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Surgical outcomes of pulmonary resection for lung cancer after neo-adjuvant treatment

World Journal of Surgical Procedures 2016年第2期6卷 19-29页

作者： Benedetto Mungo cheryl k zogg Francisco Schlottmann Arianna Barbetta Craig M Hooker Daniela Molena Divisionof Thoracic Surgery Department of SurgeryJohns Hopkins University School of Medicine Thoracic Service Department of SurgeryMemorial Sloan-Kettering Cancer Center

AIM: To evaluate the outcomes of surgery for lung cancer after induction ***: Using the American College of Surgeons National Surgical Quality Improvement Program(ACSNSQIP) database(2005-2012), we identified 4063 patients who underwent a pulmonary resection for lung cancer. Two hundred and thirty-six(5.8%) received neo-adjuvant therapy prior to surgery(64 chemo-radiation, 103 radiation alone, 69 chemotherapy alone). The outcomes were compared to 3827 patients(94.2%) treated with surgery alone. Primary outcome was 30-d mortality, and secondary outcomes included length of stay, operative time and NSQIP measured postoperative ***: Lung cancer patients who received preoperative treatment were younger(66 vs 69, P kely to have experienced recent weight loss(6.8% vs 3.5%; P = 0.011), to be active smokers(48.3 vs 34.9, P < 0.001), and had lower preoperative hematological cell counts(abnormal white blood cell: 25.6 vs 13.4; P < 0.001; low hematocrit 53% vs 17.3%, P < 0.001). On unadjusted analysis, neo-adjuvant patients had significantly higher 30-d mortality, overall and serious morbidity(all P < 0.001). Adjusted analysis showed similar findings, while matched cohorts comparison confirmed higher morbidity, but not higher early ***: Our data suggest that patients who receive neo-adjuvant therapy for lung cancer have worse early surgical outcomes. Although NSQIP does not provide stage information, this analysis shows important findings that should be considered when selecting patients for induction treatment.

关键词： Lung cancer Pulmonary resection Neoadjuvant therapy Surgical outcomes

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Predictive Factors of Hyponatremia in Under-Five Severely Malnourished Children with Pneumonia Admitted to a Large Urban Hospital in Dhaka, Bangladesh: A Nested Case-Control Design

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Food and Nutrition Sciences 2013年第4期4卷 398-404页

作者： cheryl kay zogg Tahmeed Ahmed Abu Syeed Golam Faruque Sumon kumar Das Gazi Imran Mohammod Jobayer Chisti Centre for Nutrition & Food Security (CNFS) International Centre for Diarrhoeal Disease Research Bangladesh (icddrb) Dhaka Bangladesh Dhaka Shishu Hospital Dhaka Bangladesh Johns Hopkins Bloomberg School of Public Health Baltimore USA

Background: Hyponatremia is the most common electrolyte imbalance encountered in the management of diarrheal children. Common ramifications include cerebral edema and fatal outcomes. However, pediatric data remain lacking, particularly in developmental contexts where resources are limited and associated conditions like malnutrition and pneumonia are common. Aim: This study aimed to evaluate predicting factors associated with hyponatremia in children under five years of age with severe acute malnutrition (SAM) in Bangladesh. Methods: Using a nested case-control design, we compared clinical and laboratory characteristics of children with (n = 61) and without hyponatremia (n = 183) taken from a parent population of all children under five with SAM and clinical or radiological pneumonia admitted to Dhaka Hospital of icddr,b between April 2011 and June 2012 (n = 407). Results: Logistic regression analysis adjusting for potential confounders such as lack of breast feeding, duration of vomiting (days), and severe wasting revealed that older age (OR 1.05, 95%CI 1.02 - 1.07, p = 0.001) (5% increase in the relative odds of hyponatremia for each additional month of age), presence of diarrhea (OR 2.43, 95%CI 1.0 - 6.0, p = 0.05), and difficulty breathing (OR 1.52, 95%CI 1.0 - 2.05, p = 0.05) were significantly associated with hyponatremia. Conclusion: Our data suggest that older age, presence of diarrhea, and difficulty breathing in under-five children with SAM is independent predictors of hyponatremia. These findings underscore the importance of detecting simple clinical predictors early in order to facilitate appropriate management and to prevent potential ramifications of hyponatremia in SAM children, especially in resource-poor settings.

关键词： Children Diarrhea Hyponatremia Malnutrition Pneumonia

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