treatment plan to secure the baby's airway and surgically remove the lesion may improve the prognosis.
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The neoplastic cells in a related variant, double expresser lymphoma (i.e. DEL), express the products of MYC and BCL2 genes, i.e. c-Myc and bcl-2 proteins, respectively, but do not have translocations in either of their genes. DEL, which represents about one-third of all DLBCL, NOS cases, has a poorer prognosis than standard DLBCL, NOS but not as poor as DH/THL cases. Cases in which the neoplastic cells have alterations in the MYC gene or its expression without changes in BLC2 or BLC6 also have a poor prognosis, particularly in cases where the MYC gene translocates (i.e.
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CISH is frequently applied to assess gene amplification, such as HER-2/neu status in breast cancer samples. HER-2/neu amplification is associated with higher mortality, higher recurrence rate, and poor prognosis in breast cancer. The monoclonal antibody trastuzumab is a receptor blocker that has been proven to be clinically very effective in HER-2/neu- overexpressing tumors. Therefore, it is crucial to determine receptor status before starting cancer treatment. CISH is also used for detection of chromosomal rearrangements and fusions, such as the fusion of ALK tyrosine kinase domain with the promoter and 5’ region of EML4 in lung cancer.
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Anaplastic thyroid cancer (ATC), also known as anaplastic thyroid carcinoma, is an aggressive form of thyroid cancer characterized by uncontrolled growth of cells in the thyroid gland. This form of cancer generally carries a very poor prognosis due to its aggressive behavior and resistance to cancer treatments. The cells of anaplastic thyroid cancer are highly abnormal and usually no longer resemble the original thyroid cells and have poor differentiation. ATC is an uncommon form of thyroid cancer only accounting for 1-2% of cases, but due to its high mortality, is responsible for 20-50% of deaths from thyroid cancer.
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Though expressed highly in eye lens and muscle tissues, αBC can also be found in several types of cancer, among which head and neck squamous cell carcinoma (HNSCC) and breast carcinomas, as well as in patients with tuberous sclerosis. αBC expression is associated with metastasis formation in HNSCC and in breast carcinomas and in other types of cancer, expression is often correlated with poor prognosis as well. The expression of αBC can be increased during various stresses, like heat shock, osmotic stress or exposure to heavy metals, which then may lead to prolonged survival of cells under these conditions.
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This protease has been regarded an independent marker of poor prognosis in breast cancer being correlated with the incidence of clinical metastasis. Knock-out of CTSD gene would cause intestinal necrosis and hemorrhage and increase apoptosis in thymus, indicating that cathepsin D is required in certain epithelial cells for tissue remodeling and renewal. It is also reported that there might be a strong effect for CTSD genotype on Alzheimer disease risk in male. Cathepsin D enzymatic activity induces hydrolytic modification of apolipoprotein B-100-containing lipoproteins, including LDL, which means it may be involved in atherosclerosis as well.
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Additionally, Cyclin E1 is more easily replicated in BLBC than other types of breast cancer, and its expression suggests a poor prognosis. Deletion of RB gene and overexpression of cyclin E play a significant role in the malignant proliferation of BLBC. More and more studies have shown that epithelial- mesenchymal transition (EMT) plays an important role in the invasiveness of breast cancer. EMT refers to the loss of epithelial differentiation characteristics of epithelial cells and shows the characteristics of mesenchymal differentiation, resulting in decreased cell adhesion and increased mobility of cells and allowing cancer cells to obtain infiltration and metastasis.
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Shortly before his ordination, Preca was diagnosed with acute pulmonary tuberculosis and given a poor prognosis. He attributed his recovery to the intercession of Saint Joseph, patron of the dying, however the illness left him with a damaged left lung. On 8 April 1905 his confessor Aloysius Galea died and Preca would often recount that not long after Galea seemingly appeared to him and encouraged his call to the priesthood. In his studies he began to write a rule in Latin for use in a planned religious movement for permanent deacons that he wished to establish but this desire subsided over time.
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Conversely studies have shown higher levels of TLR9 expression in breast cancer and ovarian cancer patients, and poor prognosis is associated with higher TLR9 expression in prostate cancer. Non-small cell lung cancer and glioma have also been shown to up- regulate the expression of TLR9. While these results are highly variable, it is clear that TLR9 expression increases the capacity for invasion and proliferation. Whether cancer induces modification of TLR9 expression or TLR9 expression hastens the onset of cancer is unclear, but many of the mechanisms that regulate cancer development also play a role in TLR9 expression.
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Patients with the most common, and deadliest, form of pancreatic cancer (pancreatic adenomas, which are usually malignant, with a poor prognosis and high risk for metastasis, as opposed to more treatable pancreatic neuroendocrine tumors or pancreatic insulinomas) are usually not eligible for valuable pancreatic transplantations, since the condition usually has a very high mortality rate and the disease, which is usually highly malignant and detected too late to treat, could and probably would soon return. Better surgical method can be chosen to minimize the surgical complications with enteric or bladder drainage. Advancement in immunosuppression has improved quality of life after transplantation.
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The most important reason for this fact is that this carcer can become resistant to Cisplatin, which is an important chemotherapy medication that disrupts the structure and function of DNA. Some studies have revealed that the expression of Pyrubate dehydrogenase kinase (PDK), which is an enzymatic regulator in some metabolic processes as glycolysis and oxidative phosphorilation, is increased in some tumors in colon or lung cancer. PDK2, has been identified as the most important encoding gene for the Cistaplin resistance in lung adenocarcinoma. The expression of this gene is dramatically elevated in high-grade lung adenocarcinoma and could be conversely correlated to the poor prognosis.
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As dental extractions are a major risk factor in ORN development, it was recommended to extract all teeth prior to radiotherapy. However, this is now discouraged as a treatment of choice and has many disadvantages. According to one study, the frequency of ORN pre-radiotherapy extractions and post-radiotherapy extractions are almost the same. Extractions of teeth of poor prognosis, usually less than five years is recommended and planning should take into account the likely future problems with oral care, for example if severe trismus develops and if dentures were to be prescribed, denture trauma may cause ORN. The patient’s wishes must also be taken into account.
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Canonical Wnt pathway activity is involved in the development of benign and malignant breast tumors. Its presence is revealed by elevated levels of β-catenin in the nucleus and/or cytoplasm, which can be detected with immunohistochemical staining and Western blotting. Increased β-catenin expression is correlated with poor prognosis in breast cancer patients. This accumulation may be due to factors such as mutations in β-catenin, deficiencies in the β-catenin destruction complex, most frequently by mutations in structurally disordered regions of APC, overexpression of Wnt ligands, loss of inhibitors and/or decreased activity of regulatory pathways (such as the Wnt/calcium pathway).
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It is not necessarily the length of the post within the root canal that provides for retention of the core, and thus the eventual crown, but rather the length of post that will exist within root structure that exists within surrounding bone. If the post is 16 mm long, but only extends 4 mm into root structure that is surrounded by solid bone, the restoration will have a poor prognosis. This consideration of crown-to-root ratio is essential when evaluating the tooth for a crown-lengthening procedure. In the picture at right, the two teeth on the extreme left and right are the ones under discussion.
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Because the burst suppression pattern is characteristic of inactivated brains, the pattern can be used as a marker for the level of coma a patient is in, with persistence of the pattern commonly associated with poor prognosis. When inducing coma to protect the brain post trauma, the pattern assists in maintaining the necessary level of coma so that no further damage occurs to the brain. The pattern is also used to test the ability of anesthetic arousal agents to induce emergence from comas. The burst suppression pattern can also be used to track ascent into and descent out of hypothermia through observing changes in the pattern.
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In the past, medulloblastoma was classified using histology, but recent integrated genomic studies have revealed that medulloblastoma is composed of four distinct molecular and clinical variants termed WNT/β-catenin, Sonic Hedgehog, Group 3, and Group 4. Of these subgroups, WNT patients have an excellent prognosis and group 3 patients have a poor prognosis. Also, a subgroup-specific alternative splicing further confirms the existence of distinct subgroups and highlights the transcriptional heterogeneity between subgroups. Amplification of the Sonic Hedgehog pathway is the best characterized subgroup, with 25% of human tumors having mutations in Patched, Sufu (Suppressor of Fused Homolog), Smoothened, or other genes in this pathway.
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Giant-cell lung cancers have long been considered to be exceptionally aggressive malignancies that grow very rapidly and have a very poor prognosis. Many small series have suggested that the prognosis of lung tumors with giant cells is worse than that of most other forms of non-small-cell lung cancer (NSCLC), including squamous cell carcinoma, and spindle cell carcinoma. The overall five-year survival rate in GCCL varies between studies but is generally considered to be very low. The (US) Armed Forces Institute of Pathology has reported a figure of 10%, and in a study examining over 150,000 lung cancer cases, a figure of 11.8% was given.
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Research has shown that the prognosis of long-term language abilities is determined by the initial severity level of aphasia within the first four weeks after a stroke. As a result, there is a poor prognosis for persons who retain a diagnosis of aphasia after one month due to limited initial language abilities. Nonetheless, in the first year post-stroke, patients with global aphasia showed improvement in their Western Aphasia Battery (WAB) scores from baseline. When compared to individuals with Broca’s, Wernicke’s, anomic, and conduction types of aphasia, those with Broca’s aphasia showed the best rate and extent of improvement followed by global aphasia.
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The King's College Criteria or the King's College Hospital criteria were devised in 1989 to determine if there were any early indices of poor prognosis in patients with acute liver failure. Acute liver failure is defined as the onset of encephalopathy (altered mental status) or coagulopathy (altered bleeding tendencies) within 26 weeks of a patient diagnosed with liver disease. Patients with hepatitis B acquired at birth, Wilson's disease and autoimmune hepatitis are included if their disease was identified within the past 26 weeks. These patients are very ill, and have a very high risk of dying of their illness without adequate treatment which may include liver transplantation.
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Cunningham Dax described how he selected patients: > "The operation was carried out with the primary object of relieving the most > disturbed patients in the hospital quite independently of their poor > prognosis. They formed a large proportion of the most violent, hostile, > noisy, excited, destructive or obscene cases in the hospital; the type who > distress their relatives, upset the other patients and consume the time and > energy which could be put to so much better purpose by the staff".E > Cunningham Dax and EJ Radley Smith 1943 The early effects of prefrontal > leucotomy on disturbed patients with mental illness of long duration. > Journal of Mental Science 89: 182–8.
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If the inciting defect in the heart is identified before it causes significant pulmonary hypertension, it can normally be repaired through surgery, preventing the disease. After pulmonary hypertension is sufficient to reverse the blood flow through the defect, however, the maladaptation is considered irreversible, and a heart–lung transplant or a lung transplant with repair of the heart is the only curative option. Transplantation is the final therapeutic option and only for patients with poor prognosis and quality of life. Timing and appropriateness of transplantation remain difficult decisions. 5-year and 10-year survival ranges between 70% and 80%, 50% and 70%, 30% and 50%, respectively.
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In medicine, the dense artery sign or hyperdense artery sign is an increased radiodensity of an artery as seen on computer tomography (CT) scans, and is a radiologic sign of early ischemic stroke. In earlier studies of medical imaging in patients with strokes, it was the earliest sign of ischemic stroke in a significant minority of cases. Its appearance portends a poor prognosis for the patient. The sign has been observed in the middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebral artery, and basilar artery; these have been called the dense MCA sign, dense PCA sign, dense vertebral artery sign, and dense basilar artery sign, respectively.
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Typhlitis is a medical emergency and requires prompt management. Untreated typhlitis has a poor prognosis, particularly if associated with pneumatosis intestinalis (air in the bowel wall) and/or bowel perforation, and has significant morbidity unless promptly recognized and aggressively treated. Successful treatment hinges on: # Early diagnosis provided by a high index of suspicion and the use of CT scanning # Nonoperative treatment for uncomplicated cases # Empiric antibiotics, particularly if the patient is neutropenic or at other risk of infection. In rare cases of prolonged neutropenia and complications such as bowel perforation, neutrophil transfusions can be considered but have not been studied in a randomized control trial.
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DIC is associated with a poor prognosis and a high mortality rate. There has been a recent challenge however to the basic assumptions and interpretations of the pathophysiology of DIC. A study of sepsis and DIC in animal models has shown that a highly expressed receptor on the surface of hepatocytes, termed the Ashwell-Morell receptor, is responsible for thrombocytopenia in bacteremia and sepsis due to Streptococcus pneumoniae (SPN) and possibly other pathogens. The thrombocytopenia observed in SPN sepsis was not due to increased consumption of coagulation factors such as platelets, but instead was the result of this receptor's activity enabling hepatocytes to ingest and rapidly clear platelets from circulation.
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The respiratory centre is responsible for generating and maintaining the rhythm of respiration, and also of adjusting this in homeostatic response to physiological changes. The respiratory center receives input from chemoreceptors, mechanoreceptors, the cerebral cortex, and the hypothalamus in order to regulate the rate and depth of breathing. Input is stimulated by altered levels of oxygen, carbon dioxide, and blood pH, by hormonal changes relating to stress and anxiety from the hypothalamus, and also by signals from the cerebral cortex to give a conscious control of respiration. Injury to respiratory groups can cause various breathing disorders that may require mechanical ventilation, and is usually associated with a poor prognosis.
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Additionally, the UPS also plays a role in inflammatory responses as regulators of leukocyte proliferation, mainly through proteolysis of cyclines and the degradation of CDK inhibitors. Lastly, autoimmune disease patients with SLE, Sjögren syndrome and rheumatoid arthritis (RA) predominantly exhibit circulating proteasomes which can be applied as clinical biomarkers. The protein 26S proteasome non-ATPase regulatory subunit 2 (Rpn1) which is encoded by PSMD2 has been identified as an important constituent of a signature associated with the acquisition of metastatic phenotype and poor prognosis in lung cancers. It was found that knockdown of PSMD2 decreased proteasome activity, and induced growth inhibition and apoptosis in lung cancer cell lines.
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As such, and because HSV is the most common cause of viral encephalitis, acyclovir is often administered as soon as possible to all patients suspected of having viral encephalitis even if the exact viral origin is not yet known. Viral resistance to acyclovir rarely occurs, primarily among the immunocompromised, in which case foscarnet should be used. Although not as effective, nucleoside analogs are used for other herpesviruses as well, such as acyclovir, with possible adjunctive corticosteroids for immunocompetent individuals, for varicella-zoster virus encephalitis and a combination of ganciclovir and foscarnet for cytomegalovirus encephalitis. Serial intracranial pressure (ICP) is important to monitor as elevated ICP is associated with poor prognosis.
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Subsequent studies showed that the disease is also occasionally associated with losses in the short arm of chromosome 8 at position 11.23 (8p11.23) which for unclear reasons are associated with a poor prognosis, and occasional losses at position 11l.2 in the q arm of chromosome 14 (14q11.2) which correlates with the ENKTCL-NT malignancy being of cytotoxic T cell origin. EBV-infected NK and T cells may also occasionally develop chromosome segregation errors during mitosis and consequently divide into daughter cells which possess too few or too many chromosomes and thereby exhibit chaotic losses or increases in the expression of the genes located on these chromosomes.
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All four had a poor prognosis with death expected within a few days and all four survived surgery. He carried out a number of Ross procedures, where the diseased aortic valve is replaced with the person's own pulmonary valve, particularly in growing children. It became a popular alternative to the surgical treatment of aortic valve disease in young adults and avoided the need for anticoagulation and repeated operations. Yacoub modified the operation by planning remodelling of the autograft root, the Ross-Yacoub procedure,Mark Ruzmetov, Karl F. Welke, Dale M. Geiss, Klay Buckley and Randall S. Fortuna (2014). “Failed Autograft After the Ross Procedure in Children: Management and Outcome”.
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In March, scientists, including an inventor of CRISPR, Jennifer Doudna, urged a worldwide moratorium on germline gene therapy, writing "scientists should avoid even attempting, in lax jurisdictions, germline genome modification for clinical application in humans" until the full implications "are discussed among scientific and governmental organizations". In October, researchers announced that they had treated a baby girl, Layla Richards, with an experimental treatment using donor T-cells genetically engineered using TALEN to attack cancer cells. One year after the treatment she was still free of her cancer (a highly aggressive form of acute lymphoblastic leukaemia [ALL]). Children with highly aggressive ALL normally have a very poor prognosis and Layla's disease had been regarded as terminal before the treatment.
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While Tregs normally make up only about 4% of CD4+ T cells, they can make up as much as 20–30% of the total CD4+ population around the tumor microenvironment. Although high levels of TILs were initially thought to be important in determining an immune response against cancer, it is now widely recognized that the ratio of Tregs to Teffectors in the tumor microenvironment is a determining factor in the success of the immune response against the cancer. High levels of Tregs in the tumor microenvironment are associated with poor prognosis in many cancers, such as ovarian, breast, renal, and pancreatic cancer. This indicates that Tregs suppress Teffector cells and hinder the body's immune response against the cancer.
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Whereas the prognostic relevance of 1p and 19q deletions is well established for anaplastic oligodendrogliomas and mixed oligoastrocytomas, the prognostic relevance of the deletions for low-grade gliomas is more controversial. In terms of low- grade gliomas, a recent study also suggests that 1p/19q co-deletion may be associated with a (1;19)(q10;p10) translocation which, like the combined 1p/19q deletion, is associated with superior overall survival and progression- free survival in low-grade glioma patients. Oligodendrogliomas show only rarely mutations in the p53 gene, which is in contrast to other gliomas. Epidermal growth factor receptor amplification and whole 1p/19q codeletion are mutually exclusive and predictive of completely different outcomes, with EGFR amplification predicting poor prognosis.
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The most important genetic alteration associated with poor prognosis in uveal melanoma is loss of an entire copy of Chromosome 3 (Monosomy 3), which is strongly correlated with metastatic spread. Gains on chromosomes 6 and 8 are often used to refine the predictive value of the Monosomy 3 screen, with gain of 6p indicating a better prognosis and gain of 8q indicating a worse prognosis in disomy 3 tumors. In rare instances, monosomy 3 tumors may duplicate the remaining copy of the chromosome to return to a disomic state referred to as isodisomy. Isodisomy 3 is prognostically equivalent to monosomy 3, and both can be detected by tests for chromosome 3 loss of heterozygosity.
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HHV8-positive diffuse large B-cell lymphoma, NOS (HHV8+ DLBCL, NOS; also termed HHV8-positive diffuse large B-cell lymphoma [HHV8+ DLBCL]) is a DLBCL in which Kaposi's sarcoma-associated herpesvirus- infected, medium- to large-size neoplastic B-cells that resemble lymphocytes or immunoblasts infiltrate lymph nodes (~80% of cases) and, when disseminated (20% of cases), the liver and spleen. This infiltration usually disrupts the normal architecture of the involved tissues. HHV8+ DLBCL develops in HIV- infected individuals in ~50% of cases, in individuals with multicentric Castleman disease, plasma cell variant in uncommon cases, and in individuals with Kaposi sarcoma in rare cases. HHV8+ DLBCL commonly takes an aggressive course and has a poor prognosis.
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While this study found that while there was a modest decrease in radiation dose delivery by digital mammography, the study concluded that the small dose increase should not prevent providers from using tomosynthesis given the evidence for potential clinical benefit. Tomosynthesis is also now Food and Drug Administration (FDA) approved for use in breast cancer screening. Digital breast tomosynthesis is associated with a higher detection of poor prognosis cancers compared to digital mammography. since it is able to overcome the primary limitation of standard 2D mammography which had a masking effect due to the overlapping fibroglandular tissue, whereas DBT is able to distinguish between benign and malignant features, particularly in dense breasts.
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MICA plays the role of stress-induced self-antigen and serves as a ligand for the KLRK1/NKG2D killer activation receptor. Engagement of NKG2D-MICA results in activation of effector cytolytic responses of T cells and NK cells against epithelial tumor cells (or other stressed cells) expressing MICA on their surface. As a defense mechanism, tumor cells are able to avoid recognition of MICA by the immune system through proteolytic shedding of the surface expressed protein by the cooperation of disulfide isomerase (ERp5) and ADAM (a disintegrin and metalloproteinase) and MMP (matrix metalloproteinase) proteases targeting membrane-proximal α3 domain. High levels of MICA in the serum of tumor patients are positively related to tumor size and poor prognosis.
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Together, these two systems disrupt tyrosine kinase signaling and hematopoietic gene transcription. Despite the extensively studied chromosomal abnormalities at the EVI1 locus, in anywhere from 10-50% of identified cases, EVI1 overexpression is detectable without any chromosomal abnormalities, indicating that there are other not-yet-understood systems, likely epigenetic, leading to EVI1 promoter activation. In many of these cases, it is noted that a variety of 5' transcript variants are detectable at relatively high levels. Clinical studies have shown that these variants (EVI1_1a, EVI1_1b, EVI1_1d, EVI1_3L) as well as the MDS1-EVI1 fusion transcript are all associated with poor prognosis and increased likelihood of rapid remission in cases of de novo AML.
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The most common form of extra-cranial solid tumor in children is neuroblastoma, which represents 8% to 10% of all childhood tumors. About 15% of all cancer-related deaths in the pediatric age group are related to this disease, with incidence of around 10.2 cases per million children younger than 15 years old and 500 new cases reported every year. 90% of these cases are diagnosed before 5 years of age, but 30% of them are found within the first year of life. The median age for the diagnosis of neuroblastoma is 22 months, being rare in adolescence and adulthood but showing poor prognosis when it does present in those age groups.
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The percentage of patients with minimal residual disease (stage 0-I) after chemotherapy was higher among basal-like (19 of 33, 58%) than HER2+/ER− (5 of 11, 45%). As an independent molecular subtype, BLBC's special biological behavior and poor prognosis attributes to its significance in the clinical research of breast cancer. BLBC has a high proliferative activity and strong invasiveness, suggesting that it is easier for recurrence and metastasis, and the overall survival period is significantly shortened. BLBC is easier to metastasize to brain and lung through blood vessels, but less to bone and liver, suggesting that tumors have unique metastasis mechanism and once metastasis occurs, the prognosis is very poor.
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Death from esophageal cancer per million persons in 2012 Esophageal cancer is the eighth most frequently diagnosed cancer worldwide, and because of its poor prognosis it is the sixth most common cause of cancer-related death. It caused about 400,000 deaths in 2012, accounting for about 5% of all cancer deaths (about 456,000 new cases were diagnosed, representing about 3% of all cancers). ESCC (esophageal squamous-cell carcinoma) comprises 60–70% of all cases of esophageal cancer worldwide, while EAC (esophageal adenocarcinoma) accounts for a further 20–30% (melanomas, leiomyosarcomas, carcinoids and lymphomas are less common types). The incidence of the two main types of esophageal cancer varies greatly between different geographical areas.
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They can exist in a quiescent state for many years, but the dormancy period can be interrupted to start proliferating uncontrollably and form metastases that cannot be treated. Cancer dormancy is often associated with minimal residual disease (MRD) where some tumor cells are left behind after a treatment and can persist either at the primary tumor site or as disseminated cells that are proliferating or dormant. MRD has been found in a widespread range of cancers including but not limited to: breast, prostate, colon, gastric, colon, pancreatic, head and neck, neuroblastoma, leukemia, melanoma, and others. These cells are often found in the bone marrow, but are also found in other organs and usually indicate poor prognosis for the patient.
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However, overexpression of HIF1A is cancer- and individual- specific, and depends on the accompanying genetic alternations and levels of pro- and anti-apoptotic factors present. One study on epithelial ovarian cancer shows HIF1A and nonfunctional tumor suppressor p53 is correlated with low levels of tumor cell apoptosis and poor prognosis. Further, early-stage esophageal cancer patients with demonstrated overexpression of HIF1 and absence of BCL2 expression also failed photodynamic therapy. While research efforts to develop therapeutic drugs to target hypoxia-associated tumor cells have been ongoing for many years, there has not yet been any breakthrough that has shown selectivity and effectiveness at targeting HIF1A pathways to decrease tumor progression and angiogenesis.
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It was found that melanoma inhibitory activity gene family members are frequently expressed in human tumors such as squamous cell carcinoma, esophageal squamous cell carcinoma, lung cancer with nodal or distant metastasis and cervical cancer. In addition, melanoma inhibitory activity gene family expression is also associated with poor prognosis among cancer patients overall. Nevertheless, further research is needed to determine the association between melanoma inhibitory family member expression and its diagnostic, prognostic and therapeutic relevance in clinical oncology. Additionally, a multi-locus genetic risk score study, based on a combination of 27 loci including the MIA3 gene, identified individuals at increased risk for both incidence and recurrent coronary artery disease events, as well as an enhanced clinical benefit from statin therapy.
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Because of its integral role in microtubule assembly and therefore mitosis, TPX2 is found to be overexpressed in different types of human cancers including hepatocellular carcinoma (HCC), medullary thyroid cancer, bladder carcinoma, and estrogen receptor-positive metastatic breast cancer and contributes to tumor growth and metastasis. In HCC, TPX2 has been shown to be positively correlated with poor prognosis, metastasis, and recurrence. Studies on TPX2 in HCC have also showed that TPX2 promotes tumoriogenesis and liver cancer cell growth by increasing tumor spheroid and diminishing cell growth inhibition, demonstrated by knocking out endogenous expression of TPX2 using TPX2 si-RNA. As a result, TPX2 has recently been a topic of interest for learning more about the relationship between mitotic errors and tumorigenesis, along with novel cancer therapies.
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The long-term outlook (prognosis) for people with cold agglutinin disease varies based on many factors including the severity of the condition, the signs and symptoms present in each person and the underlying cause. For example, people with cold agglutinin disease caused by bacterial or viral infections tend to have an excellent prognosis; in these cases, the symptoms typically disappear within 6 months after the infection has resolved. Mild to moderate primary (unknown cause) cold agglutinin disease can also be associated with a good prognosis if excessive exposure to the cold is avoided. Those with cold agglutinin disease caused by HIV infection or certain types of cancer generally have a poor prognosis due to the nature of the underlying condition.
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Another study have assessed the clinico-biological value of ICR in breast cancer, via the classification of around 8700 breast tumours and assessment of metastasis-free survival and pathological complete response to neoadjuvant chemotherapy. It has been proven that ICR signature is associated with metastasis-free survival and pathological response to chemotherapy. The increased enrichment of immune signature reflects the expression of cells including T cells, cytotoxic T cells, Th-1 cells, CD8+ T cells, Tγδ cells, and APCs; which defines tumours as immune-active and immune-silent. [7] Although being associated with poor- prognosis, the infiltration of immune cells in ICR4 tumours have resulted in a longer metastasis-free survival and better response to chemotherapy, proving the importance of immune reaction in breast cancer.
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IL-30 was identified as a cytokine able to condition, in an autocrine or paracrine manner, gene expression profile, at times the viability, motility, and invasiveness of breast cancer cells and to generate an inflammatory and prometastatic milieu supporting tumor growth and progression. High levels of IL-30 in myeloid derived cells of tumor-draining lymph nodes from breast cancer patients have also proven to be an independent predictor of poor prognosis, thus suggesting the involvement of IL-30, produced by the host’s immune cells, in conditioning tumor behavior and patient outcome. Directly and/or by subverting multiple oncogenes and tumor suppressor genes, IL-30 favors cancer cell proliferation, migration, and dissemination. That may boost cancer cell expression of cytokines and chemokines, which promote myeloid cell recruitment and tumor progression.
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Endoscopic image of linitis plastica, a type of stomach cancer where the entire stomach is invaded, leading to a leather bottle-like appearance with blood coming out of it Endoscopic images of the stomach cancer in early stage. Its histology was poorly differentiated adenocarcinoma with signet ring cells. Left above: normal, right above: FICE, left low: acetate stained, right low: AIM stained Stomach cancer is often either asymptomatic (producing no noticeable symptoms) or it may cause only nonspecific symptoms (symptoms that may also be present in other related or unrelated disorders) in its early stages. By the time symptoms occur, the cancer has often reached an advanced stage (see below) and may have metastasized (spread to other, perhaps distant, parts of the body), which is one of the main reasons for its relatively poor prognosis.
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Her team participated in further definition of the BRCA2 gene on chromosome 13, and found an Icelandic mutation, BRCA2 999del5, in a male breast cancer case at the end of 1995. This mutation proved to be common among Icelandic breast cancer patients of both sexes and was also linked to an increased risk of prostate cancer. Although risk of prostate cancer is much lower than risk of female breast cancer among carriers of this founder mutation, it was shown to be strongly associated with poor prognosis. International studies confirmed this association of BRCA2 mutations with aggressive prostate cancer and this was followed up by the EU funded IMPACT study Targeted prostate cancer screening that has led to a number of publications regarding prostate cancer in BRCA1 and BRCA2 mutation carriers.
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There is conflicting information over prognosis for the various subtypes, but it appears that the Nottingham prognostic index is valid and hence general prognosis is rather similar with other breast cancer of same stage, except that more aggressive treatment is required. Some types of triple-negative breast cancer are known to be more aggressive, with poor prognosis, while other types have very similar or better prognosis than hormone receptor positive breast cancers. Among breast cancer patients, 15–20% of women have been diagnosed as triple-negative, while the majority of TNBC patients have been found to be young women or women with a mutation in the BRCA1 gene. Pooled data of all triple-negative subtypes suggests that, with optimal treatment, 20-year survival rates are very close to those of hormone positive cancer.
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Epignathus diagnoses have a very poor prognosis or outcome with a death rate of 80–100% in newborn babies (either before delivery or shortly after delivery), primarily due to asphyxiation or suffocation from the tumor blocking the baby's airway. The course of the disease and outcome are dependent on many factors including size, location, and rate of development of the teratoma, all of which affect the magnitude of airway obstruction. Other complications such as the deformation of facial structure or deformation of jaw structure may impact the baby's ability to swallow and breathe, which may also negatively impact the prognosis as well. If the tumors are large, they might cause changes in the structure of face, nose and upper lips, to the point that they cannot be identified.
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The International Prognostic Index and more recently, the Index's age-adjusted variant use age >60 years, elevated serum lactate dehydrogenase levels, low performance status, and involvement in more than one extranodal site as contributors to a poor prognosis in patients with DLBCL, NOS. In addition, disease that initially involves the testes, breast, or uterus has a relatively high rate of spreading to the central nervous system while disease initially involving the kidneys, adrenal glands, ovaries, or bone marrow has a high rate of spreading to other organs, including the central nervous system. All of these cases as well as cases initially involving the central nervous system have relatively poor to very poor prognoses. Cases initially involving the stomach, thyroid, or a single bone site have relatively good prognoses.
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The 5-10% of DLBCL, NOS cases in which the neoplastic cells express CD5 have a very poor prognosis that is not improved by even aggressive treatment regimens. Cases in which fluorescence in situ hybridization analysis show that the neoplastic cells' in this disease bear translocations in both the MYC and BCL2 genes or MYC and BCL6 genes (termed double hit lymphomas) or in all three genes (termed triple hit lymphomas) are associated with advanced disease that spreads to the central nervous system. These lymphomas, termed high-grade B-cell lymphoma with MYC, BL2, and/or BL6 rearrangements or, more simply, DH/THL, are regarded as borderline DLBCL,NOS. They represent 6-14% of all DLBCL, NOS and have had long-term survival rates of only 20-25%.
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In DLBCL, NOS variants which trend to spread or to the central nervous system, methotrexate has been recommended to be added to regimens not containing it for use as prophylaxis to reduce the incidence of this complication. The role of Autologous stem-cell transplantation as an addition to first-line therapy in the treatment of DLBCL, NOS, including cases with a poor prognosis, is unclear. A phase I clinical research trial found that the addition of lenalidomide to the R-CHOP regimen produce an ~80% complete response rate in GBC as well as non- GBC DLBCL, NOS variants. Two phase III clinical research trials are underway to confirm these results and determine if the R-CHOP + lenalidomide regimen is superior to R-CHOP in the up-front treatment of GBC and/or non-GBC variants.
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Percutaneous aortic valve replacement (PAVR), also known as percutaneous aortic valve implantation (PAVI), transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR), is the replacement of the aortic valve of the heart through the blood vessels (as opposed to valve replacement by open heart surgery). The replacement valve is delivered via one of several access methods: transfemoral (in the upper leg), transapical (through the wall of the heart), subclavian (beneath the collar bone), direct aortic (through a minimally invasive surgical incision into the aorta), and transcaval (from a temporary hole in the aorta near the belly button through a vein in the upper leg), among others. Severe symptomatic aortic stenosis carries a poor prognosis. No medical cure exists today, making the timing of aortic valve replacement the most important decision to make for these patients.
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University of the West Indies Mona Campus, Jamaica Following a successful application for a post as senior lecturer at the then new University College of the West Indies, advertised in the British Medical Journal in 1952, he moved with his family to Jamaica. With respiratory disease of less interest in Jamaica, he focused his attention on diabetes, a disease traditionally thought of as one disease on a spectrum. However, a need for a classification had been noted by the French researchers Apollinaire Bouchardat and E. Lancereux between 1850 and 1875. They distinguished between those diabetics that were lean, had severe symptoms, a poor prognosis and pancreatic lesions at autopsy (diabetes maigre), and those that were overweight, presented later in life with a milder form of the disease and had a better prognosis if put on a low calorie diet (diabetes gras).
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The intensity of IL-6 in cancer cells from people with ovarian cancer is associated with poor prognosis, and in cell culture a different anti-IL-6 antibody (siltuximab) reduced IL-6 signaling and showed favorable effects in an animal model of the disease; however, the drug showed no clear effects when tested in a phase II clinical trial in people with advanced ovarian cancer. The trial investigators later showed that in high-grade ovarian cancer cells, anti-IL6 antibodies reduced the activation of STAT3 (its major downstream transcription factor), leading to increased activity of the epidermal growth factor receptor (EGFR) pathway, which is thought to confer resistance to several cancer therapies. The investigators then showed that inhibiting this pathway with the EGFR inhibitor gefitinib inhibited tumor growth was in cell culture and animals of the disease, offering a potential rationale for combining anti-IL6 antibodies with gefitinib to treat advanced- stage ovarian cancer. Tocilizumab is being studied for pulmonary arterial hypertension (PAH).
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Khuri is particularly well known for the research projects he led to develop molecularly targeted therapy for lung and aerodigestive cancer prevention and treatment. Khuri has authored more than 350 peer-reviewed articles and more than 50 editorials and perspectives in leading journals. He has also written more than 100 reviews and book chapters. Among his most important and most frequently cited publications are “A controlled trial of intratumoral ONYX-015, a selectively- replicating adenovirus, in combination with cisplatin and 5-fluorouracil in patients with recurrent head and neck cancer,” Nature Medicine (6:879-885, 2000), “Cyclooxygenase-2 overexpression is a marker of poor prognosis in stage I non-small cell lung cancer,” Clinical Cancer Research (7:861-867, 2001), “Phase I study of the farnesyl transferase inhibitor lonafarnib with paclitaxel in solid tumors,” Clinical Cancer Research (10:2968-76, 2004), “Activation of Akt and eIF4E survival pathways by rapamycin-mediated mammalian target of rapamycin inhibition,” Cancer Research (65:7052-7058, 2005), and “Randomized phase III trial of low-dose isotretinoin for prevention of second primary tumors in stage I and II head and neck cancer patients,” Journal of the National Cancer Institute (98:441-450, 2006).
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When eye melanoma is spread to distant parts of the body, the five-year survival rate is about 15%. Several clinical and pathological prognostic factors have been identified that are associated with higher risk of metastasis of uveal melanomas. These include large tumor size, ciliary body involvement, presence of orange pigment overlying the tumor, and older patient age. Likewise several histological and cytological factors are associated with higher risk of metastasis, including presence and extent of cells with epithelioid morphology, presence of looping extracellular matrix patterns, increased infiltration of immune cells,, and staining with several immunohistochemical markers. The most important genetic alteration associated with poor prognosis in uveal melanoma is inactivation of BAP1, which most often occurs through mutation of one allele and subsequent loss of an entire copy of chromosome 3 (monosomy 3) to unmask the mutant copy. Because of this function in inactivation of BAP1, monosomy 3 correlates strongly with metastatic spread Where BAP1 mutation status is not available, gains on chromosomes 6 and 8 can be used to refine the predictive value of the monosomy 3 screen, with gain of 6p indicating a better prognosis and gain of 8q indicating a worse prognosis in disomy 3 tumors.
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