Tag: nevin manimala

Nucl Med Rev Cent East Eur. 2021;24(2):63-69. doi: 10.5603/NMR.2021.0017.

ABSTRACT

BACKGROUND: About 30% of patients with disseminated differentiated thyroid cancer (DTC) may experience a loss of iodine uptake. It is associated with higher aggressiveness of the tumour and a reduced 10-year survival rate. The diagnosis of non-radioiodine avid DTC metastases remains a diagnostic challenge. A helpful technique for this diagnosis is positron emission tomography with 2-[¹⁸F]fluoro-2-deoxy-D-glucose (PET/CT with [¹⁸F]FDG). On the other hand, there are still discussions about the clinical value of using exogenous thyroid-stimulating hormone (TSH) stimulation before PET/CT with [¹⁸F]FDG. The aim of the study was the assessment of the usefulness of PET/CT with [¹⁸F]FDG under TSH suppression and stimulation of TSH performed in the detection of non-radioiodine avid DTC metastases, as well as determination of the thyroglobulin concentration under suppression and stimulation of TSH, which influences the result of PET/CT with [¹⁸F]FDG in patients with non-radioiodine avid DTC.

MATERIAL AND METHODS: Retrospective analysis of 37 PET/CT with [¹⁸F]FDG performed in patients with DTC diagnosed and treated at the Department of Endocrinology and Isotope Therapy of the Military Institute of Medicine from January 2018 to July 2020. Of these, PET/CT with [¹⁸F]FDG under exogenous rhTSH stimulation was performed in 22 patients and PET/CT with [¹⁸F]FDG under TSH suppression in 15 was performed. In all analyzed patients, the result of diagnostic whole-body scintigraphy (WBS) using 80 MBq ¹³¹I under rhTSH stimulation was negative, and the concentration of thyroglobulin after stimulation (sTg) was greater than 1.0 ng/mL.

RESULTS: In the group of patients examined under TSH suppression, non-radioiodine avid in PET/CT with [¹⁸F]FDG were found in 6 out of 15 patients (40%) and in the group of patients examined under rhTSH stimulation in 10 out of 22 patients (45%). The differences between the groups were not statistically significant. The analysis of the receiver operating characteristic (ROC) curves allowed to determine the cut-off point for the positive result of PET/CT performed under TSH suppression with sTg concentration of 11.03 ng/mL. In the group of studies performed under rhTSH stimulation, the cut-off point for sTg was 6.3 ng/mL. There was no statistically significant difference between the baseline thyroglobulin (natTg) and sTg levels and the positive PET/CT result. The administration of rhTSH before the PET/CT examination also had no statistically significant effect on the maximum standard uptake value (SUVmax) of the dominant lesion identified in the PET/CT.

CONCLUSIONS: 1) PET/CT with [¹⁸F]FDG is a useful tool for detection of non-radioiodine avid recurrence and/or metastases of DTC. 2) The concentration of natTg and sTg is highly correlated with a positive result of PET/CT with [¹⁸F]FDG. 3) The concentration of natTg is comparable with sTg in predicting a positive result of PET/CT with [¹⁸F]FDG. 4) The cut-off point for a positive result of PET/CT for natTg was 1.36 ng/mL and for sTg was 7.05 ng/mL.

PMID:34382670 | DOI:10.5603/NMR.2021.0017

Health Serv Res. 2021 Aug 12. doi: 10.1111/1475-6773.13853. Online ahead of print.

ABSTRACT

OBJECTIVES: To (1) develop a survey to assess the patient experience of care in hospital-based emergency departments (ED) and (2) evaluate the reliability and validity of composite measures of patient experience using data collected through the experimental implementation of the newly developed Emergency Department Patient Experience of Care (EDPEC) Discharged to Community (DTC) Survey.

DATA SOURCE: 4893 adult patients were treated in the ED of 16 hospitals across the United States in 2018.

STUDY DESIGN: The study utilized a cross-sectional survey.

DATA COLLECTION: Survey development activities included a literature review, focus groups, and cognitive interviews with recently discharged ED patients, technical expert panels, and multiple field experiments. Survey development resulted in a 34-item instrument; the analysis reported here focuses on 18 items on patient experience of care. Using data from the EDPEC DTC Survey in the 2018 Feasibility Test, we performed confirmatory factor analysis to group 15 evaluative survey items into composite measures. We examined internal consistency reliability, interunit reliability, and associations between each composite measure and patients’ overall rating and willingness to recommend the ED.

PRINCIPAL FINDINGS: Analyses of 15 evaluative items identified four composite measures: Getting Timely Care, How Well Doctors and Nurses Communicate, Communication about Medications, and Communication about Follow-up. Patient-level internal consistency reliability exceeded 0.75 for two of four composites; ED-level internal consistency reliability exceeded 0.83 for all four composites. Interunit reliability estimates indicated that 450 survey completes per ED results in at least 0.70 reliability for all composites. Higher scores on each composite were associated with higher overall ratings and willingness to recommend the ED.

CONCLUSIONS: The composite measures derived from the EDPEC DTC Survey are statistically reliable and valid. These results provide guidance for EDPEC DTC Survey adopters on how to construct meaningful and psychometrically-sound composite measures for monitoring the quality of care they provide.

PMID:34382685 | DOI:10.1111/1475-6773.13853

J Clin Endocrinol Metab. 2021 Aug 12:dgab564. doi: 10.1210/clinem/dgab564. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to determine the procalcitonin (ProCT) diagnostic accuracy in prediction and treatment monitoring of medullary thyroid carcinoma (MTC).

DATA SOURCES: Electronic databases were searched for observational studies published until May 2021 without language or time restrictions.

STUDY SELECTION: Studies comparing ProCT and calcitonin accuracy were included. After removing duplicates and exclusion of not-eligible articles, relevant articles were screened independently by two reviewers. Eleven studies (4.5% of the identified studies) met the selection criteria.

DATA EXTRACTION: Two reviewers independently extracted data and assessed data quality and validity through QUADAS-2.

DATA SYNTHESIS: A meta-analysis was performed on sufficiently clinically and statistically homogeneous eleven studies (n = 5817 patients, 335 MTC patients). HSROC and bivariate methods were applied. Serum ProCT was found to be a highly accurate test for MTC diagnosis and monitoring. The pooled sensitivity, specificity, positive and negative likelihood ratios, AUC, and positive and negative predictive values for ProCT were 0.90 (95%CI: 0.71-0.97), 1.00 (95%CI: 0.85-1.00), 288 (95%CI: 5.6-14929.3), 0.10 (95%CI: 0.03-0.33), 0.97 (95%CI: 0.95-0.98), 99% and 2%.

CONCLUSIONS: The high accuracy, compounded with favorable analytical characteristics, give ProCT great potential to replace calcitonin as a new standard of care in the management of MTC.

PMID:34382653 | DOI:10.1210/clinem/dgab564

J Gerontol A Biol Sci Med Sci. 2021 Aug 12:glab212. doi: 10.1093/gerona/glab212. Online ahead of print.

ABSTRACT

Quantifying the physiology of aging is essential for improving our understanding of age-related disease and the heterogeneity of healthy aging. Recent studies have shown that in regression models using “-omic” platforms to predict chronological age, residual variation in predicted age is correlated with health outcomes, and suggest that these “omic clocks” provide measures of biological age. This paper presents predictive models for age using metabolomic profiles of cerebrospinal fluid from healthy human subjects, and finds that metabolite and lipid data are generally able to predict chronological age within 10 years. We use these models to predict the age of a cohort of subjects with Alzheimer’s and Parkinson’s disease and find an increase in prediction error, potentially indicating that the relationship between the metabolome and chronological age differs with these diseases. However, evidence is not found to support the hypothesis that our models will consistently over-predict the age of these subjects. In our analysis of control subjects, we find the carnitine shuttle, sucrose, biopterin, vitamin E metabolism, tryptophan, and tyrosine to be the most associated with age. We showcase the potential usefulness of age prediction models in a small dataset (n = 85), and discuss techniques for drift correction, missing data imputation, and regularized regression, which can be used to help mitigate the statistical challenges that commonly arise in this setting. To our knowledge, this work presents the first multivariate predictive metabolomic and lipidomic models for age using mass spectrometry analysis of cerebrospinal fluid.

PMID:34382643 | DOI:10.1093/gerona/glab212

Am J Hypertens. 2021 Aug 12:hpab129. doi: 10.1093/ajh/hpab129. Online ahead of print.

ABSTRACT

BACKGROUND: Blood pressure (BP) control was only 43.7% in the National Health and Nutrition Survey (NHANES) survey in 2017-2018. Scalable, non-clinic-based strategies to control BP are needed. We therefore conducted a pilot trial of a text-messaging intervention in a national network of retail outlet health kiosks with BP devices. All study procedures were conducted remotely.

METHODS: Eligible individuals (N=140), based on average BP >140/90 mmHg at kiosks during the prior year, were randomized to intervention vs. usual care. Intervention consisted of tailored text messages providing educational information with embedded links to educational videos on topics related to BP control. BP measurements were obtained at kiosks at 3, 6, and 12 months following randomization; control was defined as BP <140/90 mmHg. Follow-up at 12 months was curtailed due to SARS-CoV-2. We therefore combined 12-month (N=62) or carried forward 6-month (N=61) data as the primary endpoint.

RESULTS: Participants were 51.4% male, 70.7% white/Caucasian, had mean age of 52.1 years, and mean baseline BP 145.5/91.8 mmHg. At the endpoint, 37.7% intervention vs. 27.4% usual care subjects achieved BP control (difference, 10.3%, 95% CI -6.2%, 26.8%). In an intention-to-treat analysis with multiple imputation of missing data, 12-month BP control was 29.0% vs. 19.8% favoring intervention (difference, 9.2%. 95% CI -7.3%, 25.7%); intervention vs. control differences in adjusted mean BP levels were SBP: -5.4 mmHg (95% CI: -13.5, 2.7) and DBP: +0.6 mmHg (95% CI: -4.2, 5.4).

CONCLUSIONS: These pilot results support the potential for a highly scalable text-messaging intervention to improve BP.

PMID:34382648 | DOI:10.1093/ajh/hpab129

J Biomech Eng. 2021 Aug 12. doi: 10.1115/1.4052110. Online ahead of print.

ABSTRACT

Repair of severed nerves without auto- or allograft has included suture, suture with glue alone, suture with conduit and suture with glue augmentation to conduit, where use of conduit is considered for separation of the nerve ends from 5mm to 3cm. Repairs must not only serve acutely to provide apposition of nerve ends but must enable the healing of the nerve. Using biological conduit can place suture at the ends of the conduit while fibrin glue alone eliminates suture but with limited strength. The combination of conduit and glue offers the growth guidance of conduit with sufficient strength from the glue to maintain the nerve within the conduit. The role of glue in the repair integrity remains an open question, however. We sought to determine the factors in the strength of a glue-conduit-nerve construct and include consideration of standard suture repair. Fresh-frozen cadaveric digital nerves were repaired with suture alone, with glue alone or with suture and glue together and loaded to failure. Previously tested specimens with conduit, suture and glue were considered for comparison. The suture alone (2.02N) and suture with glue (2.24N) were not statistically different from each other but were statistically stronger than glue alone (0.15N). Compared to the earlier results of the strength of conduit with glue (0.65N), these results show that the glue and conduit act together. The increased area over which the glue adheres to the nerve and conduit creates a composite structure stronger than either alone.

PMID:34382652 | DOI:10.1115/1.4052110

J Dairy Res. 2021 Aug 12:1-5. doi: 10.1017/S002202992100056X. Online ahead of print.

ABSTRACT

Variations in the levels of acute phase proteins and lactoferrin in serum and milk for diagnosis of subclinical mastitis in dairy cows are described in this research paper. Milking animals from two organized dairy farms in Kerala, India, were screened by California Mastitis Test (CMT), Electrical Conductivity test (EC) and Somatic Cell Count (SCC) test to identify animals affected with sub clinical mastitis (SCM). The concentrations of acute phase proteins (APP) Haptoglobin (Hp), C- reactive protein (CRP), Albumin, Lactoferrin (Lf) and α- 1 acid glycoprotein (AGP) in milk and Hp, Albumin, Serum Amyloid A (SAA) and CRP in the serum of 40 normal cows and 40 cows affected with sub clinical mastitis were assessed. Solid phase ELISA was employed for assessment of all parameters except the albumin levels, for which spectrophotometry was used. The values of Hp in milk; and SAA, AGP and Lf in serum, were significantly elevated in the group with sub clinical mastitis. Such variations were found to be independent of the specific bacterial organism causing the disease. These results show that significant variations exist in the levels of acute phase proteins Hp, AGP and Lf in milk, and SAA in serum of animals affected with subclinical bovine mastitis that are not affected by specific bacterial etiology.

PMID:34382532 | DOI:10.1017/S002202992100056X

S Afr Med J. 2021 Apr 6;111(6):550-553.

ABSTRACT

The hyperinflammation seen as part of a dysregulated immune response to SARS-CoV-2 in its most severe form leads to acute respiratory distress syndrome (ARDS), multiorgan failure and death. Corticosteroid therapy targets this hyperinflammation, otherwise known as a cytokine storm. It is the only therapeutic agent to date with a mortality benefit, with clear guidelines from national and international health authorities guiding its use. Objectives. To compare severity-of-illness indices, survival, length of intensive care unit (ICU) stay and potential ICU complications in patients treated with different corticosteroid regimens (high-dose hydrocortisone, high-dose methylprednisolone and lower-dose dexamethasone). Methods. In this single-centre descriptive retrospective observational study of a cohort of patients with severe COVID-19 admitted to a COVID-dedicated ICU, we compared patients treated with the three different corticosteroid regimens. Results. In 242 cases we could not demonstrate any statistically or clinically significant difference in the outcome of patients with critical COVID-19 treated with high-dose intravenous hydrocortisone (n=88) or methylprednisolone (n=46) compared with a relatively lower dose of dexamethasone (n=108). The survival rates were 38.6%, 39.1% and 33.3%, respectively (p=0.68). Patients treated with methylprednisolone tended to have a shorter length of ICU stay (median (interquartile range) 6 (4 – 10), 4 (2 – 8) and 5 (2 – 8) days; p=0.015) and fewer episodes of nosocomial sepsis (47.7%, 32.6% and 48.1%; p=0.01). Conclusions. Hydrocortisone or methylprednisolone can be given as an alternative to dexamethasone in the management of critical COVID-19, and this is a feasible alternative, especially in resource-constrained settings.

PMID:34382564

J Obstet Gynaecol. 2021 Aug 12:1-7. doi: 10.1080/01443615.2021.1920007. Online ahead of print.

ABSTRACT

The research aimed to investigate the expression of human leukocyte antigen G (HLA-G) in cancer tissues and normal endometrium and the expression of HLA-G in the three different grades of Endometrial cancer, to determine if HLA-G expression is related with the diagnosis and grading of endometrial cancer. The expression of HLA-G protein was analysed in the primary tumour in 97 tissue samples obtained from endometrial cancer, in which 30 samples were at pathological Grade 1; 37 samples were at Grade 2; 27 samples were at Grade 3; and the other 5 samples were obtained from normal endometrium. The HLA-G protein level was measured by immunohistochemical method and analysed according to the clinicopathological parameters of patients. A statistically significant difference (p < .05) was observed in HLA-G expression between the cancerous tissue and the normal endometrium (p = .0007), and the histochemistry score (H-score) of the negative control was 0.05 ± 0.03 (mean ± SD). Statistically significant correlations were also observed between samples of pathological Grade 1 and Grade 2 (p = .0126), Grade 2 and Grade 3 (p = .0359), Grade 1 and Grade 3 (p = .0001). Endometrial cancer cells express higher levels of HLA-G probably to escape immune surveillance, and HLA-G expression level is related with the pathological grade of endometrial cancer. Therefore, HLA-G detecting and quantifying could possibly help diagnosing, grading and treatment of endometrial cancer.Impact statementWhat is already known on this subject? The expression of a member of the non-classical HLA antigens, HLA-G, is one of the main ways for tumour immune escape and progression. The significance of HLA-G in tumour biology has been intensively investigated (Carosella et al. 2015), and now it is widely acknowledged that HLA-G expression in tumours is highly linked with immune suppressive microenvironments, advanced tumour stage, poor therapeutic responses and prognosis (Lin and Yan, 2018). However, to our knowledge, no research has been conducted on the correlation between HLA-G expression and pathological grades of endometrial cancer.What do the results of this study add? Our study demonstrated that the expression of HLA-G plays an important role in the pathological grading of endometrial cancer.What are the implications of these findings for clinical practice and/or further research? Measuring the level of HLA-G expression to help pathological grading of endometrial cancer is important in determining the treatment of patients with endometrial cancer and studying the underlying mechanisms of the development of endometrial cancer, while proving or finding new targeted therapies inhibiting or modifying these processes still requires further investigation.

PMID:34382498 | DOI:10.1080/01443615.2021.1920007

Comb Chem High Throughput Screen. 2021 Aug 10. doi: 10.2174/1386207324666210811102109. Online ahead of print.

ABSTRACT

Advancement in the sequencing technology yields a huge number of genomes of a multitude of organisms in our planet. One of the fundamental tasks for processing and analyzing these sequences is to organize them in the existing taxonomic orders. <P> Method: Recently we proposed a novel approach, GenFooT, of taxonomy classification using the concept of genomic footprint (GFP). The technique is further refined and enhanced in this work leading to improved accuracies in the task of taxonomic classification on various benchmark datasets. GenFooT maps a genome sequence in a 2D coordinate space and extracts features from that representation. It uses two hyper-parameters, namely block size and number of fragments of genomic sequence while computing the feature. In this work, we propose an analysis for choosing values of those parameters adaptively from the sequences. The enhanced version of GenFooT is named GenFooT2. <P> Results and Conclusion: We have experimented GenFooT2 on ten different biological datasets of genomic sequences of various organisms belonging to different taxonomy ranks. Our experimental results indicate more than 3% improved classification performance of the proposed features with Logistic regression classifier than the GenFooT. We also performed the statistical test to compare the performance of GenFooT2 with the state-of-the-art methods including our previous method GenFooT. The experimental results as well as the statistical test exhibit that the performance of the proposed GenFooT2 is significantly better.

PMID:34382517 | DOI:10.2174/1386207324666210811102109