Category: Nevin Manimala

Eur Radiol. 2023 Feb 11. doi: 10.1007/s00330-023-09435-0. Online ahead of print.

ABSTRACT

OBJECTIVES: To conduct brainstem MRI shape analysis across neurodegenerative parkinsonisms and control subjects (CS), along with its association with clinical and cerebrospinal fluid (CSF) correlates.

METHODOLOGY: We collected demographic and clinical variables, performed planimetric and shape MRI analyses, and determined CSF neurofilament-light chain (NfL) levels in 84 participants: 11 CS, 12 with Parkinson’s disease (PD), 26 with multiple system atrophy (MSA), 21 with progressive supranuclear palsy (PSP), and 14 with corticobasal degeneration (CBD).

RESULTS: MSA featured the most extensive and significant brainstem shape narrowing (that is, atrophy), mostly in the pons. CBD presented local atrophy in several small areas in the pons and midbrain compared to PD and CS. PSP presented local atrophy in small areas in the posterior and upper midbrain as well as the rostral pons compared to MSA. Our findings of planimetric MRI measurements and CSF NfL levels replicated those from previous literature. Brainstem shape atrophy correlated with worse motor state in all parkinsonisms and with higher NfL levels in MSA, PSP, and PD.

CONCLUSION: Atypical parkinsonisms present different brainstem shape patterns which correlate with clinical severity and neuronal degeneration. In MSA, shape analysis could be further explored as a potential diagnostic biomarker. By contrast, shape analysis appears to have a rather limited discriminant value in PSP.

KEY POINTS: • Atypical parkinsonisms present different brainstem shape patterns. • Shape patterns correlate with clinical severity and neuronal degeneration. • In MSA, shape analysis could be further explored as a potential diagnostic biomarker.

PMID:36773046 | DOI:10.1007/s00330-023-09435-0

J Magn Reson Imaging. 2023 Feb 11. doi: 10.1002/jmri.28641. Online ahead of print.

ABSTRACT

BACKGROUND: High-speed T₂ -corrected multiecho MRS (HISTO-MRS) is emerging as a quantitative modality for detecting muscle fat infiltration (MFF). However, the predictive value of HISTO-MRS for the loss of ambulation (LoA) in Duchenne muscular dystrophy (DMD) is unknown.

PURPOSE: To determine the feasibility of HISTO-MRS for assessing MFF in DMD and further identify the predictive value of HISTO-MRS for the LoA.

STUDY TYPE: Prospective.

SUBJECTS: A total of 134 DMD boys (9.20 ± 2.43 years old) and 21 healthy boys (9.25 ± 2.10 years old).

FIELD STRENGTH/SEQUENCE: A 3 T, fast spin echo T₁ -weighted imaging (T₁ WI), two-point-Dixon gradient echo sequence (2-pt-Dixon) and HISTO-MRS.

ASSESSMENT: Subjective T₁ WI fat grades by three radiologists, ROI analysis for MFF on 2 pt-Dixon (Dixon MFF) and MFF on HISTO-MRS (HISTO MFF) by two radiologists. Clinical motor function: North Star Ambulatory Assessment, 10-m run/walk time, Gowers maneuver, and time to four-stairs climb and descend.

STATISTICAL TESTS: Spearman rank correlation was used to assess the relation of fat filtration assessments and motor ability. Bland-Altman plots was performed to determine the agreement of HISTO MFF and Dixon MFF. Receiver operating characteristic (ROC) curves were analyzed to determine the discriminating ability of above MRI modalities for ambulatory and nonambulatory DMD. Logistic regression was used to identify the predictor of LoA. Variables with P < 0.05 in univariate logistic regression analysis were entered into the multivariate logistic regression model.

RESULTS: HISTO MFF was significantly correlated with Dixon MFF. Bland-Altman plots show good agreement of HISTO MFF and Dixon MFF. ROC curves indicated that HISTO MFF show similar discrimination of LoA for DMD with Dixon MFF but better value than T1WI fat grades. Logistic regression showed that HISTO MFF was an independent predictor for LoA.

DATA CONCLUSION: HISTO-MRS is a potential quantitative method for assessing fat infiltration and shows predictive value for LoA in DMD patients.

TECHNICAL EFFICACY: Stage 5.

PMID:36773028 | DOI:10.1002/jmri.28641

Alcohol Clin Exp Res. 2023 Feb 11. doi: 10.1111/acer.14962. Online ahead of print.

ABSTRACT

Clinicians’ risk behaviors, including their personal alcohol use, may influence patients’ attitudes and motivation to make changes in their lifestyle, as well as the provision of clinical preventive services to reduce unhealthy behaviors. The aim of the systematic review was to summarize the existing evidence on the association between clinicians’ alcohol consumption and their preventive practices to reduce unhealthy alcohol use. The review was conducted following Cochrane guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidance. Three databases (Cochrane, MEDLINE, Web of Science) were queried from July 1, 2021, through November 30, 2021. We included quantitative observational studies reporting clinicians’ alcohol use associations with relevant preventive practices. Two reviewers independently screened articles for inclusion, extracted data, and assessed the quality of selected studies. Ten studies, published from 1986 to 2018, were included. We found a statistically significant association between clinicians’ alcohol consumption and their preventive practices to reduce unhealthy alcohol use in eight of the 10 studies. Clinicians who drank larger quantities of alcohol offered less screening and counseling to their patients about alcohol use. Clinicians who drank regularly (3 days a week or more) were less likely to screen for alcohol use, and the frequency of alcohol use by those professionals was inversely related to recommending quitting. Clinicians’ alcohol use appears to be associated with their screening for unhealthy alcohol use and counseling to reduce it. The frequency and quantity of clinicians’ alcohol consumption were also associated with their practices to address unhealthy alcohol use.

PMID:36773022 | DOI:10.1111/acer.14962

J Magn Reson Imaging. 2023 Feb 11. doi: 10.1002/jmri.28614. Online ahead of print.

ABSTRACT

BACKGROUND: MRI-ultrasound fusion targeted biopsy (MRI-TBx) improves the clinically significant prostate cancer (csPCa) detection with fewer cores. However, whether systematic biopsy-guided by transrectal ultrasound (TRUS-SBx) can be omitted when undergoing MRI-TBx in transition zone (TZ) and peripheral zone (PZ) remains unclear.

PURPOSE: To assess the performance and effectiveness of MRI-TBx based on PI-RADS v2.1 for csPCa diagnosis in TZ and PZ, respectively.

STUDY TYPE: Retrospective.

SUBJECTS: A total of 309 selected cases (median age 70 years) with 356 lesions who underwent both MRI-TBx and TRUS-SBx were enrolled.

FIELD STRENGTH/SEQUENCE: A 3.0 T, multiparametric MRI (mp-MRI) including T2-weighted turbo-spin echo imaging (T2WI), diffusion-weighted spin-echo echo planar imaging (DWI), dynamic contrast-enhanced MRI with time-resolved T1-weighted imaging (DCE).

ASSESSMENT: Mp-MRI was assessed by two radiologists using PI-RADS v2.1. The csPCa detection rates provided by MRI-TBx, TRUS-SBx and combined biopsy in TZ and PZ were calculated, respectively.

STATISTICAL TESTS: McNemar test was used to compare the csPCa detection rates in TZ and PZ, respectively. The frequencies and distribution of all detected prostate cancers by different biopsy methods were also compared. P < 0.05 was considered statistically significant.

RESULTS: Among 356 lesions in 309 patients, 208 (68 in TZ, 140 in PZ) were pathologically confirmed as csPCa. In TZ, there were significant differences for csPCa detection with PI-RADS 3 between combined biopsy and TRUS-SBx (23.5% vs. 15.3%), MRI-TBx (23.5% vs. 16.3%), respectively. MRI-TBx detected 23% (19/83) cases missed by TRUS-SBx in which 68% (13/19) were csPCa. In PZ, there were no statistical differences between MRI-TBx and combined biopsy with PI-RADS 3-5 (P = 0.21, 0.25, 0.07, respectively). In 9% (14/152) cases only detected by MRI-TBx, 86% (12/14) were clinically significant. Five percent (7/152) of cases only detected by TRUS-SBx were completely nonclinically significant.

DATA CONCLUSION: MRI-TBx played a positive role on csPCa diagnosis in TZ, but combined biopsy might be the best choice especially in the subgroup PI-RADS 3. In PZ, MRI-TBx had an advantage over TRUS-SBx for csPCa detection.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 2.

PMID:36773016 | DOI:10.1002/jmri.28614

J Magn Reson Imaging. 2023 Feb 11. doi: 10.1002/jmri.28645. Online ahead of print.

ABSTRACT

BACKGROUND: MRI is crucial in diagnosing hepatocellular carcinoma (HCC). Superparamagnetic iron oxide particles (SPIO) are liver-specific contrast agents which enhance lesions in T₂ -weighted images. Iron oxide nano-particle m-PEG-silane (IOP) Injection, a newly developed SPIO, showed promising imaging effects and good safety profile in preclinical studies and in phase I clinical trial.

PURPOSE: To evaluate the safety and clinical validity of IOP Injection as MRI contrast agent in diagnosing HCC.

STUDY TYPE: Prospective.

SUBJECTS: A total of 52 subjects (61.6 ± 11.05 years, 45 males/7 females) with suspected HCC.

FIELD STRENGTH/SEQUENCE: 1.5 T, T₁ -weighted in/opposed phase, T₂ *-weighted gradient echo, T₂ -weighted fast spin echo, true fast imaging with steady-state free precession.

ASSESSMENT: Adverse effects and clinical monitoring were recorded throughout the 5-day study. Two independent readers (M.G.H. with 30 years of experience, S.P.K. with 26 years of experience) made the diagnosis. The diagnostic performance of IOP-enhanced MRI was evaluated with sensitivity and positive predictive value by comparing to the pathology reports from subsequent hepatic resection. The number of lesions with various sizes and degrees of differentiation detected by IOP-enhanced MRI was assessed. The relative change in signal intensities over time was indirectly measured from acquired images.

STATISTICAL TESTS: Sensitivity and positive predictive value were used to evaluate the diagnostic performance of IOP-enhanced MRI. Prevalence-adjusted and bias-adjusted 𝜅 coefficient was used to assess the interreader variability.

RESULTS: No serious adverse event related to IOP Injection was found. IOP Injection enhanced the lesion-to-liver contrast ratio in T₂ *-weighted images by 50.1% ± 4.8%. IOP-enhanced MRI detected HCC with 100% sensitivity by subject and 96% sensitivity by lesion. IOP Injection visualized subtle vascular invasion as filling defect within vessels in true fast imaging with steady-state free precession (TrueFISP) images.

DATA CONCLUSION: IOP Injection was safe and efficacious as MRI contrast agent in diagnosing HCC in a limited group of subjects.

EVIDENCE LEVEL: 2.

TECHNICAL EFFICACY: Stage 2.

PMID:36773005 | DOI:10.1002/jmri.28645

Vet Ophthalmol. 2023 Feb 11. doi: 10.1111/vop.13068. Online ahead of print.

ABSTRACT

PURPOSE: To survey commonly used, sterile ophthalmic viscoelastic materials used during routine cataract surgery for the presence of bacterial DNA and/or viable bacteria and endotoxin quantification.

METHODS: Samples from three different ophthalmic viscoelastic manufacturers and three different production lots per manufacturer were collected for 16 S ribosomal ribonucleic acid (rRNA) sequencing and conventional aerobic and capnophilic bacterial culture. Other samples of viscoelastic material from the same three manufacturers were collected for endotoxin quantification using a commercially available Limulus amebocyte lysate (LAL) assay. Statistical analysis was performed using Sigma Plot 14.0, and R v4.0.2.0. Differences (p ≤ .05) between sample collection sites in total DNA concentration, microbial richness, mean intra-group distances, and endotoxin quantification alongside reagent controls were evaluated.

RESULTS: Culture yielded two isolates, identified as Staphylococcus epidermidis and Bacillus megaterium. 16 S rRNA sequencing revealed no differences between brands in richness or overall composition. The most common bacterial DNA detected across all brands was Staphylococcus sp., Cutibacterium sp., Flavobacterium sp., and Lactobacillus sp. A significant difference was found between the median endotoxin concentration between Anvision and Hyvisc® viscoelastic (Anvision: 0.171 EU/mL, Hyvisc®: 0.03 EU/mL; p < .001).

CONCLUSIONS: No brand-specific differences in bacterial DNA were detected in the viscoelastic materials. Staphylococcus, Cutibacterium, Flavobacterium, and Lactobacillus were the dominant contributors to the bacterial DNA detected. Although Anvision viscoelastic samples contained significantly more endotoxin than Hyvisc® viscoelastic samples, endotoxin concentrations were below the FDA limit of 0.2 EU/mL for both manufacturers. These data further the understanding of inflammatory outcomes following cataract surgery.

PMID:36772992 | DOI:10.1111/vop.13068

Acta Paediatr. 2023 Feb 11. doi: 10.1111/apa.16705. Online ahead of print.

ABSTRACT

AIM: The immune status of children recovering from SARS-CoV-2 infection is not completely understood. We describe IgG anti-spike persistence in children infected during the first two pandemic waves. In addition, we compared with healthy controls their leukocyte populations and CD64 expression.

METHODS: Cross-sectional study. Done from October 2021 to February 2022 in non-reinfected and non-vaccinated children with SARS-CoV-2 in 2020. The presence of anti-spike IgG was studied using chemiluminescent immunoassay. Leukocyte populations were analysed using flow cytometry and marked for CD45, CD4, CD8, and CD64. Statistical minor than 0,05 was considered significant.

RESULTS: One hundred eighty-three control and 77 patients were included. IgG anti-spike determinations were performed after a median of 501 days (262-464); 52/77 children were positive. Cases showed significantly higher percentages of monocytes, lymphocytes, CD8+ and CD4+. In addition, CD64 expression was higher in monocytes and neutrophils. The presence of IgG anti-spike was accompanied by a higher percentage of CD64+ neutrophils.

CONCLUSION: In our series, the SARS-CoV-2 IgG anti-spike protein was usually positive beyond one year after infection. Furthermore, leukocyte populations from cases differ from controls, with higher CD64 expression on neutrophils and monocytes. Prospective clinical observations are required to confirm the implications of these findings.

PMID:36772991 | DOI:10.1111/apa.16705

Res Synth Methods. 2023 Feb 11. doi: 10.1002/jrsm.1627. Online ahead of print.

ABSTRACT

Outputs from living evidence syntheses projects have been used widely during the pandemic by guideline developers to form evidence-based recommendations. However, the needs of different stakeholders cannot be accommodated by solely providing pre-defined non amendable numerical summaries. Stakeholders also need to understand the data and perform their own exploratory analyses. This requires resources, time, statistical expertise, software knowledge as well as relevant clinical expertise to avoid spurious conclusions. To assist them, we created the metaCOVID application which, based on automation processes, facilitates the fast exploration of the data and the conduct of sub-analyses tailored to end-users needs. metaCOVID has been created in R and is freely available as an R-Shiny application. Based on the COVID-NMA platform (https://covid-nma.com/) the application conducts living meta-analyses of RCTs related to COVID-19 treatments and vaccines for several outcomes. Several options are available for subgroup and sensitivity analyses. The results are presented in downloadable forest plots. We illustrate metaCOVID through three examples involving well-known treatments and vaccines for COVID-19. The application is freely available from https://covid-nma.com/metacovid/. This article is protected by copyright. All rights reserved.

PMID:36772980 | DOI:10.1002/jrsm.1627

Am J Health Promot. 2023 Feb 11:8901171231156513. doi: 10.1177/08901171231156513. Online ahead of print.

ABSTRACT

PURPOSE: To examine the associations between dietary intake as assessed by a rapid, image-based digital tool and biomarkers of cardiometabolic health.

DESIGN: Retrospective analysis of adults with blood biomarkers performed by Boston Heart Diagnostics (BHD) between December 2020 and March 2022.

SETTING: Outpatient centers serviced by BHD.

SUBJECTS: 546 adults, excluding those taking relevant medications and/or supplements known to affect blood test results.

MEASURES: Laboratory assays of blood specimens were performed by Boston Heart Diagnostics. Nutrient intake and diet quality data were obtained using Diet Quality Photo Navigation (DQPN®; US Patent #11,328,810 B2) technique via Diet ID™ tool.

ANALYSIS: Pearson correlation coefficients (for continuous variables) and Spearman coefficients (for ordinal variables) were used to evaluate associations between nutrient intake data and laboratory data for the full study sample. Two-sided P-values < .05 were considered statistically significant.

RESULTS: Both continuous and ordinal measures of diet quality correlated significantly with HDL-C and triglycerides (n = 485; P < .0 01); with hs-CRP (n = 441; P < .001); with HgbA1c (n = 345; P < .01); with fasting insulin (n = 372; P < .001); and with HOMA-IR (n = 319; P < .001).

CONCLUSION: Findings affirm that rapid, digital diet quality and composition assessment by pattern recognition rather than recall tracks significantly with key biomarkers of cardiometabolic health.

PMID:36772929 | DOI:10.1177/08901171231156513

J Investig Med. 2023 Feb 11:10815589221140588. doi: 10.1177/10815589221140588. Online ahead of print.

ABSTRACT

Electronic cigarettes (e-cigarettes) provide a novel source of nicotine and may lead to experimentation by adolescents and eventually to their use of conventional cigarettes. The National Youth Tobacco Survey collected information from a nationally representative sample of students in 2016 to determine their experiences with conventional cigarettes and e-cigarettes, their intentions to use these products in the future, and their perceptions of harm and addiction associated with these products. We analyzed these data with ordered probit regression models to determine possible associations with the intention to try e-cigarettes and conventional cigarettes. This survey included 20,520 respondents, 50.6% were male, 5.9% had used conventional cigarettes, and 9.0% had used e-cigarettes. Approximately 10% thought e-cigarettes caused no harm, 3.7% thought that conventional cigarettes caused no harm, and 52.5% thought that e-cigarettes were less harmful than conventional cigarettes. Less than 1% of the students responded “Definitely yes” to the question, “Do you think you will try an e-cig?” The odds ratios for an intention to try e-cigarettes increased as the perception of harm decreased; these ratios increased from 1.0 for “A lot of harm” to 5.85 (95% CI: 3.51, 9.75) for “No harm.” In 2016, the majority of students thought that e-cigarettes could cause some harm. This survey indicates that most students have not tried e-cigarettes or conventional cigarettes. The minority of students who think that e-cigarettes pose no harm and students in the ages 14 and 16 are more likely to try them.

PMID:36772925 | DOI:10.1177/10815589221140588