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Nachmany I, Gudmundsdottir H, Meiri H, Eidelman P, Ziv O, Bear L, Nevo N, Jacoby H, Eshkenazy R, Pery R, Pencovich N. Perioperative Platelet Count Ratio Predicts Long-Term Survival after Left Pancreatectomy and Splenectomy for Pancreatic Adenocarcinoma. J Clin Med 2024; 13:1050. [PMID: 38398363 PMCID: PMC10888544 DOI: 10.3390/jcm13041050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The value of platelet characteristics as a prognostic factor in patients with pancreatic adenocarcinoma (PDAC) remains unclear. METHODS We assessed the prognostic ability of post-splenectomy thrombocytosis in patients who underwent left pancreatectomy for PDAC. Perioperative platelet count ratio (PPR), defined as the ratio between the maximum platelet count during the first five days following surgery and the preoperative level, was assessed in relation to long-term outcomes in patients who underwent left pancreatectomy for PDAC between November 2008 and October 2022. RESULTS A comparative cohort of 245 patients who underwent pancreaticoduodenectomy for PDAC was also evaluated. The median PPR among 106 patients who underwent left pancreatectomy was 1.4 (IQR1.1, 1.8). Forty-six had a PPR ≥ 1.5 (median 1.9, IQR1.7, 2.4) and 60 had a PPR < 1.5 (median 1.2, IQR1.0, 1.3). Patients with a PPR ≥ 1.5 had increased median overall survival (OS) compared to patients with a PPR < 1.5 (40 months vs. 20 months, p < 0.001). In multivariate analysis, PPR < 1.5 remained a strong predictor of worse OS (HR 2.24, p = 0.008). Among patients who underwent pancreaticoduodenectomy, the median PPR was 1.1 (IQR1.0, 1.3), which was significantly lower compared to patients who underwent left pancreatectomy (p > 0.001) and did not predict OS. CONCLUSION PPR is a biomarker for OS after left pancreatectomy for PDAC. Further studies are warranted to consolidate these findings.
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Affiliation(s)
- Ido Nachmany
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | | | - Hila Meiri
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Pavel Eidelman
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Ofir Ziv
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Lior Bear
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Nadav Nevo
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Harel Jacoby
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Rony Eshkenazy
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Ron Pery
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
| | - Niv Pencovich
- Department of General Surgery and Transplantation, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv 52621, Israel; (I.N.); (H.M.); (P.E.); (O.Z.); (L.B.); (N.N.); (H.J.); (R.E.); (R.P.)
- Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA
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Soehner AM, Kaplan KA, Saletin JM, Talbot LS, Hairston IS, Gruber J, Eidelman P, Walker MP, Harvey AG. You'll feel better in the morning: slow wave activity and overnight mood regulation in interepisode bipolar disorder. Psychol Med 2018; 48:249-260. [PMID: 28625231 PMCID: PMC5736461 DOI: 10.1017/s0033291717001581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Sleep disturbances are prominent correlates of acute mood episodes and inadequate recovery in bipolar disorder (BD), yet the mechanistic relationship between sleep physiology and mood remains poorly understood. Using a series of pre-sleep mood inductions and overnight sleep recording, this study examined the relationship between overnight mood regulation and a marker of sleep intensity (non-rapid eye movement sleep slow wave activity; NREM SWA) during the interepisode phase of BD. METHODS Adults with interepisode BD type 1 (BD; n = 20) and healthy adult controls (CTL; n = 23) slept in the laboratory for a screening night, a neutral mood induction night (baseline), a happy mood induction night, and a sad mood induction night. NREM SWA (0.75-4.75 Hz) was derived from overnight sleep EEG recordings. Overnight mood regulation was evaluated using an affect grid pleasantness rating post-mood induction (pre-sleep) and the next morning. RESULTS Overnight mood regulation did not differ between groups following the sad or happy inductions. SWA did not significantly change for either group on the sad induction night compared with baseline. In BD only, SWA on the sad night was related to impaired overnight negative mood regulation. On the happy induction night, SWA increased relative to baseline in both groups, though SWA was not related to overnight mood regulation for either group. CONCLUSIONS These findings indicate that SWA disruption may play a role in sustaining negative mood state from the previous night in interepisode BD. However, positive mood state could enhance SWA in bipolar patients and healthy adults.
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Affiliation(s)
- A M Soehner
- Department of Psychiatry,University of Pittsburgh School of Medicine,Pittsburgh, PA,USA
| | - K A Kaplan
- Department of Psychiatry,Stanford University School of Medicine,Stanford, CA,USA
| | - J M Saletin
- Department of Psychiatry and Human Behavior,Alpert Medical School of Brown University,Providence, RI,USA
| | - L S Talbot
- San Francisco Veterans Affairs Medical Center,San Francisco, CA,USA
| | - I S Hairston
- School of Behavioral Sciences, Academic College of Tel Aviv - Jaffa,Jaffa,Israel
| | - J Gruber
- Department of Psychology,University of Colorado,Boulder, Boulder, CO,USA
| | - P Eidelman
- Cognitive Behavior Therapy and Science Center,Oakland, CA,USA
| | - M P Walker
- Department of Psychology,University of California,Berkeley, Berkeley, CA,USA
| | - A G Harvey
- Department of Psychology,University of California,Berkeley, Berkeley, CA,USA
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Ostacher MJ, Nierenberg AA, Iosifescu DV, Eidelman P, Lund HG, Ametrano RM, Kaczynski R, Calabrese J, Miklowitz DJ, Sachs GS, Perlick DA. Correlates of subjective and objective burden among caregivers of patients with bipolar disorder. Acta Psychiatr Scand 2008; 118:49-56. [PMID: 18582347 DOI: 10.1111/j.1600-0447.2008.01201.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We examined the relationship between mood symptoms and episodes in patients with bipolar disorder and burden reported by their primary caregivers. METHOD Data on subjective and objective burden reported by 500 primary caregivers for 500 patients with bipolar disorder participating in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were collected using semistructured interviews. Patient data were collected prospectively over 1 year. The relationship between patient course and subsequent caregiver burden was examined. RESULTS Episodes of patient depression, but not mood elevation, were associated with greater objective and subjective caregiver burden. Burden was associated with fewer patient days well over the previous year. Patient depression was associated with caregiver burden even after controlling for days well. CONCLUSION Patient depression, after accounting for chronicity of symptoms, independently predicts caregiver burden. This study underscores the important impact of bipolar depression on those most closely involved with those whom it affects.
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Affiliation(s)
- M J Ostacher
- Massachusetts General Hospital, Bipolar Clinic and Research Program, Boston, MA, and Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA.
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