Abstract:
OBJECTIVE:There is a relation between tumor stage and grade with the risk of cancer recurrence in patients undergoing surgical treatment for kidney cancer. The association of patient comorbidity with disease recurrence is less well characterized. The objective of this study was to explore the association between comorbidity and the recurrence of kidney cancer. METHODS:We performed a retrospective analysis of 263 patients who received a partial or radical nephrectomy from January 1, 2000 through April 30, 2013. Patient data included race, sex, body mass index, age-adjusted Charlson Comorbidity Index (aaCCI) score, tumor histology, tumor T classification, and Fuhrman grade. The primary outcome was cancer recurrence, either local or distant. Logistic regression was used to assess the association of these risk factors with the outcome. RESULTS:The median follow-up time was 19.6 months (interquartile range 5.2-53.7). There were 101 (38.4%) African American patients and 150 (57.0%) men. The median body mass index was 28.3 and the median aaCCI was 3.0. The Fuhrman grade was G1 in 9.5% of patients, G2 in 45.2%, G3 in 32.8%, and G4 in 12.5%. Nineteen (7.2%) patients experienced disease recurrence, including 13 (4.9%) patients with metastatic disease. The risk factors significantly associated with recurrence included Fuhrman grade (odds ratio [OR] 3.0, 95% confidence interval [CI] 1.23-7.30), tumor T classification (OR 1.33, 95% CI 1.00-1.76), and CCI (OR 0.74, 95% CI 0.57-0.95). CONCLUSIONS:Physiologic factors, in addition to tumor characteristics, play a significant role in predicting cancer-specific survival in patients with kidney cancer. The reduced odds of recurrence with higher aaCCI may indicate that competing health factors have an impact before recurrence on survival in certain patients.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Reinstatler L,Klaassen Z,Madi R,Terris MK,Moses KAdoi
10.14423/SMJ.0000000000000651subject
Has Abstractpub_date
2017-05-01 00:00:00pages
369-374issue
5eissn
0038-4348issn
1541-8243pii
SMJ50380journal_volume
110pub_type
杂志文章abstract::A technic of combined split-thickness and full-thickness skin grafts and local flap closure for extensive deep cicatricial neck contractures is presented. The head and neck are mobilized by excision of limiting tissues. The lateral neck skin is mobilized to be rotated anteriorly as flaps, and a full-thickness skin gra...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197606000-00023
更新日期:1976-06-01 00:00:00
abstract::This paper briefly reviews the available evidence for the influence of environmental and occupational factors in the development of cancer of the larynx. Although several occupational exposures have been suggested to play a role in the etiology of this disease, few have been convincingly confirmed. The strong associat...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198307000-00020
更新日期:1983-07-01 00:00:00
abstract::[This corrects the article on p. 232 in vol. 113.]. ...
journal_title:Southern medical journal
pub_type: 杂志文章,已发布勘误
doi:10.14423/SMJ.0000000000001121
更新日期:2020-07-01 00:00:00
abstract::Hepatitis C is a leading cause of liver failure and transplantation in the United States and a major public health issue. Studies have shown that patients with hepatitis C are at an increased risk of cardiovascular disease, which make statins of particular benefit in this patient population. However, the National Chol...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181f0c6b4
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy of an educational curriculum designed for orthopedic surgery postgraduate year 1 (PGY-1) interns to improve initial Orthopedic In-Training Examination (OITE) performance. METHODS:A retrospective cohort study was performed that evaluated the PGY-1 intern OITE performance of one resid...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31824fb9a4
更新日期:2012-04-01 00:00:00
abstract::The diagnosis of sarcoidosis is best established when there is evidence of granulomatous involvement in two or more organs. Three patients with unusual cutaneous manifestations of sarcoidosis, including palmar and follicular lesions, nonscarring alopecia, and widespread plaque or erythrodermic sarcoidosis, are reporte...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197706000-00009
更新日期:1977-06-01 00:00:00
abstract::Acquired immunodeficiency syndrome (AIDS) has engendered a crisis of fear among the public and health professionals alike. In addition to the myriad anxieties that generally accompany dying and death, AIDS patients must deal with numerous additional fears. In rushing to treat the physiologic aspects of AIDS, health pr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198702000-00022
更新日期:1987-02-01 00:00:00
abstract::Diagnostic peritoneal lavage (DPL) is an established procedure in evaluation of trauma victims but is less well established for use in patients suspected of having acute intra-abdominal disease. Twenty-six seriously ill patients at our institution who had DPL for acute intra-abdominal disease form the basis of this re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199004000-00015
更新日期:1990-04-01 00:00:00
abstract::The effect of food on the absorption characteristics of procainamide was assessed after oral administration of the drug to eight male patients in the fasting and postprandial states. Serum concentration-time curves showed no significant difference in peak serum levels of procainamide, in the time the peak value was re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197607000-00013
更新日期:1976-07-01 00:00:00
abstract::Cyclosporine is a fungal metabolite increasingly used as an immunosuppressive agent in organ transplantation. It provides immunosuppression primarily through reversible inhibition of T-lymphocytes, without myelotoxicity. Cyclosporine appears to inhibit primary activation of helper cells and to decrease the production ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198602000-00017
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:Transmission of echocardiograms via telemedicine links has allowed remote hospitals direct access to pediatric cardiology subspecialty care. This study assessed the accuracy of echocardiogram interpretation across an integrated services digital network (ISDN) telemedicine link. METHODS:Telemedicine systems ...
journal_title:Southern medical journal
pub_type: 杂志文章,多中心研究
doi:
更新日期:2002-09-01 00:00:00
abstract::Ninety-four children with typhoid fever presented with the primary complaints of fever, diarrhea, and vomiting. Fifty-two percent had hepatomegaly and derangements of SGOT and LDH. None developed hepatic decompensation and all had rapid clinical recovery. The abnormal liver function test served no prognostic purpose. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197607000-00037
更新日期:1976-07-01 00:00:00
abstract:OBJECTIVES:Age-related macular degeneration (AMD) is the leading cause of blindness in the United States. Although AMD shares multiple risk factors with coronary artery disease (CAD), the association between AMD and CAD has not been established. The objective of our study was to demonstrate an association between the d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000329
更新日期:2015-08-01 00:00:00
abstract::We report four cases of group A streptococcal vulvovaginitis in prepubertal children. All cases were acute in onset. This illness presents with nonspecific signs and symptoms of labial inflammation. In a suburban community, streptococcal vulvovaginitis in prepubescent girls may be more common then genital infections d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198204000-00017
更新日期:1982-04-01 00:00:00
abstract::The clinical course and long-term survival of a patient with acute disseminated histiocytosis X and extrahypothalamic CNS involement were presented. The clinical significance of histiocytes appearing in the CSF cocomitant with the onset of this neurologic syndrome was discussed. Detailed cytologic examination of the C...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1977-11-01 00:00:00
abstract::Serologic tests for the diagnosis of blastomycosis have had inadequate sensitivity, but results are improved with enzyme immunoassay (EIA) with A-antigen of Blastomyces dermatitidis. The Premier Blastomyces EIA kit (Meridian Diagnostics Inc, Cincinnati, Ohio) detected antibody against the B dermatitidis A-antigen in s...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199512000-00013
更新日期:1995-12-01 00:00:00
abstract::Interaction of allergen with T-cells is associated with patterns of cytokine release by immunocompetent cells characterized as T-helper Th1 or Th2 T-immune responses. The Th2 pattern of inflammation induced by this cytokine release is associated with allergic diseases. The molecular mechanisms underlying allergic infl...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000097887.04639.39
更新日期:2003-11-01 00:00:00
abstract::We performed a retrospective study to determine the sensitivity of mammography in detecting breast cancer arising in women with augmented breasts. Of eight women with breast implants in whom breast cancer developed, six had mammograms before biopsy. Only two of the six cancers were identified mammographically (sensiti...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199101000-00013
更新日期:1991-01-01 00:00:00
abstract::Diabetes during pregnancy is associated with insulin resistance, an increase in insulin requirement, and a greater tendency to ketosis and ketoacidosis. Increased perinatal mortality is related to maternal hyperglycemia and can be decreased dramatically with strict control of plasma glucose during pregnancy and a smoo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197801000-00012
更新日期:1978-01-01 00:00:00
abstract::The risk of suicidal behavior associated with antidepressant treatment is an issue of debate and concern. The US FDA has required that antidepressants carry a black box warning that there may be a risk of suicidal ideations in depressed pediatric patients treated with these medications, and recently extended the warni...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181a918bd
更新日期:2009-07-01 00:00:00
abstract::Variant angina pectoris, usually not precipitated by exertion or emotional stress, often is more severe and lasts longer than classic angina. The pain tends to recur at about the same time each day. Arrhythmias, usually ventricular, occur in about 50% of cases during the peak of pain. Electrocardiograms show a charact...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-197603000-00034
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:Pulmonary contusion (PC) is the most common injury identified in pediatric blunt chest trauma. The disagreement over management principles of children with PC may complicate care of these patients. METHODS:We reviewed the literature and our institutional experience. RESULTS:Pulmonary contusion is most ofte...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199812000-00002
更新日期:1998-12-01 00:00:00
abstract::We evaluated 100 primary care outpatients for signs of cognitive impairment using the Mini-Mental State Examination (MMSE). The 23 subjects scoring abnormal values (less than 24/30) were found to be cognitively impaired. Seventeen had previously undetected cognitive impairment, while six had prior diagnoses consistent...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00017
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVES:The lack of access to diagnostic imaging in resource-limited settings (RLSs) poses a worldwide problem. Advances in ultrasound (US) imaging technology bridge this gap, particularly when examinations are performed by physicians and integrated into the patient encounter, termed point-of-care ultrasound (POCUS)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000826
更新日期:2018-07-01 00:00:00
abstract::Blastomycosis is an endemic systemic fungal infection that usually involves the lungs and superficial skin. Although head and neck involvement has been reported in the literature, no previous cases of neck mass resulting from direct extension of a pulmonary lesion have been published. We encountered an immunocompetent...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199810000-00009
更新日期:1998-10-01 00:00:00
abstract::Guillain-Barré syndrome (GBS) encompasses the variants of acute immune-mediated polyneuropathies usually preceded by an infection. A few case reports have associated GBS to neoplastic diseases. It remains unclear whether these are merely coincidental or represent paraneoplastic phenomena. The clinical features of GBS ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/smj.0b013e3181bfd2c0
更新日期:2010-02-01 00:00:00
abstract::Brown recluse spider bites may result in extensive soft tissue injury, causing months of disability. We have described a patient who had a series of extensive surgical debridements after envenomation. Despite skin grafting, persistent cutaneous lesions and extensive satellitosis progressed to involve the entire lower ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199002000-00029
更新日期:1990-02-01 00:00:00
abstract::We present the case of a 59-year-old woman with an International Federation of Gynecology and Obstetrics stage IIIB serous psammocarcinoma. Only 12 cases of this rare ovarian neoplasm have been reported previously. These tumors act like borderline tumors and, therefore, do not usually require chemotherapy or radiation...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199805000-00015
更新日期:1998-05-01 00:00:00
abstract::The use of silver wire retention sutures requires added operating room time and expense, and it incurs the potential hazards of caught viscera, the possibility of more adhesions, leakage of intraperitoneal fluid through the exit wound, mild infection of exit wounds, and, on removal of the sutures, pain despite sedatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197905000-00013
更新日期:1979-05-01 00:00:00
abstract::Pyogenic granuloma is a benign, vascular lesion occasionally seen on the hand. It many be quite alarming to the patient. Adequate surgical excision is advocated as the treatment of choice. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197609000-00013
更新日期:1976-09-01 00:00:00