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Four Year Prognostic Index

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161. Fifty-Year Follow-up of Late-Detected Hip Dislocation: Clinical and Radiographic Outcomes for Seventy-one Patients Treated with Traction to Obtain Gradual Closed Reduction. (Abstract)

replacement, performed at a mean patient age of 43.7 years (range, thirty-one to fifty-four years). Risk factors for osteoarthritis were an older age at the time of reduction, osteonecrosis of the femoral head, residual subluxation, a high acetabular index during childhood, and a classification of Severin grades III or IV at skeletal maturity. A survival analysis showed a reduction in "surviving" hips (no total hip replacement) from 99% at a patient age of thirty years to 74% at the age of fifty-two (...) Fifty-Year Follow-up of Late-Detected Hip Dislocation: Clinical and Radiographic Outcomes for Seventy-one Patients Treated with Traction to Obtain Gradual Closed Reduction. There is little knowledge concerning outcomes for middle-aged adults who were treated for late-detected developmental dislocation of the hip. The aims of this retrospective study were to evaluate the fifty-year clinical and radiographic results after closed reduction and to identify prognostic factors.Seventy-one patients

2014 The Journal of Bone and Joint Surgery. American Volume

162. A Study to Evaluate the Safety of Two Influenza Vaccines in Children and Adolescents 3 to <18 Years of Age at Risk for Influenza-Related Complications

of the subjects (3 to <6 years,(≥ 6 to < 9 years and 9 to <18 Years of age) who reported solicited local, systemic AEs as well as other solicited AEs after receiving one or two doses of either TIVc or TIV Number of Subjects Reporting Unsolicited Adverse Events Following Vaccination With Either TIVc or TIV by Overall Age Group and Age Sub-strata [ Time Frame: Day 1 -Day 181(one dose group) Day 1 -Day 209(two dose group) ] Safety was assessed in terms of number of subjects who reported any unsolicited AEs (four (...) A Study to Evaluate the Safety of Two Influenza Vaccines in Children and Adolescents 3 to <18 Years of Age at Risk for Influenza-Related Complications A Study to Evaluate the Safety of Two Influenza Vaccines in Children and Adolescents 3 to <18 Years of Age at Risk for Influenza-Related Complications - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved

2013 Clinical Trials

163. Arthroscopic Treatment of Osteochondral Defects of the Talus: Outcomes at Eight to Twenty Years of Follow-up. (Abstract)

Arthroscopic Treatment of Osteochondral Defects of the Talus: Outcomes at Eight to Twenty Years of Follow-up. The primary aim of this study was to assess the long-term clinical and radiographic outcomes of arthroscopic debridement and bone marrow stimulation for talar osteochondral defects. The secondary aim was to identify prognostic factors that affect the long-term results.Fifty (88%) of fifty-seven eligible patients with a primary osteochondral defect treated with arthroscopic debridement (...) with population norms and two were superior in the study group. Ninety-four percent of patients had resumed work and 88% had resumed sports. The radiographs indicated an osteoarthritis grade of 0 in 33% of the patients, I in 63%, II in 4%, and III in 0%. Compared with the preoperative osteoarthritis classification, 67% of radiographs showed no progression and 33% showed progression by one grade. None of the prognostic factors was significantly associated with the Ogilvie-Harris score or progression

2013 The Journal of Bone and Joint Surgery. American Volume

164. Evaluation of 9 biomarkers for predicting 10-year cardiovascular risk in patients undergoing coronary angiography: findings from the LUdwigshafen RIsk and Cardiovascular Health (LURIC) study. Full Text available with Trip Pro

. Four biomarkers (interleukin-6, neutrophils, von Willebrand factor, and 25-hydroxyvitamin D) were retained during stepwise selection procedures for subsequent analyses. Simultaneous inclusion of these biomarkers significantly improved discrimination as measured by the C-index (0.78, P = 0.0001), and integrated discrimination improvement (0.0219, P<0.0001). Collectively, these biomarkers improved net reclassification for cardiovascular death by 10.6% (P<0.0001) when added to the conventional risk (...) Evaluation of 9 biomarkers for predicting 10-year cardiovascular risk in patients undergoing coronary angiography: findings from the LUdwigshafen RIsk and Cardiovascular Health (LURIC) study. Conventional factors do not fully explain the distribution of cardiovascular outcomes. Biomarkers are known to participate in well-established pathways associated with cardiovascular disease, and may therefore provide further information over and above conventional risk factors. This study sought

2013 International journal of cardiology

165. LIPOPROTEINS AND DIET IN CORONARY HEART DISEASE—A Five-Year Study Full Text available with Trip Pro

LIPOPROTEINS AND DIET IN CORONARY HEART DISEASE—A Five-Year Study In a follow-up study for a five-year period of 351 patients with myocardial infarction and 119 patients with angina pectoris, the following observations were made:(a) The previously reported lipoprotein atherogenic index elevation in coronary heart disease was confirmed.(b) The prognosis in angina pectoris is strikingly and significantly worse when the lipoprotein atherogenic index is high.(c) Patients who died in the follow-up (...) period showed significantly higher atherogenic index values than those who survived.(d) The lipoprotein atherogenic index measure is much superior to the serum cholesterol measurement as an indicator of the lipid disorder in coronary disease.(e) The low fat, low cholesterol diet is effective in maintaining chronically lowered lipoprotein atherogenic index values.(f) In patients who said they did not adhere to a low fat, low cholesterol diet, the recurrence and death rate was four times as high

1956 California Medicine

166. Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction: A Target of Phosphodiesterase-5 Inhibition in a 1-Year Study Full Text available with Trip Pro

Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction: A Target of Phosphodiesterase-5 Inhibition in a 1-Year Study The prevalence of heart failure with preserved ejection fraction is increasing. The prognosis worsens with pulmonary hypertension and right ventricular (RV) failure development. We targeted pulmonary hypertension and RV burden with the phosphodiesterase-5 inhibitor sildenafil.Forty-four patients with heart failure with preserved ejection fraction (heart failure (...) (+17.0±8.3%), and reduced right atrial pressure (-54.0±7.2%). These effects may have resulted from changes within the lung (reduced lung water content and improved alveolar-capillary gas conductance, +15.8±4.5%), the pulmonary vasculature (arteriolar resistance, -71.0±8.2%), and left-sided cardiac function (wedge pulmonary pressure, -15.7±3.1%; cardiac index, +6.0±0.9%; deceleration time, -13.0±1.9%; isovolumic relaxation time, -14.0±1.7%; septal mitral annulus velocity, -76.4±9.2%). Results were

2011 EvidenceUpdates Controlled trial quality: uncertain

167. Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused Dr. Smith's ECG Blog: Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused Wednesday, October 26, 2011 These 4 recent cases illustrate acute and subacute MI with reperfusion and absence of reperfusion (or failed reperfusion). QS-waves and depth of T-wave inversion are very helpful in determining the duration of injury (the "acuteness (...) immediately after reperfusion , illustrating how hyperacute T-waves are present BOTH shortly after occlusion (when ST segments are on the way up) and shortly after reperfusion (when ST segments are on the way down). 4. A 51 year old male with h/o stent presented with 30 minutes of chest pain: Obvious anterolateral very acute STEMI with hyperacute T-waves He went for immediate PCI, with successful reperfusion of a 100% occluded proximal LAD, and a door to balloon time of 35 minutes . This was recorded 2.5

2011 Dr Smith's ECG Blog

168. COVID-19 rapid evidence summary: vitamin D for COVID-19

Government advises that everyone needs vitamin D equivalent to an average daily intake of 10 micrograms (400 international units). They advise that all people should consider taking a daily supplement containing 10 micrograms vitamin D during autumn and winter months. They also advise that people whose skin has little to no exposure to sunlight and ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds, should consider taking a vitamin D supplement all year round (...) , people with vitamin D deficiency may also be prescribed higher therapeutic doses of vitamin D. Factors for decision making Factors for decision making Effectiveness and safety Effectiveness and safety Evidence was from 5 published studies in peer-reviewed journals. One observational cohort study (D'Avolio et al. 2020), 3 observational prognostic studies involving published data sets using correlation or regression (Hastie et al. 2020, Ilie et al. 2020 and Laird et al. 2020) and 1 case- control survey

2020 National Institute for Health and Clinical Excellence - Advice

169. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement Full Text available with Trip Pro

aortic valve replacement (SAVR) in patients with pre-procedural chronic kidney disease (CKD).A total of 213 patients (mean age 82 +/- 8 years) undergoing TAVI for the treatment of severe aortic stenosis were included in the study. Acute kidney injury was defined as a reduction of >25% in estimated glomerular filtration rate (eGFR) within 48 h following the procedure or the need for haemodialysis during index hospitalization. Those patients with pre-procedural CKD (eGFR <60 mL/min/1.73 m(2), n = 119 (...) Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement Very few data exist on the occurrence of acute kidney injury (AKI) associated with transcatheter aortic valve implantation (TAVI). The objectives of the present study were (i) to determine the incidence, predictive factors, and prognostic value of AKI following TAVI, and (ii) to compare the occurrence of AKI in TAVI vs. surgical

2010 EvidenceUpdates

170. Evidence review: Assessment of COVID-19 in primary care

– addition of ‘significantly associated with death’ Immunosuppressive conditions – new category created Solid organ transplants – new category created Table 3: published revisions to preprint evidence Section 6.2.1: new section added on updates to literature review Section 6.5: new peer reviewers contributing to updated version of synthesis added Contents Introduction 1 KEY FINDINGS 2 1. Signs and symptoms 3 2. Prognostic Tools 4 3. Clinical measures 15 4. Method of patient consultation 16 5. Sources (...) requiring immediate assessment and yellow flags for those at a higher risk of deterioration (eg certain comorbidities). We conducted a search for new evidence on prognostic indicators, risk factors and clinical measures to identify people self- managing symptoms of COVID-19 in the community whose symptoms may change or worsen, and therefore may require monitoring or clinical intervention after their initial presentation to primary care. The research question and methodology can be found in section 6. 2

2020 SIGN

171. Risk for poor outcomes in older patients discharged from an emergency department: feasibility of four screening instruments. Full Text available with Trip Pro

Risk for poor outcomes in older patients discharged from an emergency department: feasibility of four screening instruments. To compare the prognostic value of four screening instruments used to detect the risk for poor outcomes [in terms of likelihood of recurrent emergency department (ED) visits, hospitalizations, or mortality] for older patients discharged home from an ED in the Netherlands.This is a prospective cohort study, which included all consecutive patients of at least 65 years (...) discharged from the ED of a university teaching hospital in the Netherlands, between 1 December 2005, and 1 November 2006. Four screening instruments were tested: the identification of seniors at risk, the triage risk screening tool, and the Runciman and Rowland questionnaires. The cutoff of the Runciman questionnaire was adapted and the age cutoff was adapted for the other instruments. Recurrent ED visits, subsequent hospitalization, and mortality within 30 and 120 days after the index visit were

2011 European Journal of Emergency Medicine

172. Genome-Wide Sequencing for Unexplained Developmental Disabilities or Multiple Congenital Anomalies

- effectiveness of whole exome and whole genome sequencing used at various times in the diagnostic pathway (e.g., first tier, second tier, after standard testing) versus standard testing. We also estimated the budget impact of publicly funding genome-wide sequencing in Ontario for the next 5 years. Results Forty-four studies were included in the clinical evidence review. The overall diagnostic yield of genome-wide sequencing for people with unexplained development disability and multiple congenital anomalies (...) , metabolic, and genetic tests over a period of years without diagnosis. Genome-wide sequencing, as whole exome or whole genome sequencing, can examine the entire genetic makeup of a person in a single test, capturing genetic information that other genetic tests (such as targeted gene tests) can miss. A genetic diagnosis can help these people and their families better understand their condition and help them connect with others who have the same condition. This health technology assessment looked at how

2020 Health Quality Ontario

173. Cell-Free Circulating Tumour DNA Blood Testing to Detect EGFR T790M Mutation in People With Advanced Non–Small Cell Lung Cancer

long-term costs (i.e., treatment and care) and effects (i.e., life-years and quality-adjusted life-years [QALYs]), liquid biopsy as a triage test was the most effective and most costly strategy followed by liquid biopsy alone. Tissue biopsy alone was the least effective and least costly strategy. The incremental cost-effectiveness ratios (ICERs) of liquid biopsy as a triage test compared with liquid biopsy alone and of liquid biopsy alone compared with tissue biopsy alone were greater than $100,000 (...) per QALY. However, this result was largely driven by the cost of osimertinib, which was used more often when liquid biopsy was used as a triage test. March 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 5, pp. 1–176, March 2020 4 We estimated that the total annual budget impact of publicly funding liquid biopsy as a triage test in Ontario over the next 5 years would range from approximateily $60,000 in year 1 to $3 million in year 5. People with lung cancer with whom we spoke said

2020 Health Quality Ontario

174. Gene Expression Profiling Tests for Early-Stage Invasive Breast Cancer

of LNs, HER2 status, Ki-67 status, and general chemotherapy regimen to predict 5- and 10-year survival. 9 The NPI incorporates tumour size, the number of LNs, and tumour grade. 11 Prognosis worsens as the NPI value increases and cut- off points are used to categorize people into good, moderate, and poor prognostic groups. NPI+ is an adaption of the NPI test that considers the breast cancer’s molecular subtype. 10 Adjuvant! Online (AOL), 12 a free online tool that prognosticates a person’s 10-year (...) Series; Vol. 20: No. 10, pp. 1–234, March 2020 9 LIST OF TABLES Table 1: Characteristics of the Four Major Molecular Subtypes of Breast Cancer 12 Table 2: Test Characteristics of EndoPredict, MammaPrint, Oncotype DX, and Prosigna (PAM50) 15 Table 3: Prognostic Ability of GEP Tests in a Lymph-Node–Negative Population 28 Table 4: Predictive Ability of GEP Tests in a Lymph-Node–Negative Population 33 Table 5: Changes in Treatment Recommendations in a Lymph-Node–Negative Population 36 Table 6: Physician

2020 Health Quality Ontario

175. Transcatheter Aortic Valve Implantation in Patients With Severe, Symptomatic Aortic Valve Stenosis at Intermediate Surgical Risk

that the prevalence of severe aortic valve stenosis in people over age 75 years was 3.4%, and three-quarters of cases were symptomatic. 6 Based on a cohort of patients who underwent surgery in the United States, about 14% of patients with severe aortic valve stenosis are at intermediate surgical risk. 7 Severe, symptomatic aortic valve stenosis is associated with a poor prognosis: without aortic valve replacement, a person’s estimated life expectancy is less than 5 years, 2 and more than half of patients will die (...) stenosis, TAVI was noninferior to SAVR with respect to the composite endpoint of all-cause mortality or disabling stroke within 2 years of follow-up (GRADE: High). However, compared with SAVR, TAVI had a higher risk of some complications and a lower risk of others. Device-related costs for TAVI (approximately $23,000) are much higher than for SAVR (approximately $6,000). Based on two published cost-effectiveness analyses conducted from the perspective of the Ontario Ministry of Health, TAVI was more

2020 Health Quality Ontario

176. Locoregional Management of In-Transit Metastasis in Melanoma

uninjected non-visceral lesions. Median overall survival (OS) was 23.3 months versus 18.9 months (hazard ratio [HR]=0.79; 95% confidence interval [CI] 0.62 to 1.00, p=0.0494) and four-year OS was 34.5% versus 23.9%. Complete response occurred in 16.9% versus 0.7% of patients and PR occurred in 14.6% versus 5.7% of patients. Grade >3 AEs occurred in 11.3% versus 4.7% of patients. The only grade 3 or 4 AE occurring in >2% of patients was cellulitis (T-VEC, n=6 [2.1%]).Of patients treated with T-VEC, those (...) may be a prognostic indicator of disseminated disease. Five-year survival rates range widely and are largely dependent on associated metastases to the surrounding lymph nodes [8]. Patients with ITM commonly experience severe morbidity including pain, bleeding, and infection, particularly if numerous large lesions exist with ulceration of the tumours [8,50]. Resection of the ITM is the preferred treatment. If resection is not possible there is little high-quality evidence to suggest which

2020 Cancer Care Ontario

177. Portable Normothermic Cardiac Perfusion System in Donation After Cardiocirculatory Death

the next 5 years would cost about $5.6 million. Although the people we spoke with had no direct experience with a perfusion system, people waiting for a heart transplant expressed hope that the technology could increase the potential donor pool. Family members of organ donors believed the technology could increase the likelihood of a successful heart transplant. February 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 3, pp. 1–90, March 2020 2 ACKNOWLEDGMENTS This report was developed (...) transplantation. We assessed the risk of bias of each included study and the quality of the body of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also reviewed the economic evidence published during the same time period for the cost-effectiveness of a portable normothermic cardiac perfusion system for DCD hearts compared with cold storage for NDD hearts. We further estimated the 5-year net budget impact of publicly funding

2020 Health Quality Ontario

178. 10-kHz High-Frequency Spinal Cord Stimulation for Adults With Chronic Noncancer Pain

types of spinal cord stimulation would save about $0.73 million over the next 5 years in Ontario. People with chronic noncancer pain said that their pain affected their ability to do daily activities and affected their emotional well-being. They said that spinal cord stimulation reduced their pain, allowing them to function better. March 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 6, pp. 1–109, March 2020 2 ACKNOWLEDGMENTS This report was developed by a multidisciplinary team from (...) . Methods We performed a systematic literature search of the clinical evidence. We assessed the risk of bias of each included study using the Cochrane Risk of Bias and ROBINS-I tools and the quality of the body of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We performed a systematic economic literature search. We analyzed the 5-year budget impact of publicly funding 10-kHz high-frequency SCS in Ontario for adults

2020 Health Quality Ontario

179. 5-Aminolevulinic Acid Hydrochloride (5-ALA)–Guided Surgical Resection of High-Grade Gliomas

of disease. The incidence of high-grade gliomas is approximately 3 to 5 per 100,000 March 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 9, pp. 1–92, March 2020 11 people, with incidence increasing with age. The median age of onset for glioblastomas is 64 years, peaking between 75 and 85 years. 10 Grade III gliomas occur in a younger population than glioblastoma, with a mean age of diagnosis in the fourth or fifth decade of life. 11 Prognosis Despite improvements in both the diagnosis (...) survival. There is uncertainty regarding the impact of 5-ALA on adverse events after surgical resection. We estimate that publicly funding 5-ALA–guided surgical resection in Ontario over the next 5 years would result in a budget impact of about $930,000 in year 1 to about $1,765,000 in year 5, yielding a total 5-year budget impact of about $7,500,000. A participant with high-grade glioma reported a positive experience with 5-ALA and felt more satisfied with the 5-ALA–guided resection compared

2020 Health Quality Ontario

180. Routine Human Papilloma Virus (HPV) Testing in Squamous Cell Head and Neck Cancer

) or DSS was seen in HPV-positive versus negative patients with non-oropharyngeal tumours. Justification for Recommendation 1 There is evidence from a meta-analysis of randomized trials that HPV-positivity is a strong predictor of prognosis in patients with oropharyngeal squamous cell carcinoma. In addition, it is likely that HPV status will influence management decisions in the near future and is now regarded as a mandatory stratification factor for clinical trials. Therefore, even though at this time (...) no recommendation can be made to base clinical management decisions on HPV status, the valuable prognostic benefits of HPV testing are sufficient to warrant routine testing. Qualifying Statements for Recommendation 1 ? The above recommendation only applies to patients with squamous cell carcinoma of the oropharynx, which includes tonsil, base of tongue, soft palate and associated pharyngeal walls. The data and recommendation do not apply to patients with non- oropharyngeal cancers. ? Altering management

2020 Cancer Care Ontario

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