• 제목/요약/키워드: risk stratification

검색결과 165건 처리시간 0.027초

A Cyclin D1 (CCND1) Gene Polymorphism Contributes to Susceptibility to Papillary Thyroid Cancer in the Turkish Population

  • Aytekin, Turkan;Aytekin, Alper;Maralcan, Gokturk;Gokalp, M. Avni;Ozen, Dogukan;Borazan, Ersin;Yilmaz, Latif
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7181-7185
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    • 2014
  • Cyclin D1 is an important positive regulator of the G1/S phase of the cell cycle. We investigated the association between the CCND1 G870A polymorphism and susceptibility to papillary thyroid cancer in Turkish people. This study covered 102 patients with papillary thyroid cancer and 174 healthy controls. CCND1 genotyping was determined by the PCR-RFLP method. We found that the A allele frequency was higher in the cases than in the controls (p=0.042). On stratification analysis, papillary thyroid cancer risk was significantly elevated in individuals older than 45 years with the A allele (OR=1.91, 95% CI, 1.09-3.35, p=0.024) and in females with the A allele (OR=1.73, 95% CI, 1.06-2.84, p=0.029), compared to the G allele. According to the subject age, there was an increased papillary thyroid cancer risk for the individuals older than 45 years with the AA genotype (OR=2.28, 95% CI, 1.02-5.13, p=0.046) compared to the AG+GG combined genotypes. In conclusion, it is suggested that the CCND1 G870A polymorphism may contribute to the susceptibility to papillary thyroid cancer, especially in those who were older subjects ($45{\leq}$ years old) and female, in the Turkish population.

ZAP-70 Protein Expression in B-cell Chronic Lymphoid Leukemia: a Single Center Experience from Pakistan

  • Zeeshan, Rozina;Irfan, Syed Mohammed;Sultan, Sadia;Bhimani, Sanjana
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1587-1590
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    • 2015
  • Background: Chronic lymphoid leukemia (CLL) is the most frequent type of adult leukemia. The Rai and Binet staging systems have been well recognized as standards for assessing the treatment requirements and overall survival in CLL patients. However, there is a need to seek newer prognostic markers to identify stable or progressive forms of CLL that will facilitate risk-adapted treatment strategies. Currently a molecular biomarker ZAP-70 has attracted interest as providing prognostic information in CLL patients. Objective: To determine the frequency of ZAP-70 positivity in B-CLL patients at disease presentation. Materials and Methods: From January 2011 to September 2014, 89 patients were diagnosed to have chronic lymphoid leukemia. Complete blood count was done on an automated analyzer (Cell Dyne, Abott Architect, USA), while immunophenotyping was conducted for each patient to establish the diagnosis of the disease. ZAP-70 expression was evaluated by flow cytometry. Data were compiled and analyzed by SPSS version 21. Results: Out of the total of 89 B-CLL patients, 62 (69.7%) were male and 27 (30.3%) were females with a male to female ratio of 2:1. The mean age was $57.5{\pm}12.1years$. The frequency of ZAP-70 positivity in our B-CLL patients was found to be 13.5%. ZAP-70 positivity was significantly correlated with stage III disease and high absolute lymphocytic count (P<0.05). No correlation of ZAP-70 could be established with age and gender (p>0.05). Conclusions: The frequency of ZAP-70 in our patients appears low. It is approximately half that in international data. We would recommend to screen all the newly diagnosed patients with CLL for ZAP-70 protein expression for risk stratification, family counseling and to predict overall survival.

Cytogenetic and Genetic Mutation Features of de novo Acute Myeloid Leukemia in Elderly Chinese Patients

  • Su, Long;Li, Xian;Gao, Su-Jun;Yu, Ping;Liu, Xiao-Liang;Tan, Ye-Hui;Liu, Ying-Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.895-898
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    • 2014
  • Objectives: The present study aimed to examine the cytogenetic and genetic mutation features of acute myeloid leukemia (AML) in elderly Chinese patients. Methods: A retrospective analysis of cytogenetics and genetic mutations was performed in 113 cases (age range 50-82 years) with de novo AML. Results: The most frequent cytogenetic abnormality was t (15;17) (q22;q21), detected in 10.0% (n = 9) of successfully analyzed cases, followed by t (8;21) (q22;q22) in 8.89% (n = 8), and complex karyotypes in 5.56% (n = 5). Those with complex karyotypes included 4 cases (4.44%) of monosomal karyotypes. The frequencies of NPM1, FLT3-ITD, c-kit, and CEBPA mutations were 27.4% (31/113), 14.5% (16/110), 5.88% (6/102), and 23.3% (7/30), respectively. The complete remission rates of patients in low, intermediate, and high risk groups were 37.5%, 48.6%, and 33.3%, respectively (${\chi}^2$ = 0.704, P = 0.703) based on risk stratification. Conclusion: Cytogenetics and genetic mutations alone may not be sufficient to evaluate the prognoses of elderly AML patients. The search for a novel model that would enable a more comprehensive evaluation of this population is therefore imperative.

Serum Hepatitis a Antibody Positivity Correlates with Higher Pancreas Cancer Mortality in Adults: Implications for Hepatitis Vaccination in High Risk Areas

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2707-2710
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    • 2013
  • Background: This study used pre-hepatitis A vaccination era data in U.S. to study the relationship between serum hepatitis A antibody positivity with pancreas cancer mortality in adults. Patients and Methods: Public use National Health and Nutrition Examination Survey (NHANES III) data were employed. NHANES III uses complex probabilistic methods to sample nationally representative samples. Household adult laboratory and mortality data were merged. Sample persons who were available to be examined in the Mobile Examination Center (MEC) were included in this study. All results were obtained by using specialized survey software taking into account the primary sampling unit and stratification variables and the weights assigned to the sample persons examined in the MEC. Thus they are representative of the U.S. population. Results: The mean risk (95%CI) of death in the study population for pancreas cancer was 0.0014 (-0.000069 -.0029); their mean age (95%CI) at the mobile examination center (MXPAXTMR) was 473.43 (463.85-482.10); the follow up in months from their medical examination (permth_exm) was 170.12 (164.17-176.07). The odds ratios (S.E.) of the statistically significant univariables were: age, 1.007 (1.005-1.009); serum anti-hepatitis antibody status, 0.038 (0.004-0.376); and drinking hard liquor, 1.014 (1.004-1.023). The coefficients (S.E.) of the statistically significant variables after multivariate analysis were 0.006 (0.002-0.010) for age and -2.528 (-4.945--0.111) for serum anti-hepatitis A antibody negativity (using serum anti-hepatitis A antibody positivity as a reference). Conclusion: Serum hepatitis A antibody positivity correlates with higher pancreas cancer mortality in adults.

Smoking, Meat Intake and Exercise related to Alcohol Use

  • Lee, Miok;Lee, Kwang Ok;Jung, Myoungjee
    • 한국컴퓨터정보학회논문지
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    • 제23권6호
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    • pp.51-58
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    • 2018
  • This study was conducted to investigate the relationship between drinking, smoking, meat intake, and exercise. The participants were 1,060 males and females who voluntarily responded to the survey by visiting the health promotion booth at the H Festival held in C city in 2014. Research data were collected in interview form using questionnaires on alcohol use, smoking, exercise, and meat intake. The data were analyzed by descriptive analysis, cross tabulation analysis, multinominal logistic regression after stratification of gender using the SPSS 24 program. The results of the study are as follows: Smokers had a significantly higher frequency of drinking ($x^2=163.33$, p<.001) than non-smokers. Meat intake was high when alcohol use was high ($x^2=35.13$, p<.001). The risk rates for smoking, meat consumption, and exercise related to alcohol use are as follows. The smoking was higher as the frequency of drinking increased. For men, smoking OR(odd ratio) was 6.26 (p=.001) and for women, smoking risk OR was 16.82 (p=.002). Meats intake showed a higher OR as the alcohol use increased. The OR of almost daily ingestion of meat at frequent drinking days was 4.40 (p=.002) for males and 4.52(p=.009) for females. As the frequency of drinking increased, the OR of days of exercise tended to decrease. In men, the OR was 0.36 (p=.003), the lowest in the probability of exercising more than 5 days when drinking high. In the case of women drinking less than once a week, the OR was 0.43 (p=.027), which was the lowest for exercise for 5 days or more. In conclusion, the higher the frequency of drinking, the higher the smoking and meat intake, and the less exercise. If drinking, smoking, and meat intake are high but there is a lack of exercise, a chronic disease can occur and cause premature death unless there is a change in the new health behavior. The results of this study suggest researches to understand the motives related to alcohol abstinence, smoking cessation, dietary control and exercise, and to develop programs.

대학생의 알코올 사용장애 정도에 따른 혈압 및 스트레스의 영향요인 (Factors Affecting Blood Pressure and Stress according to the Alcohol Use Disorders Identification Test Scores among Undergraduate Students)

  • 조미경;김미영
    • Journal of Korean Biological Nursing Science
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    • 제19권4호
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    • pp.215-226
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    • 2017
  • Purpose: The purpose of this study was to investigate the effects of general, health, and alcohol-related characteristics on blood pressure and stress according to the Alcohol Use Disorders Identification Test (AUDIT). Methods: This was a descriptive study. From participants in the 2013 Korea National Health and Nutrition Examination Survey, 319 participants who responded to the survey when they were attending college or university were selected. Data were analyzed using the SPSS Win 23.0 program for composite sample data reflecting the composite design elements of stratification, colonization, and weighting. Results: Mean age of onset of alcohol drinking was $17.91{\pm}0.16$ years, the average AUDIT score was $7.56{\pm}0.41$, and 25 (9.1%) participants fell into the high-risk drinking group. In the high-risk AUDIT group, systolic blood pressure was influenced by age, gender, institution, health status, body mass index, and suicidal ideation, and the explanatory power of the model ($R^2$) was 75.0%. For diastolic blood pressure, institution and health status were the influential factors, and $R^2$ was 66.2%. Predictors of stress were health status, depression, and the age of onset of drinking, and $R^2$ was 57.2%. Conclusion: It was confirmed that the explanatory power of the variables in models of systolic and diastolic blood pressure and stress is greater in those with higher scores on AUDIT.

금융산업보안: 은행권 내부부정 방지를 위한 질적 연구 (Financial Industry Security: A Qualitative Study for Reducing Internal Fraud in Banking Institutions)

  • 서준배
    • 시큐리티연구
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    • 제56호
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    • pp.165-185
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    • 2018
  • 금융산업은 일상 국민 생활경제와 매우 밀접한 관련이 있다. 따라서 저축은행 사태와 같이 금융기관 임직원들에 의한 횡령, 배임 등 부정행위(fraud)가 발생할 경우, 신용경색과 연쇄파산 등 민생경제에 심대한 악영향을 끼칠 수 있다. 이에 외국에서는 금융산업 보안의 중요성이 특히 강조되고 있고, 물적, 인적, 사이버를 통합하는 융합보안(converged security)으로 발전하고 있다. 본 연구는 우리나라 은행권에서 내부 임직원들에 의해 발생하는 부정행위를 방지하는데 목적이 있다. 이를 위하여, 리스크 관리(risk management) 업무를 담당하고 있는 은행권 임직원, 금융 정책수립 및 규제기관 담당자, 보안전문가 등 총 16 명에 대하여 반구조화된 심층 인터뷰(in-depth semi-structured interview)를 실시하였다. 수집된 데이터를 개인, 조직, 사회 문화적 레벨 등, 세 가지 계층화 수준에서 분석하였고, 이를 바탕으로 금융산업보안(financial industry security)의 발전과 금융권 내부부정 행위 방지를 위한 정책적 권고사항들을 도출하였다.

2018 Korean Guideline of Atrial Fibrillation Management

  • Joung, Boyoung;Lee, Jung Myung;Lee, Ki Hong;Kim, Tae-Hoon;Choi, Eue-Keun;Lim, Woo-Hyun;Kang, Ki-Woon;Shim, Jaemin;Lim, Hong Euy;Park, Junbeom;Lee, So-Ryoung;Lee, Young Soo;Kim, Jin-Bae;KHRS Atrial Fibrillation Guideline Working Group
    • Korean Circulation Journal
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    • 제48권12호
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    • pp.1033-1080
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    • 2018
  • Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. The Korean Heart Rhythm Society organized a Korean AF Management Guideline Committee and analyzed all available studies regarding the management of AF, including studies on Korean patients. This guideline is based on recent data of the Korean population and the recent guidelines of the European Society of Cardiology, European Association for Cardio-Thoracic Surgery, American Heart Association, and Asia Pacific Heart Rhythm Society. Expert consensus or guidelines for the optimal management of Korean patients with AF were achieved after a systematic review with intensive discussion. This article provides general principles for appropriate risk stratification and selection of anticoagulation therapy in Korean patients with AF. This guideline deals with optimal stroke prevention, screening, rate and rhythm control, risk factor management, and integrated management of AF.

Personalized Diabetes Risk Assessment Through Multifaceted Analysis (PD- RAMA): A Novel Machine Learning Approach to Early Detection and Management of Type 2 Diabetes

  • Gharbi Alshammari
    • International Journal of Computer Science & Network Security
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    • 제23권8호
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    • pp.17-25
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    • 2023
  • The alarming global prevalence of Type 2 Diabetes Mellitus (T2DM) has catalyzed an urgent need for robust, early diagnostic methodologies. This study unveils a pioneering approach to predicting T2DM, employing the Extreme Gradient Boosting (XGBoost) algorithm, renowned for its predictive accuracy and computational efficiency. The investigation harnesses a meticulously curated dataset of 4303 samples, extracted from a comprehensive Chinese research study, scrupulously aligned with the World Health Organization's indicators and standards. The dataset encapsulates a multifaceted spectrum of clinical, demographic, and lifestyle attributes. Through an intricate process of hyperparameter optimization, the XGBoost model exhibited an unparalleled best score, elucidating a distinctive combination of parameters such as a learning rate of 0.1, max depth of 3, 150 estimators, and specific colsample strategies. The model's validation accuracy of 0.957, coupled with a sensitivity of 0.9898 and specificity of 0.8897, underlines its robustness in classifying T2DM. A detailed analysis of the confusion matrix further substantiated the model's diagnostic prowess, with an F1-score of 0.9308, illustrating its balanced performance in true positive and negative classifications. The precision and recall metrics provided nuanced insights into the model's ability to minimize false predictions, thereby enhancing its clinical applicability. The research findings not only underline the remarkable efficacy of XGBoost in T2DM prediction but also contribute to the burgeoning field of machine learning applications in personalized healthcare. By elucidating a novel paradigm that accentuates the synergistic integration of multifaceted clinical parameters, this study fosters a promising avenue for precise early detection, risk stratification, and patient-centric intervention in diabetes care. The research serves as a beacon, inspiring further exploration and innovation in leveraging advanced analytical techniques for transformative impacts on predictive diagnostics and chronic disease management.

Assessment of the Effectiveness of a Film-Forming Cream in the Management of Oral Aphthous Ulcers: A Placebo-Controlled Randomized Clinical Trial

  • Simone Marconcini;Giacomo Oldoini;Annamaria Genovesi;Enrica Giammarinaro
    • 치위생과학회지
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    • 제23권2호
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    • pp.88-92
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    • 2023
  • Background: Aphthous stomatitis is a common disease of the oral mucosa and its pathogenesis is associated with several risk factors. Frequently, minor ulcers are idiopathic in nature and often resolve naturally. However, those ulcers are painful and sensibly compromise patients' eating. There are different treatment strategies for the clinical management of oral aphthae. Methods: The present study assessed the efficacy of a film-forming cream in accelerating the healing and diminishing the pain associated with minor aphthae in a randomized fashion design. The test product (AphtoFix®) was compared with placebo cream in a cohort of patients with a diagnosis of minor recurrent stomatitis. Patients were randomly distributed into two groups and were followed for 10 days. The primary outcomes included the number of days until symptoms were relieved and the number of days to complete healing. Results: Thirty-six patients completed the follow-up, eighteen per group. All lesions eventually healed within day 10. However, patients in the test group experienced significantly less pain, already from day 1. Patients in the test group also showed a faster healing rate of the lesion with an average of 7 days against the 9 days required for patients in the control group. Conclusion: The present study supported the utility of a film-forming in cream in relieving the patient from symptoms associated with aphthous stomatitis already at day 1 of product use. Patients also displayed faster healing of the lesions when compared to the control group. Further studies with greater sample size and patient stratification according to age and risk factors are recommended to support the present findings.