Construction of a clinical survival prognostic model for middle-aged and elderly patients with stage III rectal adenocarcinoma

paythelady.612 shared this article with you from Inoreader Construction of a clinical survival prognostic model for middle-aged and elderly patients with stage III rectal adenocarcinoma Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1563-1579. doi: 10.12998/wjcc.v9.i7.1563. ABSTRACT BACKGROUND: Nomograms for prognosis prediction in colorectal cancer patients are few, and prognostic indicators differ with age. AIM: To construct a new nomogram survival prediction tool for middle-aged and elderly patients with stage III rectal adenocarcinoma. METHODS: A total of 2773 eligible patients were divided into the training cohort (70%) and the validation cohort (30%). Optimal cutoff values were calculated using the X-tile software for continuous variables. Univariate and multivariate Cox proportional hazards regression analyses were used to determine overall survival (OS) and cancer-specific survival (CSS)-related prognostic factors. Two nomograms were successfully constructed. The discriminant and predictive ability and clinical usefulness of the model were also assessed by multiple methods of analysis. RESULTS: The 95%C I in the training group was 0.719 (0.690-0.749) and 0.733 (0.702-0.74), while that in the validation group was 0.739 (0.696-0.782) and 0.750 (0.701-0.800) for the OS and CSS nomogram prediction models, respectively. In the validation group, the AUC of the three-year survival rate was 0.762 and 0.770, while the AUC of the five-year survival rate was 0.722 and 0.744 for the OS and CSS nomograms, respectively. The nomogram distinguishes all-cause mortality from cancer-specific mortality in patients with different risk grades. The time-dependent AUC and decision curve analysis showed that the nomogram had good clinical predictive ability and decision efficacy and was significantly better than the tumor-node-metastases staging system. CONCLUSION: The survival prediction model constructed in this study is helpful in evaluating the prognosis of patients and can aid physicians in clinical diagnosis and treatment. PMID:33728300 | PMC:PMC7942048 | DOI:10.12998/wjcc.v9.i7.1563 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Autologous scalp skin grafting to treat toxic epidermal necrolysis in a patient with a large skin injury: A case report

paythelady.612 shared this article with you from Inoreader Autologous scalp skin grafting to treat toxic epidermal necrolysis in a patient with a large skin injury: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 6;9(7):1646-1653. doi: 10.12998/wjcc.v9.i7.1646. ABSTRACT BACKGROUND: Toxic epidermal necrolysis (TEN) is often associated with skin wounds affecting large areas. Healing of this type of wound is difficult because of pressure, infection and other factors. It can increase the length of hospital stay and result in wound sepsis and even death. CASE SUMMARY: A 49-year-old woman developed a skin lesion covering 80% of the total body surface area after using a kind of Chinese medicinal ointment on a burn wound on her back; she developed life-threatening wound sepsis and septic shock. Methicillin-resistant Staphylococcus aureus, carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa and other bacteria were cultured from wound tissue, deep venous catheter and blood samples. Imipenem cilastatin sodium, tigecycline and teicoplanin were used for anti-infect ion therapy. Finally, the patient was transferred to the burn department because of severe wound sepsis. In the burn intensive care unit, pain-free dressing changes and autologous scalp skin grafting were performed to heal the wound in addition to reasonable and effective antibacterial treatment according to microbial susceptibility test results. After three operations within 2 wk, the wound healed and sepsis resolved. CONCLUSION: TEN patients with large areas of skin injury may develop wound infection and life-threatening wound sepsis. Autologous scalp skin grafting may be beneficial for rapid wound healing and reducing the risk of sepsis in TEN patients, and it leaves no scar at the donor site. PMID:33728308 | PMC:PMC7942035 | DOI:10.12998/wjcc.v9.i7.1646 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.