MIT-HOL kerdes [0288]: orvostudomany

1999. Nov. 8., H, 13:42:51 CET

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Kedves Bozsik Anna,

mellekelek nehany tetelt a Medline-bol es szinten a Medline adatbazisbol a
Karnofsky-index definiciojat.
A Medline ingyenesen elerheto az interneten tobb helyen is, az egyik cime a
kovetkezo:
http://www.ncbi.nlm.nih.gov/PubMed/

Udvozlettel:
egy internet-konyvtaros

Az index definicioja a Medline tezauruszban:

Karnofsky Performance Status
TERM NOTES: DEFINITION OF TERM: A performance measure for rating the
ability of a person to perform usual activities, evaluating a patient's
progress after a therapeutic procedure, and determining a patient's
suitability for therapy. It is used most commonly in the prognosis
of cancer therapy, usually after chemotherapy and customarily
administered before and after therapy. It was named for Dr. David A.
Karnofsky, an American specialist in cancer chemotherapy.

Nehany cikk a Medline-bol 1997-tol napjainkig:

[Using Karnofsky's scale to measure the quality of life]
Cuadras-Lacasa-F; Alcaraz-Benavides-M; Llort-Mateu-M; Madriles-Basaganas-MS;
Martin-Ramirez-C; Mesalles-Sin-M; Nogue-Aliguer-M; Rubio-Garcia-A; Saigi-Grau-E
Rev-Enferm. 1998 Jan; 21(233): 18-20
SPANISH
Karnofsky's scale is one of the indexes most frequently used to measure
cancer patients' quality of life. The main problem encountered when trying
to verify it is the degree of subjectivity inherent in it. Due to this, an
attempt was made to create a more objective measuring instrument based on
Karnofsky's scale. To this end, a retrospective study involving 300
outpatients was carried out. For these patients, their Karnofsky index was
determined by two independent agents: the patient's oncologist and the
nursing team which complied its measure based on a survey answered by the
patient himself/herself. The differences between these two methods proved to
be statistically insignificant.

Influence of HIV-infection on the Karnofsky score and general social
functioning in patients with hemophilia.
Wenzel-T; Pindur-G; Morsdorf-S; Giacchi-J
Haemostasis. 1998 Mar-Apr; 28(2): 106-10
Quality of live, defined by different models, has become a major focus of
research in chronic disorders. Patients with hemophilia have been found to
suffer seriously from the impact of HIV infection. To compare the impact of
HIV infection on HIV-positive and HIV-negative patients, we evaluated a
group of 60 patients, 30 being positive and 30 negative, suffering from
hemophilia, using the Karnofsky index of functioning besides more general
social and clinical data. Most patients (n = 53) suffered from hemophilia A.
The mean Karnofsky score decreased from 65.22 to 63.43 in the HIV-infected
group between 1988 and 1991, but increased from 77.7 to 82.2 in the
HIV-negative group; differences were not significant, though differences
were significant between the HIV-infected and HIV-negative groups. The
Karnofsky score remained constant or increased in 26 (86.6%) of the
HIV-negative patients, in contrast to 50% in the infected group. Seven
patients, all from the infected group, had died in 1991. The initial
Karnofsky score was not a prognosticator of survival. The group as a whole
was socially well integrated. Consequently, the Karnofsky score can be a
useful instrument in evaluating the global quality of live in HIV-infected
patients, though a careful evaluation of results is necessary and a low
initial score does not predict survival.
1999189230

Performance status and comorbidity in elderly cancer patients compared with
young patients with neoplasia and elderly patients without neoplastic
conditions [letter]
Rikkert-MG; Diepstraten-AM
Cancer. 1999 Mar 1; 85(5): 1210-1

Outcome of palliative urinary diversion in the treatment of advanced
malignancies.
Shekarriz-B; Shekarriz-H; Upadhyay-J; Banerjee-M; Becker-H; Pontes-JE;
Wood-DP Jr
Cancer. 1999 Feb 15; 85(4): 998-1003
BACKGROUND: It is unclear whether palliative endourologic or percutaneous
urinary diversion in the treatment of advanced cancer provides significant
improvement in quality or duration of life. The purpose of this study was to
evaluate survival and performance status after endourologic palliative
urinary diversion in patients with advanced malignancy and to compare the
results for different malignancies. METHODS: One hundred three patients with
advanced malignancies underwent palliative urinary diversion (stent or
nephrostomy) between 1986 and 1997. Ninety-two patients and 11 patients had
bilateral and unilateral obstruction, respectively. Indications,
complications, performance status after diversion, and survival for patients
with different malignancies were identified and compared. A modified
Karnofsky performance scale (KPS) was used for assessment of physical
performance. A scale of 0-4 was used: 0) hospitalized until death; 1)
bedridden at home, severe pain despite analgesia; 2) moderate disability,
moderate pain despite analgesia; 3) mild disability, pain free with
medication; and 4) normal. RESULTS: The mean age of patients was 68 years.
The mean pre- and postoperative creatinine levels were 6 mg/dL and 3.3
mg/dL, respectively (P < 0.0001). The median survival and days of
hospitalization were 112 and 45, respectively. The median postdiversion KPS
score was 2 (range, 0-4), and 15% of patients never left the hospital.
Overall, 51% required secondary percutaneous procedures, and 68.4% had
complications (minor, 63%; major, 5.4%). CONCLUSIONS: Most patients with
advanced cancers had poor performance status and survival after diversion.
Eighty six percent had cancer-related symptoms despite the diversion. The
average survival was 5 months, 50% of which was spent in the hospital.
Primary endourologic procedures had a high failure rate, and additional
procedures were required.

Who took the clinical out of clinical research?--Mouse versus man: seventh
David A Karnofsky Memorial Lecture--1976.
Freireich-EJ
Clin-Cancer-Res. 1997 Dec; 3(12 Pt 2): 2711-22

Is surgery useful in very old patients with intracranial meningioma? [letter]
Pompili-A; Callovini-G; Delfini-R; Domenicucci-M; Occhipinti-E
Lancet. 1998 Jan 31; 351(9099): 337-8

Karnofsky's score modified for cats.
Hartmann-K; Kuffer-M
Eur-J-Med-Res. 1998 Feb 21; 3(1-2): 95-8
The index of Karnofsky evaluating quality of life was originally developed
by David A. Karnofsky in 1948. It determines the ability of a patient to
carry on normal activities in life by using a scale from 0 to 100%. This
index was modified for the cat. The index enables judgment of life quality
and well-being in cats which is very difficult to interpret. Objectivity is
given by a classification orientated in details concerning general condition
as well as eating, playing, sleeping, and social behavior.

Karnofsky Memorial Lecture. Hereditary cancer: theme and variations.
Knudson-AG
J-Clin-Oncol. 1997 Oct; 15(10): 3280-7

[Use of the Karnofsky index in the evaluation of patients with acute leukemia]
Sretenovic-M; Maksimovic-R; Berger-D; Rolovic-Z; Petrovic-M
Vojnosanit-Pregl. 1997 Mar-Apr; 54(2): 113-7
SERBO-CROATIAN-ROMAN
The longitudinal study of prospective character was performed during the
treatment with the aim to test if Karnofsky's index is an instrument
susceptible to the changes in performance status in the population of adult
patients with acute leukemia. Performance status points out the person's
independence in every day activities and personal care, and more widely, the
independence in social and other activities. The aim was to establish its
changes in adult patients and its possible prognostic value for the therapy
success. The prognostic value of person's activity level was confirmed for
the survival length and the lasting, but not for the complete remission
achievement. It was concluded that Karnofsky's index was sensitive only for
large changes in functional status of acute leukemia patients.
1997357532

Performance status and age as independent predictors of survival among AIDS
patients with primary CNS lymphoma: a multivariate analysis of a
multi-institutional experience.
Corn-BW; Donahue-BR; Rosenstock-JG; Hyslop-T; Brandon-AH; Hegde-HH;
Cooper-JS; Sherr-DL; Fisher-SA; Berson-A; Han-H; Abdel-Wahab-M;
Koprowski-CD; Ruffer-JE; Curran-WJ Jr
Cancer-J-Sci-Am. 1997 Jan-Feb; 3(1): 52-6
PURPOSE: There is limited information about the outcome of AIDS patients
with primary central nervous system lymphoma treated with definitive
irradiation. The purpose of this study was to determine factors associated
with increased survival in such patients. METHODS: An analysis was performed
of 163 patients with AIDS who were evaluated at nine urban hospitals. These
patients were treated for primary central nervous system lymphoma after the
establishment of a tissue diagnosis or on a presumptive basis after failing
empiric treatment for toxoplasmosis. All patients were treated between 1983
and 1995 with radiotherapy (median dose-fractionation scheme = 3 Gy x 10)
and steroids (> 90% dexamethasone). Because multiple fractionation schemes
were used, prescriptions were converted to biologically effective dose
according to the formula Gy10 = Total Dose x (1 + fractional
dose/alpha-beta), using an alpha-beta of 10. RESULTS: Longer median survival
times were associated with high Karnofsky performance status (KPS > or = 70
vs < or = 60: 181 vs 77 days), young age (< 35 vs > 35: 162 vs 61 days), and
high total definitive irradiation doses (> 39 Gy10 vs < 39 Gy10: 162 vs 40
days). Tissue diagnosis, gender, race, number of lesions (solitary vs
multiple), and the presence of other cancers did not influence outcome. In
multivariate analysis, young age, high Karnofsky performance status, and the
delivery of higher biologically effective doses of irradiation retained
independent significance relative to the endpoint of survival. CONCLUSIONS:
Even at urban tertiary medical centers, few AIDS patients with intracranial
lesions undergo biopsies to establish a precise tissue diagnosis. Survival
following definitive irradiation is strongly related to two pretreatment
factors (young age, high performance status) and one treatment factor (total
biologically effective dose of cranial radiotherapy). These variables should
be considered in selecting patients for definitive irradiation and in
designing future studies.

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