Prognostic Factors for Clinical Outcomes After Arthroscopic Rotator Cuff Repair.

Background: Limited knowledge exists regarding prognostic factors after rotator cuff repair. Purpose: To identify pre- and perioperative predictors for functional outcomes after arthroscopic rotator cuff repair. Study Design: Case-control study; Level of evidence, 3. Methods: This study included patients who underwent arthroscopic rotator cuff repair between January 2013 and April 2019 and who had preoperative magnetic resonance imaging scans. The procedures were performed by 4 shoulder surgeons at a single institution. Excluded were patients who had previous surgeries, those who underwent open surgery, and those without 12- and 24-month follow-up clinical data. Patient-reported outcomes (American Shoulder and Elbow Surgeons [ASES] Standardized Shoulder Assessment Form and University of California, Los Angeles [UCLA] Shoulder Rating Scale scores) were assessed preoperatively and at 6, 12, and 24 months postoperatively. Using multiple linear regression analysis, the authors evaluated the influence of 29 variables relating to patient, lesion, and procedure characteristics on postoperative outcomes, with the 24-month ASES score as the dependent variable. Results: The study sample consisted of 474 patients (500 shoulders). The median ASES score increased from 41.6 preoperatively to 88.3 at 24 months (P < .001), and the median UCLA score increased from 14 preoperatively to 32 in the same period (P < .001). The following variables were found to be independent predictors for higher 24-month postoperative ASES score: male sex, absence of rheumatologic disease, older age, lower degree of supraspinatus muscle fatty degeneration, acromioplasty, and a higher preoperative ASES score. Conclusion: The prognostic factors for better clinical results at 24 months after arthroscopic rotator cuff repair were male sex, absence of rheumatologic disease, older age, lower degree of fatty degeneration of the supraspinatus muscle, concomitant acromioplasty, and higher preoperative ASES score.

Psychological suppressive profile and autoantibodies variability in women living with breast cancer: A prospective cross-sectional study.

Breast cancer (BC) is a leading cause of women's morbimortality worldwide. Unfortunately, attempts to predict women's susceptibility to developing BC well before it becomes symptomatic, based on their genetic, family, and reproductive background have proved unsatisfactory. Here we analyze the matching of personality traits and protein serum profiles to predict women's susceptibility to developing cancer. We conducted a prospective study among 150 women (aged 18-70 years), who were distributed into three groups (n = 50): women without breast pathology and women diagnosed with BC or benign breast pathology. Psychological data were obtained through standardized psychological tests and serum protein samples were analyzed through semiquantitative protein immunoblotting. The matching for psychological and immunological profiles was constructed from these data using a mathematical generalized linear model.The model predicted that women who have stronger associations between high-intensity stress responses, emotional containment, and an increased number and reduced variability of serum proteins (detected by IgG autoantibodies) have the greatest susceptibility to develop BC before the disease has manifested clinically. Hence, the present study endorses the possibility of using psychological and biochemical tests in combination to increase the possibility of identifying women at risk of developing BC before the disease shows clinical manifestations. A longitudinal study must be instrumented to test the prediction ability of the instrument in real scenarios. Trial registration: Committee of Ethical Research of the Hospital General de México "Dr. Eduardo Liceaga," Ministry of Health (DI/12/111/03/064).

Equine simplified acute physiology score: Personalised medicine for the equine emergency patient.

BACKGROUND: Scoring models are useful tools that guide the attending clinician in gauging the severity of disease evolution and in evaluating the efficacy of treatment. There are few tools available with this purpose for the non-human patient, including horses. We aimed (i) to adapt the simplified acute physiology score 3 (SAPS-3) model for the equine species, reaching a margin of accuracy greater than 75% in the calculation of the probability of survival/death and (ii) to build a decision tree that helps the attending veterinarian in assessment of the clinical evolution of the equine patient. METHODS: From an initial pool of 5568 medical records from University-based Veterinary Hospitals, a final cohort of 1000 was further mined manually for data extraction. A set of 19 variables were evaluated and tested by five machine learning data mining algorithms. RESULTS: The final scoring model, named EqSAPS for equine simplified acute physiology score, reached 91.83% of correct estimates (post hoc) for probability of death within 24 hours upon hospitalization. The area under receiver operating characteristic curve for outcome 'death' was 0.742, while for 'survival' was 0.652. The final decision tree was able to refine prognosis of patients whose EqSAPS score suggested 'death'. CONCLUSION: EqSAPS is a useful tool to gauge the severity of the clinical presentation of the equine patient.

Herramienta pronóstico para estimar el riesgo quirúrgico aterosclerótico / Prognostic tool to estimate surgical atherosclerotic risk

Introducción: el abordaje activo de la prevención de las enfermedades cardiovasculares se basa fundamentalmente en que estas constituyen la causa principal de muerte prematura en la mayoría de los países desarrollados.Objetivo: determinar la eficacia pronóstico de la herramienta de riesgo aterosclerótico.Métodos: se realizó estudio analítico, sobre el comportamiento de los factores de riesgo aterosclerótico, en 1 926 pacientes propuestos para cirugía electiva no cardiaca que pertenecen al Hospital Universitario Manuel Ascunce Domenech, durante el período comprendido de septiembre 2007 a septiembre de 2010 en Camagüey. Se elaboró un modelo que utilizó la técnica de análisis multivariado y regresión logística binaria. Al sustituir el valor de cada uno de los factores en el modelo se obtiene como resultado la probabilidad de un individuo de padecer la enfermedad. Se calculó el mejor punto de coincidencia que permite clasificar los individuos como potencialmente sanos o enfermos mediante el procedimiento de curva ROC (Ratio Odd Curve). Resultados: los factores de riesgo asociados fueron: el hábito de fumar, hipertensión arterial, diabetes mellitus, hipercolesterolemia, obesidad, sedentarismo y como factor protector, el sexo femenino. Conclusiones: se determinó la eficacia de la herramienta en y para soporte computarizado, la cual proporciona un pronóstico confiable a los especialistas, sobre los pacientes programados para cirugía con factores de riesgo aterosclerótico(AU)

Introduction: the active approach to the prevention of cardiovascular diseases is mainly based on the fact that these constitute the main cause of premature death in most developed countries. Objective: determine the prognostic efficacy of the atherosclerotic risk tool. Methods: an analytical study was conducted of atherosclerotic risk factors in 1 926 patients proposed for elective non-cardiac surgery at Manuel Ascunce Domenech University Hospital in the province of Camag³ey from September 2007 to September 2010. A model was developed based on multivariate analysis and binary logistic regression. The probability that an individual will have the disease is obtained by substituting into the model the value of each one of the factors. A calculation was made of the best point of coincidence allowing to classify individuals as potentially healthy or ill using the ROC (ratio odd curve) procedure. Results: the risk factors associated were the following: smoking, hypertension, diabetes mellitus, hypercholesterolemia, obesity and a sedentary lifestyle, and as a protective factor: female sex. Conclusions: Determination was made of the efficacy of the tool for computerized support, providing specialists with a reliable prognosis about atherosclerotic risk patients scheduled for surgery(AU)

Herramienta pronóstico para estimar el riesgo quirúrgico aterosclerótico / Prognostic tool to estimate surgical atherosclerotic risk

Introducción: el abordaje activo de la prevención de las enfermedades cardiovasculares se basa fundamentalmente en que estas constituyen la causa principal de muerte prematura en la mayoría de los países desarrollados. Objetivo: determinar la eficacia pronóstico de la herramienta de riesgo aterosclerótico. Métodos: se realizó estudio analítico, sobre el comportamiento de los factores de riesgo aterosclerótico, en 1 926 pacientes propuestos para cirugía electiva no cardiaca que pertenecen al Hospital Universitario "Manuel Ascunce Domenech", durante el período comprendido de septiembre 2007 a septiembre de 2010 en Camagüey. Se elaboró un modelo que utilizó la técnica de análisis multivariado y regresión logística binaria. Al sustituir el valor de cada uno de los factores en el modelo se obtiene como resultado la probabilidad de un individuo de padecer la enfermedad. Se calculó el mejor punto de coincidencia que permite clasificar los individuos como potencialmente sanos o enfermos mediante el procedimiento de curva ROC (Ratio Odd Curve). Resultados: los factores de riesgo asociados fueron: el hábito de fumar, hipertensión arterial, diabetes mellitus, hipercolesterolemia, obesidad, sedentarismo y como factor protector, el sexo femenino. Conclusiones: se determinó la eficacia de la herramienta en y para soporte computarizado, la cual proporciona un pronóstico confiable a los especialistas, sobre los pacientes programados para cirugía con factores de riesgo aterosclerótico.

Introduction: the active approach to the prevention of cardiovascular diseases is mainly based on the fact that these constitute the main cause of premature death in most developed countries. Objective: determine the prognostic efficacy of the atherosclerotic risk tool. Methods: an analytical study was conducted of atherosclerotic risk factors in 1 926 patients proposed for elective non-cardiac surgery at Manuel Ascunce Domenech University Hospital in the province of Camagüey from September 2007 to September 2010. A model was developed based on multivariate analysis and binary logistic regression. The probability that an individual will have the disease is obtained by substituting into the model the value of each one of the factors. A calculation was made of the best point of coincidence allowing to classify individuals as potentially healthy or ill using the ROC (ratio odd curve) procedure. Results: the risk factors associated were the following: smoking, hypertension, diabetes mellitus, hypercholesterolemia, obesity and a sedentary lifestyle, and as a protective factor: female sex. Conclusions: Determination was made of the efficacy of the tool for computerized support, providing specialists with a reliable prognosis about atherosclerotic risk patients scheduled for surgery.