Prevalence and prognostic impact of comorbidities and peripheral blood indices in sarcomas.

BACKGROUND: The prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas. METHODS: A population-based database was assembled to extract patients with sarcoma in Hong Kong between January 2004 and March 2018. Charlson's Comorbidity Index (CCI) score and prevalence of comorbidities, neutrophil, lymphocyte and platelet counts at diagnosis were assessed. The prognostic values of CCI, neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) were estimated using Cox proportional hazard models. Restricted cubic spline plots were used to explore the association of baseline NLR and PLR with all-cause and cancer-specific mortality. RESULTS: Among 3358 eligible patients with sarcomas, 52.2% died after a median 26 months of follow-up. The most common comorbidities were diabetes mellitus (9.8%) and cerebrovascular disease (4.8%). Patients with higher CCI had higher mortality (CCI=3 vs CCI=2; HR 1.49; 95% CI 1.19 to 1.87; p<0.01; CCI ≥7 vs CCI =2; HR 3.20; 95% CI 2.62 to 3.92; p<0.001). Abnormal NLR and PLR levels were associated with higher all-cause mortality (NLR: HR 1.698, p<0.001, 95% CI 1.424 to 2.025; PLR: HR 1.346, p<0.001, 95% CI 1.164 to 1.555) and cancer-related mortality (NLR: HR 1.648, p<0.001, 95% CI 1.341 to 2.024; PLR: HR 1.430, p<0.001, 95% CI 1.205 to 1.697). CONCLUSIONS: This is the largest population-based soft-tissue or bone sarcoma cohort worldwide. Comorbidities have significant negative prognostic impact on the survival of patients with sarcomas. Moreover, NLR and PLR are robust prognostic factors, and abnormal NLR and PLR have negative effects yet non-linear effects on survival.

Treatment of pelvic arteriovenous malformations with ethylene vinyl alcohol copolymer (Onyx).

In this article, two successful embolizations of large pelvic arteriovenous malformations (AVMs) with use of ethylene vinyl alcohol, a radiopaque, nonadhesive liquid casting agent, are reported. Both patients presented with large symptomatic pelvic AVMs requiring therapy. Coaxial microcatheter techniques were used to achieve complete success in one case and partial success in the other. Clinical success has been maintained in both patients at 2-year follow-up.

Growth and carcass evaluation of Holstein steers fed liquid acid whey.

Thirty Holstein steer calves, 96.5 kg, were assigned to three groups. Two groups received liquid acid whey, and one was the water control. Grain was fed either restricted or ad libitum to the whey groups and ad libitum to the water control group over three 14-wk growth periods. Hay, up to .4% body weight, reduced symptoms of bloat. Period 1: Calves started on a 20% crude protein dry ration for 7 wk and then changed to a 16% crude protein dry ration for 7 wk gained faster and were heavier than calves statred on a 30% crude protein dry ration for 7 wk and then changed to a 20% crude protein dry ration for 7 wk. Period 2: Body weights among groups were not different by the end of the period. Intakes of whey were 33.6 kg daily with grain ad libitum and 49.7 kg daily with restricted grain feeding. Water intake was 22.2 kg daily. The steers obtained 28% of their total dry matter intake from acid whey under ad libitum feeding, and 48% from acid whey under restricted feeding. Period 3: Final body weights were decreased by restricted feeding, but acid whey intake increased to 55.6 kg daily. These steers obtained 57% of their total dry matter intake from acid whey. Acid whey treatment resulted in lower carcass dressing percent, rib fat cover, and loin eye area. Grades averaged Standard for acid whey, restricted grain feeding and Low Good for acid whey, ad libitum grain feeding. Lower panel scores were given for aroma and quantity of juice for restricted grain feeding. Acid whey treatment did not change tenderness, shear values, or overall carcass desirability.