At baseline, all participants reported past daily drug use, with 27% currently using opioids daily, and 20% currently using stimulants daily. Between April 2019 and May 2022, the study enrolled 257 participants ages 19 years or older (median age: 51 40% Indigenous, 11.6% non-Indigenous people of colour 39% cis-gender women, 3.9% transgender, genderqueer, or two-spirit) and 41 qualitative participants. A subset of participants complete nested semi-structured qualitative interviews semi-annually. Participants complete interviewer-administered surveys quarterly. This paper describes the objectives, design, and characteristics of the ASSET study cohort, an open prospective cohort which aims to provide data on opportunities for addressing economic engagement in an inner-city drug-using population in Vancouver, Canada. The Assessing Economic Transitions (ASSET) study was established to identify relationships between economic engagement, health and well-being in inner-city populations given that research in this area is currently underdeveloped.
Neutrophilia at any time interval surrounding radiotherapy, pre-radiation NLR, and post-radiation thrombocytopenia, but not lymphocytes or monocytes, are predictors of poor patient survival in glioma patients. Lymphopenia, changes in lymphocyte counts, monocytosis, MLR, and changes in monocyte counts did not impact patient survival. Patients receiving dexamethasone during radiation exhibited greater increases in neutrophil counts than those not receiving steroids. Patients receiving more than 15 fractions of radiation exhibited greater post-radiation decreases in neutrophil and platelet counts than those receiving fewer. Post-radiation PLR > 200 (Hazard ratio = 0.587, p = 0.0062) and a percent increase in platelets after radiation (Hazard ratio = 0.387, p = 0.0077) were also associated with improved OS. Multivariable analysis identified pre-radiation NLR > 4.0 (Hazard ratio = 1.847, p = 0.0039) and neutrophilia prior to (Hazard ratio = 1.706, p = 0.0185), during (Hazard ratio = 1.641, p = 0.0277), or after (Hazard ratio = 1.517, p = 0.0879) radiation as significant predictors of worse OS, with similar results for PFS. Multivariable cox proportional hazards analysis for overall survival (OS) and progression-free survival (PFS) was performed to control for patient variables. Patient blood samples were collected within one month before, during, or within 3 months after radiation for quantification of hematologic cell counts, for which failure patterns were evaluated. We sought to identify which hematologic cell measurements before, during, or after radiation predicted for patient survival.Ī cohort of 182 patients with pathologically confirmed gliomas treated at our institution was retrospectively reviewed. While preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) have been suggested as prognostic systemic inflammation markers, the impact of post-radiation changes in these cell types is unclear.
Poor outcomes in glioma patients indicate a need to determine prognostic indicators of survival to better guide patient specific treatment options.
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