Comparing the Ability of Physician-Reported Versus Patient-Reported Performance Status to Predict Survival in a Population-Based Cohort of Newly Diagnosed Cancer Patients.

AIMS: Performance status is an important prognostic tool in cancer. In oncology, the Eastern Cooperative Oncology Group (ECOG) measure is commonly used. Patient-reported functional status (PRFS) is an emerging method that allows patients to provide an estimate of their function; however, there is limited information about its prognostic significance. The aim of this study was to compare the predictive validity of functional status as reported by patients and physicians in relation to the observed survival after a new cancer diagnosis. MATERIALS AND METHODS: This was a retrospective, population-based study using observational data of newly diagnosed patients in Ontario, Canada. We included patients who had both PRFS and ECOG recorded on the same day during an outpatient cancer clinic visit between March 2013 and March 2018. The dataset was randomly divided into 60% training and 40% validation cohorts. One-year survival was estimated by modelling clinical characteristics with PRFS, with ECOG, and alone. RESULTS: In total, 13 045 patients met the inclusion criteria. Covariates were similar at baseline for both training and validation datasets. PRFS and ECOG scores were statistically significant predictors of overall survival. Higher PRFS and ECOG scores were both associated with inferior survival, hazard ratio = 1.71 (P < 0.0001) and hazard ratio = 1.90 (P < 0.0001), respectively. Models that included either PRFS or ECOG scores outperformed the model with clinical characteristics only. C statistics were 0.836, 0.839 and 0.811, respectively. CONCLUSIONS: PRFS adds to survival modelling and is equally predictive as the ECOG scale. PRFS may be used instead of ECOG in clinical or research settings for survival estimation.

Endoscopic ultrasound-guided fine-needle aspiration with or without flow cytometry for the diagnosis of primary pancreatic lymphoma - a case series.

The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with flow cytometry for the diagnosis of primary pancreatic lymphoma (PPL) has not been previously described. Our aims were to describe the EUS features of PPL and the role of EUS-FNA with and without flow cytometry in the diagnosis of 16 patients. When EUS-FNA with flow cytometry was compared with EUS-FNA without flow cytometry, the sensitivities for diagnosing non-Hodgkin's lymphoma were 84.6 % versus 30.8 %, respectively ( P = 0.01). EUS-FNA with flow cytometry is a valuable tool to diagnose PPL. Flow cytometry analysis complements traditional assessment by standard cytology.

Staphylococcus capitis causing aortic valve endocarditis.

Coagulase-negative staphylococci have been implicated in certain human infections but are generally considered to be contaminants. Although their clinical significance has been questioned, rare species of coagulase-negative staphylococci such as Staphylococcus capitis and Staphylococcus ludgunensis have recently emerged which cause endocarditis with high morbidity and mortality rates. We report a case of severe aortic valve endocarditis with conduction delays due to S. capitis infection which was treated successfully with antibiotics.

Lead speciation by HPLC-ICP-AES and HPLC-ICP-MS.

Speciation of inorganic lead (Pb2+) and several trialkyllead species (trimethyllead chloride [TML], triethyllead chloride [TEL], and triphenyllead chloride [TPhL]) is investigated using high-performance liquid chromatography (HPLC) with detection by both inductively coupled plasma emission spectroscopy (ICP-AES), and inductively coupled plasma mass spectrometry (ICP-MS). Reversed-phase, ion-pairing, and ion-exchange HPLC modes are studied. Optimal chromatographic conditions for ICP-AES detection include a reversed-phase separation utilizing a step gradient from 10 to 70% methanol. However, the gradient has been found to destabilize the plasma when using ICP-MS detection. An isocratic separation with a 30% methanol mobile phase has been found to be the best compromise between plasma stability and chromatographic resolution. Detection limits using ICP-MS detection are 3 orders of magnitude improved over ICP-AES detection.