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Nevin Manimala Statistics

Prolactin promotes a partial recovery from the atrophy of both male and female gerbil prostates caused by castration

Reprod Biol Endocrinol. 2021 Jun 22;19(1):94. doi: 10.1186/s12958-021-00777-2.

ABSTRACT

BACKGROUND: The male and female prostates are controlled by steroid hormones, suffering important morphological and physiological changes after castration. Prolactin is involved in the regulation of the male prostate, having already been identified in the tissue, acting through its receptor PRLR. In the Mongolian gerbil, in addition to the male prostate, the female prostate is also well developed and active in its secretion processes. The aim of the present study was to evaluate the effects of exposure to exogenous prolactin in the prostate of both intact and castrated male and female gerbils in order to establish if prolactin administration can sustain prostate cell activity in conditions of sexual hormone deprivation.

METHODS: The morphological analyses were performed by biometric analysis, lesion histological analysis and morphometric-stereological aspects. In addition, immune-cytochemical tests were performed for prolactin and its receptor, as well as for the receptors of androgen and oestrogen and serum prolactin dosage. All data were submitted to ANOVA or Kruskal-Wallis tests for comparison between groups. P < 0.05 was considered to be statistically significant.

RESULTS: The results showed a strong influence of prolactin on the morphology of the prostate, with the development of important epithelial alterations, after only 3 days of administration, and an expressive epithelial cell discard process after 30 days of administration. Prolactin acts in synergy with testosterone in males and mainly with oestrogens in females, establishing different steroid hormonal receptor immunoreactivity according to sex. It was also demonstrated that prolactin can assist in the recovery from some atrophic effects caused in the gland after castration, without causing additional tissue damage.

CONCLUSIONS: The prolactin and its receptor are involved in the maintenance of the homeostasis of male and female gerbils, and also cause distinct histological alterations after exogenous exposure for 3 and 30 days. The effects of prolactin are related to its joint action on androgens and oestrogens and it can also assist in the recovery from the atrophic effects of castration.

PMID:34158080 | DOI:10.1186/s12958-021-00777-2

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Nevin Manimala Statistics

Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection

J Cardiothorac Surg. 2021 Jun 22;16(1):179. doi: 10.1186/s13019-021-01558-z.

ABSTRACT

BACKGROUND: Obesity is dramatically increasing worldwide, and more obese patients may develop aortic dissection and present for surgical repair. The study aims to analyse the impact of body mass index (BMI) on surgical outcomes in patients with acute Stanford type A aortic dissection (ATAAD).

METHODS: From January 2017 to June 2019, the clinical data of 268 ATAAD patients in a single centre were retrospectively reviewed. They were divided into three groups based on the BMI: normal weight (BMI 18.5 to < 25 kg/m2, n = 110), overweight (BMI 25 to < 30 kg/m2, n = 114) and obese (BMI ≥30 kg/m2, n = 44).

RESULTS: There was no statistical difference among the three groups in terms of the composite adverse events including 30-day mortality, stroke, paraplegia, renal failure, hepatic failure, reintubation or tracheotomy and low cardiac output syndrome (20.9% vs 21.9% vs 18.2% for normal, overweight and obese, respectively; P = 0.882). No significant difference was found in the mid-term survival among the three groups. The proportion of prolonged ventilation was highest in the obese group followed by the overweight and normal groups (59.1% vs 45.6% vs 34.5%, respectively; P = 0.017). Multivariable logistic regression analysis suggested that BMI was not associated with the composite adverse events, while BMI ≥30 kg/m2 was an independent risk factor for prolonged ventilation (OR 2.261; 95% CI 1.056-4.838; P = 0.036).

CONCLUSIONS: BMI had no effect on the early major adverse outcomes and mid-term survival after surgery for ATAAD. Satisfactory surgical outcomes can be obtained in patients with ATAAD at all weights.

PMID:34158094 | DOI:10.1186/s13019-021-01558-z

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Nevin Manimala Statistics

Role of hippocampal location and radiation dose in glioblastoma patients with hippocampal atrophy

Radiat Oncol. 2021 Jun 22;16(1):112. doi: 10.1186/s13014-021-01835-0.

ABSTRACT

BACKGROUND: The hippocampus is a critical organ for irradiation. Thus, we explored changes in hippocampal volume according to the dose delivered and the location relative to the glioblastoma.

METHODS: All patients were treated for glioblastoma with surgery, concomitant radiotherapy and temozolomide, and adjuvant temozolomide. Hippocampi were retrospectively delineated on three MRIs, performed at baseline, at the time of relapse, and on the last MRI available at the end of follow-up. A total of 98, 96, and 82 hippocampi were measured in the 49 patients included in the study, respectively. The patients were stratified into three subgroups according to the dose delivered to 40% of the hippocampus. In the group 1 (n = 6), the hippocampal D40% was < 7.4 Gy, in the group 2 (n = 13), only the Hcontra D40% was < 7.4 Gy, and in the group 3 (n = 30), the D40% for both hippocampi was > 7.4 Gy.

RESULTS: Regardless of the time of measurement, homolateral hippocampal volumes were significantly lower than those contralateral to the tumor. Regardless of the side, the volumes at the last MRI were significantly lower than those measured at baseline. There was a significant correlation among the decrease in hippocampal volume regardless of its side, and Dmax (p = 0.001), D98% (p = 0.028) and D40% (p = 0.0002). After adjustment for the time of MRI, these correlations remained significant. According to the D40% and volume at MRIlast, the hippocampi decreased by 4 mm3/Gy overall.

CONCLUSIONS: There was a significant relationship between the radiotherapy dose and decrease in hippocampal volume. However, at the lowest doses, the hippocampi seem to exhibit an adaptive increase in their volume, which could indicate a plasticity effect. Consequently, shielding at least one hippocampus by delivering the lowest possible dose is recommended so that cognitive function can be preserved. Trial registration Retrospectively registered.

PMID:34158078 | DOI:10.1186/s13014-021-01835-0

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Nevin Manimala Statistics

Assumptions about frequency-dependent architectures of complex traits bias measures of functional enrichment

Genet Epidemiol. 2021 Jun 22. doi: 10.1002/gepi.22388. Online ahead of print.

ABSTRACT

Linkage-Disequilibrium Score Regression (LDSC) is a popular framework for analyzing Genome-wide Association Studies (GWAS) summary statistics that allows for estimating single nucleotide polymorphism heritability, confounding, and functional enrichment of genetic variants with different annotations. Recent work has highlighted the influence of implicit and explicit assumptions of the model on the biological interpretation of the results. In this study, we explored a formulation of LDSC that replaces the r2 measure of LD with a recently proposed unbiased estimator of the D2 statistic. In addition to modest statistical difference across estimators, this derivation highlighted implicit and unrealistic assumptions about the relationship between allele frequency, effect size, and annotation status. We carry out a systematic comparison of alternative LDSC formulations by applying them to summary statistics from 47 GWAS traits. Our results show that commonly used models likely underestimate functional enrichment. These results highlight the importance of calibrating the LDSC model to achieve a more robust understanding of polygenic traits.

PMID:34157784 | DOI:10.1002/gepi.22388

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Nevin Manimala Statistics

Survival Analysis of 76 Cases of Head and Neck Adenoid Cystic Carcinoma
with Lung Metastasis

Zhongguo Fei Ai Za Zhi. 2021 Jun 20;24(6):412-419. doi: 10.3779/j.issn.1009-3419.2021.102.21.

ABSTRACT

BACKGROUND: Adenoid cystic carcinoma (ACC) of the head and neck often develops lung metastasis. At present, there are not many research reports on ACC lung metastasis, little is known about its exact clinical features and treatment results, and there is no consensus on the best treatment strategy. This study explored the effective treatment strategies, clinical outcomes and long-term prognosis of head and neck ACC lung metastases.

METHODS: The clinical and follow-up data of 76 patients with head and neck ACC lung metastases were retrospectively analyzed. According to the initial treatment of patients, they are divided into 4 groups: surgery, surgery+chemotherapy or radiotherapy, chemotherapy or radiotherapy and supportive treatment. The patients were staged according to the International Registry of Lung Metastases Staging System (IRLM). Kaplan-Meier method and Log-rank test were used to compare the statistical differences of overall survival (OS) and progression-free survival (PFS) of patients with different treatment methods and different IRLM stages.

RESULTS: The OS and PFS of patients undergoing surgery are better than those of supportive therapy or radiotherapy and/or chemotherapy (OS: P<0.000,1; PFS: P<0.000,1). The OS and PFS of patients with low stage IRLM are better than those with high stage (OS: P<0.000,1; PFS: P<0.000,1). Patients with single lung metastasis and without pleural effusion have better OS and PFS.

CONCLUSIONS: The long-term prognosis of patients with lung metastasis of head and neck ACC who undergo surgery is better than other treatments, which is related to higher OS and PFS. For patients with ACC lung metastases who are operationally eligible, the significance of complete surgical resection should be higher than other treatment options.

PMID:34157801 | DOI:10.3779/j.issn.1009-3419.2021.102.21

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Nevin Manimala Statistics

Value of Combined Detection of Cytokines and Tumor Markers in the 
Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodules

Zhongguo Fei Ai Za Zhi. 2021 Jun 20;24(6):426-433. doi: 10.3779/j.issn.1009-3419.2021.102.20.

ABSTRACT

BACKGROUND: Solitary pulmonary nodule has received increasing attention in recent years. A couple of lung nodules have been recognized as primary malignant tumors, which leads to an urgent need in enhancing the diagnosis of benign/malignant lung nodules at clinical settings. This study aims to explore the value of the combined detection of cytokines and tumor markers in differencing benign and malignant solitary pulmonary nodules in diagnose.

METHODS: With 81 solitary pulmonary nodules cases with a clear diagnosis, the general clinical data, nodule imaging features, pathological diagnosis data, serological index cytokine series and tumor marker expression levels were collected in groups. Both single factor and multi-factors analysis were conducted to screen out the serum influence indexes that can predict the malignant probability of lung nodules, and mean while binary logistic regression analysis was used to construct joint indexes; After receiver operating characteristic curve (ROC) was drawn, the area under the curve and the corresponding sensitivity, specificity and positive of each index predicted value, negative predicted value and accuracy could be calculated with a view to determine the statistical significance of area under the curve (AUC).

RESULTS: There are differences in the distribution of malignant solitary pulmonary nodules at different locations, with the highest proportion of the right upper lobe (40.4%). The serum levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment 21-1 (CYFRA21-1), interleukin-6 (IL-6), interleukin-8 (IL-8) in the malignant nodule group were higher than those in the benign nodule group. Logistic regression analysis suggests that CEA, IL-6 and IL-8 are independent risk factors for predicting malignant nodules. ROC curve analysis shows that the areas under the curve of the individual indicators CEA, IL-6 and IL-8 are 0.642, 0.684 and 0.749. The comparison result of the test efficiency of the area under the curve suggests that CEA+IL-6+IL-8 has a larger area under the curve and higher detection efficiency.

CONCLUSIONS: CEA, IL-6 and IL-8 are independent risk factors for malignant solitary pulmonary nodules. The combined detection of cytokines and tumor markers has played a role in the differential diagnosis of benign and malignant lung nodules. The diagnostic value of the combined detection of CEA+IL-6+IL-8 is the highest.

PMID:34157802 | DOI:10.3779/j.issn.1009-3419.2021.102.20

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Nevin Manimala Statistics

Science and Statistics

Diving Hyperb Med. 2021 Jun 30;51(2):230. doi: 10.28920/dhm51.2.230.

NO ABSTRACT

PMID:34157744 | DOI:10.28920/dhm51.2.230

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Nevin Manimala Statistics

Semiquantitative Criteria in the Eye Bank That Correlate with Cornea Guttata in Donor Corneas

Klin Monbl Augenheilkd. 2021 Jun;238(6):680-687. doi: 10.1055/a-1498-1846. Epub 2021 Jun 22.

ABSTRACT

BACKGROUND: Cornea guttata may not be recognized in the eye bank and recent studies have displayed that guttae are transplanted in about 15% of cases in varying severities. The purpose of this study was to establish semiquantitative criteria for the detection of cornea guttata in donor corneas in the eye bank.

METHODS: In this retrospective cohort study, preoperative endothelial pictures of donor corneas were collected and classified according to the post-penetrating keratoplasty cornea guttata grade into three distinct groups: group 1 consists of healthy corneas with no guttae (guttata grade 0); group 2 constitutes corneas with mild asymptomatic cornea guttata (guttata grade +); and group 3 comprises corneas with advanced widespread cornea guttata (guttata grade ++/+++/++++). The preoperative pictures of each group were then individually analyzed using the following five semiquantitative criteria: The number and the area of the cell-depleted surfaces, the presence of less than 50% of the cells having a hexagonal or a circular shape, the presence of cell membrane defects and interruptions, the presence of blebs in the cell membrane, and the presence of groups of cells with a distinct whitish color.

RESULTS: In total, 262 patients were included in this study, with a total number of 1582 preoperative donor corneal endothelial pictures. Out of those pictures, groups 1, 2, and 3 encompassed 995 (62.9%), 411 (26.0%), and 176 (11.1%) pictures, respectively. Three out of the five eye bank criteria were found to correlate with postoperative cornea guttata with a highly significant p value of < 0.001. These three criteria are the presence of less than 50% of the cells having a hexagonal or a circular shape, the presence of cell membrane defects and interruptions and, the presence of blebs. The presence of groups of cells with a distinct whitish color was only a weak predictive factor for cornea guttata (p = 0.069). There was no statistically significant correlation between the number and the area of cell-depleted surfaces and postoperative cornea guttata with a p = 0.181.

CONCLUSION: Three semiquantitative criteria that can be detected in the eye bank using inverted light microscopy seem to correlate with postoperative cornea guttata: The presence of blebs, the presence of cell membrane defects and interruptions, as well as endothelial pictures with less than 50% of the cells having a hexagonal of circular shape. The presence of groups of cells with a distinct whitish color appears to be a weak predictor of cornea guttata.

PMID:34157770 | DOI:10.1055/a-1498-1846

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Nevin Manimala Statistics

A methodology to estimate the patient diameter and thickness from thoracic and abdominal projection radiographs of adult patients

Phys Med Biol. 2021 Jun 22. doi: 10.1088/1361-6560/ac0d8c. Online ahead of print.

ABSTRACT

Patient dose management systems can be part of a department’s quality management tools to estimate items such as the radiation burden in specific groups or list dose outliers for further follow up. Patient size information could improve both aspects, but is not generally available. A new metric is proposed to estimate patient size for thorax and abdominal projection radiography from parameters available in the DICOM header and therefore accessible by dose management software. The tested hypothesis was that an attenuation metric, related to the ratio of detector air-kerma to incident air-kerma, inversely correlates with patient size. Such a metric was defined and then worked out for thorax and abdomen projection radiography. Input material consisted of the thorax or abdominal radiographs of 137 cases, completed with a recent CT scan as ground truth size. From the CT, the water equivalent diameter and water equivalent thickness were calculated. The correlation between the attenuation metric and the patient size was established separately for thorax and abdomen. Validation of the attenuation metric predicting the patient size was performed using extra sets of examinations on three more radiographic x-ray devices, with available CT scan. The attenuation metric had a good correlation (R2) of 0.91 and 0.84 with the water equivalent diameter for thorax and abdomen respectively. The corresponding values for the water equivalent thickness were 0.89 and 0.78. Validation of the methodology on the devices with standardized exposure index in the DICOM headers showed that the water equivalent diameter could be estimated within ±15% and the water equivalent thickness within ±30% for thorax and abdomen examinations. The ground truth and estimated size were found statistically equivalent. An attenuation metric based on DICOM tags allows to estimate the patient size in projection radiography. This could now be implemented in patient dose management systems.

PMID:34157703 | DOI:10.1088/1361-6560/ac0d8c

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Nevin Manimala Statistics

Oxygen toxicity seizures during United States Navy Treatment Table 6: An acceptable risk in monoplace chambers?

Diving Hyperb Med. 2021 Jun 30;51(2):167-172. doi: 10.28920/dhm51.2.167-172.

ABSTRACT

INTRODUCTION: Hyperbaric oxygen treatment (HBOT) may be complicated by oxygen toxicity seizures, which typically occur with hyperbaric partial pressures of oxygen exceeding 203 kPa (2 atmospheres absolute). All other hyperbaric units in Australia exclusively use a multiplace chamber when treating with United States Navy Treatment Table 6 (USN TT6) due to this perceived risk. The purpose of this study was to determine the safety of a monoplace chamber when treating decompression illness (DCI) with USN TT6.

METHODS: A retrospective review of the medical records of all patients treated at Fiona Stanley Hospital Hyperbaric Medicine Unit with USN TT6 between November 2014 and June 2020 was undertaken. These data were combined with previous results from studies performed at our hyperbaric unit at Fremantle Hospital from 1989 to 2014, creating a data set covering a 30-year period.

RESULTS: One thousand treatments with USN TT6 were performed between 1989 and 2020; 331 in a monoplace chamber and 669 in a multiplace chamber. Four seizures occurred: a rate of 0.59% (1/167) in a multiplace chamber; and none in a monoplace chamber, indicating no statistically significant difference between seizures in a monoplace versus multiplace chamber (P = 0.31).

CONCLUSIONS: The rate of oxygen toxicity seizures in a monoplace chamber is not significantly higher than for treatment in the multiplace chamber. We conclude that using the monoplace chamber for USN TT6 in selected patients poses an acceptably low seizure risk.

PMID:34157732 | DOI:10.28920/dhm51.2.167-172