BACKGROUND: Sepsis is a medical emergency during which early detection is closely associated with mortality. In sepsis, red blood cell (RBC) abnormalities have been reported. However, it is not known how early RBC abnormalities are expressed compared with various clinical manifestations used in sepsis-related organ failure assessment (SOFA). OBJECTIVE: Therefore, using a lipopolysaccharide (LPS)-induced sepsis model we investigated the clinical significance of RBC abnormalities as an early indicator in the detection of septic injury compared with clinical variables. METHODS: Sprague-Dawley rats received LPS (20 mg/kg) intraperitoneally. Aggregation indices (AIs) and aggregation half-time (T1/2), and elongation indices (EI max ) were measured. Clinical data-related SOFA and lactate were measured at 2 h, 4 h, 8 h and 12 h after LPS injection. RESULTS: AIs increased at 4 h, and T1/2 decreased at 2 h after LPS injection. Platelet counts decreased at 4 h, and lactate increased at 2 h after LPS injection. AIs showed strong correlations with T1/2 and platelets, EI max increased at 2 h after LPS injection, while EI max had a positive correlation with lactate. CONCLUSIONS: RBC aggregation appears to be an early indicator of clinical deterioration in sepsis and may represent a diagnostic indicator in sepsis.
Purpose: In the treatment of breast cancer, neoadjuvant chemotherapy (NAC) is useful to reduce breast cancer size before surgical intervention. Patients who achieve a pathologic complete response (pCR) to NAC have improved overall survival (OS). However, the relationship between prognosis and partial response is yet unclear. In this study, we evaluated prognostic factors and the tumor response ratio (TRR) method among patients who received NAC. Methods: Clinicopathologic factors were evaluated to predict OS. The TRR was calculated by dividing pathologic tumor size by clinical tumor size. TRRs were then categorized into four groups, and the survival times for the different TRR groups were compared using statistical evaluation. Results: Clinical N stage (p= 0.02), overall stage (p= 0.04), pathologic N stage (p= 0.03), hormone receptor status (p= 0.01), and lymphovascular invasion (p= 0.02) were significantly associated with OS. Pathologic overall stage and TRR did not correlate with OS. Patients with a pCR exhibited the best survival rates using the current staging system and the TRR method. Conclusion: Clinicopathologic factors can be easily applied to predict OS, and clinicians could use these parameters until an accurate, simple, and highly discriminatory methods is developed to assess breast cancer patients with a partial.
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