Background: Conditional survival (CS) has been established as a clinically relevant prognostic factor for cancer sur-vivors, and the CS in gallbladder (GB) cancer has not yet been fully evaluated. In this study, we evaluated the cancer-specific CS rate and cancer-specific survival (CSS) rate in patients with GB cancer at multiple time points and investi-gated prognostic factors which affect cancer-specific CS rate to provide more accurate survival information. Methods: Between 2004 and 2013, a total of 9760 patients with GB cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) data. The 3-year cancer-specific CS rate was calculated using the covariate-adjusted survival function in the Cox model for each year since diagnosis, and the results were analyzed together with the adjusted CSS rates at the same time points. Cox proportional hazards regression was performed to ascertain the individual contribution of factors associated with CSS rate at diagnosis and cancer-specific CS rates at 1, 3, and 5 years after diagnosis. Results: The adjusted 5-year CSS rate was 26.1%. The adjusted 3-year cancer-specific CS rates at 1, 2, 3, 4, and 5 years after diagnosis were 55.5, 72.2, 81.5, 86.8, and 90.5%, respectively. At the time of diagnosis, age, race, histology, grade, T, N, and M categories, surgery, radiotherapy, insurance status, and marriage status were significant prognostic fac-tors of CSS. Five years after diagnosis, however, T and M categories were significant prognostic factors for survivors (P = 0.007 and P = 0.009, respectively), whereas surgery and radiotherapy were not. Conclusions: T and M categories were significant prognostic factors even 5 years after the initial diagnosis, whereas local treatments at the time of diagnosis were not, suggesting that patients with GB cancer at high risks might need further adjuvant therapy after primary treatments. The combined analysis of CSS and cancer-specific CS rates offered more accurate survival information for patients who have already survived a certain period of time after diagnosis.

OBJECTIVE: Prognostic factors of metastatic brain tumors have been widely reported and their operative indications also have been extended gradually even to the poor grade patients. Authors intended to analyze the causative factors for the clinical outcome of metastatic brain tumors, especially with relevant to the poor prognosis by one year follow-up evaluation. PATIENTS AND METHODS: The authors retrospectively studied the clinical characteristics of 46 cases(35 patients) with metastatic brain tumors among 466 cases(437 patients) which were operated on due to the brain tumor, during the period between January 1994 to June 1999. Statistical analysis was performed by using SPSS 8.0(r). A p-value of less than 0.05 was considered clinically significant. RESULT: Among the variable clinical factors in patients with metastatic brain tumors, Karnofsky Performance Scale (KPS) score of less than 70(16 patients), uncontrolled primary tumor(8 patients), and surgical resection without further adjuvant therapy(9 patients) showed statistically significant poor prognosis; p value of 0.002, 0.032, and 0.001, respectively. Other tested variables, such as old age(greater than 65 years; 10 patients), gender(male; 20 patients), type of primary cancer(primary undefined; 6 patients, lung cancer; 15 patients), location(infratentorial; 9 patients, sellar; 5 patients), number of lesion(multiple; 12 patients), and number of operation(multiple craniotomy; 7 patients) were not related to the poor prognosis. CONCLUSIONS: The most common primary site of distant metastasis was lung. The poorer prognosis was highly correlated with various factors including low KPS score(<70), no postoperative adjuvant therapy, and uncontrolled primary tumors.
Brain Neoplasms* ; Brain* ; Craniotomy ; Follow-Up Studies* ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Prognosis* ; Retrospective Studies

Objectives: Addiction to prescription narcotics is a global issue, and detecting individuals with narcotic use disorder (NUD) at an early stage can help prevent narcotics misuse and abuse. We developed a novel index for the early detection of NUD based on an analysis of real-world prescription patterns in a large hospital. Methods: We analyzed the narcotic prescriptions of 221,887 patients, prescribed by 8,737 doctors from July 2000 to June 2018. To facilitate the early detection of patients at risk of developing NUD after a prolonged period of narcotic use, we developed a weighted morphine equivalent daily dose (wt-MEDD) score. This score was based on the number of prescription dates where the actual MEDD exceeded the intended MEDD. We compared the performance of the wt-MEDD scoring system in identifying patients diagnosed with NUD by doctors against other high-risk NUD indices.These indices included the MEDD scoring system, the number of days on prescribed narcotics, the frequency and duration of prescriptions, narcotics prescriptions from multiple doctors, and the number of early narcotic refills. Results: A wt-MEDD score cut-off value of 10.5 successfully identified all outliers and diagnosed patients with NUD with 100% sensitivity and 99.6% specificity. This score demonstrated the highest sensitivity and specificity for detecting NUD compared to all other indexes. The predictive performance was further improved by combining the wt-MEDD score with other high-risk NUD indexes. Conclusion We developed a novel index, the wt-MEDD score, which showed excellent performance in the early detection of NUD.

Objectives: Addiction to prescription narcotics is a global issue, and detecting individuals with narcotic use disorder (NUD) at an early stage can help prevent narcotics misuse and abuse. We developed a novel index for the early detection of NUD based on an analysis of real-world prescription patterns in a large hospital. Methods: We analyzed the narcotic prescriptions of 221,887 patients, prescribed by 8,737 doctors from July 2000 to June 2018. To facilitate the early detection of patients at risk of developing NUD after a prolonged period of narcotic use, we developed a weighted morphine equivalent daily dose (wt-MEDD) score. This score was based on the number of prescription dates where the actual MEDD exceeded the intended MEDD. We compared the performance of the wt-MEDD scoring system in identifying patients diagnosed with NUD by doctors against other high-risk NUD indices.These indices included the MEDD scoring system, the number of days on prescribed narcotics, the frequency and duration of prescriptions, narcotics prescriptions from multiple doctors, and the number of early narcotic refills. Results: A wt-MEDD score cut-off value of 10.5 successfully identified all outliers and diagnosed patients with NUD with 100% sensitivity and 99.6% specificity. This score demonstrated the highest sensitivity and specificity for detecting NUD compared to all other indexes. The predictive performance was further improved by combining the wt-MEDD score with other high-risk NUD indexes. Conclusion We developed a novel index, the wt-MEDD score, which showed excellent performance in the early detection of NUD.

Objectives: Addiction to prescription narcotics is a global issue, and detecting individuals with narcotic use disorder (NUD) at an early stage can help prevent narcotics misuse and abuse. We developed a novel index for the early detection of NUD based on an analysis of real-world prescription patterns in a large hospital. Methods: We analyzed the narcotic prescriptions of 221,887 patients, prescribed by 8,737 doctors from July 2000 to June 2018. To facilitate the early detection of patients at risk of developing NUD after a prolonged period of narcotic use, we developed a weighted morphine equivalent daily dose (wt-MEDD) score. This score was based on the number of prescription dates where the actual MEDD exceeded the intended MEDD. We compared the performance of the wt-MEDD scoring system in identifying patients diagnosed with NUD by doctors against other high-risk NUD indices.These indices included the MEDD scoring system, the number of days on prescribed narcotics, the frequency and duration of prescriptions, narcotics prescriptions from multiple doctors, and the number of early narcotic refills. Results: A wt-MEDD score cut-off value of 10.5 successfully identified all outliers and diagnosed patients with NUD with 100% sensitivity and 99.6% specificity. This score demonstrated the highest sensitivity and specificity for detecting NUD compared to all other indexes. The predictive performance was further improved by combining the wt-MEDD score with other high-risk NUD indexes. Conclusion We developed a novel index, the wt-MEDD score, which showed excellent performance in the early detection of NUD.

Objectives: Addiction to prescription narcotics is a global issue, and detecting individuals with narcotic use disorder (NUD) at an early stage can help prevent narcotics misuse and abuse. We developed a novel index for the early detection of NUD based on an analysis of real-world prescription patterns in a large hospital. Methods: We analyzed the narcotic prescriptions of 221,887 patients, prescribed by 8,737 doctors from July 2000 to June 2018. To facilitate the early detection of patients at risk of developing NUD after a prolonged period of narcotic use, we developed a weighted morphine equivalent daily dose (wt-MEDD) score. This score was based on the number of prescription dates where the actual MEDD exceeded the intended MEDD. We compared the performance of the wt-MEDD scoring system in identifying patients diagnosed with NUD by doctors against other high-risk NUD indices.These indices included the MEDD scoring system, the number of days on prescribed narcotics, the frequency and duration of prescriptions, narcotics prescriptions from multiple doctors, and the number of early narcotic refills. Results: A wt-MEDD score cut-off value of 10.5 successfully identified all outliers and diagnosed patients with NUD with 100% sensitivity and 99.6% specificity. This score demonstrated the highest sensitivity and specificity for detecting NUD compared to all other indexes. The predictive performance was further improved by combining the wt-MEDD score with other high-risk NUD indexes. Conclusion We developed a novel index, the wt-MEDD score, which showed excellent performance in the early detection of NUD.

Objectives: Addiction to prescription narcotics is a global issue, and detecting individuals with narcotic use disorder (NUD) at an early stage can help prevent narcotics misuse and abuse. We developed a novel index for the early detection of NUD based on an analysis of real-world prescription patterns in a large hospital. Methods: We analyzed the narcotic prescriptions of 221,887 patients, prescribed by 8,737 doctors from July 2000 to June 2018. To facilitate the early detection of patients at risk of developing NUD after a prolonged period of narcotic use, we developed a weighted morphine equivalent daily dose (wt-MEDD) score. This score was based on the number of prescription dates where the actual MEDD exceeded the intended MEDD. We compared the performance of the wt-MEDD scoring system in identifying patients diagnosed with NUD by doctors against other high-risk NUD indices.These indices included the MEDD scoring system, the number of days on prescribed narcotics, the frequency and duration of prescriptions, narcotics prescriptions from multiple doctors, and the number of early narcotic refills. Results: A wt-MEDD score cut-off value of 10.5 successfully identified all outliers and diagnosed patients with NUD with 100% sensitivity and 99.6% specificity. This score demonstrated the highest sensitivity and specificity for detecting NUD compared to all other indexes. The predictive performance was further improved by combining the wt-MEDD score with other high-risk NUD indexes. Conclusion We developed a novel index, the wt-MEDD score, which showed excellent performance in the early detection of NUD.

No abstract available.
Arteries* ; Intracranial Aneurysm*

No abstract available.
Aneurysm*

No abstract available.
Aneurysm*