INTRODUCTION: Cognitive impairment is frequent in multiple sclerosis and predominantly affects visuospatial abilities, memory, attention, and executive functions. Because of the specific cognitive profile, different from that in Alzheimer's disease and other frequent disorders presenting with dementia, specific neuropsychological instruments need to be used in multiple sclerosis. The aim of the present study is to assess the applicability of the Rey-Osterrieth complex figure test (ROCFT) for assessing cognitive impairment in patients with multiple sclerosis in comparison with a control group. MATERIAL AND METHODS: One hundred and two individuals, 70 patients with MS and 32 healthy control subjects were assessed using ROCFT. A standardized system for assessment by points and percentages was used. The results from both groups were compared statistically using independent samples t-test. RESULTS: On the copying task, the differences between patients and controls reached statistical significance, p<0.05 for the raw score, and p<0.001 after results were grouped by percentiles. On the drawing by memory task the differences between the two groups also showed statistical significance, p<0.01. CONCLUSION: ROCFT shows statistically significant differences between patients with multiple sclerosis and healthy subjects. Highest levels of significance were observed for copying, scored by percentiles, and for drawing by memory. The application of ROCFT can provide valuable information about cognitive dysfunction in multiple sclerosis.
Introductions
Immuno-oncology is a rapidly developing field wherein tumor-immune system interactions can be harnessed for diagnostics. Herein, we set out to establish the role of the immune system response, as measured by preoperative neutrophil, platelet, and monocyte to lymphocyte ratios (NLR, PLR, and MLR) as prognostic markers for patient survival based on the newly defined criteria for glioblastoma (GBM).
Materials and methods
The study included patients diagnosed with GBM at a four-year interval. Exclusion criteria were patients subject to reoperation in the time period; tumors in more than one system; a history of hematological and autoimmune diseases; and cases with infectious or other inflammatory conditions. Data regarding patient demographics and preoperative blood counts were pulled from patient records and compared to postoperative survival.
Results
A total of 22 patients fit the established criteria, with a male to female ratio of 2.14:1, a mean age of 66.23 years, and a mean survival of 255.72 days (8.04 months, range 24-801 days). Eight patients had an elevation of NLR and five of PLR, with no statistical correlation to survival. Six patients had an increase in MLR with a statistically significant (p=0.0044) shorter postoperative survival. Synergic increases in NLR and PLR did not show significance, while synergic increases with MLR showed no added benefit.
Conclusion
Preoperative MLR, but not NLR or PLR, is a promising independent biomarker for patient survival in GBM. It is suggested that elevations in these ratios directly correlate to tumor biological potential.
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