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Sample records for thalassaemic patients quantitative

  1. Non cardiopatic and cardiopatic beta thalassaemic patients: quantitative and qualitative cardiac iron deposition evaluation with MRI

    International Nuclear Information System (INIS)

    Macarini, Luca; Marini, Stefania; Scardapane, Arnaldo; Pietrapertosa, Anna; Ettore, Giovanni Carlo

    2005-01-01

    Purpose: Cardiomyopathy is one of the major complications of β thalassaemia major as a result of transfusion iron overload. The aim of our study is to evaluate with MR if there is any difference of iron deposition signal intensity (SI) or distribution between non-cardiopatic and cardiopatic thalassaemic patients in order to establish if there is a relationship between cardiopathy and iron deposition. Materials and methods: We studied 20 patients affected by β thalassaemia major, of whom 10 cardiopatic and 10 non-cardiopatic, and 10 healthy volunteers as control group. Serum ferritin and left ventricular ejection fraction were calculated in thalassaemic patients. All patients were examinated using a 1.5 MR unit with ECG-gated GE cine-MR T2*-weighted, SE T1-weighted and GE T2*-weighted sequences. In all cases, using an adequate ROI, the myocardial and skeletal muscle signal intensity (SI), the myocardial/skeletal muscle signal intensity radio (SIR) and the SI average of the myocardium and skeletal muscle were calculated for every study group. The qualitative evaluation of iron deposition distribution was independently performed by three radiologists who analysed the extension, the site and the morphology of iron deposition on the MR images and reported their observations on the basis of a four-level rating scale: 0 (absent), 1 (limited), 2 (partial), 3 (widespread deposition). The results of quantitative and qualitative evaluation were analysed with statistical tests. Results: Cardiac iron deposition was found in 8/10 non-cardiopatic thalassaemic patients and in all cardiopatic thalassaemic patients. We noticed a significant SI difference (p>0.05) between the healthy volunteer control group and the thalassaemic patients with iron deposition, but no significant SI difference in iron deposition between non-cardiopatic thalassaemic patients in the areas evaluated. The qualitative evaluation revealed a different distribution of iron deposition between the two

  2. Non cardiopatic and cardiopatic beta thalassaemic patients: quantitative and qualitative cardiac iron deposition evaluation with MRI; Pazienti {beta} talassemici non cardiopatici e cardiopatici: valutazione quantitativa e qualitativa del deposito di ferro cardiaco con RM

    Energy Technology Data Exchange (ETDEWEB)

    Macarini, Luca; Marini, Stefania; Scardapane, Arnaldo [Bari Univ., Bari (Italy). DIMIMP-Sezione di Diagnostica per Immagini; Pietrapertosa, Anna [Bari Univ., Bari (Italy). MIDIM-Cattedra di Ematologia II; Ettore, Giovanni Carlo [Foggia Univ., Foggia (Italy). Cattedra di Radiologia

    2005-02-01

    Purpose: Cardiomyopathy is one of the major complications of {beta} thalassaemia major as a result of transfusion iron overload. The aim of our study is to evaluate with MR if there is any difference of iron deposition signal intensity (SI) or distribution between non-cardiopatic and cardiopatic thalassaemic patients in order to establish if there is a relationship between cardiopathy and iron deposition. Materials and methods: We studied 20 patients affected by {beta} thalassaemia major, of whom 10 cardiopatic and 10 non-cardiopatic, and 10 healthy volunteers as control group. Serum ferritin and left ventricular ejection fraction were calculated in thalassaemic patients. All patients were examinated using a 1.5 MR unit with ECG-gated GE cine-MR T2*-weighted, SE T1-weighted and GE T2*-weighted sequences. In all cases, using an adequate ROI, the myocardial and skeletal muscle signal intensity (SI), the myocardial/skeletal muscle signal intensity radio (SIR) and the SI average of the myocardium and skeletal muscle were calculated for every study group. The qualitative evaluation of iron deposition distribution was independently performed by three radiologists who analysed the extension, the site and the morphology of iron deposition on the MR images and reported their observations on the basis of a four-level rating scale: 0 (absent), 1 (limited), 2 (partial), 3 (widespread deposition). The results of quantitative and qualitative evaluation were analysed with statistical tests. Results: Cardiac iron deposition was found in 8/10 non-cardiopatic thalassaemic patients and in all cardiopatic thalassaemic patients. We noticed a significant SI difference (p>0.05) between the healthy volunteer control group and the thalassaemic patients with iron deposition, but no significant SI difference in iron deposition between non-cardiopatic thalassaemic patients in the areas evaluated. The qualitative evaluation revealed a different distribution of iron deposition between the two

  3. C-reactive (CRP) protein in transfusion dependent thalassaemic patients

    International Nuclear Information System (INIS)

    Jokhio, R.; Mughal, Z.U.N.

    2009-01-01

    In thalassaemic patients iron overload, secondary to blood transfusion, results toxic effects by producing reactive radicals. Iron overload can be studied using serum ferritin level which has a direct correlation with the body's iron status. While oxidative damage can be studied using biomarker of inflammation like hsC-reactive proteins. Blood samples of 55 thalassaemic patients (39 males, 16 females) were collected from Fatmid Foundation (Hyderabad). The samples were analyzed for CBC, serum ferritin level and hsC-reactive proteins. High mean serum ferritin levels was found in all the patients regardless of the frequency of blood transfusion (4774.2135+-3143.3040 mu g/L), indicating the iron overload. High mean hsC-reactive protein was found (2.5151+-1.3712) with a positive correlation with ferritin (r= 0.8371198, p= 0.0000) and platelets (r= 0.43293443, p=0.000962175). C-reactive proteins serve as biomarker of various inflammatory conditions, progression of cardiovascular diseases and as indicator of morbidity and mortality. High C-reactive proteins in these patients indicate ongoing iron overload toxicity related damage in these patients. The estimation of hsC-reactive proteins and other biomarkers of inflammation and oxidation may help in better management of these patients. (author)

  4. Thyroid stimulating hormone and leptin levels and severe growth retardation among beta- thalassaemic patients

    International Nuclear Information System (INIS)

    Dayer, D.; Salahcheh, M.; Jazayeri, S.M.H.; Kaydani, G.A.; Kadkhodaei Elyaderani, M.K.; Shaneh, S.

    2012-01-01

    Objective: It has been proposed that thyroid stimulating hormone (TSH) influences leptin secretion from adipocytes. We evaluated the association between TSH and leptin levels in thalassaemic patients with growth retardation. Methodology: Blood samples were collected from 30 major thalassaemic patients and 24 normal subjects (range: 12 - 20 y). Both Leptin and TSH were measured by Enzyme-Linked Immunosorbent Assay (ELISA) method. The anthropomorphic data were collected based on standard methods. Independent sample t-test and Pearson's correlation were used to analyze data. Results: Patients had severe growth retardation. Mean concentration of leptin in thalassaemic mean value of serum TSH concentration of lepton in thalassaemic patients was significantly lower than normal subjects (2.26 +- 2,61 vs 13.14 +- 15.95 ng/ml). The mean value os serum TSH concentration in beta- thalassaemic patients was higher than normal subjects. But the difference was not statistically significant (P = 0.146). There was no marked relationship between TSH and leptin concentration in thalassaemic patients (r= -0.022, P =0.909) and in control group (r =0.289, P=0.214). Conclusion: In beta - thalassaemic patients and normal group leptin secretion is a not affected by TSH concentration. (author)

  5. Radioisotope assessment of heart damage in hypertransfused thalassaemic patients

    International Nuclear Information System (INIS)

    Scopinaro, F.; Banci, M.; Vania, A.; Tavolaro, R.; Schillaci, O.; Tisei, A.; Werner, B.; Digilio, G.; Ventriglia, F.; Colloridi, V.

    1993-01-01

    Twenty-five thalassaemic patients treated with repeated blood transfusion (BT) and intensive iron removal therapy were studied by echocardiography and rest/stress equilibrium gated radionuclide angiocardiography (EGNA). Stress left ventricular ejection fraction (LVEF) showed an important negative correlation with number of BTs (r=-0.75). Abnormal values of stress LVEF were measured after 200 BTs: these data demonstrate the effectiveness of stress LVEF in the follow-up of patients who have undergone repeated BT and the clinical importance of intensive chelation therapy. Peak filling rate did not show diagnostic value in the early detection of iron cardiotoxicity. However, its inverse correlation with BT (r=-60) indicates that iron overload depresses the diastolic parameters. (orig.)

  6. Desferrioxamine-induced long bone changes in thalassaemic patients - Radiographic features, prevalence and relations with growth

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    Chan, Y.L.; Li, C.K.; Pang, L.M.; Chik, K.W

    2000-08-01

    AIM: To study the radiographic findings of desferrioxamine-induced bone dysplasia, its prevalence and relation to growth in thalassaemic patients. MATERIALS AND METHODS: A cross-sectional study was performed in 35 thalassaemic patients on a hypertransfusion scheme and chelation therapy at a dose not exceeding 50 mg/kg/day. Radiographs of the left hand taken for bone age assessment in consecutive patients over the past 12 months were evaluated for signs of desferrioxamine-induced bone dysplasia. The findings were correlated with data on growth, chelation and body iron content. RESULTS: Twelve of 35 patients had evidence of desferrioxamine-induced long bone dysplasia. There was no significant difference in the groups with and without radiographic evidence of bone dysplasia with respect to the height percentile at time of initiation of therapy, height percentile at time of radiography, skeletal age delay, age at starting chelation, chelation dose and duration, units of blood transfused, average chelation dose, and serum ferritin levels at time of radiography. Both groups showed a reduced percentile growth with a significantly greater reduction (P = 0.03) in the patients with dysplastic change. CONCLUSION: Desferrioxamine-induced bone dysplasia is associated with height reduction and can be seen in patients receiving desferrioxamine chelation therapy at doses of less than 50 mg/kg/day. Awareness of the diagnosis is of importance as reduction of the desferrioxamine dose may improve bone growth. Chan, Y. L. (2000)

  7. Transfusion-dependent thalassaemic patients with renal Fanconi syndrome due to deferasirox use.

    Science.gov (United States)

    Chuang, Gwo-Tsann; Tsai, I-Jung; Tsau, Yong-Kwei; Lu, Meng-Yao

    2015-12-01

    Deferasirox is a new oral iron chelating agent with several cases reporting renal adverse events in recent years. Our aim was to identify the incidence of deferasirox-related Fanconi syndrome (FS) and its risk factors. All transfusion-dependent thalassaemic patients who received deferasirox at the outpatient department of the National Taiwan University Hospital (NTUH) from January 2006 to February 2014 were evaluated. This cohort study included 57 patients, and mean age of deferasirox initiation was 18.2 ± 7.7 years. After 6.9 ± 1.8 years of follow-up, 5 in 57 (8.8%) thalassaemic patients had FS. Age of starting deferasirox negatively correlated with incidence of FS (correlation coefficient -0.892, P = 0.008). Other factors were not significantly associated with FS. Serum creatinine level at the start of deferasirox compared to at the end of study or onset of FS did not show significant change (P = 0.277). All the deferasirox-related FS manifested with proximal renal tubular acidosis and hypophosphataemia, which needed specific treatment or withdrawal of deferasirox use. We recommend that children, especially of young age, who regularly use deferasirox should undergo routine urinalysis and blood testing for early detection of FS. © 2015 Asian Pacific Society of Nephrology.

  8. Thalassaemic osteoarthropathy treated with radiotherapy

    International Nuclear Information System (INIS)

    Davies, A.N.

    1993-01-01

    Patients with beta thalassaemia may develop a specific osteoarthropathy involving the feet. A number of different treatments for this condition have been tried, including rest, analgesia and hypertransfusion. We report a case of a patient with thalassaemic osteoarthropathy who responded to radiotherapy after failing conventional treatment. (author)

  9. Thalassaemic osteoarthropathy treated with radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Davies, A.N. (King' s Coll. Hospital, London (United Kingdom))

    1993-11-01

    Patients with beta thalassaemia may develop a specific osteoarthropathy involving the feet. A number of different treatments for this condition have been tried, including rest, analgesia and hypertransfusion. We report a case of a patient with thalassaemic osteoarthropathy who responded to radiotherapy after failing conventional treatment. (author).

  10. Effect ALPHA Globalin Gene Deletion and GAMMA Globin Gene -158 (C/T) Polymorphism in BETA- Thalassaemic Patients

    International Nuclear Information System (INIS)

    EL Serafi, T.I.; Ismail, E.F.; Mahmoud, M.A.; Mohamed, M.A.; Ghattas, M.H.; Badran, D.I.; El Serafi, I.T.; Mohamed, H.S.

    2008-01-01

    The beta-thalassemias (β- thalassemias) are among the most common autosomal recessive disorders. They have a remarkably high frequency in the Mediterranean region and represent one of the most common genetic diseases in Egypt. In this study, the spectrum of P- thalassemia mutations and genotype-to-phenotype correlations were defined in 32 β- thalassaemic patients (β- thalassemias major and intermedia) with varying disease severity in two cities of the Suez Canal region. Ten different mutations were identified and the most frequent ones were: Isi-6 (T-C) (37.5%), IVSI-110 (G-A) (34.4%) and both IVSI-1 (G-A), IVSII-745 (C-G) and -102 (C-G) (12.5% each). There was a wide spectrum of phenotypic severity in all patients. We studied the Xmnl polymorphism (C/T) in γ- globin gene position -158 of P- thalassemia as a modulating factor of the disease severity. Presence of the polymorphism was found in two patients and this was not sufficient to explain the diversity of the phenotype encountered. Co-inheritance of alpha thalassaemia as a modulating factor was not evident in our patients. In conclusion, we have been unable to find a molecular basis for the benign clinical course in all our patients. Other genetic or acquired factors must be hypothesized which ameliorate the clinical condition.

  11. An Evaluation of Sensory Neural Hearing Loss in Thalassaemic Patients Treated with Desferrioxamine and Its Risk Factors

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    M Sonbolestan

    2005-07-01

    Full Text Available Back ground: In major thalassaemia patients who need blood transfusion, iron overload is a major therapeutic disadvantage that leads to heart failure which is the major cause of death in such patients. Desferrioxamine (DFO is the most efficient factor for iron chelation, but it carries adverse effects such sensory-neural hearing loss. Methods: The study began in March 2002 and continued untill March 2003, on 160 cases of thalassaemia to determine the incidence of sensory – neural hearing loss and its risk factors in patients who received Desferrioxamine (DFO. All cases underwent audiometric tests. Retrospectively, other needed information were either obtained through interview or extracted from the medical files. Results were analyzed with ANOVA, t-test and Chi-square tests. Results: Seventy-six patients of the total 156 patients showed impairment in PTA (48.7% with 24 of them suffering significant involvement (15.4%. These abnormalities generally affected high frequencies including, 4000 and 8000 Hz. Male gender, increased serum billirubin level and fasting blood sugar were statistically correlated with hearing loss (p.v = 0.038, p.v = 0.38, p.v = 0.002 respectively. There was no significant correlation between hearing loss and other factors. Mean DFO administration in patients, was 29.69 mg/kg/day and mean therapeutic index of DFO was 0.01 mg/kg/day/mg/lit. Both of them were below the critical level (<40mg/kg/day and <0.025mg/kg/day/mg/lit respectively, however hearing loss had developed. Conclusion: Controlling DFO dosage per se does not seem to be enough for decreasing ototoxicity rate. Periodic audiometric tests are highly recommended to detect hearing loss as soon as possible. There are some other factors such as male gender, increased billirubin and FBS, which contribute to DFO ototoxicity. Looking for these risk factors and controlling them, would help identifying susceptible patients and preventing this complication. Key words

  12. Endocrine concerns and quality of life in thalassaemics

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    A. Unver

    2011-12-01

    Full Text Available I would like to tell you a main message: to fight against this disease is always useful. Imagine you are a little kid and want to play with your friends, you want to run with them play ball with them but you couldn’t. You have to stay at home or sit on the side and watch it is a hard thing to do for a kid. However, the help of your parents, the encouragement and the patience of your doctors, the support of associations are crucial issues to continue the fight. Patients have to remember that continuing their treatments strictly is the main aim to reach in the next future the cure. 我想把主要内容告诉你: 与这个病魔斗争总是有用的。 假如你是一个小孩,想同伙伴一起玩耍、赛跑、打球,但是你却不能。您必须呆在家里或坐在一边看他们高兴地玩耍。这对一个小孩儿来说是件不容易的事情。 然而,父母的帮助、医生的鼓励和耐心治疗以及同伴们的支持,都将成为你继续与病魔抗争的坚强动力。 病人必须记住只有严格继续治疗才能在将来痊愈。

  13. Quantitative analysis of gai pattern in hemiparetic patients | Zverev ...

    African Journals Online (AJOL)

    Objective: To characterise gait pattern in hemiparetic patients quantitatively using clinical footprint method. Design: A case control study. Subjects: Sixteen hemiparetic patients (12 males and 4 females) aged 16 to 64 years who attended neurological clinic at Queen Elizabeth Central Hospital, Blantyre, Malawi.

  14. Quantitative proton radiography of an animal patient

    Science.gov (United States)

    Schneider, Uwe; Dellert, Matthias; Pedroni, Eros; Pemler, Peter; Besserer, Juergen; Moosburger, Martin; Theiler, Prisca; Kaser-Hotz, Barbara

    2003-06-01

    Images (with a spatial resolution of 1 mm x 1mm) were produced both, with range and range dilution information of the protons passing through a dog. The radiographies were taken prior to a proton radiotherapy treatment of a nasal tumor, while the dog patient was under anesthetics. The first image was created by calculating the mean range of the protons detected in each pixel. This image was compared to calculations of the treatment planning system based on a CT-scan of the dog. Errors in the calculated range could be detected. The second image was produced by calculating the width of the range spectrum in each pixel. This value is a measure of the dilution of the range due to tissue inhomogeneities. The dilution image can be used to indicate critical situations during proton therapy, to determine the safety margin around the tumor volume, or to optimise treatment. In a preliminary analysis of the radiography data we found range uncertainty and range dilution effects in the order of up to 10 mm.

  15. Quantitative EEG evaluation in patients with acute encephalopathy

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    Aline Souza Marques da Silva Braga

    2013-12-01

    Full Text Available Objective To investigate the use of quantitative EEG (qEEG in patients with acute encephalopathies (AEs and EEG background abnormalities. Method Patients were divided into favorable outcome (group A, 43 patients and an unfavorable outcome (group B, 5 patients. EEGLAB software was used for the qEEG analysis. A graphic of the spectral power from all channels was generated for each participant. Statistical comparisons between the groups were performed. Results In group A, spectral analysis revealed spectral peaks (theta and alpha frequency bands in 84% (38/45 of the patients. In group B, a spectral peak in the delta frequency range was detected in one patient. The remainder of the patients in both groups did not present spectral peaks. Statistical analysis showed lower frequencies recorded from the posterior electrodes in group B patients. Conclusion qEEG may be useful in the evaluations of patients with AEs by assisting with the prognostic determination.

  16. Evaluation of two types of leukocyte removal filters on transfusion dependent thalassaemics.

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    Jamal, R; Mazeni, N R; Hussin, H

    2000-12-01

    The advent of leukocyte filters has enabled effective removal of leukocytes from certain blood products thus avoiding many adverse effects of blood transfusion. Many different materials have been incorporated into these filters to achieve >95% leukocyte removal. In this study we evaluated the efficacy of leukocyte removal of two different filters, using actual bedside transfusion settings involving patients with transfusion dependent thalassaemia. Fifty-one transfusion events were randomised to use either a polyurethane filter or a non-woven polyester filter. We found that the two filters achieved 98.4% and 96.2% leukocyte removal respectively (p = 0.022). We also found no significant correlation between pre-filtration white blood cell count and the volume transfused with the efficacy of leukodepletion. No untoward events or transfusion reactions were observed during the study.

  17. Quantitative measures of spasticity in post-stroke patients.

    Science.gov (United States)

    Pisano, F; Miscio, G; Del Conte, C; Pianca, D; Candeloro, E; Colombo, R

    2000-06-01

    Quantitative evaluation of muscle tone in post-stroke patients; correlation of biomechanical indices with conventional clinical scales and neurophysiological measures; characterization of passive and neural components of muscle tone. Mechanical stretches of the wrist flexor muscles of 53 post-stroke patients were imposed by means of a torque motor at constant speed. Patients were clinically studied using the Ashworth scale for spasticity and the Medical Research Council score for residual muscle strength. The neurophysiological measures were Hoffmann reflex latency, Hmax/Mmax ratio, stretch reflex threshold speed (SRTS), stretch reflex (SR) latency and area, passive (ISI) and total (TSI) stiffness indices. Hmax/Mmax ratio, SR area, ISI and TSI values were significantly higher in patients, while SRTS was significantly lower. TSI, SRTS and SR area were highly correlated to the Ashworth score. This EMG-biomechanical technique allows an objective evaluation of changes in muscle tone in post-stroke patients, providing easily measurable, quantitative indices of muscle stiffness. The linear distribution of these measures is particularly indicated for monitoring changes induced by treatment. The apparatus seems suitable to characterize neural stiffness, while difficulties were found in isolating the passive components, because of the occurrence of tonic EMG activity in most spastic patients.

  18. Quantitative bone scintigraphy. A study in patients with prostatic carcinoma

    International Nuclear Information System (INIS)

    Sundkvist, G.

    1991-01-01

    Quantitative bone scintigraphy was performed in patients with prostatic carcinoma before orchiectomy as well as two weeks, two and six months after operation. The count rate was recorded as serial gamma camera images over the lower thoracic and all lumbar vertebrae from 1 to 240 min and at 24 h after injection of 99T c m -MDP. In almost all abnormal vertebrae an increased count rate was observed within one hour after injection. Most of the vertebrae which were considered normal at 4 h after injection, but had an increased 24h/4h ratio developed into abnormal vertebrae later in the study. The patients with normal bone scintigrams showed no change in 99 Tc m -MDP uptake during the study. The reproducibility of quantitative bone scintigraphy was found to be ± 7% (1 SD). In response to therapy, most of the patients with abnormal bone scintigrams showed an increase in count rate two weeks after operation followed by a decrease to the pre-operative level after two months and a further decrease after six months. This so called 'flare phenomenon' was found to indicate 99 Tc m -MDP in the vascular phase as well as an active bone uptake. In some of the patients the whole-body retention of 99 Tc m -MDP after 24 h and the bone mineral density in the vertebrae were determined and found to be valuable in the interpretation of skeletal metastases and the assessment of response to therapy. (71 refs.)

  19. Quantitative Measures of Swallowing Deficits in Patients With Parkinson's Disease.

    Science.gov (United States)

    Ellerston, Julia K; Heller, Amanda C; Houtz, Daniel R; Kendall, Katherine A

    2016-05-01

    Dysphagia and associated aspiration pneumonia are commonly reported sequelae of Parkinson's disease (PD). Previous studies of swallowing in patients with PD have described prolonged pharyngeal transit time, delayed onset of pharyngeal transit, cricopharyngeal (CP) achalasia, reduced pharyngeal constriction, and slowed hyolaryngeal elevation. These studies were completed using inconsistent evaluation methodology, reliance on qualitative analysis, and a lack of a large control group, resulting in concerns regarding diagnostic precision. The purpose of this study was to investigate swallowing function in patients with PD using a norm-referenced, quantitative approach. This retrospective study includes 34 patients with a diagnosis of PD referred to a multidisciplinary voice and swallowing clinic. Modified barium swallow studies were performed using quantitative measures of pharyngeal transit time, hyoid displacement, CP sphincter opening, area of the pharynx at maximal constriction, and timing of laryngeal vestibule closure relative to bolus arrival at the CP sphincter. Reduced pharyngeal constriction was found in 30.4%, and a delay in airway closure relative to arrival of the bolus at the CP sphincter was the most common abnormality, present in 62% of patients. Previously reported findings of prolonged pharyngeal transit, poor hyoid elevation, and CP achalasia were not identified as prominent features. © The Author(s) 2015.

  20. Quantitative and qualitative changes in leukocytes of psoriatic patients

    International Nuclear Information System (INIS)

    Mahesar, S.M.; Khand, A.A.

    2011-01-01

    Background: Psoriasis is a disease concerned with inflammation and scaling of skin. In psoriasis, cells of the skin come on surface quickly before their complete maturation. In psoriatic patients, T-cells produce an abnormally large amount of toxic chemicals and cause inflammation. This study was undertaken to find out values of prognostic significance for worsening of the disease at early stage and to evaluate the changes (quantitative and qualitative) occurring in white blood cells of psoriatic patients. Methods: A total of 158 subjects, 79 psoriatic patients (44 males and 35 females) and same numbers of normal control volunteers were recruited. Total and Differential Leukocyte Counts (TLC and DLC) were determined. Morphological examination was also undertaken. All results of patients were compared with normal control volunteers. Results : In 47.7% male and 54.2% female patients TLC was higher than controls while variation in differential count was observed in 61.3% male and 62.8% female patients. Overall, neutrophils in 45% patients, basophils in 30.3%, eosinophils in 65.8%, and monocytes in 15% of patients were elevated. In 77.2% psoriatic patients, lymphocytes were decreased. In volunteers total and differential leukocyte counts were within normal range. Total leukocyte count in normal males was 5,136 +- 31, and in psoriatic male subjects it was 10,498 +- 43, and it was 5,023 +- 35 against 11,390 +- 31 in normal versus psoriatic females ( p<0.001). Conclusion: Total leukocyte count was elevated in psoriatics while on DLC neutrophils, eosinophils and neutrophils were significantly raised where as lymphocytes were significantly decreased in psoriatic patients. Morphological changes were also noted. (author)

  1. Cancer patients' needs during hospitalisation: a quantitative and qualitative study

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    Greco Margherita

    2003-04-01

    Full Text Available Abstract Background The evaluation of cancer patients needs, especially during that delicate period when they are hospitalized, allows the identification of those areas of care that require to be improved. Aims of the study were to evaluate the needs in cancer inpatients and to improve the understanding of the meanings of the needs expressed. Methods The study was conducted during a "sample day", with all the cancer patients involved having been hospitalized at the Istituto Nazionale Tumori of Milan (INT for at least 48 hours beforehand. The study was carried out using quantitative and qualitative methodologies. The quantitative part of the study consisted in making use of the Needs Evaluation Questionnaire (NEQ, a standardized questionnaire administered by the INT Psychology Unit members, supported by a group of volunteers from the Milan section of the Italian League Against Cancer. The aim of the qualitative part of the study, by semi-structured interviews conducted with a small sample of 8 hospitalized patients, was to improve our understanding of the meanings, implications of the needs directly described from the point of view of the patients. Such an approach determines the reasons and conditions of the dissatisfaction in the patient, and provides additional information for the planning of improvement interventions. Results Of the 224 eligible patients, 182 (81% completed the questionnaire. Four of the top five needs expressed by 40% or more of the responders concerned information needs (diagnosis, future conditions, dialogue with doctors, economic-insurance solutions related to the disease. Only one of the 5 was concerned with improved "hotel" services (bathrooms, meals, cleanliness. Qualitative analysis showed that the most expressed need (to receive more information on their future conditions has the meaning to know how their future life will be affected more than to know his/her actual prognosis. Conclusions Some of the needs which

  2. Polysomnography with quantitative EEG in patients with and without fibromyalgia.

    Science.gov (United States)

    Rosenfeld, Victor W; Rutledge, Dana N; Stern, John M

    2015-04-01

    Characterize the polysomnographic (PSG) and quantitative EEG (qEEG) features of fibromyalgia and determine whether fibromyalgia patients differ in these measures when compared with a control sleep disorder population. All undergoing all-night PSG for evaluation of a sleep disorder were evaluated for fibromyalgia. The PSGs were interpreted for routine sleep measures, and qEEG was performed to measure the delta and alpha frequency power during non-rapid eye movement sleep. Measures and qEEG were analyzed according to fibromyalgia diagnosis. Community-based sleep medicine center. All patients undergoing PSG over a 2-year period. None. Of the 385 patients in the study population, 133 had fibromyalgia according to American College of Rheumatology criteria. The population's average Epworth Sleepiness Score was 10.5, the average sleep efficiency was 78%, and the Periodic Limb Movement disorder prevalence was 15%. None of these sleep measures differed significantly between the fibromyalgia and non-fibromyalgia groups. Obstructive sleep apnea was present in 45% of the fibromyalgia group. Significant differences were present in the qEEG ratio of delta to alpha frequency power, which was 95% specific for fibromyalgia when ≤1. A qEEG ratio ≤10.5 was 85% sensitive for fibromyalgia, and a qEEG ratio >10.5 had an 89% negative predictive value for fibromyalgia. Among patients with fibromyalgia who were not taking a benzodiazepine or benzodiazepine agonist, a qEEG ratio ≤10.5 was 84% specific and had a 78% positive predictive value. Sleep disorders identified by routine PSG, including obstructive sleep apnea, are common in fibromyalgia, but periodic leg movement disorder and poor sleep efficiency are not. A qEEG low delta/alpha ratio during non-rapid eye movement sleep can differentiate patients with fibromyalgia from others who are referred for PSG. Consideration of benzodiazepine and benzodiazepine agonist use is important when interpreting the delta/alpha ratio.

  3. Detection of TT Virus Among Thalassaemic Children With Chronic Viral Hepatitis B and C Receiving Irradiated and Non Irradiated RBCs

    International Nuclear Information System (INIS)

    El-Maghraby, D.F.; EL-Shafie, A.I.; El-Sayed, S.A.; Alkady, M.M.

    2010-01-01

    TTV was first identified in the serum of a patient with post transfusion hepatitis of unknown etiology in 1997.As a consequence of the high prevalence of TTV in blood donors, thalassemia patients frequently acquire various genotypes of this virus through therapeutic blood transfusions.TTV as a cause of chronic hepatitis has not yet determined . Ten healthy and twenty-eight poly-transfused thalassemia children were evolved in this study where ten patients were receiving irradiated RBCs and eighteen receiving non irradiated ones.TTV was detected in serum samples by semi-nested polymerase chain reaction (PCR) using TTV-specific primer. Transaminases levels, hepatitis B and C virus markers were interpreted for possible association with TTV infection. As a result, TTV was found in 50% of thalassemia patients and in 20 % of the controls. Among thalassemia patients, isolated HBsAG, isolated HCV-AB, HBsAG and TTV-DNA and HCV-AB and TTV-DNA distributions were: 6 (21.43%) ,8 ( 28.57%) , 4 ( 14.29%) and 10 (35.7%) respectively. Regarding thalassemia patients receiving irradiated RBCs, the frequency of viral infections were 8(80%), 2(20%) and 0% for TTV co-infections, isolated HBV and isolated HCV, respectively. On the other hand, the prevalence of viral infections among patients receiving non irradiated RBCs were 6(33.3%), 4(22.2%) and 8(44.5%) for TTV co-infection, isolated HBV and isolated HCV, respectively. These data may give evidence that radiation raises the levels of blood safety especially regarding HCV. Furthermore, liver transaminase levels were significantly higher in all patients versus the controls, meanwhile, transaminase values were not different in HBsAG-positive subjects as compared with subjects who had both HBsAG and TTV-DNA positive. Also, there was no significant difference between isolated HCV infection and HCV and TTV co-infection. So, no convincing evidence was found to support TTV involvement in the D. F. EL-MAGHRABY, et al. / J. Rad. Res. Appl. Sci

  4. Quantitative analysis of Esophageal Transit of Radionuclide in Patients with Dermatomyositis-Polymyositis

    Energy Technology Data Exchange (ETDEWEB)

    Chung, June Key; Lee, Myung Chul; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Myung Hae [Asan Medical Center, Seoul (Korea, Republic of)

    1989-07-15

    Esophageal transit of radionuclide was quantitatively analyzed in 29 patients with dermatomyositis-polymyositis Fourteen patients (48.3%) showed retention of tracer in oropharynx. The mean value of percent retention of oropharynx was 15.5+16.6%. Esophageal dysfunction was found in 19 patients (65.5%). Among them 4 showed mild, 12 showed moderate and 3 showed severe esophageal dysfunction. Dysphagia was found in 11 patients (37.9%), which was closely related to percent retention of oropharynx. Quantitative analysis of esophageal transit of radionuclide seemed to be a useful technique for evaluation of dysphagia in patients with dermatomyositis-polymyositis.

  5. Flow cytometric immunobead assay for quantitative detection of platelet autoantibodies in immune thrombocytopenia patients.

    Science.gov (United States)

    Zhai, Juping; Ding, Mengyuan; Yang, Tianjie; Zuo, Bin; Weng, Zhen; Zhao, Yunxiao; He, Jun; Wu, Qingyu; Ruan, Changgeng; He, Yang

    2017-10-23

    Platelet autoantibody detection is critical for immune thrombocytopenia (ITP) diagnosis and prognosis. Therefore, we aimed to establish a quantitative flow cytometric immunobead assay (FCIA) for ITP platelet autoantibodies evaluation. Capture microbeads coupled with anti-GPIX, -GPIb, -GPIIb, -GPIIIa and P-selectin antibodies were used to bind the platelet-bound autoantibodies complex generated from plasma samples of 250 ITP patients, 163 non-ITP patients and 243 healthy controls, a fluorescein isothiocyanate (FITC)-conjugated secondary antibody was the detector reagent and mean fluorescence intensity (MFI) signals were recorded by flow cytometry. Intra- and inter-assay variations of the quantitative FCIA assay were assessed. Comparisons of the specificity, sensitivity and accuracy between quantitative and qualitative FCIA or monoclonal antibody immobilization of platelet antigen (MAIPA) assay were performed. Finally, treatment process was monitored by our quantitative FCIA in 8 newly diagnosed ITPs. The coefficient of variations (CV) of the quantitative FCIA assay were respectively 9.4, 3.8, 5.4, 5.1 and 5.8% for anti-GPIX, -GPIb, -GPIIIa, -GPIIb and -P-selectin autoantibodies. Elevated levels of autoantibodies against platelet glycoproteins GPIX, GPIb, GPIIIa, GPIIb and P-selectin were detected by our quantitative FCIA in ITP patients compared to non-ITP patients or healthy controls. The sensitivity, specificity and accuracy of our quantitative assay were respectively 73.13, 81.98 and 78.65% when combining all 5 autoantibodies, while the sensitivity, specificity and accuracy of MAIPA assay were respectively 41.46, 90.41 and 72.81%. A quantitative FCIA assay was established. Reduced levels of platelet autoantibodies could be confirmed by our quantitative FCIA in ITP patients after corticosteroid treatment. Our quantitative assay is not only good for ITP diagnosis but also for ITP treatment monitoring.

  6. Quantitative Sensory Testing in Patients With Postthoracotomy Pain Syndrome

    DEFF Research Database (Denmark)

    Wildgaard, Kim; Ringsted, Thomas K; Kehlet, Henrik

    2013-01-01

    was demonstrated, the much lower within-patient than between-patient variances facilitated estimations of highly statistical significant, within-patient differences in thermal thresholds. DISCUSSION:: In patients with postthoracotomy pain syndrome, several statistical methods indicated an excessively high......-retest variability of thermal thresholds in patients (n=14) with the postthoracotomy pain syndrome. METHODS:: Sensory mapping with a metal roller (25°C) on the surgical side delineated an area with cool sensory dysfunction. In this area and in a contralateral area, 4 prespecified sites (2.6 cm) were outlined......, in addition to the maximum pain site on the surgical side. In these total 9 sites, warmth detection threshold, cool detection threshold, and heat pain threshold were assessed. RESULTS:: Comparisons of thermal test-retest assessments did not demonstrate any significant intraside differences. The SDs...

  7. Postural stability in patients with decompression sickness evaluated by means of Quantitative Romberg testing

    DEFF Research Database (Denmark)

    Hedetoft, Morten; Hyldegaard, Ole

    2015-01-01

    OBJECTIVE: The present study was designed to retrospectively evaluate the use of quantitative Romberg's testing on postural stability during the course of hyperbaric oxygen (HBO2) therapy in patients presenting with decompression sickness (DCS). METHODS: The Quantitative Romberg test was used...... obtained with the Quantitative Romberg test were observed in the group of DCS with vertigo relative to DCS without vertigo and healthy controls. A stepwise improvement in postural instability for DCS patients with vertigo was found following HBO2 therapy. After three treatments of HBO2, postural stability...... was found to be within the normal range of healthy controls. CONCLUSIONS: The Quantitative Romberg test offers the the clinician a fast, reliable and objective set of parametrical data to document postural instability in patients with either confirmed or suspected DCS....

  8. Quantitative thallium-201 myocardial exercise scintigraphy in normal subjects and patients with normal coronary arteries

    International Nuclear Information System (INIS)

    Niemeyer, M.G.; St. Antonius Hospital Nieuwegein; Laarman, G.J.; Lelbach, S.; Cramer, M.J.; Ascoop, C.A.P.L.; Verzijlbergen, J.F.; Wall, E.E. van der; Zwinderman, A.H.; Pauwels, E.K.J.

    1990-01-01

    Quantitative thallium-201 myocardial exercise scintigraphy was tested in two patient populations representing alternative standards for cardiac normality: group I comprised 18 male uncatherized patients with a low likelihood of coronary artery disease (CAD); group II contained 41 patients with normal coronary arteriograms. Group I patients were younger, they achieved a higher rate-pressure product than group II patients; all had normal findings by phisical examination and electrocardiography at rest and exercise. Group II patients comprised 21 females, 11 patients showed abnormal electrocardiography at rest, and five patients showed ischemic ST depression during exercise. Twelve patients had sign of minimal CAD. Twelve patients revealed abnormal visual and quantitative thallium findings, three of these patients had minimal CAD. Profiles of uptake and washout of thallium-201 were derived from both patient groups, and compared with normal limits developed by Maddahi et al. Furthermore, low likelihood and angiographically normal patients may differ substantially, and both sets of normal patients should be considered when establishing criteria of abnormality in exercise thallium imaging. When commercial software containing normal limits for quantitative analysis of exercise thallium-201 imaging is used in clinical practice, it is mandatory to compare these with normal limits of uptake and washout of thallium-201, derived from the less heterogeneous group of low-likelihood subjects, which should be used in selecting a normal population to define normality. (author). 37 refs.; 3 figs; 1 tab

  9. Angiogenic and anti-angiogenic factor gene transcript level quantitation by quantitative real time PCR in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Sharma, Bal Krishan; Srinivasan, Radhika; Kapil, Shweta; Singla, Bhupesh; Chawla, Yogesh Kumar; Chakraborti, Anuradha; Saini, Nitin; Duseja, Ajay; Das, Ashim; Kalra, Naveen; Dhiman, Radha Krishan

    2013-10-01

    Tumor angiogenesis, a major requirement for tumor growth and metastasis, is regulated by pro- and anti-angiogenic factors. The aim of this study was to quantify the expression of angiogenic (VEGF, HIF-1α, Angiopiotein-2) and anti-angiogenic (endostatin, angiostatin and Thrombospondin-1) factors and to discern their clinical relevance. A total 90 patients (67 HCC, 9 cirrhosis and 14 chronic hepatitis) were enrolled in the study. Tissue transcript levels of angiogenic (VEGF, HIF-1α, Ang-2) and anti-angiogenic (endostatin, angiostatin and TSP-1) factors were analyzed by quantitative real time-polymerase chain reaction (qRT-PCR) in the tissue samples. The tissue transcript levels of VEGF, HIF-1α and endostatin were found to be significantly higher in HCC in comparison to cirrhosis and chronic hepatitis. Although Ang-2, angiostatin and TSP-1 tissue transcript levels were higher in HCC group than the others groups but the difference was not statistically significant. In univariate analysis both VEGF and HIF-1α were found to be associated with poor survival of HCC patients. Multivariate analysis by the cox proportional hazard model revealed only VEGF as an independent factor predicting poor survival of the HCC patients. Angiogenic and anti-angiogenic factors are all highly expressed in HCC patients. Upregulation of tissue anti-angiogenic factors indicates the urgency for the alternative of anti-angiogenic therapies.

  10. Quantitative Assessment of Statistical Reviews of Patient Safety Research Articles.

    Science.gov (United States)

    Daniels, Jeffrey R; Dexter, Franklin; Espy, Jennifer L; Brull, Sorin J

    2017-06-06

    For 8.5 consecutive years, all patient safety articles of a journal underwent statistical review before publication. We sought to establish the prevalence of statistical themes in the statistical reviews, consideration of contemporary statistical methods, and their associations with time to journal receipt of authors' revision. An initial set of statistical themes was created using the statistical editor's notes. For example, for the statistical theme of "CONSORT checklist," the search term needed was "CONSORT." A complete (exhaustive) list of additional themes was obtained inductively. Among the 273 subsequent reviews for manuscripts that were ultimately accepted, the number of paragraphs that included a theme of a statistical method was only weakly associated with longer revision times (Kendall τ = 0.139 ± 0.039, P = 0.0004). Among the total 3274 paragraphs of statistical reviews, 72.2% did not include a theme of a statistical method (e.g., the editor instead asked the authors to clarify what statistical method had been used) (95% confidence interval [CI] = 70.6%-73.7%, P the 207 manuscripts with a review that included a statistical method, 47.3% included a contemporary topic (e.g., generalized pivotal methods) (95% CI = 40.4%-54.4%). However, among the 911 corresponding paragraphs of statistical review comments, only 16.0% included a contemporary theme (95% CI = 13.7%-18.6%). The revised versions of patient safety articles, which are eventually to be accepted for publication, have many statistical limitations especially in the reporting (writing) of basic statistical methods and results. The results suggest a need for education of patient safety investigators to include statistical writing.

  11. Quantitative analysis of DNA methylation in chronic lymphocytic leukemia patients.

    Science.gov (United States)

    Lyko, Frank; Stach, Dirk; Brenner, Axel; Stilgenbauer, Stephan; Döhner, Hartmut; Wirtz, Michaela; Wiessler, Manfred; Schmitz, Oliver J

    2004-06-01

    Changes in the genomic DNA methylation level have been found to be closely associated with tumorigenesis. In order to analyze the relation of aberrant DNA methylation to clinical and biological risk factors, we have determined the cytosine methylation level of 81 patients diagnosed with chronic lymphocytic leukemia (CLL). The analysis was based on DNA hydrolysis followed by derivatization of the 2'-desoxyribonucleoside-3'-monophosphates with BODIPY FL EDA. Derivatives were separated by micellar electrokinetic chromatography, and laser-induced fluorescence was used for detection. We analyzed potential correlations between DNA methylation levels and numerous patient parameters, including clinical observations and biological data. As a result, we observed a significant correlation with the immunoglobulin variable heavy chain gene (VH) mutation status. This factor has been repeatedly proposed as a reliable prognostic marker for CLL, which suggests that the methylation level might be a valuable factor in determining the prognostic outcome of CLL. We are now in the process of refining our method to broaden its application potential. In this context, we show here that the oxidation of the fluorescence marker in the samples and the evaporation of methanol in the electrolytes can be prevented by a film of paraffin oil. In summary, our results thus establish capillary electrophoresis as a valuable tool for analyzing the DNA methylation status of clinical samples.

  12. Quantitative assessment of the microcirculation in healthy volunteers and in patients with septic shock

    NARCIS (Netherlands)

    Edul, Vanina S. Kanoore; Enrico, Carolina; Laviolle, Bruno; Vazquez, Alejandro Risso; Ince, Can; Dubin, Arnaldo

    2012-01-01

    The microcirculation of septic patients has been characterized only semiquantitatively. Our goal was to characterize the sublingual microcirculation in healthy volunteers and patients with septic shock quantitatively. Our hypotheses were that 1) hyperdynamic blood flow is absent in septic shock; 2)

  13. The value of quantitative patient preferences in regulatory benefit-risk assessment

    NARCIS (Netherlands)

    Oude Egbrink, Mart; IJzerman, Maarten Joost

    2014-01-01

    Quantitative patient preferences are a method to involve patients in regulatory benefit-risk assessment. Assuming preferences can be elicited, there might be multiple advantages to their use. Legal, methodological and procedural issues do however imply that preferences are currently at most part of

  14. Complex and unstable simple elbow dislocations: a review and quantitative analysis of individual patient data

    NARCIS (Netherlands)

    de Haan, Jeroen; Schep, Niels; Tuinebreijer, Wim; den Hartog, Dennis

    2010-01-01

    The primary objective of this review of the literature with quantitative analysis of individual patient data was to identify the results of available treatments for complex elbow dislocations and unstable simple elbow dislocations. The secondary objective was to compare the results of patients with

  15. Focus Groups in Elderly Ophthalmologic Patients: Setting the Stage for Quantitative Preference Elicitation.

    Science.gov (United States)

    Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Stock, Stephanie

    2016-02-01

    Patients suffering from age-related macular degeneration (AMD) are rarely actively involved in decision-making, despite facing preference-sensitive treatment decisions. This paper presents a qualitative study to prepare quantitative preference elicitation in AMD patients. The aims of this study were (1) to gain familiarity with and learn about the special requirements of the AMD patient population for quantitative data collection; and (2) to select/refine patient-relevant treatment attributes and levels, and gain insights into preference structures. Semi-structured focus group interviews were performed. An interview guide including preselected categories in the form of seven potentially patient-relevant treatment attributes was followed. To identify the most patient-relevant treatment attributes, a ranking exercise was performed. Deductive content analyses were done by two independent reviewers for each attribute to derive subcategories (potential levels of attributes) and depict preference trends. The focus group interviews included 21 patients. The interviews revealed that quantitative preference surveys in this population will have to be interviewer assisted to make the survey feasible for patients. The five most patient-relevant attributes were the effect on visual function [ranking score (RS): 139], injection frequency (RS: 101), approval status (RS: 83), side effects (RS: 79), and monitoring frequency (RS: 76). Attribute and level refinement was based on patients' statements. Preference trends and dependencies between attributes informed the quantitative instrument design. This study suggests that qualitative research is a very helpful step to prepare the design and administration of quantitative preference elicitation instruments. It especially facilitated familiarization with the target population and its preferences, and it supported attribute/level refinement.

  16. A systematic review of quantitative burn wound microbiology in the management of burns patients.

    Science.gov (United States)

    Halstead, Fenella D; Lee, Kwang Chear; Kwei, Johnny; Dretzke, Janine; Oppenheim, Beryl A; Moiemen, Naiem S

    2018-02-01

    The early diagnosis of infection or sepsis in burns are important for patient care. Globally, a large number of burn centres advocate quantitative cultures of wound biopsies for patient management, since there is assumed to be a direct link between the bioburden of a burn wound and the risk of microbial invasion. Given the conflicting study findings in this area, a systematic review was warranted. Bibliographic databases were searched with no language restrictions to August 2015. Study selection, data extraction and risk of bias assessment were performed in duplicate using pre-defined criteria. Substantial heterogeneity precluded quantitative synthesis, and findings were described narratively, sub-grouped by clinical question. Twenty six laboratory and/or clinical studies were included. Substantial heterogeneity hampered comparisons across studies and interpretation of findings. Limited evidence suggests that (i) more than one quantitative microbiology sample is required to obtain reliable estimates of bacterial load; (ii) biopsies are more sensitive than swabs in diagnosing or predicting sepsis; (iii) high bacterial loads may predict worse clinical outcomes, and (iv) both quantitative and semi-quantitative culture reports need to be interpreted with caution and in the context of other clinical risk factors. The evidence base for the utility and reliability of quantitative microbiology for diagnosing or predicting clinical outcomes in burns patients is limited and often poorly reported. Consequently future research is warranted. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. Rapid quantitative determination of C-reactive protein at chair side in dental emergency patients.

    Science.gov (United States)

    Ren, Yan-Fang; Malmstrom, Hans S

    2007-07-01

    The objective of this study was to quantitatively determine, at chair side, the serum C-reactive protein (CRP) levels in dental emergency patients. Quantitative CRP test was performed at chair side in 40 patients with acute alveolar abscess (AAA), acute periodontal abscess (APA), and alveolar osteitis (AO) at the time of dental emergency treatment and 1 week after. CRP levels were compared between groups and before and after treatments using ANOVA and Fisher's Exact tests. Serum CRP levels were greater than 5 mg/L in 30 (75%) of the 40 patients. At 1-week follow-up, the decline in CRP levels was evident in the AAA group (P .05). Serum CRP levels are often elevated in patients with odontogenic infections and postoperative complications. Rapid reduction in serum CRP levels was likely to occur following successful treatment of AAA, but less likely to occur in APA and AO.

  18. Quantitative analysis of planar bone scintigraphy in patients with unilateral condylar hyperplasia

    NARCIS (Netherlands)

    Saridin, Carrol P.; Raijmakers, Pieter; Becking, Alfred G.

    2007-01-01

    This study compares quantitative analysis of planar bone scintigrams with visual interpretation in patients having unilateral condylar hyperplasia (UCH) and normal control subjects. The possibility of using a bony structure in a region near the condyle as an objective measurement of bone activity is

  19. Quantitative analysis of planar bone scintigraphy in patients with unilateral condylar hyperplasia

    NARCIS (Netherlands)

    Saridin, C.P.; Raijmakers, P.; Becking, A.G.

    2007-01-01

    Objective This study compares quantitative analysis of planar bone scintigrams with visual interpretation in patients having unilateral condylar hyperplasia (UCH) and normal control subjects. The possibility of using a bony structure in a region near the condyle as an objective measurement of bone

  20. A Quantitative Exploration of the Relationship between Patient Health and Electronic Personal Health Records

    Science.gov (United States)

    Hines, Denise Williams

    2009-01-01

    The use of electronic personal health records is becoming increasingly more popular as healthcare providers, healthcare and government leaders, and patients are seeking ways to improve healthcare quality and to decrease costs (Abrahamsen, 2007). This quantitative, descriptive correlational study examined the relationship between the degree of…

  1. Complex and Unstable Simple Elbow Dislocations: A Review and Quantitative Analysis of Individual Patient Data

    NARCIS (Netherlands)

    J. de Haan (Jeroen); N.W.L. Schep (Niels); D. den Hartog (Dennis); W.E. Tuinebreijer (Wim)

    2010-01-01

    textabstractThe primary objective of this review of the literature with quantitative analysis of individual patient data was to identify the results of available treatments for complex elbow dislocations and unstable simple elbow dislocations. The secondary objective was to compare the results of

  2. Diagnosis of cytomegalovirus infections by qualitative and quantitative PCR in HIV infected patients

    OpenAIRE

    CUNHA, Aldo de Albuquerque; MARIN, Lauro Juliano; AQUINO, Victor Hugo; FIGUEIREDO, Luiz Tadeu Moraes

    2002-01-01

    A high incidence of cytomegalovirus (CMV) infections is observed in Brazil. These viruses are causatives of significant morbidity and mortality among patients with advanced human immunodeficiency virus (HIV) infection. This work, shows the application of a PCR on determination of CMV load in the buffy coat and plasma. We analyzed the samples of 247 HIV infected patients in order to diagnose CMV infection and disease. We developed a semi-quantitative PCR that amplifies part of the glycoprotein...

  3. Penumbra pattern assessment in acute stroke patients: comparison of quantitative and non-quantitative methods in whole brain CT perfusion.

    Directory of Open Access Journals (Sweden)

    Kolja M Thierfelder

    Full Text Available BACKGROUND AND PURPOSE: While penumbra assessment has become an important part of the clinical decision making for acute stroke patients, there is a lack of studies measuring the reliability and reproducibility of defined assessment techniques in the clinical setting. Our aim was to determine reliability and reproducibility of different types of three-dimensional penumbra assessment methods in stroke patients who underwent whole brain CT perfusion imaging (WB-CTP. MATERIALS AND METHODS: We included 29 patients with a confirmed MCA infarction who underwent initial WB-CTP with a scan coverage of 100 mm in the z-axis. Two blinded and experienced readers assessed the flow-volume-mismatch twice and in two quantitative ways: Performing a volumetric mismatch analysis using OsiriX imaging software (MM(VOL and visual estimation of mismatch (MM(EST. Complementarily, the semiquantitative Alberta Stroke Programme Early CT Score for CT perfusion was used to define mismatch (MM(ASPECTS. A favorable penumbral pattern was defined by a mismatch of ≥ 30% in combination with a cerebral blood flow deficit of ≤ 90 ml and an MM(ASPECTS score of ≥ 1, respectively. Inter- and intrareader agreement was determined by Kappa-values and ICCs. RESULTS: Overall, MM(VOL showed considerably higher inter-/intrareader agreement (ICCs: 0.751/0.843 compared to MM(EST (0.292/0.749. In the subgroup of large (≥ 50 mL perfusion deficits, inter- and intrareader agreement of MM(VOL was excellent (ICCs: 0.961/0.942, while MM(EST interreader agreement was poor (0.415 and intrareader agreement was good (0.919. With respect to penumbra classification, MM(VOL showed the highest agreement (interreader agreement: 25 agreements/4 non-agreements/κ: 0.595; intrareader agreement 27/2/0.833, followed by MM(EST (22/7/0.471; 23/6/0.577, and MM(ASPECTS (18/11/0.133; 21/8/0.340. CONCLUSION: The evaluated approach of volumetric mismatch assessment is superior to pure visual and ASPECTS penumbra

  4. Diagnosis and quantitative detection of HSV DNA in samples from patients with suspected herpes simplex encephalitis

    Directory of Open Access Journals (Sweden)

    Mazyar Ziyaeyan

    Full Text Available Diagnosis of herpes simplex encephalitis (HSE is based on the detection of herpes simplex virus (HSV DNA in patients' CSF samples. HSV DNA quantitation has the potential for estimating the effects of antiviral therapy. The aim of this study was to diagnose HSV DNA in HSE suspected patients and the quantitative analysis of its genome using real-time PCR to assess the value of the viral load in the course of antiviral treatment. The CSF samples were collected from 236 consecutive HSE suspected patients from November 2004 to May 2008. Upon DNA extraction, the samples were analyzed by Real-Time PCR assay. A set of primers amplified a common sequence of HSV glycoprotein B gene. The copy numbers of unknown samples were expressed via a standard curve drawn with a known amount of amplified cloned plasmid. Of the 236 samples, 137 (58% came from males and 99 (42% from females. The HSV genome was detected in 22 (9.3% patients by PCR, 13 males/ 9 females. Serial CSF samples were available from 10 of the 22 patients. The range of the HSV DNA copy numbers in the clinical samples ranged from 2.5 × 10² to 1.7 × 10(6 copies/mL of CSF. Quantitative PCR results can be helpful in evaluating the efficacy of antiviral therapy in the above-mentioned patients. There is an association between the initial viral load and the duration of treatment course.

  5. Using Qualitative and Quantitative Assessment to Develop a Patient Safety Curriculum for Surgical Residents.

    Science.gov (United States)

    McKee, Rohini; Sussman, Andrew L; Nelson, M Timothy; Russell, John C

    2016-01-01

    The objective is to use qualitative and quantitative analysis to develop a patient safety curriculum for surgical residents. A prospective study of surgical residents using both quantitative and qualitative methods to craft a patient safety curriculum. Both a survey and focus groups were held before and 4 months after delivery of the patient safety curriculum. The University of New Mexico Hospital, a tertiary academic medical center. General surgery residents, postgraduate years 1 to 5 RESULTS: Qualitative and quantitative analysis revealed areas that required attention and thus helped to mold the curriculum. Qualitative analysis after delivery of the curriculum showed positive changes in attitudes and normative beliefs toward patient safety. Specifically, attitudes and approach to quality improvement and teamwork showed improvement. Survey analysis did not show any significant change in resident perception of the environment during the time frame of this study. Using qualitative analysis to uncover attitudinal barriers to a safe patient environment can help to enhance the relevance and content of a patient safety curriculum for general surgery residents. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. Quantitative determination of pulmonary artery flow by scintiscanning in patients with mitral stenosis

    International Nuclear Information System (INIS)

    Carvalho, N.; Fujioka, T.; Dias Neto, A.; Papaleo Netto, M.

    1974-01-01

    In twenty-two patients with pure or predominant mitral stenosis, with pulmonary hypertension, the quantitative blood flow of the pulmonary artery systems through the distribution of macroaggregated radio-iodinated ( 131 I) albumin is studied, by pulmonary digital scanning. Through the relations ship between the radioactive concentration in each organ, it is possible to classify three types of images: normal, balanced and inverted. This technique is useful for quantitative analysis of pulmonary artery flow, as a test that should preced cardiac catheterization and in the follow-up of the surgical results [pt

  7. Performance comparison between static and dynamic cardiac CT on perfusion quantitation and patient classification tasks

    Science.gov (United States)

    Bindschadler, Michael; Modgil, Dimple; Branch, Kelley R.; La Riviere, Patrick J.; Alessio, Adam M.

    2015-03-01

    Cardiac CT acquisitions for perfusion assessment can be performed in a dynamic or static mode. In this simulation study, we evaluate the relative classification and quantification performance of these modes for assessing myocardial blood flow (MBF). In the dynamic method, a series of low dose cardiac CT acquisitions yields data on contrast bolus dynamics over time; these data are fit with a model to give a quantitative MBF estimate. In the static method, a single CT acquisition is obtained, and the relative CT numbers in the myocardium are used to infer perfusion states. The static method does not directly yield a quantitative estimate of MBF, but these estimates can be roughly approximated by introducing assumed linear relationships between CT number and MBF, consistent with the ways such images are typically visually interpreted. Data obtained by either method may be used for a variety of clinical tasks, including 1) stratifying patients into differing categories of ischemia and 2) using the quantitative MBF estimate directly to evaluate ischemic disease severity. Through simulations, we evaluate the performance on each of these tasks. The dynamic method has very low bias in MBF estimates, making it particularly suitable for quantitative estimation. At matched radiation dose levels, ROC analysis demonstrated that the static method, with its high bias but generally lower variance, has superior performance in stratifying patients, especially for larger patients.

  8. Quantitative prediction of oral cancer risk in patients with oral leukoplakia.

    Science.gov (United States)

    Liu, Yao; Li, Yicheng; Fu, Yue; Liu, Tong; Liu, Xiaoyong; Zhang, Xinyan; Fu, Jie; Guan, Xiaobing; Chen, Tong; Chen, Xiaoxin; Sun, Zheng

    2017-07-11

    Exfoliative cytology has been widely used for early diagnosis of oral squamous cell carcinoma. We have developed an oral cancer risk index using DNA index value to quantitatively assess cancer risk in patients with oral leukoplakia, but with limited success. In order to improve the performance of the risk index, we collected exfoliative cytology, histopathology, and clinical follow-up data from two independent cohorts of normal, leukoplakia and cancer subjects (training set and validation set). Peaks were defined on the basis of first derivatives with positives, and modern machine learning techniques were utilized to build statistical prediction models on the reconstructed data. Random forest was found to be the best model with high sensitivity (100%) and specificity (99.2%). Using the Peaks-Random Forest model, we constructed an index (OCRI2) as a quantitative measurement of cancer risk. Among 11 leukoplakia patients with an OCRI2 over 0.5, 4 (36.4%) developed cancer during follow-up (23 ± 20 months), whereas 3 (5.3%) of 57 leukoplakia patients with an OCRI2 less than 0.5 developed cancer (32 ± 31 months). OCRI2 is better than other methods in predicting oral squamous cell carcinoma during follow-up. In conclusion, we have developed an exfoliative cytology-based method for quantitative prediction of cancer risk in patients with oral leukoplakia.

  9. Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

    Directory of Open Access Journals (Sweden)

    Ana Carolina Fragoso MOTTA

    2015-01-01

    Full Text Available Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ who received intravenous or oral bisphosphonates (BP were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI, amplitude-dependent speed of sound (AD-SoS, bone biophysics profile (BBP, and bone transmission time (BTT were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82; 10 (58.8% were male and seven (41.1% were female, of whom 11 (64.7% suffered from multiple myeloma, three (17.6% from osteoporosis, one (5.8% from prostate cancer, one (5.8% from kidney cancer, and one (5.8% from leukemia. Fourteen (82.3% of them received intravenous BP whereas three (17.6% received oral BP. Nine (9/17; 52.9% patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004. The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.

  10. Quantitative analysis of patients with celiac disease by video capsule endoscopy: A deep learning method.

    Science.gov (United States)

    Zhou, Teng; Han, Guoqiang; Li, Bing Nan; Lin, Zhizhe; Ciaccio, Edward J; Green, Peter H; Qin, Jing

    2017-06-01

    Celiac disease is one of the most common diseases in the world. Capsule endoscopy is an alternative way to visualize the entire small intestine without invasiveness to the patient. It is useful to characterize celiac disease, but hours are need to manually analyze the retrospective data of a single patient. Computer-aided quantitative analysis by a deep learning method helps in alleviating the workload during analysis of the retrospective videos. Capsule endoscopy clips from 6 celiac disease patients and 5 controls were preprocessed for training. The frames with a large field of opaque extraluminal fluid or air bubbles were removed automatically by using a pre-selection algorithm. Then the frames were cropped and the intensity was corrected prior to frame rotation in the proposed new method. The GoogLeNet is trained with these frames. Then, the clips of capsule endoscopy from 5 additional celiac disease patients and 5 additional control patients are used for testing. The trained GoogLeNet was able to distinguish the frames from capsule endoscopy clips of celiac disease patients vs controls. Quantitative measurement with evaluation of the confidence was developed to assess the severity level of pathology in the subjects. Relying on the evaluation confidence, the GoogLeNet achieved 100% sensitivity and specificity for the testing set. The t-test confirmed the evaluation confidence is significant to distinguish celiac disease patients from controls. Furthermore, it is found that the evaluation confidence may also relate to the severity level of small bowel mucosal lesions. A deep convolutional neural network was established for quantitative measurement of the existence and degree of pathology throughout the small intestine, which may improve computer-aided clinical techniques to assess mucosal atrophy and other etiologies in real-time with videocapsule endoscopy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Quantitative histopathology in the prognostic evaluation of patients with transitional cell carcinoma of the urinary bladder

    DEFF Research Database (Denmark)

    Sasaki, M; Sørensen, Flemming Brandt; Fukuzawa, S

    1993-01-01

    BACKGROUND: Morphologic grading of malignancy is considered to be of prognostic value in patients with transitional cell carcinomas of the urinary bladder (TCC). This qualitative approach is, however, associated with low reproducibility. Grading of malignancy can be carried out on a reproducible......, quantitative scale. METHODS: A retrospective, prognostic study of 110 patients treated for TCC in clinical Stages Ta-T4 (median follow-up time, 6 years) was performed, evaluating various grading techniques. Unbiased estimates of the volume-weighted mean nuclear volume (nuclear vV), nuclear volume fraction...... of nuclear vV are prognostically superior to morphologic grading of malignancy in noninvasive TCC, whereas both morphologically and quantitatively based malignancy grading are without prognostic value in invasive TCC....

  12. Intraoral somatosensory abnormalities in patients with atypical odontalgia – a controlled multicenter quantitative sensory testing study

    Science.gov (United States)

    Baad-Hansen, Lene; Pigg, Maria; Ivanovic, Susanne El’Masry; Faris, Hanan; List, Thomas; Drangsholt, Mark; Svensson, Peter

    2013-01-01

    Intraoral somatosensory sensitivity in patients with atypical odontalgia (AO) has not been investigated systematically according to the most recent guidelines. The aims of this study were to: 1. Examine intraoral somatosensory disturbances in AO patients using healthy subjects as reference and 2. Evaluate the percent agreement between intraoral quantitative sensory testing (QST) and qualitative sensory testing (QualST). Forty-seven AO patients and 69 healthy controls were included at Universities of Washington, Malmö and Aarhus. In AO patients, intraoral somatosensory testing was performed on the painful site, the corresponding contralateral site and at thenar. In healthy subjects, intraoral somatosensory testing was performed bilaterally on the upper premolar gingiva and at thenar. Thirteen QST and 3 QualST parameters were evaluated at each site, z-scores were computed for AO patients based on the healthy reference material and LossGain scores were created. 87.3% of AO patients had QST abnormalities compared with controls. The most frequent somatosensory abnormalities in AO patients were somatosensory gain with regard to painful mechanical and cold stimuli and somatosensory loss with regard to cold detection and mechanical detection. The most frequent LossGain code was L0G2 (no somatosensory loss with gain of mechanical somatosensory function)(31.9% of AO patients). Percent agreement between corresponding QST and QualST measures of thermal and mechanical sensitivity ranged between 55.6 and 70.4% in AO patients and between 71.1 and 92.1% in controls. In conclusion, intraoral somatosensory abnormalities were commonly detected in AO patients and agreement between quantitative and qualitative sensory testing was good to excellent. PMID:23725780

  13. Intraoral somatosensory abnormalities in patients with atypical odontalgia--a controlled multicenter quantitative sensory testing study.

    Science.gov (United States)

    Baad-Hansen, Lene; Pigg, Maria; Ivanovic, Susanne Eímasry; Faris, Hanan; List, Thomas; Drangsholt, Mark; Svensson, Peter

    2013-08-01

    Intraoral somatosensory sensitivity in patients with atypical odontalgia (AO) has not been investigated systematically according to the most recent guidelines. The aims of this study were to examine intraoral somatosensory disturbances in AO patients using healthy subjects as reference, and to evaluate the percent agreement between intraoral quantitative sensory testing (QST) and qualitative sensory testing (QualST). Forty-seven AO patients and 69 healthy control subjects were included at Universities of Washington, Malmö, and Aarhus. In AO patients, intraoral somatosensory testing was performed on the painful site, the corresponding contralateral site, and at thenar. In healthy subjects, intraoral somatosensory testing was performed bilaterally on the upper premolar gingiva and at thenar. Thirteen QST and 3 QualST parameters were evaluated at each site, z-scores were computed for AO patients based on the healthy reference material, and LossGain scores were created. Compared with control subjects, 87.3% of AO patients had QST abnormalities. The most frequent somatosensory abnormalities in AO patients were somatosensory gain with regard to painful mechanical and cold stimuli and somatosensory loss with regard to cold detection and mechanical detection. The most frequent LossGain code was L0G2 (no somatosensory loss with gain of mechanical somatosensory function) (31.9% of AO patients). Percent agreement between corresponding QST and QualST measures of thermal and mechanical sensitivity ranged between 55.6% and 70.4% in AO patients and between 71.1% and 92.1% in control subjects. In conclusion, intraoral somatosensory abnormalities were commonly detected in AO patients, and agreement between quantitative and qualitative sensory testing was good to excellent. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  14. Comparison of qualitative and quantitative analysis of capillaroscopic findings in patients with rheumatic diseases.

    Science.gov (United States)

    Lambova, Sevdalina Nikolova; Hermann, Walter; Müller-Ladner, Ulf

    2012-12-01

    No guidelines for the application of qualitative and quantitative analysis of the capillaroscopic examination in the rheumatologic practice exist. The aims of the study were to compare qualitative and quantitative analysis of key capillaroscopic parameters in patients with common rheumatic diseases and to assess the reproducibility of the qualitative evaluation of the capillaroscopic parameters, performed by two different investigators. Two hundred capillaroscopic images from 93 patients with different rheumatic diseases were analysed quantitatively and qualitatively by two different investigators. The distribution of the images according to the diagnosis and the microvascular abnormalities was as follows-group 1: 73 images from systemic sclerosis patients ("scleroderma" type pattern), group 2: 10 images from dermatomyositis ("scleroderma-like" pattern), group 3: 25 images from undifferentiated connective tissue disease and different forms of overlap (24 "scleroderma-like"), group 4: 26 images from systemic lupus erythematosus patients, group 5: 46 images from rheumatoid arthritis and group 6: 20 images from primary Raynaud's phenomenon patients. All the images were mixed and blindly presented to both investigators. For comparison of the quantitative and qualitative method, investigator 1 assessed presence of dilated, giant capillaries and avascular areas quantitatively by the available software programme and his estimates were compared with the results of investigator 2, who assessed the parameters qualitatively. In addition, the capillaroscopic images were evaluated qualitatively by the investigator 1 and 2 for presence of dilated, giant capillaries, avascular areas and haemorrhages. The comparison of the quantitative and qualitative assessment of the two investigators demonstrated statistically significant difference between the two methods for the detection of dilated and giant capillaries (P difference regarding the detection of avascular areas (P > 0.05). As

  15. Value of Quantitative Collateral Scoring on CT Angiography in Patients with Acute Ischemic Stroke.

    Science.gov (United States)

    Boers, A M M; Sales Barros, R; Jansen, I G H; Berkhemer, O A; Beenen, L F M; Menon, B K; Dippel, D W J; van der Lugt, A; van Zwam, W H; Roos, Y B W E M; van Oostenbrugge, R J; Slump, C H; Majoie, C B L M; Marquering, H A

    2018-04-19

    Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship. From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance of both hemispheres and was compared with the visual collateral score. Primary outcomes were 90-day mRS score and follow-up infarct volume. The relation with outcome and the association with treatment effect were estimated. The influence of the CTA acquisition phase on the relation of collateral scores with outcome was determined. A total of 442 patients were included. The quantitative collateral score strongly correlated with the visual collateral score (ρ = 0.75) and was an independent predictor of mRS (adjusted odds ratio = 0.81; 95% CI, .77-.86) and follow-up infarct volume (exponent β = 0.88; P collateral score showed areas under the curve of 0.71 and 0.69 for predicting functional independence (mRS 0-2) and follow-up infarct volume of >90 mL, respectively. We found significant interaction of the quantitative collateral score with the endovascular therapy effect in unadjusted analysis on the full ordinal mRS scale ( P = .048) and on functional independence ( P = .049). Modification of the quantitative collateral score by acquisition phase on outcome was significant (mRS: P = .004; follow-up infarct volume: P collateral scoring in patients with acute ischemic stroke is a reliable and user-independent measure of the collateral capacity on baseline CTA and

  16. Quantitative computed tomography-derived clusters: redefining airway remodeling in asthmatic patients.

    Science.gov (United States)

    Gupta, Sumit; Hartley, Ruth; Khan, Umair T; Singapuri, Amisha; Hargadon, Beverly; Monteiro, William; Pavord, Ian D; Sousa, Ana R; Marshall, Richard P; Subramanian, Deepak; Parr, David; Entwisle, James J; Siddiqui, Salman; Raj, Vimal; Brightling, Christopher E

    2014-03-01

    Asthma heterogeneity is multidimensional and requires additional tools to unravel its complexity. Computed tomography (CT)-assessed proximal airway remodeling and air trapping in asthmatic patients might provide new insights into underlying disease mechanisms. The aim of this study was to explore novel, quantitative, CT-determined asthma phenotypes. Sixty-five asthmatic patients and 30 healthy subjects underwent detailed clinical, physiologic characterization and quantitative CT analysis. Factor and cluster analysis techniques were used to determine 3 novel, quantitative, CT-based asthma phenotypes. Patients with severe and mild-to-moderate asthma demonstrated smaller mean right upper lobe apical segmental bronchus (RB1) lumen volume (LV) in comparison with healthy control subjects (272.3 mm(3) [SD, 112.6 mm(3)], 259.0 mm(3) [SD, 53.3 mm(3)], 366.4 mm(3) [SD, 195.3 mm(3)], respectively; P = .007) but no difference in RB1 wall volume (WV). Air trapping measured based on mean lung density expiratory/inspiratory ratio was greater in patients with severe and mild-to-moderate asthma compared with that seen in healthy control subjects (0.861 [SD, 0.05)], 0.866 [SD, 0.07], and 0.830 [SD, 0.06], respectively; P = .04). The fractal dimension of the segmented airway tree was less in asthmatic patients compared with that seen in control subjects (P = .007). Three novel, quantitative, CT-based asthma clusters were identified, all of which demonstrated air trapping. Cluster 1 demonstrates increased RB1 WV and RB1 LV but decreased RB1 percentage WV. On the contrary, cluster 3 subjects have the smallest RB1 WV and LV values but the highest RB1 percentage WV values. There is a lack of proximal airway remodeling in cluster 2 subjects. Quantitative CT analysis provides a new perspective in asthma phenotyping, which might prove useful in patient selection for novel therapies. Copyright © 2013 The Authors. Published by Mosby, Inc. All rights reserved.

  17. Prognostic importance of quantitative echocardiographic evaluation in patients suspected of first non-massive pulmonary embolism

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Schaadt, Bente Krogsgaard; Lund, Jens Otto

    2008-01-01

    is predictive of event-free survival (all-cause mortality and heart failure hospitalizations) adjusted for LV ejection fraction, age, and sex (HR=0.78 per 10 ms increase, P=0.04). Measures of regional myocardial function were not related to outcome in this study, regardless of presence of PE. CONCLUSION: PA...... tissue Doppler imaging, was performed in 283 consecutive patients referred for ventilation/perfusion scintigraphy (V/Q scan) on suspicion of first non-massive PE. The prognostic information of quantitative measures of right ventricular (RV) size, function, and pressure was assessed. Patients with PE had...

  18. Measurement error of a simplified protocol for quantitative sensory tests in chronic pain patients

    DEFF Research Database (Denmark)

    Müller, Monika; Biurrun Manresa, José; Limacher, Andreas

    2017-01-01

    BACKGROUND AND OBJECTIVES: Large-scale application of Quantitative Sensory Tests (QST) is impaired by lacking standardized testing protocols. One unclear methodological aspect is the number of records needed to minimize measurement error. Traditionally, measurements are repeated 3 to 5 times......, and their mean value is considered. When transferring QST to a clinical setting, reducing the number of records would be desirable to meet the time constraints encountered in a routine clinical environment and to reduce the testing burden to chronic pain patients. However, there might be a trade-off between...... to reduce the testing burden. This would allow saving time, resources, and patient discomfort....

  19. Quantitative and qualitative deficiencies of regulatory T cells in patients with systemic lupus erythematosus (SLE).

    Science.gov (United States)

    Bonelli, Michael; Savitskaya, Anastasia; von Dalwigk, Karolina; Steiner, Carl Walter; Aletaha, Daniel; Smolen, Josef S; Scheinecker, Clemens

    2008-07-01

    The objective of the study was that the regulatory T cells (Treg) that specialize in the suppression of immune responses might be critically involved in the pathogenesis of autoimmune disease. As for systemic lupus erythematosus (SLE), however, published data concerning Treg phenotype and function are partly conflicting. We therefore performed quantitative and qualitative analyses of naturally occurring CD4(+)CD25(+) Treg from SLE patients as compared with healthy controls (HC) in order to further elucidate the role of Treg in this systemic autoimmune disease. The phenotype of peripheral blood CD4(+)CD25(+) Treg was determined by flow cytometry (FACS) in SLE patients and HC. Treg were isolated from SLE patients and HC and their functional capacity was analyzed in suppression assays. Phenotypic and functional data were correlated with clinical data. Decreased proportions of CD4(+) Treg with high-level expression of CD25 (CD4(+)CD25(hi)) were observed in active and inactive SLE patients (0.96 +/- 0.08 and 1.17 +/- 0.08%, respectively) as compared with HC (2 +/- 0.1%). In contrast to HC, Treg from SLE patients displayed an activated phenotype as determined by the expression of CD69, CD71 and HLA-DR. The suppressive capacity of isolated Treg from SLE patients, however, was significantly reduced as compared with HC. Proportions of CD4(+)CD25(hi) T cells and the suppressive capacity of Treg were inversely correlated with the clinical disease activity in SLE patients. Our data describe quantitative and qualitative defects of Treg in SLE patients. These deficiencies might contribute to the breakdown of self-tolerance and the development of the autoimmune response in SLE patients.

  20. Applying Quantitative CT Image Feature Analysis to Predict Response of Ovarian Cancer Patients to Chemotherapy.

    Science.gov (United States)

    Danala, Gopichandh; Thai, Theresa; Gunderson, Camille C; Moxley, Katherine M; Moore, Kathleen; Mannel, Robert S; Liu, Hong; Zheng, Bin; Qiu, Yuchen

    2017-10-01

    The study aimed to investigate the role of applying quantitative image features computed from computed tomography (CT) images for early prediction of tumor response to chemotherapy in the clinical trials for treating ovarian cancer patients. A dataset involving 91 patients was retrospectively assembled. Each patient had two sets of pre- and post-therapy CT images. A computer-aided detection scheme was applied to segment metastatic tumors previously tracked by radiologists on CT images and computed image features. Two initial feature pools were built using image features computed from pre-therapy CT images only and image feature difference computed from both pre- and post-therapy images. A feature selection method was applied to select optimal features, and an equal-weighted fusion method was used to generate a new quantitative imaging marker from each pool to predict 6-month progression-free survival. The prediction accuracy between quantitative imaging markers and the Response Evaluation Criteria in Solid Tumors (RECIST) criteria was also compared. The highest areas under the receiver operating characteristic curve are 0.684 ± 0.056 and 0.771 ± 0.050 when using a single image feature computed from pre-therapy CT images and feature difference computed from pre- and post-therapy CT images, respectively. Using two corresponding fusion-based image markers, the areas under the receiver operating characteristic curve significantly increased to 0.810 ± 0.045 and 0.829 ± 0.043 (P quantitative imaging markers computed from pre-therapy CT images. However, using image feature difference computed between pre- and post-therapy CT images yielded higher prediction accuracy. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  1. Quantitative analysis of exercise 201Tl myocardial emission CT in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Okada, Mitsuhiro; Kawai, Naoki; Yamamoto, Shuhei

    1984-01-01

    The clinical usefulness of quantitative analysis of exercise thallium-201 myocardial emission computed tomography (ECT) was evaluated in coronary artery disease (CAD). The subjects consisted of 20 CAD patients and five normal controls. All CAD patients underwent coronary angiography. Tomographic thallium-201 myocardial imaging was performed with a rotating gamma camera, and long-axial and short-axial myocardial images of the left ventricle were reconstructed. The tomographic images were interpreted quantitatively using circumferential profile analysis. Based on features of regional myocardial thallium-201 kinetics, two types of abnormalities were studied: (1) diminished initial distribution (stress defect) and (2) slow washout of thallium-201, as evidenced by patients' initial thallium-201 uptake and 3-hour washout rate profiles which fell below the normal limits, respectively. Two diagnostic criteria including the stress defect and a combination of the stress defect and slow washout were used to detect coronary artery lesions of significance (>=75 % luminal narrowing). The ischemic volumes were also evaluated by quantitative analysis using thallium-201 ECT. The diagnostic accuracy of the stress defect criterion was 95 % for left anterior descending, 90 % for right, and 70 % for left circumflex coronary artery lesions. The combined criteria of the stress defect and slow washout increased detection sensitivity with a moderate loss of specificity for identifying individual coronary artery lesion. A relatively high diagnostic accuracy was obtained using the stress defect criterion for multiple vessel disease (75 %). Ischemic myocardial volume was significantly larger in triple vessel than in single vessel disease (p < 0.05) using the combined criteria. It was concluded that quantitative analysis of exercise thallium-201 myocardial ECT images proves useful for evaluating coronary artery lesions. (author)

  2. Quantitative muscle ultrasound and quadriceps strength in patients with post-polio syndrome.

    Science.gov (United States)

    Bickerstaffe, Alice; Beelen, Anita; Zwarts, Machiel J; Nollet, Frans; van Dijk, Johannes P

    2015-01-01

    We investigated whether muscle ultrasound can distinguish muscles affected by post-polio syndrome (PPS) from healthy muscles and whether severity of ultrasound abnormalities is associated with muscle strength. Echo intensity, muscle thickness, and isometric strength of the quadriceps muscles were measured in 48 patients with PPS and 12 healthy controls. Patients with PPS had significantly higher echo intensity and lower muscle thickness than healthy controls. In patients, both echo intensity and muscle thickness were associated independently with muscle strength. A combined measure of echo intensity and muscle thickness was more strongly related to muscle strength than either parameter alone. Quantitative ultrasound distinguishes healthy muscles from those affected by PPS, and measures of muscle quality and quantity are associated with muscle strength. Hence, ultrasound could be a useful tool for assessing disease severity and monitoring changes resulting from disease progression or clinical intervention in patients with PPS. © 2014 Wiley Periodicals, Inc.

  3. Quantitation of Human Papillomavirus DNA in Plasma of Oropharyngeal Carcinoma Patients

    International Nuclear Information System (INIS)

    Cao Hongbin; Banh, Alice; Kwok, Shirley; Shi Xiaoli; Wu, Simon; Krakow, Trevor; Khong, Brian; Bavan, Brindha; Bala, Rajeev; Pinsky, Benjamin A.; Colevas, Dimitrios; Pourmand, Nader; Koong, Albert C.; Kong, Christina S.; Le, Quynh-Thu

    2012-01-01

    Purpose: To determine whether human papillomavirus (HPV) DNA can be detected in the plasma of patients with HPV-positive oropharyngeal carcinoma (OPC) and to monitor its temporal change during radiotherapy. Methods and Materials: We used polymerase chain reaction to detect HPV DNA in the culture media of HPV-positive SCC90 and VU147T cells and the plasma of SCC90 and HeLa tumor-bearing mice, non-tumor-bearing controls, and those with HPV-negative tumors. We used real-time quantitative polymerase chain reaction to quantify the plasma HPV DNA in 40 HPV-positive OPC, 24 HPV-negative head-and-neck cancer patients and 10 non-cancer volunteers. The tumor HPV status was confirmed by p16 INK4a staining and HPV16/18 polymerase chain reaction or HPV in situ hybridization. A total of 14 patients had serial plasma samples for HPV DNA quantification during radiotherapy. Results: HPV DNA was detectable in the plasma samples of SCC90- and HeLa-bearing mice but not in the controls. It was detected in 65% of the pretreatment plasma samples from HPV-positive OPC patients using E6/7 quantitative polymerase chain reaction. None of the HPV-negative head-and-neck cancer patients or non-cancer controls had detectable HPV DNA. The pretreatment plasma HPV DNA copy number correlated significantly with the nodal metabolic tumor volume (assessed using 18 F-deoxyglucose positron emission tomography). The serial measurements in 14 patients showed a rapid decline in HPV DNA that had become undetectable at radiotherapy completion. In 3 patients, the HPV DNA level had increased to a discernable level at metastasis. Conclusions: Xenograft studies indicated that plasma HPV DNA is released from HPV-positive tumors. Circulating HPV DNA was detectable in most HPV-positive OPC patients. Thus, plasma HPV DNA might be a valuable tool for identifying relapse.

  4. Multiparametric Classification of Skin from Osteogenesis Imperfecta Patients and Controls by Quantitative Magnetic Resonance Microimaging.

    Science.gov (United States)

    Ashinsky, Beth G; Fishbein, Kenneth W; Carter, Erin M; Lin, Ping-Chang; Pleshko, Nancy; Raggio, Cathleen L; Spencer, Richard G

    2016-01-01

    The purpose of this study is to evaluate the ability of quantitative magnetic resonance imaging (MRI) to discriminate between skin biopsies from individuals with osteogenesis imperfecta (OI) and skin biopsies from individuals without OI. Skin biopsies from nine controls (unaffected) and nine OI patients were imaged to generate maps of five separate MR parameters, T1, T2, km, MTR and ADC. Parameter values were calculated over the dermal region and used for univariate and multiparametric classification analysis. A substantial degree of overlap of individual MR parameters was observed between control and OI groups, which limited the sensitivity and specificity of univariate classification. Classification accuracies ranging between 39% and 67% were found depending on the variable of investigation, with T2 yielding the best accuracy of 67%. When several MR parameters were considered simultaneously in a multivariate analysis, the classification accuracies improved up to 89% for specific combinations, including the combination of T2 and km. These results indicate that multiparametric classification by quantitative MRI is able to detect differences between the skin of OI patients and of unaffected individuals, which motivates further study of quantitative MRI for the clinical diagnosis of OI.

  5. Quantitation of extent, depth, and severity of planar thallium defects in patients undergoing exercise thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Reisman, S.; Maddahi, J.; Van Train, K.; Garcia, E.; Berman, D.

    1986-01-01

    Previous quantitation of exercise-redistribution planar 201 TI scintigraphy has shown high sensitivity and specificity in the detection of coronary artery disease and improved detection of individual coronary stenoses over visual analysis. By using similar methodology based on the circumferential profile method, we studied 133 patients to quantitatively assess the extent, depth, and severity of thallium defects compared with consensus visual analysis. These quantitative measurements are objective, requiring only three operator interactions. In comparing quantitative and visual results, a close correlation was found for measurement of extent of thallium defect (r = 0.73) and severity of defect (r = 0.79). In detecting patients with the high-risk scintigraphic pattern of a severe stress thallium defect, a quantitative depth score of greater than or equal to 36 had an 81% sensitivity and an 82% specificity. Thus, this nearly automatic, computerized quantitative method allows objective determination of extent, severity, and depth of planar 201 TI defects

  6. Quantitative histopathology in the prognostic evaluation of patients with transitional cell carcinoma of the urinary bladder

    DEFF Research Database (Denmark)

    Sasaki, M; Sørensen, Flemming Brandt; Fukuzawa, S

    1993-01-01

    , quantitative scale. METHODS: A retrospective, prognostic study of 110 patients treated for TCC in clinical Stages Ta-T4 (median follow-up time, 6 years) was performed, evaluating various grading techniques. Unbiased estimates of the volume-weighted mean nuclear volume (nuclear vV), nuclear volume fraction......, estimates of nuclear mean profile area (aH(nuc)), nuclear profile density index (NI), and mitotic profile density index (MI) were obtained by stereologic and morphometric techniques. RESULTS: The T-stage and morphologic grade of malignancy were closely cross-correlated (+0.63 ... was documented between nuclear vV and NI (r = -0.63). Estimates of nuclear volume fraction showed no correlation with nuclear vV. Comparisons between categorical and quantitative data revealed the following: a decrease in averaged estimates of NI for tumors in advanced T-stage and malignancy grade (2P

  7. Quantitative Parameters of Interdental Gingiva in Chronic Periodontitis Patients with IFN-γ Gene Polymorphism

    Directory of Open Access Journals (Sweden)

    Nadia Sheibak

    2017-03-01

    Full Text Available Chronic periodontitis (CP, an infectious disease resulting in inflammation within the periodontal tissue, is the main cause of adult tooth loss. CP is a multi-factorial disorder and the interaction between multiple genetic and environmental factors results in the manifestation of this disease. Recent researches in periodontitis has focused on cytokine gene polymorphisms that play important role in periodontal inflammation, but few studies investigated histological change that occur during CP in the supporting tissue of teeth. The aims of this study were to investigate the association of IFN-γ +874 A/T polymorphisms and quantitative parameters of interdental gingiva in CP patients. The study samples were interdental gingiva biopsies from 60 individuals including 38 patients and 22 healthy subjects. After determination of IFN-γ +874 A/T gene polymorphism by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR, patients were divided in three subgroups: 10 AA, 18 AT and 10 TT. After slides preparation, quantitative parameters were estimated by Cavalieri’s point-counting method. Statistical analyses were performed using Mann-Whitney and Kruskal-Wallis test to compare differences between groups. The volume density (Vv of epithelium, connective tissue and its components were significantly different between the control and CP groups (P<0.05. Statistically significant differences in the Vv of collagenous and non-collagenous matrix of interdental gingiva between AA, AT and TT groups were found (P<0.05. Result of present study shows that IFN-γ +874 A/T is strongly associated with some quantitative parameters of connective tissue constituents of interdental papilla in CP patients.

  8. Quantitative susceptibility mapping differentiates between blood depositions and calcifications in patients with glioblastoma.

    Directory of Open Access Journals (Sweden)

    Andreas Deistung

    Full Text Available OBJECTIVES: The application of susceptibility weighted imaging (SWI in brain tumor imaging is mainly used to assess tumor-related "susceptibility based signals" (SBS. The origin of SBS in glioblastoma is still unknown, potentially representing calcifications or blood depositions. Reliable differentiation between both entities may be important to evaluate treatment response and to identify glioblastoma with oligodendroglial components that are supposed to present calcifications. Since calcifications and blood deposits are difficult to differentiate using conventional MRI, we investigated whether a new post-processing approach, quantitative susceptibility mapping (QSM, is able to distinguish between both entities reliably. MATERIALS AND METHODS: SWI, FLAIR, and T1-w images were acquired from 46 patients with glioblastoma (14 newly diagnosed, 24 treated with radiochemotherapy, 8 treated with radiochemotherapy and additional anti-angiogenic medication. Susceptibility maps were calculated from SWI data. All glioblastoma were evaluated for the appearance of hypointense or hyperintense correlates of SBS on the susceptibility maps. RESULTS: 43 of 46 glioblastoma presented only hyperintense intratumoral SBS on susceptibility maps, indicating blood deposits. Additional hypointense correlates of tumor-related SBS on susceptibility maps, indicating calcification, were identified in 2 patients being treated with radiochemotherapy and in one patient being treated with additional anti-angiogenic medication. Histopathologic reports revealed an oligodendroglial component in one patient that presented calcifications on susceptibility maps. CONCLUSIONS: QSM provides a quantitative, local MRI contrast, which reliably differentiates between blood deposits and calcifications. Thus, quantitative susceptibility mapping appears promising to identify rare variants of glioblastoma with oligodendroglial components non-invasively and may allow monitoring the role of

  9. The Quantitative Analgesic Questionnaire: A Tool to Capture Patient-Reported Chronic Pain Medication Use.

    Science.gov (United States)

    Robinson-Papp, Jessica; George, Mary Catherine; Wongmek, Arada; Nmashie, Alexandra; Merlin, Jessica S; Ali, Yousaf; Epstein, Lawrence; Green, Mark; Serban, Stelian; Sheth, Parag; Simpson, David M

    2015-09-01

    The extent to which patients take chronic pain medications as prescribed is not well studied, and there are no generally agreed-upon measures. The Quantitative Analgesic Questionnaire (QAQ) is a new instrument designed to comprehensively document patient-reported medication use, generate scores to quantify it (by individual drug, class, and/or overall), and compare it (qualitatively and/or quantitatively) to the regimen as prescribed. The aim of this study was to describe the development and preliminary validation of the QAQ. The QAQ was studied in a convenience sample of 149 HIV-infected participants. We found that the QAQ scores computed for participants' chronic pain medication regimens were valid based on their correlation with 1) patient-reported pain intensity (r = 0.38; P pain management physicians' independent quantification of the regimens (r = 0.89; P medical record alone in 94%, including use of over-the-counter medications and quantification of "as needed" dosing. The QAQ also was found to be useful in quantifying change in the medication regimen over time, capturing a change in 50% of the participants from baseline to eight week follow-up. The QAQ is a simple tool that can facilitate understanding of patient-reported chronic pain medication regimens, including calculation of percent adherence and generation of quantitative scores suitable for estimating and tracking change in medication use over time. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Quantitative sensory testing in type 1 diabetic patients with painful and painless diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Ahmed T Alahmar

    2016-09-01

    Full Text Available The mechanism underlying the development of painful diabetic neuropathy (DN is unknown. The aim of this study was to compare quantitative sensory testing (QST characteristics of patients with painful and painless DN and to correlate QST measures with DN pain. Fifty type 1 diabetic patients with DN (30 with painful DN and 20 with painless DN and 32 age-matched non-diabetic controls were included in this study. For all patients and controls, a detailed assessment of DN was performed which comprised McGill visual analogue scale (McGill VAS for pain, neuropathy symptom profile and neuropathy disability score (NDS, quantitative sensory testing in form of cold, warm and vibration perception thresholds, nerve conduction studies (NCS, deep-breathing hear rate variability and Neuropad staining scores. Measures of QST, NCS and DB-HRV were correlated with McGill VAS for pain. There were no significant differences in cold, warm and vibration perception thresholds, NCS, DB-HRV and Neuropad scores between patients with painful and painless DN. Cold (r=-0.57, P=0.005, warm (r=0.47, P=0.026 and DB-HRV (r=0.50, P=0.023, however, correlated significantly with McGill VAS scores of pain. In conclusion, Quantitative sensory testing is a helpful tool to identify small nerve fibres damage of DN, correlates with pain intensity but cannot differentiate between painful and painless DN. Both central and peripheral neural injury could be implicated in the genesis of DN pain. [Dis Mol Med 2016; 4(3.000: 24-30

  11. QUANTITATIVE ULTRASOUND BONE DENSITOMETRY IN CHILDREN WITH THALASSAEMIA IN NORTH EAST INDIA

    Directory of Open Access Journals (Sweden)

    Chao Rochek Buragohain

    2016-11-01

    Full Text Available BACKGROUND Thalassaemic children who are on regular blood transfusion are at increased risk of hypothyroidism, growth hormone deficiency, hypoparathyroidism, diabetes mellitus and osteoporosis because of deposition of iron in various endocrine glands with age. Low bone mineral density is a significant problem in these children, which may lead to increased risk for fractures and suboptimal peak bone mass. The aim of the study is to determine the bone health status of children with thalassaemia using quantitative ultrasound densitometry. MATERIALS AND METHODS A case control study was done at Department of Paediatrics, Jorhat Medical College and Hospital, which included 32 regularly transfused thalassaemic children. Age and sex matched healthy controls were included. Quantitative ultrasound bone densitometry was done in both the groups and compared with each other. RESULTS Broadband Ultrasound Attenuation (BUA and Speed of Sound (SOS measurements were found to be independent of sex. BUA values in boys showed increasing trend with age, which was not observed in girls. SOS values did not show any increasing trend with age in both sexes. In both the groups, the BUA and SOS increased continuously with increasing age. The values of BUA were more in control group compared to case group while opposite was noticed with SOS values. BUA values were more when ferritin level was >2000 ng/dL and increased number of blood transfusion, whereas SOS values decreased with increase in serum ferritin level and number of transfusion, which was statistically significant (P=0.0125. Both BUA and SOS values decreased with increased severity of malnutrition, which was statistically significant for SOS (P=0.0266. CONCLUSION Quantitative ultrasound bone densitometry can be used as a screening method to assess the bone health status in children, particularly those with thalassaemia, but requires further studies in large groups.

  12. Quantitative cholescintigraphy and bile abnormalities in patients with acalculous biliary pain

    Energy Technology Data Exchange (ETDEWEB)

    Ponce, Julio; Pons, Vicente; Garrigues, Vicente; Ponce, Marta; Ortiz, Vicente; Pertejo, Virginia [Gastroenterology Unit, La Fe University Hospital, Valencia (Spain); Sopena, Ramon [Service of Nuclear Medicine, Dr. Peset University Hospital, Valencia (Spain)

    2004-08-01

    Acalculous biliary pain has been related to gallbladder dysfunction that produces a gallbladder emptying defect - a condition which favours the development of lithiasis. It is therefore probable that microlithiasis is present in patients with gallbladder dysfunction. The aims of this study were to measure gallbladder emptying and investigate bile abnormalities in patients with acalculous biliary pain. In 92 consecutive patients, gallbladder emptying was assessed by quantitative cholescintigraphy (abnormal ejection fraction {<=}40%). In 64 patients, a microscopic study was performed on duodenal bile, defining abnormality as the presence of cholesterol crystals in any amount and/or calcium bilirubinate granules and/or microspheroliths at a rate of >10 per slide. The ejection fraction was abnormal in 45 patients (49%) (median 25.1%, range 6.8-39.3%) and normal in the remaining 47 cases (median 71.3%, range 41.0-96.1%). Bile was abnormal in 32 of 64 patients (50%), the most frequent finding being calcium bilirubinate granules. In the patients with bile abnormalities, abnormal ejection fraction was more frequent (20 of 32) and the median ejection fraction was lower (30.9%, range 12.0-94.1%) than in the patients with normal bile (16 of 32 with an abnormal ejection fraction; median ejection fraction 50.7%, range 6.8-96.1%). Abnormal bile was frequent (55.5%) in patients with reduced ejection fraction, but was not uncommon in patients with normal ejection fraction (33.3%). Fewer patients showed no alteration (25%). It is concluded that in most patients, acalculous biliary pain coexists with gallbladder dysfunction or abnormal bile, the combination of both alterations being common. (orig.)

  13. Quantitative cholescintigraphy and bile abnormalities in patients with acalculous biliary pain

    International Nuclear Information System (INIS)

    Ponce, Julio; Pons, Vicente; Garrigues, Vicente; Ponce, Marta; Ortiz, Vicente; Pertejo, Virginia; Sopena, Ramon

    2004-01-01

    Acalculous biliary pain has been related to gallbladder dysfunction that produces a gallbladder emptying defect - a condition which favours the development of lithiasis. It is therefore probable that microlithiasis is present in patients with gallbladder dysfunction. The aims of this study were to measure gallbladder emptying and investigate bile abnormalities in patients with acalculous biliary pain. In 92 consecutive patients, gallbladder emptying was assessed by quantitative cholescintigraphy (abnormal ejection fraction ≤40%). In 64 patients, a microscopic study was performed on duodenal bile, defining abnormality as the presence of cholesterol crystals in any amount and/or calcium bilirubinate granules and/or microspheroliths at a rate of >10 per slide. The ejection fraction was abnormal in 45 patients (49%) (median 25.1%, range 6.8-39.3%) and normal in the remaining 47 cases (median 71.3%, range 41.0-96.1%). Bile was abnormal in 32 of 64 patients (50%), the most frequent finding being calcium bilirubinate granules. In the patients with bile abnormalities, abnormal ejection fraction was more frequent (20 of 32) and the median ejection fraction was lower (30.9%, range 12.0-94.1%) than in the patients with normal bile (16 of 32 with an abnormal ejection fraction; median ejection fraction 50.7%, range 6.8-96.1%). Abnormal bile was frequent (55.5%) in patients with reduced ejection fraction, but was not uncommon in patients with normal ejection fraction (33.3%). Fewer patients showed no alteration (25%). It is concluded that in most patients, acalculous biliary pain coexists with gallbladder dysfunction or abnormal bile, the combination of both alterations being common. (orig.)

  14. Quantitative sensory testing and mapping: a review of nonautomated quantitative methods for examination of the patient with neuropathic pain.

    Science.gov (United States)

    Walk, David; Sehgal, Nalini; Moeller-Bertram, Tobias; Edwards, Robert R; Wasan, Ajay; Wallace, Mark; Irving, Gordon; Argoff, Charles; Backonja, Misha-Miroslav

    2009-09-01

    Despite a growing interest in neuropathic pain, neurologists and pain specialists do not have a standard, validated, office examination for the evaluation of neuropathic pain signs to complement the neurologic, musculoskeletal, and general physical examinations. An office neuropathic pain examination focused on quantifying sensory features of neuropathic pain, ranging from deficits to allodynia and hyperalgesia, and evoked by a physiologically representative array of stimuli, will be an essential tool to monitor treatment effectiveness and for clinical investigation into the mechanisms and management of neuropathic pain. Such an examination should include mapping of areas of stimulus-evoked neuropathic pain and standardized, reproducible quantitative sensory testing (QST) of tactile, punctuate, pressure, and thermal modalities. We review quantitative sensory testing methodology in general and specific tests for the evaluation of neuropathic pain phenomena. Numerous quantitative sensory testing techniques for dynamic mechanical, pressure, vibration, and thermal sensory testing and mapping have been described. We propose a comprehensive neuropathic pain evaluation protocol that is based upon these available techniques. A comprehensive neuropathic pain evaluation protocol is essential for further advancement of clinical research in neuropathic pain. A protocol that uses tools readily available in clinical practice, when established and validated, can be used widely and thus accelerate data collection for clinical research and increase clinical awareness of the features of neuropathic pain.

  15. Chronic Pain in Multiple Sclerosis Patients: Utility of Sensory Quantitative Testing in Patients with Fibromyalgia Comorbidity.

    Science.gov (United States)

    Pompa, Alessandra; Clemenzi, Allessandro; Troisi, Elio; Pace, Luca; Casillo, Paolo; Catani, Sheila; Grasso, Maria Grazia

    2015-01-01

    Lower thermal and discomfort thresholds may predispose multiple sclerosis (MS) patients to chronic pain, but a possible effect of fibromyalgia (FM) comorbidity has never been investigated. Aims were to investigate the thermal and discomfort thresholds in the evaluation of pain intensity between MS patients with FM (PFM+) and MS patients with pain not associated to FM (PFM-). One hundred thirty three MS patients were investigated for chronic pain. FM was assessed according to the 1990 ACR diagnostic criteria. An algometer was used to measure the thresholds in the patients and 60 matched healthy subjects. Chronic pain was present in 88 (66.2%) patients; 12 (13.6%) had neuropathic pain, 22 (17.3%) were PFM+ and 65 (48.9%) PFM-. PFM+ were predominantly female (p = 0.03) and had a greater EDSS (p = 0.01) than NoP; no other significant differences emerged than PFM-. The thresholds were lower in MS patients than controls (p < 0.01), mainly in the PFM+. FM severity influenced the thermal threshold (p < 0.001), while the female gender influenced the discomfort threshold (p < 0.001). Thermal and discomfort thresholds were lower in patients than controls and were the lowest in PFM+. Their more severely impaired thermal threshold supports a neurophysiological basis of such association. © 2015 S. Karger AG, Basel.

  16. Quantitative dermatoglyphic asymmetry: a comparative study between schizophrenic patients and control groups of West Bengal, India.

    Science.gov (United States)

    Karmakar, B; Sengupta, M

    2012-01-01

    Quantitative Fluctuating (FA) and Directional asymmetry (DA) of dermatoglyphics on digito-palmar complex were analyzed in a group of 111 patients (males: 61, females: 50) with schizophrenia (SZ), and compared to an ethnically matched phenotypically healthy control (males: 60, females: 60) through MANOVA, ANOVA and canonical Discriminant analyses. With few exceptions, asymmetries are higher among patients, and this is more prominent in FA than DA. Statistically significant differences were observed between patient and control groups, especially in males. In both sexes, FA of combined dermatoglyphic traits (e.g. total finger ridge count, total palmar pattern ridge count) are found to be a strong discriminator between the two groups with a correct classification of over 83% probability.

  17. Quantitative measurement of vibratory sense and temperature sense in patients with multiple sclerosis.

    Science.gov (United States)

    Heijenbrok, M W; Anema, J R; Faes, T J; Bertelsmann, F W; Heimans, J J; Polman, C H

    1992-01-01

    In this study the vibratory perception threshold (VPT) and the thermal discrimination threshold (TDT) were measured in 33 patients with clinically definite multiple sclerosis (MS). VPT values were abnormal in a majority of MS patients (68%). There was no relation between VPT and the severity of the disease. TDT values were elevated less frequently (30%); abnormal TDTs were found only in patients with severe disease. It is suggested that this can be explained by MS-plaques having predilection sites within the central nervous system and by differences in functional and morphological properties of sensory pathways. Quantitative measurements of VPT and TDT seem to be suitable techniques for the detection of minor sensory signs of central origin.

  18. Single- versus dual-energy quantitative computed tomography for spinal densitometry in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Laan, R.F.J.M.; Erning, L.J.Th.O. van; Lemmens, J.A.M.; Putte, L.B.A. van de; Ruijs, S.H.J.; Riel, P.L.C.M. van

    1992-01-01

    Lumbar bone mineral density was measured by both single- and dual-energy quantitative computed tomography in 109 patients with rheumatoid arthritis. The results were corrected for the age-related increase in vertebral fat content by converting them to percentages of expected densities, using sex and energy-level specific regression equations obtained in a normal reference population. The percentages of expected density are approximately 10% lower in the single- than in the dual-energy mode, both in the patients with and without prednisone therapy. This difference is statistically highly significant, and is positively correlated with the duration of the disease and with the degree of radiological joint destruction. The data suggest that the vertebral fat content may be increased in patients with rheumatoid arthritis, as a consequence of disease-dependent mechanisms. (Author)

  19. Quantitative measurement of bone mineral contents in patients with senile osteoporosis and chronic renal failure

    International Nuclear Information System (INIS)

    Fukuda, Teruo

    1985-01-01

    Computed tomography using X-ray (XCT) and single photon emission computed tomography (SPECT) using sup(99m)Tc-MDP of the skull were performed in patients with ''senile osteoporosis'' and with chronic renal failure, in order to quantitatively determine bone mineral contents. XCT: In females with postmenopausal osteoporosis (6th decade), the EMI number of frontal bone was significantly low compared with that of control group, of the same age. The EMI number in ''senile osteoporosis'' correlated with the value of serum 25 (OH) D and 1 α - 25 (OH) 2 D. The EMI number in hemodialyzed patients was significantly low compared with that in the control group. On the other hand, the EMI number in non-hemodialyzed chronic renal failure patients showed no significant difference compared with findings in the control group. The EMI number of the frontal bone in patients with partial parathyroidectomy showed a slight rise compared with findings before surgery. Bone scintigram, Bone scan SPECT: Positive scan was seen in patients with long term hemodialysis and increased values of serum Alk-Pase and PTH were often apparent. Scintigraphic improvement in patients with renal osteodystrophy treated with vitamin D 3 showed a good correlation with improvement in serum Alk-Pase values. On SPECT, frontal bone activity in patients with renal osteodystrophy was significantly high compared with that in the control group. In case of renal osteodystrophy treated with partial parathyroidectomy, the frontal bone activity was markedly decreased compared with findings before surgery. (J.P.N.)

  20. Quantitative analysis of SPECT imaging parameters in patients with resting perfusion defects on myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Pruthi, Ankur; Asopa, Ramesh; Rajan, M.G.R.; Basu, Sandip

    2010-01-01

    Functional status/contractile behaviour of hibernating myocardium was analyzed objectively by analyzing the available quantitative parameters obtained on gated SPECT myocardial perfusion imaging (MPI) using Emory cardiac toolbox (ECTB) software. Materials and Methods: In this retrospective study, 70 patients with perfusion defects on 99 Tc-Sestamibi MPI (12 females, 58 males) who also underwent 18 F-FDG Cardiac PET study for assessment of hibernating myocardium were included for analysis. Patients were divided in three categories based on summed rest score (SRS) obtained from ECTB software, depicting the extent of perfusion defects. In a study population matched for extent of perfusion defects, quantitative parameters obtained from ECTB software such as left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (EDV), left ventricular end systolic volume (ESV) and left ventricular stroke volume (SV) were compared between patients showing evidence of hibernating myocardium and patients showing no evidence of hibernating myocardium. Student 't' test was applied on the given observations and a P-value <0.05 was considered as a significant difference between the means in two categories. Results: There was no significant difference in LVEF, EDV, ESV and SV measurements between those who demonstrate hibernating myocardium and those who show no evidence of hibernating myocardium across all the categories of patients. Few trends were evident in the present study in LVEF, EDV and ESV measurements i.e., fall in mean LVEF with increasing SRS and rise in mean EDV and ESV with increasing SRS. Conclusions: The findings were consistent with the nature of hibernating myocardium i.e., non-contractile and dysfunctional. The fall in the LVEF was suggestive of deteriorating myocardial function with increasing extent of perfusion defects. The increasing left ventricular EDV and ESV with increasing extent of perfusion defects was suggestive of rising incidence of

  1. Patient Characteristics by Type of Hypersexuality Referral: A Quantitative Chart Review of 115 Consecutive Male Cases.

    Science.gov (United States)

    Sutton, Katherine S; Stratton, Natalie; Pytyck, Jennifer; Kolla, Nathan J; Cantor, James M

    2015-01-01

    Hypersexuality remains an increasingly common but poorly understood patient complaint. Despite diversity in clinical presentations of patients referred for hypersexuality, the literature has maintained treatment approaches that are assumed to apply to the entire phenomenon. This approach has proven ineffective, despite its application over several decades. The present study used quantitative methods to examine demographic, mental health, and sexological correlates of common clinical subtypes of hypersexuality referrals. Findings support the existence of subtypes, each with distinct clusters of features. Paraphilic hypersexuals reported greater numbers of sexual partners, more substance abuse, initiation to sexual activity at an earlier age, and novelty as a driving force behind their sexual behavior. Avoidant masturbators reported greater levels of anxiety, delayed ejaculation, and use of sex as an avoidance strategy. Chronic adulterers reported premature ejaculation and later onset of puberty. Designated patients were less likely to report substance abuse, employment, or finance problems. Although quantitative, this article nonetheless presents a descriptive study in which the underlying typology emerged from features most salient in routine sexological assessment. Future studies might apply purely empirical statistical techniques, such as cluster analyses, to ascertain to what extent similar typologies emerge when examined prospectively.

  2. Patient-specific coronary blood supply territories for quantitative perfusion analysis.

    Science.gov (United States)

    Zakkaroff, Constantine; Biglands, John D; Greenwood, John P; Plein, Sven; Boyle, Roger D; Radjenovic, Aleksandra; Magee, Derek R

    2018-01-01

    Myocardial perfusion imaging, coupled with quantitative perfusion analysis, provides an important diagnostic tool for the identification of ischaemic heart disease caused by coronary stenoses. The accurate mapping between coronary anatomy and under-perfused areas of the myocardium is important for diagnosis and treatment. However, in the absence of the actual coronary anatomy during the reporting of perfusion images, areas of ischaemia are allocated to a coronary territory based on a population-derived 17-segment (American Heart Association) AHA model of coronary blood supply. This work presents a solution for the fusion of 2D Magnetic Resonance (MR) myocardial perfusion images and 3D MR angiography data with the aim to improve the detection of ischaemic heart disease. The key contribution of this work is a novel method for the mediated spatiotemporal registration of perfusion and angiography data and a novel method for the calculation of patient-specific coronary supply territories. The registration method uses 4D cardiac MR cine series spanning the complete cardiac cycle in order to overcome the under-constrained nature of non-rigid slice-to-volume perfusion-to-angiography registration. This is achieved by separating out the deformable registration problem and solving it through phase-to-phase registration of the cine series. The use of patient-specific blood supply territories in quantitative perfusion analysis (instead of the population-based model of coronary blood supply) has the potential of increasing the accuracy of perfusion analysis. Quantitative perfusion analysis diagnostic accuracy evaluation with patient-specific territories against the AHA model demonstrates the value of the mediated spatiotemporal registration in the context of ischaemic heart disease diagnosis.

  3. Patient-specific coronary blood supply territories for quantitative perfusion analysis

    Science.gov (United States)

    Zakkaroff, Constantine; Biglands, John D.; Greenwood, John P.; Plein, Sven; Boyle, Roger D.; Radjenovic, Aleksandra; Magee, Derek R.

    2018-01-01

    Abstract Myocardial perfusion imaging, coupled with quantitative perfusion analysis, provides an important diagnostic tool for the identification of ischaemic heart disease caused by coronary stenoses. The accurate mapping between coronary anatomy and under-perfused areas of the myocardium is important for diagnosis and treatment. However, in the absence of the actual coronary anatomy during the reporting of perfusion images, areas of ischaemia are allocated to a coronary territory based on a population-derived 17-segment (American Heart Association) AHA model of coronary blood supply. This work presents a solution for the fusion of 2D Magnetic Resonance (MR) myocardial perfusion images and 3D MR angiography data with the aim to improve the detection of ischaemic heart disease. The key contribution of this work is a novel method for the mediated spatiotemporal registration of perfusion and angiography data and a novel method for the calculation of patient-specific coronary supply territories. The registration method uses 4D cardiac MR cine series spanning the complete cardiac cycle in order to overcome the under-constrained nature of non-rigid slice-to-volume perfusion-to-angiography registration. This is achieved by separating out the deformable registration problem and solving it through phase-to-phase registration of the cine series. The use of patient-specific blood supply territories in quantitative perfusion analysis (instead of the population-based model of coronary blood supply) has the potential of increasing the accuracy of perfusion analysis. Quantitative perfusion analysis diagnostic accuracy evaluation with patient-specific territories against the AHA model demonstrates the value of the mediated spatiotemporal registration in the context of ischaemic heart disease diagnosis. PMID:29392098

  4. A remote quantitative Fugl-Meyer assessment framework for stroke patients based on wearable sensor networks.

    Science.gov (United States)

    Yu, Lei; Xiong, Daxi; Guo, Liquan; Wang, Jiping

    2016-05-01

    To extend the use of wearable sensor networks for stroke patients training and assessment in non-clinical settings, this paper proposes a novel remote quantitative Fugl-Meyer assessment (FMA) framework, in which two accelerometer and seven flex sensors were used to monitoring the movement function of upper limb, wrist and fingers. The extreme learning machine based ensemble regression model was established to map the sensor data to clinical FMA scores while the RRelief algorithm was applied to find the optimal features subset. Considering the FMA scale is time-consuming and complicated, seven training exercises were designed to replace the upper limb related 33 items in FMA scale. 24 stroke inpatients participated in the experiments in clinical settings and 5 of them were involved in the experiments in home settings after they left the hospital. Both the experimental results in clinical and home settings showed that the proposed quantitative FMA model can precisely predict the FMA scores based on wearable sensor data, the coefficient of determination can reach as high as 0.917. It also indicated that the proposed framework can provide a potential approach to the remote quantitative rehabilitation training and evaluation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Vertebral body bone mineral density in patients with lumbar spondylolysis: a quantitative CT study.

    Science.gov (United States)

    Gezer, Naciye Sinem; Balcı, Ali; Kalemci, Orhan; Köremezli, Nevin; Başara Akın, Işıl; Ur, Koray

    2017-01-01

    Spondylolysis is known to be a part of a disease process, which describes a defect in the pars interarticularis of vertebra. We aimed to use quantitative computed tomography (QCT) to measure vertebral body bone mineral density (BMD) in patients with lumbar spondylolysis and compare it with readings in controls. Forty symptomatic patients with lumbar spondylolysis aged 18-52 years and 40 matched controls of same sex and approximate age (±2 years) were included in the study. Measurements of BMD were performed by QCT analysis for each vertebral body from T12 to L5 and mean BMD was calculated for each case. Of 40 patients, 22 (55%) demonstrated L5 spondylolysis, 14 (35%) L4 spondylolysis, three (7.5%) L3 spondylolysis, and one (2.5%) L2 spondylolysis. Spondylolisthesis was found in 29 patients (73%). Patients with spondylolisthesis were significantly older than patients without spondylolisthesis (42±6.9 vs. 37.2±5.4, P = 0.024). Mean BMD value of the patient group was significantly lower than that of the controls (105±24 mg/cm³ vs. 118.7±25.6 mg/cm³, P = 0.015). Subgroup analysis of 19 patients and 19 controls under the age of 40 revealed that the mean BMD value of the patients was significantly lower than that of the controls in the younger age group as well (108.7±23.5 mg/cm³ vs. 130±25.8 mg/cm³, P = 0.009). This study demonstrated that patients with spondylolysis had significantly lower mean vertebral body BMD compared with controls.

  6. Patient needs and research priorities in the enteral nutrition market - a quantitative prioritization analysis.

    Science.gov (United States)

    Weenen, T C; Jentink, A; Pronker, E S; Commandeur, H R; Claassen, E; Boirie, Y; Singer, P

    2014-10-01

    A quantitative systematic identification and prioritization of unmet needs and research opportunities in relation to enteral nutrition was conducted by means of a tailor-made health research prioritization process. The research objectives were reached by conducting qualitative interviews followed by quantitative questionnaires targeting enteral nutrition key opinion leaders (KOLs). (1) Define disease areas that deserve more research attention; (2) Rank importance of product characteristics of tube feeding (TF) and oral nutritional supplements (ONS); (3) Assess involvement of KOLs in enteral nutrition R&D process. KOLs ranked three product characteristics and three disease areas that deserve additional research attention. From these, overall priority scores were calculated by multiplying ranks for both product characteristics and disease areas. 17 qualitative interviews were conducted and 77 questionnaires (response rate 35%) were completed and returned. (1) Disease areas in ONS and TF with highest priorities are: ONS: general malnutrition & geriatrics, TF: intensive care. (2) TF product characteristics with highest priorities are: composition and clinical evidence from a KOL perspective; tolerance and ease of use from a patient perspective. ONS product characteristics with highest priorities are: composition, clinical evidence and taste from a KOL perspective; taste from a patient perspective. We find a high discrepancy between product characteristic prioritization from a KOL and patient perspective. (3) Although 62% of all KOLs give advice to enteral nutrition companies on patient needs, they under-influence the setting of research priorities by enteral nutrition companies. This study provides a systematic approach to achieve research prioritization in enteral nutrition. In addition to providing new directions for enteral nutrition research and development, this study highlights the relevance of involving KOLs in the identification of research priorities as they

  7. HDL proteome in hemodialysis patients: a quantitative nanoflow liquid chromatography-tandem mass spectrometry approach.

    Directory of Open Access Journals (Sweden)

    Alain Mangé

    Full Text Available Aside from a decrease in the high-density lipoprotein (HDL cholesterol levels, qualitative abnormalities of HDL can contribute to an increase in cardiovascular (CV risk in end-stage renal disease (ESRD patients undergoing chronic hemodialysis (HD. Dysfunctional HDL leads to an alteration of reverse cholesterol transport and the antioxidant and anti-inflammatory properties of HDL. In this study, a quantitative proteomics approach, based on iTRAQ labeling and nanoflow liquid chromatography mass spectrometry analysis, was used to generate detailed data on HDL-associated proteins. The HDL composition was compared between seven chronic HD patients and a pool of seven healthy controls. To confirm the proteomics results, specific biochemical assays were then performed in triplicate in the 14 samples as well as 46 sex-matched independent chronic HD patients and healthy volunteers. Of the 122 proteins identified in the HDL fraction, 40 were differentially expressed between the healthy volunteers and the HD patients. These proteins are involved in many HDL functions, including lipid metabolism, the acute inflammatory response, complement activation, the regulation of lipoprotein oxidation, and metal cation homeostasis. Among the identified proteins, apolipoprotein C-II and apolipoprotein C-III were significantly increased in the HDL fraction of HD patients whereas serotransferrin was decreased. In this study, we identified new markers of potential relevance to the pathways linked to HDL dysfunction in HD. Proteomic analysis of the HDL fraction provides an efficient method to identify new and uncharacterized candidate biomarkers of CV risk in HD patients.

  8. Quantitative histopathology in the prognostic evaluation of patients with transitional cell carcinoma of the urinary bladder

    DEFF Research Database (Denmark)

    Sasaki, M; Sørensen, Flemming Brandt; Fukuzawa, S

    1993-01-01

    BACKGROUND: Morphologic grading of malignancy is considered to be of prognostic value in patients with transitional cell carcinomas of the urinary bladder (TCC). This qualitative approach is, however, associated with low reproducibility. Grading of malignancy can be carried out on a reproducible......, quantitative scale. METHODS: A retrospective, prognostic study of 110 patients treated for TCC in clinical Stages Ta-T4 (median follow-up time, 6 years) was performed, evaluating various grading techniques. Unbiased estimates of the volume-weighted mean nuclear volume (nuclear vV), nuclear volume fraction......, estimates of nuclear mean profile area (aH(nuc)), nuclear profile density index (NI), and mitotic profile density index (MI) were obtained by stereologic and morphometric techniques. RESULTS: The T-stage and morphologic grade of malignancy were closely cross-correlated (+0.63

  9. Semi-quantitative myocardial perfusion measured by computed tomography in patients with refractory angina

    DEFF Research Database (Denmark)

    Qayyum, Abbas Ali; Kühl, Jørgen Tobias; Kjaer, Andreas

    2017-01-01

    INTRODUCTION: Computed tomography (CT) is a novel method for assessment of myocardial perfusion and has not yet been compared to rubidium-82 positron emission tomography (PET). We aimed to compare CT measured semi-quantitative myocardial perfusion with absolute quantified myocardial perfusion using...... scanner and CT/PET 64-slice scanner. CT measured myocardial attenuation density (AD) and perfusion index (PI) were correlated to absolute PET myocardial perfusion values. RESULTS: Rest AD, rest and stress PI did not correlate to PET findings (r = 0·412, P = 0·113; r = 0·300, P = 0·259; and r = 0·508, P...... PET and to detect stenotic territories in patients with severe coronary artery disease. MATERIALS AND METHODS: Eighteen patients with stenosis narrowing coronary arteries ≥70% demonstrated on invasive coronary angiography underwent rest and adenosine stress imaging obtained by 320-multidetector CT...

  10. Quantitation of right and left ventricular volume with MR imaging in patients with primary pulmonary hypertension

    International Nuclear Information System (INIS)

    Boxt, L.M.; Katz, J.; Kolb, T.; Czegledy, F.P.; Barst, R.J.

    1990-01-01

    This paper tests the utility of MR imaging in quantitating changes in ventricular volume and function in patients with primary pulmonary hypertension (PPH). Right ventricular (RV) and left ventricular (LV) end-diastolic (ED) and end-systolic (ES) volumes were determined in six patients with PPH and in eight controls. Short-axis images were obtained from the cardiac apex to the base at ED and ES, and the ventricular cavities were planimetered. Volumes were computed by summing the areas of the cavities times the thickness of the sections (12-14 mm). The intersection gap (1-3 mm) was averaged between adjacent sections. Results were indexed to the subject's body surface area. This technique was verified by comparison of results obtained by this method with the water displacement volumes of ventricular casts of eight excised bovine hearts and six water-filled balloons. Linear regression and the unpaired Students t test were used to test significance

  11. Quantitative radioisotope measurement of duodenogastric reflux in patients with ulcer or gastrectomized for ulcer

    International Nuclear Information System (INIS)

    Hyoedynmaa, S.; Paeaekkoenen, A.; Laensimies, E.; Korhonen, K.; Paeaekkoenen, M.; Aukee, S.

    1985-01-01

    In this work the duodenogastric reflux was quantified as the amount of radioactivity entering the stomach after an i.v. administration of sup(99m)Tc-HIDA in ulcer patients and in patients who had undergone BI gastrectomy. The results were compared with visual evidence of gastric activity in the gamma camera images and biochemical determination of gastric bile reflux. The method is useful in quantifying the reflux if the activity is above the background activity. It allows the determination of an upper limit for the reflux when the reflux is evident visually. Only two or three images are needed for the quantitation. No correlation was found between biochemical measurements of fasting bile reflux in the stomach and radioisotopic quantification. (orig.) [de

  12. Quantitative sensory and autonomic testing in male diabetic patients with erectile dysfunction.

    Science.gov (United States)

    Wellmer, A; Sharief, M K; Knowles, C H; Misra, V P; Kopelman, P; Ralph, D; Anand, P

    1999-01-01

    To correlate abnormalities of nerve fibres in the lower limbs with erectile dysfunction in male diabetic patients, using a range of quantitative sensory and autonomic function tests. The study included 68 male diabetic patients with symptomatic erectile dysfunction and 11 matched diabetics without erectile dysfunction; none had clinical evidence of peripheral vascular disease or psychological disorder. Patients were evaluated with a symptom questionnaire based on the Michigan Neuropathy Screening Instrument questionnaire and examined clinically. Sural and peroneal nerve-conduction studies, and quantitative sensory and autonomic tests (vibration, thermal, light-touch thresholds, sensory and autonomic cutaneous axon-reflexes) were used to detect nerve abnormalities in the lower limbs, which were correlated with erectile dysfunction. Symptoms of neuropathy were more common in the group with male erectile dysfunction (MED), but statistically significant only for neuropathic pain (53% MED, 18% nonMED, P<0.05, chi-square test) and gastroparesis (44% MED, 0% nonMED, P<0.05). Tests of unmyelinated afferents (warming perception and capsaicin-induced sensory axon-reflex vasodilatation) were most often abnormal, sometimes with no other abnormalities on tests or neurological examination. However, abnormality of warm perception was not significantly different between groups (81% MED, 70% nonMED), suggesting that it is a poorer discriminant than abnormal sensory axon-reflex vasodilatation (89% MED, 22% nonMED, P<0.001). The only other significant test difference was decreased sural nerve action potential (70% MED, 22% non-MED, P<0.01). There appeared to be preferential involvement of unmyelinated sensory fibres that mediate axon-reflex vasodilatation in the limbs of diabetic patients with erectile dysfunction. This test appears to be a helpful indicator of neurological involvement in erectile dysfunction, and may be used to monitor the effect of new treatments.

  13. Mass Spectrometry-Based Quantitative Metabolomics Revealed a Distinct Lipid Profile in Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Yun Yen

    2013-04-01

    Full Text Available Breast cancer accounts for the largest number of newly diagnosed cases in female cancer patients. Although mammography is a powerful screening tool, about 20% of breast cancer cases cannot be detected by this method. New diagnostic biomarkers for breast cancer are necessary. Here, we used a mass spectrometry-based quantitative metabolomics method to analyze plasma samples from 55 breast cancer patients and 25 healthy controls. A number of 30 patients and 20 age-matched healthy controls were used as a training dataset to establish a diagnostic model and to identify potential biomarkers. The remaining samples were used as a validation dataset to evaluate the predictive accuracy for the established model. Distinct separation was obtained from an orthogonal partial least squares-discriminant analysis (OPLS-DA model with good prediction accuracy. Based on this analysis, 39 differentiating metabolites were identified, including significantly lower levels of lysophosphatidylcholines and higher levels of sphingomyelins in the plasma samples obtained from breast cancer patients compared with healthy controls. Using logical regression, a diagnostic equation based on three metabolites (lysoPC a C16:0, PC ae C42:5 and PC aa C34:2 successfully differentiated breast cancer patients from healthy controls, with a sensitivity of 98.1% and a specificity of 96.0%.

  14. Response monitoring of breast cancer patients receiving neoadjuvant chemotherapy using quantitative ultrasound, texture, and molecular features.

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    Lakshmanan Sannachi

    Full Text Available Pathological response of breast cancer to chemotherapy is a prognostic indicator for long-term disease free and overall survival. Responses of locally advanced breast cancer in the neoadjuvant chemotherapy (NAC settings are often variable, and the prediction of response is imperfect. The purpose of this study was to detect primary tumor responses early after the start of neoadjuvant chemotherapy using quantitative ultrasound (QUS, textural analysis and molecular features in patients with locally advanced breast cancer.The study included ninety six patients treated with neoadjuvant chemotherapy. Breast tumors were scanned with a clinical ultrasound system prior to chemotherapy treatment, during the first, fourth and eighth week of treatment, and prior to surgery. Quantitative ultrasound parameters and scatterer-based features were calculated from ultrasound radio frequency (RF data within tumor regions of interest. Additionally, texture features were extracted from QUS parametric maps. Prior to therapy, all patients underwent a core needle biopsy and histological subtypes and biomarker ER, PR, and HER2 status were determined. Patients were classified into three treatment response groups based on combination of clinical and pathological analyses: complete responders (CR, partial responders (PR, and non-responders (NR. Response classifications from QUS parameters, receptors status and pathological were compared. Discriminant analysis was performed on extracted parameters using a support vector machine classifier to categorize subjects into CR, PR, and NR groups at all scan times.Of the 96 patients, the number of CR, PR and NR patients were 21, 52, and 23, respectively. The best prediction of treatment response was achieved with the combination mean QUS values, texture and molecular features with accuracies of 78%, 86% and 83% at weeks 1, 4, and 8, after treatment respectively. Mean QUS parameters or clinical receptors status alone predicted the

  15. Repeated Quantitative Urine Toxicology Analysis May Improve Chronic Pain Patient Compliance with Opioid Therapy.

    Science.gov (United States)

    Knezevic, Nebojsa Nick; Khan, Omar M; Beiranvand, Afsaneh; Candido, Kenneth D

    2017-02-01

    Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic benign pain, many Americans continue to seek pain relief through opioid consumption. Assuring compliance of these patients may be a difficult aspect of proper management even with regular behavioral monitoring. The purpose of this study was to accurately assess the compliance of chronic opioid-consuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing (UDT) could improve compliance. Retrospective analysis of prospectively collected data. Outpatient pain management clinic. After Institutional Review Board (IRB) approval, a retrospective analysis of data for 500 patients was conducted. We included patients who were aged 18 years and older who were treated with opioid analgesic medication for chronic pain. Patients were asked to provide supervised urine toxicology specimens during their regular clinic visits, and were asked to do so without prior notification. The specimens were sent to an external laboratory for quantitative testing using liquid chromatography-tandem mass spectrometry. Three hundred and eighty-six (77.2%) patients were compliant with prescribed medications and did not use any illicit drugs or undeclared medications. Forty-one (8.2%) patients tested positive for opioid medication(s) that were not prescribed in our clinic; 8 (1.6%) of the patients were positive for medication that was not prescribed by any physician and was not present in the Illinois Prescription Monitoring Program; 5 (1%) patients tested negative for prescribed opioids; and 60 (12%) patients were positive for illicit drugs (8.6% marijuana, 3.2% cocaine, 0.2% heroin). Repeated UDTs following education and disclosure, showed 49 of the 77 patients (63.6%) had improved compliance. This was a single-site study and we normalized concentrations of opioids in urine with creatinine levels while specific gravity normalization was not

  16. Development of a quantitative food frequency questionnaire for Brazilian patients with type 2 diabetes.

    Science.gov (United States)

    Sarmento, Roberta Aguiar; Riboldi, Bárbara Pelicioli; da Costa Rodrigues, Ticiana; de Azevedo, Mirela Jobim; de Almeida, Jussara Carnevale

    2013-08-09

    To investigate the association between dietary components and development of chronic diabetic complications, the dietary evaluation should include a long period, months or years. The present manuscript aims to develop a quantitative food frequency questionnaire (FFQ) and a portfolio with food photos to assess the usual intake pattern of Brazilian patients with type 2 diabetes to be used in future studies. Dietary data using 3-day weighed diet records (WDR) from 188 outpatients with type 2 diabetes were used to construct the list of usually consumed foods. Foods were initially clustered into eight groups: "cereals, tubers, roots, and derivatives"; "vegetables and legumes"; "fruits"; "beans"; "meat and eggs"; "milk and dairy products"; "oils and fats", and "sugars and sweets". The frequency of food intake and the relative contribution of each food item to the total energy and nutrient intakes were calculated. Portion sizes were determined according to the 25th, 50th, 75th, and 95th percentiles of intake for each food item. A total of 62 food items were selected based on the 3-day WDR and another 27 foods or how they are prepared and nine beverages were included after the expert examination. Also, a portfolio with food photos of each included food item and portion sizes was made to assist the patients in identifying the consumed portion. We developed a practical quantitative FFQ and portfolio with photos of 98 food items covering those most commonly consumed in the past 12 months, to assess the usual diet pattern of patients with type 2 diabetes in Southern Brazil.

  17. Correlation between Parameters of Calcaneal Quantitative Ultrasound and Hip Structural Analysis in Osteoporotic Fracture Patients.

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    Licheng Zhang

    Full Text Available Calcaneal quantitative ultrasound (QUS, which is used in the evaluation of osteoporosis, is believed to be intimately associated with the characteristics of the proximal femur. However, the specific associations of calcaneal QUS with characteristics of the hip sub-regions remain unclear.A cross-sectional assessment of 53 osteoporotic patients was performed for the skeletal status of the heel and hip.We prospectively enrolled 53 female osteoporotic patients with femoral fractures. Calcaneal QUS, dual energy X-ray absorptiometry (DXA, and hip structural analysis (HSA were performed for each patient. Femoral heads were obtained during the surgery, and principal compressive trabeculae (PCT were extracted by a three-dimensional printing technique-assisted method. Pearson's correlation between QUS measurement with DXA, HSA-derived parameters and Young's modulus were calculated in order to evaluate the specific association of QUS with the parameters for the hip sub-regions, including the femoral neck, trochanteric and Ward's areas, and the femoral shaft, respectively.Significant correlations were found between estimated BMD (Est.BMD and BMD of different sub-regions of proximal femur. However, the correlation coefficient of trochanteric area (r = 0.356, p = 0.009 was higher than that of the neck area (r = 0.297, p = 0.031 and total proximal femur (r = 0.291, p = 0.034. Furthermore, the quantitative ultrasound index (QUI was significantly correlated with the HSA-derived parameters of the trochanteric area (r value: 0.315-0.356, all p<0.05 as well as with the Young's modulus of PCT from the femoral head (r = 0.589, p<0.001.The calcaneal bone had an intimate association with the trochanteric cancellous bone. To a certain extent, the parameters of the calcaneal QUS can reflect the characteristics of the trochanteric area of the proximal hip, although not specifically reflective of those of the femoral neck or shaft.

  18. Quantitative Assessment of Proprioception Using Dynamometer in Incomplete Spinal Cord Injury Patients: A Preliminary Study

    Science.gov (United States)

    2017-01-01

    Objective To investigate the feasibility of a knee proprioception evaluation using a dynamometer as a tool for evaluating proprioception of the lower extremities in patients with incomplete spinal cord injury (SCI), and to explore its usefulness in predicting the ambulatory outcome. Methods A total of 14 SCI patients (10 tetraplegic, 4 paraplegic; all AIS D) were included in this study. The passive repositioning error (PRE) and active repositioning error (ARE) were measured with a dynamometer, along with tibial somatosensory evoked potential (SSEP) and abductor hallucis motor-evoked potential (MEP). Ambulatory capacity was assessed with the Walking Index for Spinal Cord Injury II (WISCI-II), both at the time of the proprioception test (WISCI_i) and at least 6 months after the test (WISCI_6mo). Results The PRE showed a negative correlation with WISCI_i (r=-0.440, p=0.034) and WISCI_6mo (r=-0.568, p=0.010). Linear multiple regression showed the type of injury, lower extremities motor score, MEP, and PRE accounted for 75.4% of the WISCI_6mo variance (p=0.080). Conclusion Proprioception of the knee can be measured quantitatively with a dynamometer in patients with incomplete SCI, and PRE was related to the outcome of the ambulatory capacity. Along with the neurological and electrophysiological examinations, a proprioception test using a dynamometer may have supplementary value in predicting the ambulatory capacity in patients with incomplete SCI. PMID:28503454

  19. Quantitative MR evaluation of body composition in patients with Duchenne muscular dystrophy

    International Nuclear Information System (INIS)

    Pichiecchio, Anna; Uggetti, Carla; Egitto, Maria Grazia; Berardinelli, Angela; Orcesi, Simona; Gorni, Ksenija Olga Tatiana; Zanardi, Cristina; Tagliabue, Anna

    2002-01-01

    The aim of this study was to propose a quantitative MR protocol with very short acquisition time and good reliability in volume construction, for the evaluation of body composition in patients affected by Duchenne muscular dystrophy (DMD). This MR protocol was compared with common anthropometric evaluations of the same patients. Nine boys affected by DMD, ranging in age from 6 to 12 years, were selected to undergo MR examination. Transversal T1-weighted spin-echo sequences (0.5T; TR 300 ms, TE 10 ms, slice thickness 10 mm, slice gap 1 mm) were used for all acquisitions, each consisting of 8 slices and lasting just 54 s. Whole-body examination needed an average of nine acquisitions. Afterwards, images were downloaded to an independent workstation and, through their electronic segmentation with a reference filter, total volume and adipose tissue volumes were calculated manually. This process took up to 2 h for each patient. The MR data were compared with anthropometric evaluations. Affected children have a marked increase in adipose tissue and a decrease in lean tissue compared with reference healthy controls. Mean fat mass calculated by MR is significantly higher than mean fat mass obtained using anthropometric measurements (p<0.001). Our MR study proved to be accurate and easy to apply, although it was time-consuming. We recommend it in monitoring the progression of the disease and planning DMD patients' diet. (orig.)

  20. Quantitative MR evaluation of body composition in patients with Duchenne muscular dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Pichiecchio, Anna; Uggetti, Carla; Egitto, Maria Grazia [Department of Neuroradiology, Istituto Neurologico ' ' Fondazione C.Mondino' ' I.R.C.C.S, Via Palestro, 3, 27100 Pavia (Italy); Berardinelli, Angela; Orcesi, Simona; Gorni, Ksenija Olga Tatiana [Department of Neuropsychiatry, Istituto Neurologico ' ' Fondazione C.Mondino' ' I.R.C.C.S, Via Palestro, 3, 27100 Pavia (Italy); Zanardi, Cristina; Tagliabue, Anna [Department of Human Nutrition, Cascina Cravino, Via Bassi, 23, 27100 Pavia (Italy)

    2002-11-01

    The aim of this study was to propose a quantitative MR protocol with very short acquisition time and good reliability in volume construction, for the evaluation of body composition in patients affected by Duchenne muscular dystrophy (DMD). This MR protocol was compared with common anthropometric evaluations of the same patients. Nine boys affected by DMD, ranging in age from 6 to 12 years, were selected to undergo MR examination. Transversal T1-weighted spin-echo sequences (0.5T; TR 300 ms, TE 10 ms, slice thickness 10 mm, slice gap 1 mm) were used for all acquisitions, each consisting of 8 slices and lasting just 54 s. Whole-body examination needed an average of nine acquisitions. Afterwards, images were downloaded to an independent workstation and, through their electronic segmentation with a reference filter, total volume and adipose tissue volumes were calculated manually. This process took up to 2 h for each patient. The MR data were compared with anthropometric evaluations. Affected children have a marked increase in adipose tissue and a decrease in lean tissue compared with reference healthy controls. Mean fat mass calculated by MR is significantly higher than mean fat mass obtained using anthropometric measurements (p<0.001). Our MR study proved to be accurate and easy to apply, although it was time-consuming. We recommend it in monitoring the progression of the disease and planning DMD patients' diet. (orig.)

  1. Quantitative ultrasound does not identify patients with an inflammatory disease at risk of vertebral deformities

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    Geusens Piet

    2008-05-01

    Full Text Available Abstract Background Previous studies from our group have shown that a high prevalence of vertebral deformities suggestive of fracture can be found in patients with an inflammatory disease, despite a near normal bone mineral density (BMD. As quantitative ultrasound (QUS of the heel can be used for refined assessment of bone strength, we evaluated whether QUS can be used to identify subjects with an inflammatory disease with an increased chance of having a vertebral fracture. Methods 246 patients (mean age: 44 ± 12.4 years with an inflammatory disease (sarcoidosis or inflammatory bowel disease (IBD were studied. QUS of the heel and BMD of the hip (by dual X-ray absorptiometry (DXA were measured. Furthermore lateral single energy densitometry of the spine for assessment of vertebral deformities was done. Logistic regression analysis was performed to assess the strength of association between the prevalence of a vertebral deformity and BMD and QUS parameters, adjusted for gender and age. Results Vertebral deformities (ratio of Conclusion Our findings imply that QUS measurements of the calcaneus in patients with an inflammatory condition, such as sarcoidosis and IBD, are likely of limited value to identify patients with a vertebral fracture.

  2. QUEST-RA: quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Kautiainen, Hannu; Toloza, Sergio

    2007-01-01

    ) within and between countries was graphically analysed. A median regression model was applied to analyse differences in disease activity between countries. RESULTS: Between January 2005 and October 2006, the QUEST-RA (Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid...

  3. Quantitative analysis of iris parameters in keratoconus patients using optical coherence tomography

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    Gustavo Bonfadini

    2015-10-01

    Full Text Available ABSTRACTPurpose:To investigate the relationship between quantitative iris parameters and the presence of keratoconus.Methods:Cross-sectional observational study that included 15 affected eyes of 15 patients with keratoconus and 26 eyes of 26 normal age- and sex-matched controls. Iris parameters (area, thickness, and pupil diameter of affected and unaffected eyes were measured under standardized light and dark conditions using anterior segment optical coherence tomography (AS-OCT. To identify optimal iris thickness cutoff points to maximize the sensitivity and specificity when discriminating keratoconus eyes from normal eyes, the analysis included the use of receiver operating characteristic (ROC curves.Results:Iris thickness and area were lower in keratoconus eyes than in normal eyes. The mean thickness at the pupillary margin under both light and dark conditions was found to be the best parameter for discriminating normal patients from keratoconus patients. Diagnostic performance was assessed by the area under the ROC curve (AROC, which had a value of 0.8256 with 80.0% sensitivity and 84.6% specificity, using a cutoff of 0.4125 mm. The sensitivity increased to 86.7% when a cutoff of 0.4700 mm was used.Conclusions:In our sample, iris thickness was lower in keratoconus eyes than in normal eyes. These results suggest that tomographic parameters may provide novel adjunct approaches for keratoconus screening.

  4. A Quantitative Ethnopharmacological Documentation of Natural Pharmacological Agents Used by Pediatric Patients in Mauritius

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    M. Fawzi Mahomoodally

    2014-01-01

    Full Text Available The pediatric population constitutes the most vulnerable patients due to a dearth of approved drugs. Consequently, there is a pressing need to probe novel natural pharmacological agents in an endeavour to develop new drugs to address pediatric illnesses. To date, no studies have explored the use of natural therapies for pediatric health care in Mauritius. Parents (n=325 from different regions of the island were interviewed. Quantitative indexes such as fidelity level (FL, informant consensus factor (FIC, and use-value (UV were calculated. Thirty-two plants were reported to be used by pediatric patients. Gastrointestinal disorders (FIC=0.97 encompassing regurgitation, infantile colic, and stomach aches were the most common ailments managed with herbs. Matricaria chamomilla used for infantile colic and its pharmacological properties has previously been documented for pediatric patients. Product from A. mellifera (UV = 0.75 was the most utilized zootherapy for managing cough. Most plants and animal products reported in this study have bioactive constituents supported by existing scientific literature but their use for the pediatric population is scant. The present ethnopharmacological study has opened new perspectives for further research into their pharmacology, which can subsequently support and facilitate timely pediatric medicinal product development.

  5. Effect of topical anaesthesia in patients with persistent dentoalveolar pain disorders: A quantitative sensory testing evaluation.

    Science.gov (United States)

    Porporatti, André Luís; Costa, Yuri Martins; Stuginski-Barbosa, Juliana; Bonjardim, Leonardo Rigoldi; Conti, Paulo César Rodrigues

    2015-07-01

    The aim of this study was to test the hypothesis that patients with persistent dentoalveolar pain disorder (PDAP) expresses somatosensory abnormalities through quantitative sensory testing (QST), when compared to healthy controls; and that individuals with PDAP do not have somatosensory alterations after application of a topical anaesthetic gel. QST was performed in 25 subjects with PDAP (19 women and 6 men), at baseline and after topical application of benzocaine 2% (Benzotop 200mg/g, DFL) and compared to 25 matched healthy controls. After "Z" score transformation, results were analyzed using the paired "t" test and "t" test with significance level of 5%. PDAP subjects have lower pain detection thresholds confirmed through mechanical tests; and higher pain intensity report through thermal stimuli tests (heat and cold) when compared to healthy subjects. Topical anaesthesia partially reduces in 60% pain intensity of PDAP patients; and anaesthetic gel increases mechanical detection thresholds and reduces pain intensity report in dynamical mechanical allodynia tests. PDAP patients had abnormal thermal sensory and mechanical allodynia, which is indicative of central sensitization. Moreover, topical anaesthetic incited a significant reduction in pain intensity, and an increase in mechanical and pain detection thresholds, which could be also suggestive of a peripheral disorder. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Reduced quantitative ultrasound bone mineral density in HIV-infected patients on antiretroviral therapy in Senegal.

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    Amandine Cournil

    Full Text Available BACKGROUND: Bone status in HIV-infected patients on antiretroviral treatment (ART is poorly documented in resource-limited settings. We compared bone mineral density between HIV-infected patients and control subjects from Dakar, Senegal. METHODS: A total of 207 (134 women and 73 men HIV-infected patients from an observational cohort in Dakar (ANRS 1215 and 207 age- and sex-matched controls from the general population were enrolled. Bone mineral density was assessed by quantitative ultrasound (QUS at the calcaneus, an alternative to the reference method (i.e. dual X-absorptiometry, often not available in resource-limited countries. RESULTS: Mean age was 47.0 (±8.5 years. Patients had received ART for a median duration of 8.8 years; 45% received a protease inhibitor and 27% tenofovir; 84% had undetectable viral load. Patients had lower body mass index (BMI than controls (23 versus 26 kg/m(2, P<0.001. In unadjusted analysis, QUS bone mineral density was lower in HIV-infected patients than in controls (difference: -0.36 standard deviation, 95% confidence interval (CI: -0.59;-0.12, P = 0.003. Adjusting for BMI, physical activity, smoking and calcium intake attenuated the difference (-0.27, CI: -0.53;-0.002, P = 0.05. Differences in BMI between patients and controls explained a third of the difference in QUS bone mineral density. Among patients, BMI was independently associated with QUS bone mineral density (P<0.001. An association between undetectable viral load and QUS bone density was also suggested (β = 0.48, CI: 0.02;0.93; P = 0.04. No association between protease inhibitor or tenofovir use and QUS bone mineral density was found. CONCLUSION: Senegalese HIV-infected patients had reduced QUS bone mineral density in comparison with control subjects, in part related to their lower BMI. Further investigation is needed to clarify the clinical significance of these observations.

  7. Quantitative ultrasound technique at the phalanges in discriminating between uremic and osteoporotic patients

    International Nuclear Information System (INIS)

    Guglielmi, G.; De Terlizzi, F.; Aucella, F.; Scillitani, A.

    2006-01-01

    This study was conducted to test the ability of quantitative ultrasound technique (QUS) at the phalanges to discriminate between uremic and osteoporotic patients. Three groups of subjects (38 dialytic women, 16 osteoporotic women with vertebral fractures, 19 non-dialytic and non-fractured women) were recruited at the Department of Radiology at 'Casa Sollievo della Sofferenza' Hospital, San Giovanni Rotondo, Italy. The groups were matched for age and body mass index (BMI). On all subjects the following measurements were performed: spinal BMD by QCT and by DXA, Femoral BMD by DXA, phalangeal QUS. For QUS measurements, the DBM Sonic (IGEA, Carpi, Italy) was applied to the metaphysis of the proximal phalanges of the last four fingers of the hand. Osteoporotic women with vertebral fractures showed significantly lower values of spinal BMD by QCT and DXA and Ward's Triangle BMD with respect to hemodialytic patients (p < 0.005). All QUS values, except for BTT and SoS, showed lower values in osteoporotic women with respect to hemodialytic patients (p < 0.05). Control group showed higher values of AD-SoS, BTT and SoS than hemodialytic patients (p < 0.005) while the two groups did not differ for BMD values measured with both QCT and DXA. UBPI and FWA data showed a similar behaviour to DXA and QCT results, whereas BTT and SoS showed a completely different behaviour. AD-SoS was the only parameter that could effectively discriminate among the three groups (ANOVA, p < 0.0001). We conclude that phalangeal QUS can discriminate between hemodialysed patients and controls with similar bone mineral density, and can also discriminate between hemodialysed and osteoporotic subjects with vertebral fractures. Different characteristics of ultrasound signal can be ascribed to each bone tissue condition, enabling a clear differentiation of bone tissue changes occurring in menopause, osteoporosis and renal osteodystrophy

  8. Quantitative ultrasound technique at the phalanges in discriminating between uremic and osteoporotic patients

    Energy Technology Data Exchange (ETDEWEB)

    Guglielmi, G. [Department of Radiology, Scientific Institute Hospital ' Casa Sollievo della Sofferenza' , Viale Cappuccini 1, 71013 San Giovanni Rotondo (Italy)]. E-mail: guglielmi_g@hotmail.com; De Terlizzi, F. [IGEA srl, Carpi (Italy); Aucella, F. [Division of Nephrology, Scientific Institute Hospital ' Casa Sollievo della Sofferenza' , San Giovanni Rotondo (Italy); Scillitani, A. [Division of Endocrinology, Scientific Institute Hospital ' Casa Sollievo della Sofferenza' , San Giovanni Rotondo (Italy)

    2006-10-15

    This study was conducted to test the ability of quantitative ultrasound technique (QUS) at the phalanges to discriminate between uremic and osteoporotic patients. Three groups of subjects (38 dialytic women, 16 osteoporotic women with vertebral fractures, 19 non-dialytic and non-fractured women) were recruited at the Department of Radiology at 'Casa Sollievo della Sofferenza' Hospital, San Giovanni Rotondo, Italy. The groups were matched for age and body mass index (BMI). On all subjects the following measurements were performed: spinal BMD by QCT and by DXA, Femoral BMD by DXA, phalangeal QUS. For QUS measurements, the DBM Sonic (IGEA, Carpi, Italy) was applied to the metaphysis of the proximal phalanges of the last four fingers of the hand. Osteoporotic women with vertebral fractures showed significantly lower values of spinal BMD by QCT and DXA and Ward's Triangle BMD with respect to hemodialytic patients (p < 0.005). All QUS values, except for BTT and SoS, showed lower values in osteoporotic women with respect to hemodialytic patients (p < 0.05). Control group showed higher values of AD-SoS, BTT and SoS than hemodialytic patients (p < 0.005) while the two groups did not differ for BMD values measured with both QCT and DXA. UBPI and FWA data showed a similar behaviour to DXA and QCT results, whereas BTT and SoS showed a completely different behaviour. AD-SoS was the only parameter that could effectively discriminate among the three groups (ANOVA, p < 0.0001). We conclude that phalangeal QUS can discriminate between hemodialysed patients and controls with similar bone mineral density, and can also discriminate between hemodialysed and osteoporotic subjects with vertebral fractures. Different characteristics of ultrasound signal can be ascribed to each bone tissue condition, enabling a clear differentiation of bone tissue changes occurring in menopause, osteoporosis and renal osteodystrophy.

  9. Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies

    Energy Technology Data Exchange (ETDEWEB)

    Silva-Rodríguez, Jesús, E-mail: jesus.silva.rodriguez@sergas.es; Aguiar, Pablo, E-mail: pablo.aguiar.fernandez@sergas.es [Fundación Ramón Domínguez, Santiago de Compostela, Galicia (Spain); Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain); Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias (IDIS), Santiago de Compostela, 15706, Galicia (Spain); Sánchez, Manuel; Mosquera, Javier; Luna-Vega, Víctor [Servicio de Radiofísica y Protección Radiológica, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain); Cortés, Julia; Garrido, Miguel [Servicio de Medicina Nuclear, Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Galicia, Spain and Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias (IDIS), Santiago de Compostela, 15706, Galicia (Spain); Pombar, Miguel [Servicio de Radiofísica y Protección Radiológica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Galicia (Spain); Ruibal, Álvaro [Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain); Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias (IDIS), Santiago de Compostela, 15706, Galicia (Spain); Fundación Tejerina, 28003, Madrid (Spain)

    2014-05-15

    Purpose: Current procedure guidelines for whole body [18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) state that studies with visible dose extravasations should be rejected for quantification protocols. Our work is focused on the development and validation of methods for estimating extravasated doses in order to correct standard uptake value (SUV) values for this effect in clinical routine. Methods: One thousand three hundred sixty-seven consecutive whole body FDG-PET studies were visually inspected looking for extravasation cases. Two methods for estimating the extravasated dose were proposed and validated in different scenarios using Monte Carlo simulations. All visible extravasations were retrospectively evaluated using a manual ROI based method. In addition, the 50 patients with higher extravasated doses were also evaluated using a threshold-based method. Results: Simulation studies showed that the proposed methods for estimating extravasated doses allow us to compensate the impact of extravasations on SUV values with an error below 5%. The quantitative evaluation of patient studies revealed that paravenous injection is a relatively frequent effect (18%) with a small fraction of patients presenting considerable extravasations ranging from 1% to a maximum of 22% of the injected dose. A criterion based on the extravasated volume and maximum concentration was established in order to identify this fraction of patients that might be corrected for paravenous injection effect. Conclusions: The authors propose the use of a manual ROI based method for estimating the effectively administered FDG dose and then correct SUV quantification in those patients fulfilling the proposed criterion.

  10. Quantitative sensory testing measures individual pain responses in emergency department patients

    Directory of Open Access Journals (Sweden)

    Duffy KJ

    2017-05-01

    Full Text Available Kevin J Duffy, Katharyn L Flickinger, Jeffrey T Kristan, Melissa J Repine, Alexandro Gianforcaro, Rebecca B Hasley, Saad Feroz, Jessica M Rupp, Jumana Al-Baghli, Maria L Pacella, Brian P Suffoletto, Clifton W Callaway Department of Emergency Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Background: Refining and individualizing treatment of acute pain in the emergency department (ED is a high priority, given that painful complaints are the most common reasons for ED visits. Few tools exist to objectively measure pain perception in the ED setting. We speculated that variation in perception of fixed painful stimuli would explain individual variation in reported pain and response to treatment among ED patients. Materials and methods: In three studies, we 1 describe performance characteristics of brief quantitative sensory testing (QST in 50 healthy volunteers, 2 test effects of 10 mg oxycodone versus placebo on QST measures in 18 healthy volunteers, and 3 measure interindividual differences in nociception and treatment responses in 198 ED patients with a painful complaint during ED treatment. QST measures adapted for use in the ED included pressure sensation threshold, pressure pain threshold (PPT, pressure pain response (PPR, and cold pain tolerance (CPT tests. Results: First, all QST measures had high inter-rater reliability and test–retest reproducibility. Second, 10 mg oxycodone reduced PPR, increased PPT, and prolonged CPT. Third, baseline PPT and PPR revealed hyperalgesia in 31 (16% ED subjects relative to healthy volunteers. In 173 (88% ED subjects who completed repeat testing 30 minutes after pain treatment, PPT increased and PPR decreased (Cohen’s dz 0.10–0.19. Verbal pain scores (0–10 for the ED complaint decreased by 2.2 (95% confidence intervals [CI]: 1.9, 2.6 (Cohen’s dz 0.97 but did not covary with the changes in PPT and PPR (r=0.05–0.13. Treatment effects were greatest in ED subjects

  11. Degenerative disc disease as a cause of back pain in the thalassaemic population: a case-control study using MRI and plain radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Desigan, S.; Hall-Craggs, M.A.; Ho, C.-P. [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Eliahoo, J. [University College London Hospitals NHS Trust, Research and Development Directorate, London (United Kingdom); Porter, J.B. [University College Hospital, Department of Haematology, University College London Hospitals NHS Trust, London (United Kingdom)

    2006-02-15

    The aim of this study was to test our observation that back pain in thalassemic patients could be caused by premature and extensive lumbar degenerative disc disease, when compared to non-thalassemic patients with back pain. Sixteen thalassemic patients with their sex- and age-matched controls were recruited into the study, 12 with thalassemia major, and 4 with thalassemia intermedia. Both the thalassemia patients and control subjects suffered from back pain, which was subjective rather than measured/pain scored. All subjects underwent magnetic resonance (MR) imaging of the lumbar spine, and 11 of the cases and 8 controls had lumbar spine radiographs. Each lumbar disc was scored for radiographic appearances and MR features of disc degeneration and disc protrusion. Proportion values for these parameters and median scores were derived at each disc level, and were analyzed and compared. There was a statistically-significant difference between proportion values of cases and controls for the MR features (P value=0.01, n=16) and the radiographic features (P value=0.01, n=11 cases, n=8 controls) of disc degeneration. The median disc level scores for the thalassemic group were uniformly high across all lumbar discs, and at all levels except at L 4/5. The control group conversely demonstrated a predilection for disc degeneration at L4/5 level. The distribution of lumbar disc degeneration in thalassemic patients with back pain is more extensive, severe and multi-level in nature compared to matched controls, and disc degeneration should be considered as a significant cause of back pain in this population group. (orig.)

  12. A qualitative and quantitative needs assessment of pain management for hospitalized orthopedic patients.

    Science.gov (United States)

    Cordts, Grace A; Grant, Marian S; Brandt, Lynsey E; Mears, Simon C

    2011-08-08

    Despite advances in pain management, little formal teaching is given to practitioners and nurses in its use for postoperative orthopedic patients. The goal of our study was to determine the educational needs for orthopedic pain management of our residents, nurses, and physical therapists using a quantitative and qualitative assessment. The needs analysis was conducted in a 10-bed orthopedic unit at a teaching hospital and included a survey given to 20 orthopedic residents, 9 nurses, and 6 physical therapists, followed by focus groups addressing barriers to pain control and knowledge of pain management. Key challenges for nurses included not always having breakthrough pain medication orders and the gap in pain management between cessation of patient-controlled analgesia and ordering and administering oral medications. Key challenges for orthopedic residents included treating pain in patients with a history of substance abuse, assessing pain, and determining when to use long-acting vs short-acting opioids. Focus group assessments revealed a lack of training in pain management and the need for better coordination of care between nurses and practitioners and improved education about special needs groups (the elderly and those with substance abuse issues). This needs assessment showed that orthopedic residents and nurses receive little formal education on pain management, despite having to address pain on a daily basis. This information will be used to develop an educational program to improve pain management for postoperative orthopedic patients. An integrated educational program with orthopedic residents, nurses, and physical therapists would promote understanding of issues for each discipline. Copyright 2011, SLACK Incorporated.

  13. Prognostic Role of Methylation Status of the MGMT Promoter Determined Quantitatively by Pyrosequencing in Glioblastoma Patients.

    Science.gov (United States)

    Kim, Dae Cheol; Kim, Ki Uk; Kim, Young Zoon

    2016-01-01

    This study investigated whether pyrosequencing can be used to determine the methylation status of the MGMT promoter as a clinical biomarker using relatively old archival tissue samples of glioblastoma. We also examined other prognostic factors for survival of glioblastoma patients. The available study set included formalin-fixed paraffin-embedded (FFPE) tissue from 104 patients at two institutes from 1997 to 2012, all of which were diagnosed histopathologically as glioblastoma. Clinicopathologic data were collected by review of medical records. For pyrosequencing analysis, the PyroMark Q96 CpG MGMT kit (Qiagen, Hilden, Germany) was used to detect the level of methylation at exon 1 positions 17-39 of the MGMT gene, which contains 5 CpGs. Methylation of the MGMT promoter was detected in 43 (41.3%) of 104 samples. The average percentage methylation was 14.0±16.8% overall and 39.0±14.7% for methylated cases. There was no significant pattern of linear increase or decrease according to the age of the FFPE block (p=0.687). In multivariate analysis, age, performance status, extent of surgery, method of adjuvant therapy, and methylation status estimated by pyrosequencing were independently associated with overall survival. Additionally, patients with a high level of methylation survived longer than those with low methylation (p=0.016). In this study, the status and extent of methylation of the MGMT promoter analyzed by pyrosequencing were associated with overall survival in glioblastoma patients. Pyrosequencing is a quantitative method that overcomes the problems of MSP and a simple technique for accurate analysis of DNA sequences.

  14. Quantitative assessment of Wilms tumor 1 expression by real-time quantitative polymerase chain reaction in patients with acute myeloblastic leukemia

    Directory of Open Access Journals (Sweden)

    Hossein Ayatollahi

    2017-01-01

    Full Text Available Background: The Wilms tumor 1 (WT1 gene is originally defined as a tumor suppressor gene and a transcription factor that overexpressed in leukemic cells. It is highly expressed in more than 80% of acute myeloid leukemia (AML patients, both in bone marrow (BM and in peripheral blood (PB, and it is used as a powerful and independent marker of minimal residual disease (MRD; we have determined the expression levels of the WT1 by real-time quantitative polymerase chain reaction (RQ-PCR in PB and BM in 126 newly diagnosed AML patients. Materials and Methods: This study was done in molecular pathology and cancer research center from April 2014 to June 2015, RQ-PCR method was used to determine the WT1 gene expression in BM and/or PB samples from 126 patients of AML, we cloned both WT1 and ABL genes for creating a standard curve, and we calculate copy number of WT1 genes in patients. Results: A total of 126 AML patients consist of 70 males (55.6% and 56 females (44.4%, with a median age of 26 years; 104 (81% patients out of 126 show overexpression of WT1 gene. We also concomitant monitoring of fusion transcripts (PML RARa, AML1-ETO, MLL-MLL, CBFb-MYH11, or DEK-CAN in our patients, the AML1-ETO group showing remarkably low levels of WT1 compared with other fusion transcript and the CBFB-MYH11 showing high levels of WT1. Conclusion: We conclude that WT1 expression by RQ-PCR in AML patients may be employed as an independent tool to detect MRD in the majority of normal karyotype AML patients.

  15. Quantitative T1-mapping detects cloudy-enhancing tumor compartments predicting outcome of patients with glioblastoma.

    Science.gov (United States)

    Müller, Andreas; Jurcoane, Alina; Kebir, Sied; Ditter, Philip; Schrader, Felix; Herrlinger, Ulrich; Tzaridis, Theophilos; Mädler, Burkhard; Schild, Hans H; Glas, Martin; Hattingen, Elke

    2017-01-01

    Contrast enhancement of glioblastomas (GBM) is caused by the decrease in relaxation time, T1. Here, we demonstrate that the quantitative measurement of T1 (qT1) discovers a subtle enhancement in GBM patients that is invisible in standard MRI. We assessed the volume change of this "cloudy" enhancement during radio-chemotherapy and its impact on patients' progression-free survival (PFS). We enrolled 18 GBM patients in this observational, prospective cohort study and measured 3T-MRI pre- and post contrast agent with standard T1-weighted (T1w) and with sequences to quantify T1 before radiation, and at 6-week intervals during radio-chemotherapy. We measured contrast enhancement by subtracting pre from post contrast contrast images, yielding relative signal increase ∆T1w and relative T1 shortening ∆qT1. On ∆qT1, we identified a solid and a cloudy-enhancing compartment and evaluated the impact of their therapy-related volume change upon PFS. In ∆qT1 maps cloudy-enhancing compartments were found in all but two patients at baseline and in all patients during therapy. The qT1 decrease in the cloudy-enhancing compartment post contrast was 21.64% versus 1.96% in the contralateral control tissue (P < 0.001). It was located at the margin of solid enhancement which was also seen on T1w. In contrast, the cloudy-enhancing compartment was visually undetectable on ∆T1w. A volume decrease of more than 21.4% of the cloudy-enhancing compartment at first follow-up predicted longer PFS (P = 0.038). Cloudy-enhancing compartment outside the solid contrast-enhancing area of GBM is a new observation which is only visually detectable with qT1-mapping and may represent tumor infiltration. Its early volume decrease predicts a longer PFS in GBM patients during standard radio-chemotherapy. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  16. Quantitative assessment of nutrition in patients with polycystic ovary syndrome (PCOS)

    Science.gov (United States)

    Szczuko, Małgorzata; Skowronek, Magdalena; Zapałowska-Chwyć, Marta; Starczewski, Andrzej

    PCOS (polycystic ovary syndrome) is called a pathology of the XX century and affects at least 10-15% women of childbearing age. The therapy involves pharmacotherapy of hormonal imbalance, as well as the change of lifestyle, including the diet. Performing the quantitative assessment of components of diets of women with PCOS, comparing the results with current dietary standards for Polish people and defining dietary requirements for the patients. The study was performed on 54 women of childbearing age (average age 26.03± 5.52) with PCOS syndrome diagnosed according to on the Rotterdam criteria. Anthropometric measurements of the patients were made and BMI and WHR calculated. Quantitative assessment of women’s diets was performed based on the analysis of 3-day food diaries and food records taken from the previous 24h with the interview method. The data were introduced to a dietary software DIETA 5.0, calculating the average intake of the energy, nutrients, vitamins, minerals, cholesterol and dietary fibre. The obtained results were compared to Polish dietary guidelines. Examined group was characterized by increased waist circumference (98.71± 13.6 cm) and an average WHR was 0.92± 0.08. An increased average value of BMI was also shown (28.91± 5.54 kg/m2). The patients consumed, on average, 1952.5±472.7 kcal daily, and the risk of insufficient intake of protein was determined in 36.7% of examined women. The highest risk of deficiency in minerals in women with PCOS was related to calcium (634 mg), potassium (3493 mg) and magnesium (250.1 mg), whereas with reference to vitamins deficiency as much as 70% of tested women were at risk of insufficient intake of folic acid, 36.7% of them - vitamin C, and 26.7% - vitamin B12. The average consumption of vitamin D was at the level of 3.4 μg. Test group was characterized by excessive average consumption of total fat (50%), SFA (70.4%) and saccharose (50%). The percentage of people with excessive average intake of

  17. Quantitative analysis of digitopalmar dermatoglyphics in fifty male psoriatic spondylitis patients.

    Science.gov (United States)

    Cvjetičanin, Miljenko; Jajić, Zrinka

    2012-01-01

    By the quantitative dermatoglyphic analysis of digitopalmar ridge count in fifty male psoriatic spondylitis patients were researched 25 dermatoglyphics traits: number of epidermal ridges on the all ten fingers, their sum for five and ten fingers, four traits on the both palms, i.e. between a-b, b-c, c-d and a-d triradii, and atd angles and their bilateral sum in degrees. The data obtained were compared with those recorded in a control group of 200 pairs of imprints of phenotypically healthy males from the Zagreb area. Statistically significant differences to control were found in 13 variables in decreased ridge count in second, third, fourth and fifth finger on the right palm, and in their sum on the all five fingers, than in second, third, fourth and fifth finger on the left palm, and in their sum in the all fingers, and in the all ten fingers. Atd angle was decreased on the left palm, and on the both palm together. Accordingly a polygenetic system identical in some loci to polygenetic system predisposing to male psoriatic spondylitis susceptibility might be found responsible for dermatogliyphic pattern development.

  18. Quantitative determination of fibrinogen of patients with coronary heart diseases through piezoelectric agglutination sensor.

    Science.gov (United States)

    Chen, Qinghai; Hua, Xing; Fu, Weiling; Liu, Dongbo; Chen, Ming; Cai, Guoru

    2010-01-01

    Fibrinogen can transform fibrin through an agglutination reaction, finally forming fibrin polymer with grid structure. The density and viscosity of the reaction system changes drastically during the course of agglutination. In this research, we apply an independently-developed piezoelectric agglutination sensor to detect the fibrinogen agglutination reaction in patients with coronary heart diseases. The terminal judgment method of determining plasma agglutination reaction through piezoelectric agglutination sensor was established. In addition, the standard curve between plasma agglutination time and fibrinogen concentration was established to determinate fibrinogen content quantitatively. The results indicate the close correlation between the STAGO paramagnetic particle method and the method of piezoelectric agglutination sensor for the detection of Fibrinogen. The correlation coefficient was 0.91 (γ = 0.91). The determination can be completed within 10 minutes. The fibrinogen concentration in the coronary heart disease group was significantly higher than that of the healthy control group (P diseases. Compared with other traditional methods, the method of piezoelectric agglutination sensor has some merits such as operation convenience, small size, low cost, quick detecting, good precision and the common reacting agents with paramagnetic particle method.

  19. Quantitative Determination of Fibrinogen of Patients with Coronary Heart Diseases through Piezoelectric Agglutination Sensor

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2010-03-01

    Full Text Available Fibrinogen can transform fibrin through an agglutination reaction, finally forming fibrin polymer with grid structure. The density and viscosity of the reaction system changes drastically during the course of agglutination. In this research, we apply an independently-developed piezoelectric agglutination sensor to detect the fibrinogen agglutination reaction in patients with coronary heart diseases. The terminal judgment method of determining plasma agglutination reaction through piezoelectric agglutination sensor was established. In addition, the standard curve between plasma agglutination time and fibrinogen concentration was established to determinate fibrinogen content quantitatively. The results indicate the close correlation between the STAGO paramagnetic particle method and the method of piezoelectric agglutination sensor for the detection of Fibrinogen. The correlation coefficient was 0.91 (γ = 0.91. The determination can be completed within 10 minutes. The fibrinogen concentration in the coronary heart disease group was significantly higher than that of the healthy control group (P < 0.05. The results reveal that high fibrinogen concentration is closely correlated to the incurrence, development and prognosis of coronary heart diseases. Compared with other traditional methods, the method of piezoelectric agglutination sensor has some merits such as operation convenience, small size, low cost, quick detecting, good precision and the common reacting agents with paramagnetic particle method.

  20. PET imaging and quantitation of Internet-addicted patients and normal controls

    Science.gov (United States)

    Jeong, Ha-Kyu; Kim, Hee-Joung; Jung, Haijo; Son, Hye-Kyung; Kim, Dong-Hyeon; Yun, Mijin; Shin, Yee-Jin; Lee, Jong-Doo

    2002-04-01

    Internet addicted patients (IAPs) have widely been increased, as Internet games are becoming very popular in daily life. The purpose of this study was to investigate regional brain activation patterns associated with excessive use of Internet games in adolescents. Six normal controls (NCs) and eight IAPs who were classified as addiction group by adapted version of DSM-IV for pathologic gambling were participated. 18F-FDG PET studies were performed for all adolescents at their rest and activated condition after 20 minutes of each subject's favorite Internet game. To investigate quantitative metabolic differences in both groups, all possible combinations of group comparison were carried out using Statistical Parametric Mapping (SPM 99). Regional brain activation foci were identified on Talairach coordinate. SPM results showed increased metabolic activation in occipital lobes for both groups. Higher metabolisms were seen at resting condition in IAPs than that of in NCs. In comparison to both groups, IAPs showed different patterns of regional brain metabolic activation compared with that of NCs. It suggests that addictive use of Internet games may result in functional alteration of developing brain in adolescents.

  1. Quantitative indices of baroreflex-sympathoneural function: application to patients with chronic autonomic failure.

    Science.gov (United States)

    Rahman, Faisal; Goldstein, David S

    2014-06-01

    Chronic autonomic failure syndromes such as Parkinson disease with orthostatic hypotension (PD + OH), multiple system atrophy (MSA), and pure autonomic failure (PAF) typically feature arterial baroreflex failure. Identifying baroreflex-sympathoneural failure from hemodynamic responses to the maneuver usually has been qualitative. We report quantitative methods for evaluating baroreflex-sympathoneural function, based on beat-to-beat systolic blood pressure (BPs) responses to the Valsalva maneuver. Using the trapezoid rule, we calculated the area under the curve (baroreflex area, BRA) between baseline systolic blood pressure (BPs) and the BPs for each beat in Phase II (BRA-II) and Phase IV (BRA-IV) in 136 autonomic failure patients and 171 controls. The sum of the areas was defined as total BRA (BRA-T). We compared individual values by the BRA approach with those by other measures. Mean values for log BRA-II, BRA-IV, and BRA-T were higher in PD + OH, PAF, and MSA than in controls (p baroreflex-cardiovagal slope (r = -0.40, p baroreflex-sympathoneural function. Chronic autonomic failure syndromes entail deficiencies of both the cardiovagal and sympathoneural limbs of the arterial baroreflex.

  2. Investigation of airways using MDCT for visual and quantitative assessment in COPD patients

    Directory of Open Access Journals (Sweden)

    Pierre-Yves Brillet

    2008-03-01

    Full Text Available Pierre-Yves Brillet1, Catalin I Fetita2, Amaury Saragaglia2, Anne-Laure Brun3, Catherine Beigelman-Aubry3, Françoise Prêteux2, Philippe A Grenier31Department of Radiology, Avicenne Hospital, Assistance Publique–Hôpitaux de Paris, Université Léonard de Vinci–Paris Nord, EA 2361, Bobigny, France; 2ARTEMIS Department, Institut National des Télécommunications, Université Paris V, Evry, France; 3Department of Radiology, Pitié-Salpêtrière Hospital, Assistance Publique–Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, FranceAbstract: Multidetector computed tomography (MDCT acquisition during a single breath hold using thin collimation provides high resolution volumetric data set permitting multiplanar and three dimensional reconstruction of the proximal airways. In chronic obstructive pulmonary disease (COPD patients, this technique provides an accurate assessment of bronchial wall thickening, tracheobronchial deformation, outpouchings reflecting dilatation of the submucous glands, tracheobronchomalacia, and expiratory air trapping. New software developed to segment adequately the lumen and walls of the airways on MDCT scans allows quantitative assessment of the airway dimensions which has shown to be reliable in clinical practice. This technique can become important in longitudinal studies of the pathogenesis of COPD, and in the assessment of therapeutic interventions.Keywords: COPD – tracheobronchial tree, multidetector CT – airway remodeling, tracheobronchomalacia

  3. Qualitative and quantitative dermatoglyphic traits in patients with breast cancer: a prospective clinical study.

    Science.gov (United States)

    Chintamani; Khandelwal, Rohan; Mittal, Aliza; Saijanani, Sai; Tuteja, Amita; Bansal, Anju; Bhatnagar, Dinesh; Saxena, Sunita

    2007-03-13

    Breast cancer is one of the most extensively studied cancers and its genetic basis is well established. Dermatoglyphic traits are formed under genetic control early in development but may be affected by environmental factors during first trimester of pregnancy. They however do not change significantly thereafter, thus maintaining stability not greatly affected by age. These patterns may represent the genetic make up of an individual and therefore his/her predisposition to certain diseases. Patterns of dermatoglyphics have been studied in various congenital disorders like Down's syndrome and Kleinfelter syndrome. The prints can thus represent a non-invasive anatomical marker of breast cancer risk and thus facilitate early detection and treatment. The study was conducted on 60 histo-pathologically confirmed breast cancer patients and their digital dermatoglyphic patterns were studied to assess their association with the type and onset of breast cancer. Simultaneously 60 age-matched controls were also selected that had no self or familial history of a diagnosed breast cancer and the observations were recorded. The differences of qualitative (dermatoglyphic patterns) data were tested for their significance using the chi-square test, and for quantitative (ridge counts and pattern intensity index) data using the t- test. It was observed that six or more whorls in the finger print pattern were statistically significant among the cancer patients as compared to controls. It was also seen that whorls in the right ring finger and right little finger were found increased among the cases as compared to controls. The differences between mean pattern intensity index of cases and controls were found to be statistically significant. The dermatoglyphic patterns may be utilized effectively to study the genetic basis of breast cancer and may also serve as a screening tool in the high-risk population. In a developing country like India it might prove to be an anatomical, non

  4. Quantitative Proteomic Analysis of Serum Proteins from Oral Cancer Patients: Comparison of Two Analytical Methods

    Directory of Open Access Journals (Sweden)

    Yan Yang

    2014-08-01

    Full Text Available Serum proteomic analysis can be a valuable approach for the discovery of protein biomarkers for early detection or monitoring of a disease. In this study, two analytical methods were compared for quantification of serum proteins in patients with oral cancer. In the first approach, we quantified serum proteins between oral squamous cell carcinoma (OSCC and healthy control subjects by performing in-solution digestion of serum proteins, isobaric tags for relative and absolute quantification (iTRAQ labeling of the resulting peptides, strong cation exchange (SCX fractionation of labeled peptides and finally capillary liquid chromatography with tandem mass spectrometry (LC-MS/MS analysis of the peptides. In the second approach, we first separated serum proteins with SDS-PAGE. The gel-separated proteins were then digested with trypsin and the resulting peptides were labeled with iTRAQ and analyzed with LC-MS/MS for protein quantification. A total of 319 serum proteins were quantified with the first proteomic approach whereas a total of 281 proteins were quantified by the second proteomic approach. Most of the proteins were identified and quantified by both approaches, suggesting that these methods are similarly effective for serum proteome analysis. This study provides compelling evidence that quantitative serum proteomic analysis of OSCC is a valuable approach for identifying differentially expressed proteins in cancer patients’ circulation systems that may be used as potential biomarkers for disease detection. Further validation in large oral cancer patient populations may lead to a simple and low invasive clinical tool for OSCC diagnosis or monitoring.

  5. Comparison of99mTc-MDP SPECT qualitative vs quantitative results in patients with suspected condylar hyperplasia.

    Science.gov (United States)

    López Buitrago, D F; Ruiz Botero, J; Corral, C M; Carmona, A R; Sabogal, A

    To compare qualitative vs quantitative results of Single Photon Emission Computerised Tomography (SPECT), calculated from percentage of 99m Tc-MDP (methylene diphosphonate) uptake, in condyles of patients with a presumptive clinical diagnosis of condylar hyperplasia. A retrospective, descriptive study was conducted on the 99m Tc-MDP SPECT bone scintigraphy reports from 51 patients, with clinical impression of facial asymmetry related to condylar hyperplasia referred by their specialist in orthodontics or maxillofacial surgery, to a nuclear medicine department in order to take this type of test. Quantitative data from 99m Tc-MDP condylar uptake of each were obtained and compared with qualitative image interpretation reported by a nuclear medicine expert. The concordances between the 51 qualitative and quantitative reports results was established. The total sample included 32 women (63%) and 19 men (37%). The patient age range was 13-45 years (21±8 years). According to qualitative reports, 19 patients were positive for right side condylar hyperplasia, 12 for left side condylar hyperplasia, with 8 bilateral, and 12 negative. The quantitative reports diagnosed 16 positives for right side condylar hyperplasia, 10 for left side condylar hyperplasia, and 25 negatives. Nuclear medicine images are an important diagnostic tool, but the qualitative interpretation of the images is not as reliable as the quantitative calculation. The agreement between the two types of report is low (39.2%, Kappa=0.13; P>.2). The main limitation of quantitative reports is that they do not register bilateral condylar hyperplasia cases. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  6. Association between preoperative magnetic resonance imaging, pain intensity and quantitative sensory testing in patients awaiting lumbar diskectomy.

    LENUS (Irish Health Repository)

    Hegarty, Dominic

    2011-02-01

    Magnetic resonance imaging (MRI) offers important information regarding the morphology, location and size of a herniated disc, which influences the decision to offer lumbar diskectomy (LD). This study aims to examine the association between clinical neurophysiologic indices including pain intensity and quantitative sensory testing (QST), and the degree of lumbar nerve root compromise depicted on magnetic resonance (MR) in patients awaiting LD.

  7. Comparison of rest and adenosine stress quantitative and semi-quantitative myocardial perfusion using magnetic resonance in patients with ischemic heart disease

    DEFF Research Database (Denmark)

    Qayyum, Abbas A; Qayyum, Faiza; Larsson, Henrik B W

    2017-01-01

    The aim was to compare absolute quantified myocardial perfusion (MP) to semi-quantitative measurements of MP using MRI for detection of ischemia. Twenty-nine patients underwent rest and stress MP imaging obtained by 1.5T MRI and analyzed using own developed software and by commercial available...... software. Linear regression analysis demonstrated that absolute quantitative data correlated stronger to maxSI (rest: r=0.296, p=.193; stress: r=0.583, p=0.011; myocardial perfusion reserve (MPR): r=0.789, p....058; stress: r=0.096, p=0.704; MPR: r=0.682, p=0.004; and Δ MBF: r=0.055, p=0.804). Absolute quantified MP was able to distinguish between ischemic and non-ischemic territories at rest (left anterior descending artery (LAD): 103.1±11.3mL/100g/min vs. 206.3±98.5mL/100g/min; p=0.001, right coronary artery (RCA...

  8. [The value of quantitative analysis of procalcitonine in diagnostics of septic complications in patients with autoimmune rheumatic diseases].

    Science.gov (United States)

    Lapin, S V; Maslianskiĭ, A L; Lazareva, N M; Vasil'eva, E Iu; Totolian, A A

    2013-01-01

    The infections very often complicate the course of autoimmune rheumatic diseases. In diagnostic of septic complications in rheumatic patients the new biomarkers of infections can have a decisive importance. The procalciotonine test is one of them. The issue was to evaluate the diagnostic informativity of this test. The sample included 93 patients. The examination was applied to 65 patients with rheumatic diseases. Among them, 13 patients had bacterial infections. The group consisted of 33 patients with rheumatoid arthritis, 11 patients with systemic lupus erythematous, 6 patients with systemic angiitis, and 15 patients with other rheumatic diseases. The comparative group included 27 patients of cardio-therapeutic profile and 8 of these patients had bacterial infections. The procalcitonine test was applied with quantitative electrochemiluminescent technique. In patients with rheumatoid arthritis the mean levels of procalciotonine test consisted 0.10 +/- 0.13 ng/ml; with systemic lupus erythematous--0.08 +/- 0.06 ng/ml; with systemic angiitis--0.22 +/- 0.2 ng/ml; with other rheumatic diseases--0.12 +/- 0.15 ng/ml; of cardio-therapeutic profile without infections--0.08 +/- 0.06 ng/vl/ With threshold of procalcitonine test higher than 0.5/ml the sensitivity to diagnostic of infections consisted of 58%, specificity--94% in the group with rheumatic diseases. The procalciotonine test in case of no infection process with values higher than 0.5 ng/ml was detected in three patients. The evaluation of dependence of sensitivity and specificity for procalciotonine test and C-reactive protein the area under curve of procalcitonine test was larger in patients with rheumatic diseases (0.85 against 0.79) and in patients of cardio-therapeutic profile (0.92 against 0.90). The quantitative procalcitonine test is the best technique to detect septic complications in rheumatic patients.

  9. Assessment of parotid salivary gland function in head and neck cancer patients receiving radiation therapy using quantitative salivary gland scintigraphy

    International Nuclear Information System (INIS)

    Lakshmana, B.; Preethi, G.; Naveen, T.

    2011-01-01

    Background: Radiation therapy for cancer of the head and neck region often causes salivary gland dysfunction and xerostomia. Several reports suggest that the submandibular and sublingual glands may be less radiosensitive than the parotid glands. The effect of radiotherapy on parotid gland function was studied by salivary scintigraphy in patients irradiated with different doses of radiation in the head and neck region. The purpose of this study was to evaluate differential dose of radiation effects on the parotid glands using quantitative salivary gland scintigraphy (QSGS). Methods: Thirty-five patients with head and neck tumours were enrolled in a prospective salivary function study using Scintigraphy. Twenty-seven of thirty-five patients received different doses of radiation and remaining 8 patients did not receive radiation and they were considered as control. Stimulated parotid flow rate was measured in all the patients from scintigraphy of parotid glands. Results: Patients who received radiation dose of =50 Gy showed severe salivary dysfunction when compared to patients who received radiation dose <50 Gy. Overall, patients who received radiation showed significant dysfunction of parotid gland when compared to patients who did not receive radiotherapy. Conclusion: Dysfunction of the parotid salivary gland increases as the radiation dose increases . QSGS appears to be a useful toll in qualitatively and quantitatively evaluating the grade of dysfunction following radiotherapy. (author)

  10. Neurological Assessment Using a Quantitative Sensory Test in Patients with Chronic Unilateral Orofacial Pain.

    Science.gov (United States)

    Salame, Talal H; Blinkhorn, Antony; Karami, Zahra

    2018-01-01

    Quantitative Sensory Testing (QST) has been used in clinical and experimental settings to establish sensory assessment for different types of pains, and may be a useful tool for the assessment of orofacial pain, but this premise needs to be tested. The aim of the study was to evaluate responses to thermal stimuli between painful and non-painful facial sites in subjects with orofacial pain using QST. A total of 60 participants (5o females: 28-83 years; 10 males: 44-81 years) with unilateral orofacial pain were recruited from the Orofacial Pain Clinic at the Pain Management and Research Centre, Royal North Shore Hospital, Sydney, Australia. The study followed the methods of limits of the German Research Network testing four modalities of thermal thresholds, the Warm Sensation, the Cold Sensation, the Heat Pain and the Cold Pain using a TSA-II Neurosensory Analyser. The results were compared to the results from the unaffected side of the same patient on the same area and a single t test statistical analysis was performed, where a p value of less than 0.05 was considered significant. The Mean Difference for Cold Sensation between the pain side and the non-pain side was 0.48 °C ± 1.5 (t= 2.466, p=0.017), 0.68 °C ± 2.04 for Warm Sensation (t= -2.573, p= 0.013), 2.56 °C ± 2.74 for Cold Pain (t= 7.238, pcool and warm sensation, and cold and hot pain.

  11. Quantitative regional cerebral blood flow study with 123I-IMP in patients with dementia and in patients with poor activities of daily living

    International Nuclear Information System (INIS)

    Iwamiya, Takashi

    1993-01-01

    N-isopropyl-p[ 123 I]iodoamphetamine ( 123 I-IMP) SPECT and quantitative regional cerebral blood flow (rCBF) studies were performed in 111 patients with cerebral disorders. Continuous arterial blood sampling method based on the microsphere model was used as a quantitative rCBF measurement. We evaluated rCBF in patients with dementia and also in patients with poor activities of daily living (ADL). Patients with dementia showed significant reduction of mean CBF in contrast to patients without dementia. Significant decrease of rCBF in the bilateral frontal cortex, parietal cortex and basal ganglia and the right temporal cortex were found in demented patients. Although patients with vascular dementia showed decreased rCBF in bilateral basal ganglia, demented patients with Parkinson's disease showed no significant reduction of rCBF in any region. Patients with poor ADL showed decreased rCBF in all brain regions. And particularly frontal and basal ganglionic defects were most pronounced. Patients with poor ADL resulting from cerebral infarction showed significant decrease of rCBF in bilateral basal ganglia. However, there was no significant correlation in Parkinson's disease between ADL and rCBF. The rCBF measurement with 123 I-IMP is useful for clinical evaluation of demented patients and patients with poor ADL. (author)

  12. Qualitative and quantitative dermatoglyphic traits in patients with breast cancer: a prospective clinical study

    Directory of Open Access Journals (Sweden)

    Tuteja Amita

    2007-03-01

    Full Text Available Abstract Background Breast cancer is one of the most extensively studied cancers and its genetic basis is well established. Dermatoglyphic traits are formed under genetic control early in development but may be affected by environmental factors during first trimester of pregnancy. They however do not change significantly thereafter, thus maintaining stability not greatly affected by age. These patterns may represent the genetic make up of an individual and therefore his/her predisposition to certain diseases. Patterns of dermatoglyphics have been studied in various congenital disorders like Down's syndrome and Kleinfelter syndrome. The prints can thus represent a non-invasive anatomical marker of breast cancer risk and thus facilitate early detection and treatment. Methods The study was conducted on 60 histo-pathologically confirmed breast cancer patients and their digital dermatoglyphic patterns were studied to assess their association with the type and onset of breast cancer. Simultaneously 60 age-matched controls were also selected that had no self or familial history of a diagnosed breast cancer and the observations were recorded. The differences of qualitative (dermatoglyphic patterns data were tested for their significance using the chi-square test, and for quantitative (ridge counts and pattern intensity index data using the t- test. Results It was observed that six or more whorls in the finger print pattern were statistically significant among the cancer patients as compared to controls. It was also seen that whorls in the right ring finger and right little finger were found increased among the cases as compared to controls. The differences between mean pattern intensity index of cases and controls were found to be statistically significant. Conclusion The dermatoglyphic patterns may be utilized effectively to study the genetic basis of breast cancer and may also serve as a screening tool in the high-risk population. In a developing

  13. Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Pauly John M

    2008-04-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR can provide quantitative data of the myocardial tissue utilizing high spatial and temporal resolution along with exquisite tissue contrast. Previous studies have correlated myocardial scar tissue with the occurrence of ventricular arrhythmia. This study was conducted to evaluate whether characterization of myocardial infarction by CMR can predict cardiovascular events in patients with ischemic cardiomyopathy (ICM. Results We consecutively studied 86 patients with ICM (LVEF Conclusion Quantification of the scar volume and scar percentage by CMR is superior to LVEDV, LVESV, and LVEF in prognosticating the future likelihood of the development of cardiovascular events in patients with ICM.

  14. Relationship between quantitative measurement of Porphyromonas gingivalis on dental plaque with periodontal status of patients with coronary heart disease

    Science.gov (United States)

    Dwiyanti, Stephani; Soeroso, Yuniarti; Sunarto, Hari; Radi, Basuni

    2017-02-01

    Coronary heart disease is a narrowing of coronary artery due to plaque build-up. [1] Chronic periodontitis increases risk of cardiovascular disease. P.gingivalis is linked to both diseases. Objective: to analyse quantitative difference of P.gingivalis on dental plaque and its relationship with periodontal status of CHD patient and control. Methods: Periodontal status of 66 CHD patient and 40 control was checked. Subgingival plaque was isolated and P.gingivalis was measured using real-time PCR. Result: P.gingivalis of CHD patient differs from control. P.gingivalis is linked to pocket depth of CHD patient. Conclusion: P.gingivalis count of CHD patient is higher than control. P.gingivalis count is not linked to any periodontal status, except for pocket depth of CHD patient.

  15. Functional MR imaging of the motor cortex in healthy volunteers and patients with brain tumours: qualitative and quantitative results

    International Nuclear Information System (INIS)

    Fellner, C.; Friedrich-Alexander-Univ., Erlangen-Nuernberg; Schlaier, J.; Schwerdtner, J.; Brawanski, A.; Fellner, F.; Oberoesterreichische Landesnervenklinik, Linz; Held, P.; Blank, M.; Kalender, W.A.

    1999-01-01

    The purpose of this study was to compare functional magnetic resonance (MR) imaging of the motor cortex in healthy volunteers and patients with brain tumours. Functional MR imaging was performed in 14 healthy volunteers and 14 patients with tumours in or near the primary motor cortex with groups being matched for age, sex, and handedness. Functional images were acquired during motion of the right and left hand. Time courses of signal intensity within the contralateral, ipsilateral, and supplementary motor cortex as well as z-maps were calculated, their quality being assessed visually. Mean signal increase between activation and rest were evaluated within the contralateral, ipsilateral, and supplementary motor cortex, the activated area in those regions of interest was measured using z-maps. The quality of functional MR experiments was generally lower in patients than in volunteers. The quantitative results showed a trend towards increased ipsilateral activation in volunteers during left hand compared to right hand motion and in patients during motion of the affected compared to the non-affected hand. Considering quantitative and qualitative results, significantly increased ipsilateral activation was found in patients compared to healthy volunteers. In conclusion, functional MR imaging quality was significantly reduced in patient studies compared to healthy volunteers, even if influences of age, sex, and handedness were excluded. Increased ipsilateral activation was found in patients with brain tumours which can be interpreted by an improved connectivity between both hemispheres. (orig.) [de

  16. Influences on patient satisfaction in healthcare centers: a semi-quantitative study over 5 years.

    Science.gov (United States)

    Thornton, Ruth D; Nurse, Nicole; Snavely, Laura; Hackett-Zahler, Stacey; Frank, Kenice; DiTomasso, Robert A

    2017-05-19

    Knowledge of ambulatory patients' satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction. A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years. Patients' responses to 21 questions were analyzed by principal components varimax rotated factor analysis. Three classifiable components emerged: Satisfaction with Physician, Availability/Convenience, and Orderly/Time. To study the effects of several independent variables (location of clinics, patients' and physicians' age, education level and duration at the clinic), data were subjected to multivariate analysis of variance (MANOVA).. Changes in the healthcare centers over time were not significantly related to patient satisfaction. However, location of the center did affect satisfaction. Urban patients were more satisfied with their physicians than rural, and inner city patients were less satisfied than urban or rural on Availability/Convenience and less satisfied than urban patients on Orderly/Time. How long a patient attended a center most affected satisfaction, with patients attending >10 years more satisfied in all three components than those attending 60 years old. Patients were significantly more satisfied with their 30-40 year-old physicians compared with those over 60. On Orderly/Time, patients were more satisfied with physicians who were in their 50's than physicians >60. Improvement in patient satisfaction includes a need for immediate, specific feedback. Although Medical Directors received feedback yearly, we found no significant changes in patient satisfaction over time. Our results

  17. Quantitative versus qualitative cultures of respiratory secretions for clinical outcomes in patients with ventilator-associated pneumonia.

    Science.gov (United States)

    Berton, Danilo Cortozi; Kalil, Andre C; Teixeira, Paulo José Zimermann

    2014-10-30

    Ventilator-associated pneumonia (VAP) is a common infectious disease in intensive care units (ICUs). The best diagnostic approach to resolve this condition remains uncertain. To evaluate whether quantitative cultures of respiratory secretions and invasive strategies are effective in reducing mortality in immunocompetent patients with VAP, compared with qualitative cultures and non-invasive strategies. We also considered changes in antibiotic use, length of ICU stay and mechanical ventilation. We searched CENTRAL (2014, Issue 9), MEDLINE (1966 to October week 2, 2014), EMBASE (1974 to October 2014) and LILACS (1982 to October 2014). Randomised controlled trials (RCTs) comparing respiratory samples processed quantitatively or qualitatively, obtained by invasive or non-invasive methods from immunocompetent patients with VAP and which analysed the impact of these methods on antibiotic use and mortality rates. Two review authors independently reviewed the trials identified in the search results and assessed studies for suitability, methodology and quality. We analysed data using Review Manager software. We pooled the included studies to yield the risk ratio (RR) for mortality and antibiotic change with 95% confidence intervals (CI). Of the 5064 references identified from the electronic databases (605 from the updated search in October 2014), five RCTs (1367 patients) met the inclusion criteria. Three studies compared invasive methods using quantitative cultures versus non-invasive methods using qualitative cultures, and we used them to answer the main objective of this review. The other two studies compared invasive versus non-invasive methods, both using quantitative cultures. We combined all five studies to compare invasive versus non-invasive interventions for diagnosing VAP. The studies that compared quantitative and qualitative cultures (1240 patients) showed no statistically significant differences in mortality rates (RR 0.91; 95% CI 0.75 to 1.11). The analysis of

  18. Comparison of rest and adenosine stress quantitative and semi-quantitative myocardial perfusion using magnetic resonance in patients with ischemic heart disease.

    Science.gov (United States)

    Qayyum, Abbas A; Qayyum, Faiza; Larsson, Henrik B W; Kjaer, Andreas; Hasbak, Philip; Vejlstrup, Niels G; Kastrup, Jens

    The aim was to compare absolute quantified myocardial perfusion (MP) to semi-quantitative measurements of MP using MRI for detection of ischemia. Twenty-nine patients underwent rest and stress MP imaging obtained by 1.5T MRI and analyzed using own developed software and by commercial available software. Linear regression analysis demonstrated that absolute quantitative data correlated stronger to maxSI (rest: r=0.296, p=.193; stress: r=0.583, p=0.011; myocardial perfusion reserve (MPR): r=0.789, pstress: r=0.096, p=0.704; MPR: r=0.682, p=0.004; and Δ MBF: r=0.055, p=0.804). Absolute quantified MP was able to distinguish between ischemic and non-ischemic territories at rest (left anterior descending artery (LAD): 103.1±11.3mL/100g/min vs. 206.3±98.5mL/100g/min; p=0.001, right coronary artery (RCA): 124.1±45.2mL/100g/min vs. 241.3±81.7mL/100g/min; pstress (LAD: 148.1±47.2mL/100g/min vs. 296.6±111.6mL/100g/min; p=0.012, RCA: 173.4±63.7mL/100g/min vs. 290.2±100.6mL/100g/min; p=0.008, and LCX: 206.6±105.1mL/100g/min vs. 273.8±78.0mL/100g/min; p=0.186). The correlation between global maxSI and positron emission tomography data was non-significant at rest and borderline significant at stress (r=0.265, p=0.382 and r=0.601, p=0.050, respectively). Quantified MP may be useful in patients for detection of ischemia. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Quantitative gene expression of somatostatin receptors and noradrenaline transporter underlying scintigraphic results in patients with neuroendocrine tumors

    DEFF Research Database (Denmark)

    Binderup, Tina; Knigge, Ulrich; Mellon Mogensen, Anne

    2008-01-01

    AIM: To measure, by a quantitative approach, the gene expression underlying the results of somatostatin receptor (sst) scintigraphy ((111)In-DTPA-octreotide) and noradrenaline transporter (NAT) scintigraphy ((123)I-MIBG) in patients with neuroendocrine (NE) tumors. METHODS: The gene expression of...... to achieve a better understanding of the link between them, which in turn could aid in planning and development of noninvasive molecular imaging of key molecular processes....

  20. Patient-focused goal planning process and outcome after spinal cord injury rehabilitation: quantitative and qualitative audit.

    Science.gov (United States)

    Byrnes, Michelle; Beilby, Janet; Ray, Patricia; McLennan, Renee; Ker, John; Schug, Stephan

    2012-12-01

    To evaluate the process and outcome of a multidisciplinary inpatient goal planning rehabilitation programme on physical, social and psychological functioning for patients with spinal cord injury. Clinical audit: quantitative and qualitative analyses. Specialist spinal injury unit, Perth, Australia. Consecutive series of 100 newly injured spinal cord injury inpatients. MAIN MEASURE(S): The Needs Assessment Checklist (NAC), patient-focused goal planning questionnaire and goal planning progress form. The clinical audit of 100 spinal cord injured patients revealed that 547 goal planning meetings were held with 8531 goals stipulated in total. Seventy-five per cent of the goals set at the first goal planning meeting were achieved by the second meeting and the rate of goal achievements at subsequent goal planning meetings dropped to 56%. Based on quantitative analysis of physical, social and psychological functioning, the 100 spinal cord injury patients improved significantly from baseline to discharge. Furthermore, qualitative analysis revealed benefits consistently reported by spinal cord injury patients of the goal planning rehabilitation programme in improvements to their physical, social and psychological adjustment to injury. The findings of this clinical audit underpin the need for patient-focused goal planning rehabilitation programmes which are tailored to the individual's needs and involve a comprehensive multidisciplinary team.

  1. Early antibiotic discontinuation in patients with clinically suspected ventilator-associated pneumonia and negative quantitative bronchoscopy cultures.

    Science.gov (United States)

    Raman, Kirthana; Nailor, Michael D; Nicolau, David P; Aslanzadeh, Jaber; Nadeau, Michelle; Kuti, Joseph L

    2013-07-01

    Preliminary data suggest that antibiotic discontinuation in patients with negative quantitative bronchoscopy and symptom resolution will not increase mortality. Because our hospital algorithm for antibiotic discontinuation rules out ventilator-associated pneumonia in the setting of negative quantitative bronchoscopy cultures, we compared antibiotic utilization and mortality in empirically treated, culture-negative ventilator-associated pneumonia patients whose antibiotic discontinuation was early versus late. Retrospective, observational cohort study. Eight hundred sixty-seven bed, tertiary care, teaching hospital in Hartford, CT. Eighty-nine patients with clinically suspected ventilator-associated pneumonia and a negative (<10 colony forming units/mL) quantitative bronchoscopy culture between January 2009 and March 2012. Early discontinuation patients (n = 40) were defined as those who had all antibiotic therapy stopped within one day of final negative culture report, whereas late discontinuation patients (n = 49) had antibiotics stopped later than one day. Univariate analyses assessed mortality, antibiotic duration, and frequency of superinfections. Multivariate logistic regression was performed to assess the effect of early discontinuation on hospital mortality. Patients had a mean ± SD Acute Physiology and Chronic Health Evaluation II score of 26.0 ± 6.0. Mortality was not different between early discontinuation (25.0%) and late discontinuation (30.6%) patients (p = 0.642). Antibiotic duration (days) was also not different for patients who died vs. those who survived (Median [interquartile range]: 3 [1-7.5] vs. 3 [1.75-6.25], respectively, p = 0.87), and when controlling for baseline characteristics and symptom resolution, only Acute Physiology and Chronic Health Evaluation II score was associated with hospital mortality on multivariate analyses. There were fewer superinfections (22.5% vs. 42.9%, p = 0.008), respiratory superinfections (10.0% vs. 28.6%, p = 0

  2. Comparison of qualitative and quantitative CT and MRI parameters for monitoring of longitudinal spine involvement in patients with multiple myeloma.

    Science.gov (United States)

    Horger, M; Fritz, J; Thaiss, W M; Ditt, H; Weisel, K; Haap, M; Kloth, Christopher

    2018-03-01

    To compare qualitative and quantitative computed tomography (CT) and magnetic resonance imaging (MRI) parameters for longitudinal disease monitoring of multiple myeloma (MM) of the axial skeleton. We included 31 consecutive patients (17 m; mean age 59.20 ± 8.08 years) with MM, who underwent all baseline (n = 31) and at least one or more (n = 47) follow-up examinations consisting of multi-parametric non-enhanced whole-body MRI ( WB MRI) and non-enhanced whole-body reduced-dose thin-section MDCT (NEWBMDCT) between 06/2013 and 09/2016. We classified response according to qualitative CT criteria into progression (PD), stable(SD), partial/very good partial (PR/VGPR) and complete response(CR), grouping the latter three together for statistical analysis because CT cannot reliably assess PR and CR. Qualitative MR-response criteria were defined and grouped similarly to CT using longitudinal quantification of signal-intensity changes on T1w/STIR/ T2*w and calculating ADC-values. Standard of reference was the hematological laboratory (M-gradient). Hematological response categories were CR (14/47, 29.7%), PR (2/47, 4.2%), SD (16/47, 34.0%) and PD (15/47, 29.9%). Qualitative-CT-evaluation showed PD in 12/47 (25.5%) and SD/PR/VGPR/CR in 35/47 (74.5%) cases. These results were confirmed by quantitative-CT in all focal lytic lesions (p Quantitative-CT at sites with diffuse bone involvement showed significant increase of maximum bone attenuation (p Quantitative MRI diagnosis showed a statistically significant decrease in signal intensity on short tau inversion recovery sequences (STIR) in bone marrow in patients with diffuse bone marrow involvement achieving SD/PR/VGPR/CR (p quantitative parameters with either CT or MRI.

  3. Cognitive functioning in patients with schizophrenia and bipolar disorder: A quantitative review

    NARCIS (Netherlands)

    Krabbendam, L.; Arts, B.; Van Os, J.; Aleman, A.

    2005-01-01

    Objective: Evidence suggests that cognitive functioning in bipolar disorder may be impaired even in euthymic states, but it is unclear if the pattern of deficits is similar to the deficits found in schizophrenia. The aim of this study was to review quantitatively the studies on cognitive performance

  4. Use of computed tomography and automated software for quantitative analysis of the vasculature of patients with pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Wada, Danilo Tadao; Pádua, Adriana Ignácio de; Lima Filho, Moyses Oliveira; Marin Neto, José Antonio; Elias Júnior, Jorge; Baddini-Martinez, José; Santos, Marcel Koenigkam, E-mail: danilowada@yahoo.com.br [Universidade de São Paulo (HCFMRP/USP), Ribeirão Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clínicas

    2017-11-15

    Objective: To perform a quantitative analysis of the lung parenchyma and pulmonary vasculature of patients with pulmonary hypertension (PH) on computed tomography angiography (CTA) images, using automated software. Materials And Methods: We retrospectively analyzed the CTA findings and clinical records of 45 patients with PH (17 males and 28 females), in comparison with a control group of 20 healthy individuals (7 males and 13 females); the mean age differed significantly between the two groups (53 ± 14.7 vs. 35 ± 9.6 years; p = 0.0001). Results: The automated analysis showed that, in comparison with the controls, the patients with PH showed lower 10{sup th} percentile values for lung density, higher vascular volumes in the right upper lung lobe, and higher vascular volume ratios between the upper and lower lobes. In our quantitative analysis, we found no differences among the various PH subgroups. We inferred that a difference in the 10{sup th} percentile values indicates areas of hypovolaemia in patients with PH and that a difference in pulmonary vascular volumes indicates redistribution of the pulmonary vasculature and an increase in pulmonary vasculature resistance. Conclusion: Automated analysis of pulmonary vessels on CTA images revealed alterations and could represent an objective diagnostic tool for the evaluation of patients with PH. (author)

  5. [Quantitative mineralogical analyzes of kidney stones and diagnosing metabolic disorders in female patients with calcium oxalate urolithiasis].

    Science.gov (United States)

    Kustov, A V; Moryganov, M A; Strel'nikov, A I; Zhuravleva, N I; Airapetyan, A O

    2016-02-01

    To conduct a complex examination of female patients with calcium oxalate urolithiasis to detect metabolic disorders, leading to stone formation. The study was carried out using complex physical and chemical methods, including quantitative X-ray phase analysis of urinary stones, pH measurement, volumetry, urine and blood spectrophotometry. Quantitative mineralogical composition of stones, daily urine pH profile, daily urinary excretion of ions of calcium, magnesium, oxalate, phosphate, citrate and uric acid were determined in 20 female patients with calcium oxalate stones. We have shown that most of the stones comprised calcium oxalate monohydrate or mixtures of calcium oxalate dihydrate and hydroxyapatite. Among the identified abnormalities, the most frequent were hypocitraturia and hypercalciuria - 90 and 45%, respectively. Our findings revealed that the daily secretion of citrate and oxalate in patients older than 50 years was significantly lower than in younger patients. In conclusion, daily urinary citrate excretion should be measured in female patients with calcium oxalate stones. This is necessary both to determine the causes of stone formation, and to monitor the effectiveness of citrate therapy.

  6. Diagnostic contribution of quantitative analysis of salivary scintigraphy in patients with suspected Sjögren's syndrome.

    Science.gov (United States)

    Infante, J R; García, L; Rayo, J I; Serrano, J; Domínguez, M L; Moreno, M

    2016-01-01

    The evaluation of the salivary scintigraphy is part of the classification criteria of Sjögren's syndrome (SS). The aim of the study was to determine a method of quantitative evaluation of this technique with easy application and high diagnostic accuracy. A review was carried out on a total of 111 patients with clinical suspicion of SS, referred to our department over the last 4 years (94 women, range 14-82 years). Thirty-minute dynamic studies were performed after injection of (99m)Tc-pertechnetate, with secretory stimulus at 15 minutes. After drawing regions of interest in both parotids, submandibular glands, and in the background, quantitative parameters were determined. These included the ejection fraction, uptake ratio at 15 min, and the percentage uptake (PC). Based on the definitive diagnosis, the subjects were classified into patients with SS, with sicca syndrome, and healthy subjects. Significant differences were found between the SS group and healthy subjects in the 3 quantitative parameters for the 4 glands. Significant differences in the PC parameter were observed between the group with sicca syndrome and healthy subjects. ROC analysis showed that the best differentiation parameter for the 3 groups was the PC in both parotid and submandibular glands. The quantitative analysis of salivary scintigraphy has proved to be a useful method and easy to apply in daily practice to differentiate patients with SS from healthy subjects, with the PC, both in parotid and submandibular glands, being the parameter with highest diagnostic accuracy. Copyright © 2015 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  7. New quantitative aPTT waveform analysis and its application in laboratory management of haemophilia A patients.

    Science.gov (United States)

    Milos, M; Coen Herak, D; Zupancic-Salek, S; Zadro, R

    2014-11-01

    Diagnosis of haemophilia A is usually made by the measurement of factor VIII (FVIII) activity that allows categorization of the disease severity. However, tests that assess global haemostasis may better reflect clinical features and give additional clinically relevant information. The aim of this study was to develop a new quantitative activated partial thromboplastin time (aPTT) waveform analysis and compare it with FVIII activities to find out whether waveform parameters are superior determinants of clinical phenotype. A total of 81 haemophilia A patients divided into two groups (37 severe, 44 non-severe) were included in the study. The control group comprised 101 healthy male volunteers. Quantitative aPTT waveform analysis was performed with Actin FS on BCS (Siemens Healthcare Diagnostics, Marburg, Germany) using three parameters (DELTA, RATIO-1, RATIO-2) obtained from a single aPTT measurement with two evaluation modes. FVIII activities were measured by one-stage clotting and two-stage chromogenic assay. Statistically significant difference (P quantitative waveform parameters. Our study revealed parameter DELTA as the best waveform parameter, showing significant correlation with FVIII activities and clinical parameters, and excellent performance for distinguishing between severe and non-severe haemophilia A patients (ROC analysis: sensitivity 97.3%, specificity 93.2%). The results obtained by new quantitative aPTT waveform analysis were superior to those obtained by standard laboratory methods. The simplicity and cost-benefit of the method make this approach a reasonable and promising tool for assessing coagulation in haemophilia A patients. © 2014 John Wiley & Sons Ltd.

  8. Provision of inpatient rehabilitation and challenges experienced with participation post discharge: quantitative and qualitative inquiry of African stroke patients.

    Science.gov (United States)

    Rhoda, Anthea; Cunningham, Natalie; Azaria, Simon; Urimubenshi, Gerard

    2015-09-28

    The provision of rehabilitation differs between developed and developing countries, this could impact on the outcomes of post stroke rehabilitation. The aim of this paper is to present provision of in-patient stroke rehabilitation. In addition the challenges experienced by the individuals with participation post discharge are also presented. Qualitative and quantitative research methods were used to collect data. The quantitative data was collected using a retrospective survey of stroke patients admitted to hospitals over a three- to five-year period. Quantitative data was captured on a validated data capture sheet and analysed descriptively. The qualitative data was collected using interviews from a purposively and conveniently selected sample, audio-taped and analysed thematically. The qualitative data was presented within the participation model. A total of 168 medical folders were reviewed for a South African sample, 139 for a Rwandan sample and 145 for a Tanzanian sample. The mean age ranged from 62.6 (13.78) years in the South African sample to 56.0 (17.4) in the Rwandan sample. While a total of 98 % of South African stroke patients received physiotherapy, only 39.4 % of Rwandan patients received physiotherapy. From the qualitative interviews, it became clear that the stroke patients had participation restrictions. When conceptualised within the Participation Model participation restrictions experienced by the stroke patients were a lack of accomplishment, inability to engage in previous roles and a perception of having health problems. With the exception of Rwanda, stroke patients in the countries studied are admitted to settings early post stroke allowing for implementation of effective acute interventions. The participants were experiencing challenges which included a lack of transport and the physical geographic surroundings in the rural settings not being conducive to wheelchair use. Stroke patients admitted to hospitals in certain African countries

  9. Glucose meters and opportunities for in-hospital transmission of infection: Quantitative assessment and management with and without patient assignment.

    Science.gov (United States)

    Hellinger, Walter C; Grant, Rhonda L; Hernke, Debra A; Shalev, Jefree A; Barber, Bruce W; Meek, Shon E; Jones, Arthur D; Thompson, Kristine M

    2011-11-01

    Increasing use of glucose meters in hospitals has increased opportunities for infection transmission that have not been quantitatively assessed or managed. Before-and-after study of the effects of augmentation of glucose meter inventory and of assignment of glucose meters to individual patients on the sequential use of glucose meters on different patients in a 214-bed hospital. During October 2008, 11,665 measurements were performed using 38 glucose meters on 803 patients. A total of 9,302 tests (79.7%) was performed sequentially within 24 hours on different patients. From October 28 through November 27, 2009, the glucose meter inventory on 3 high-use units glucose meters was increased (from 22 to 87) with meters assigned to individual patients; on 4 low-use units, glucose meter inventory was increased (from 16 to 28) without assignment to individual patients. Sequential glucose meter use on different patients within 24 hours decreased by 95.1% on high-use units and increased by 17% on low-use units. Use of glucose meters was associated with a high number of opportunities to transmit infections, and those opportunities were reduced only when glucose meters were assigned to individual patients. Recent guidance from the Centers for Disease Control and Prevention and the US Food and Drug Administration to assign glucose meters to individual persons whenever possible is relevant to inpatient care. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Prevalence of ischemia by quantitative thallium-201 scintigraphy in patients with ventricular tachycardia or fibrillation inducible by programmed stimulation

    International Nuclear Information System (INIS)

    Sellers, T.D.; Beller, G.A.; Gibson, R.S.; Watson, D.D.; DiMarco, J.P.

    1987-01-01

    The prevalence of exercise-induced ischemia was determined by thallium-201 (TI-201) scintigraphic criteria in patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) inducible by programmed electrical stimulation. Thirty-eight patients (age 57 +/- 19 years), of whom 87% had angiographic coronary artery disease, underwent quantitative TI-201 exercise scintigraphy within 14 days of invasive electrophysiologic testing. The mean rest ejection fraction was 38 +/- 9%. Eighty percent of patients had 1 or more regions with akinetic or dyskinetic wall motion. Thallium-201 scan segments were scored as normal or containing redistribution defects or mild or severe persistent defects. Only 4 patients (10%) had only redistribution defects and 9 (24%) had both redistribution defects and persistent defects; 32 of 38 patients (84%) had 1 or more persistent defects, of which 26 had at least 1 severe, persistent defect (more than 50% reduction in TI-201 activity). Patients with and without exercise-induced VT had a similar prevalence of redistribution. Redistribution defect prevalence was similar in patients with polymorphic VT (3 of 13) and monomorphic VT (10 of 25) during programmed electrical stimulation (difference not significant). Thus, patients with VT or VF induced by programmed ventricular stimulation have extensive TI-201 scintigraphic abnormalities on exercise scintigrams, predominantly those suggesting scar, with associated severe regional wall motion abnormalities at rest

  11. Quantitative analysis of computed tomography images and early detection of cerebral edema for pediatric traumatic brain injury patients: retrospective study.

    Science.gov (United States)

    Kim, Hakseung; Kim, Gwang-dong; Yoon, Byung C; Kim, Keewon; Kim, Byung-Jo; Choi, Young Hun; Czosnyka, Marek; Oh, Byung-Mo; Kim, Dong-Joo

    2014-10-22

    The purpose of this study was to identify whether the distribution of Hounsfield Unit (HU) values across the intracranial area in computed tomography (CT) images can be used as an effective diagnostic tool for determining the severity of cerebral edema in pediatric traumatic brain injury (TBI) patients. CT images, medical records and radiology reports on 70 pediatric patients were collected. Based on radiology reports and the Marshall classification, the patients were grouped as mild edema patients (n=37) or severe edema patients (n=33). Automated quantitative analysis using unenhanced CT images was applied to eliminate artifacts and identify the difference in HU value distribution across the intracranial area between these groups. The proportion of pixels with HU=17 to 24 was highly correlated with the existence of severe cerebral edema (Pcerebral edema from mild TBI patients. A significant difference between deceased patients and surviving patients in terms of the HU distribution came from the proportion of pixels with HU=19 to HU=23 (Pcerebral area of a non-enhanced CT image can be an effective basis for evaluating the severity of cerebral edema. Based on this result, we propose a novel approach for the early detection of severe cerebral edema.

  12. The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies.

    Science.gov (United States)

    Rajah, Retha; Ahmad Hassali, Mohamed Azmi; Jou, Lim Ching; Murugiah, Muthu Kumar

    2018-03-01

    Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers. CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality. A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients. Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.

  13. A Quantitative Analysis of Nursing Students' Perceptions of Patient Safety Competencies

    Science.gov (United States)

    Steighner, Tammy Rose

    2017-01-01

    The purpose of the study was to determine nursing students' perceptions of patient safety competencies as it related to Quality and Safety Education for Nurses (QSEN) competencies and the Safety Competencies Framework developed by The Canadian Patient Safety Institute. The study determined if nursing students knew how to provide safe patient care…

  14. The effect of qualitative vs. quantitative presentation of probability estimates on patient decision‐making: a randomized trial

    Science.gov (United States)

    Man‐Son‐Hing, Malcolm; O'Connor, Annette M.; Drake, Elizabeth; Biggs, Jennifer; Hum, Valerie; Laupacis, Andreas

    2002-01-01

    its treatment, and other dimensions of decisional conflict (all P‐values >0.05). Conclusions  For participants without the disease in question, this study found that providing sufficient quantitative risk information makes them feel more informed, which sometimes affects their treatment choices. Further studies are necessary to confirm these findings for patients making actual clinical decisions. PMID:12199663

  15. Assessment of active and inactive sacroiliitis in patients with ankylosing spondylitis using quantitative dynamic contrast-enhanced MRI.

    Science.gov (United States)

    Zhang, Mengchao; Zhou, Le; Huang, Ning; Zeng, Hong; Liu, Songyan; Liu, Lin

    2017-07-01

    To investigate the feasibility of using quantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) to differentiate the active and inactive stage of sacroiliitis and the correlation between quantitative parameters and disease activity as measured by clinical scores. Forty-two patients with ankylosing spondylitis underwent DCE-MRI on a 3.0T MRI unit. According to the results of the blood sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the patients were grouped into inactive and active groups. Pharmacokinetic models were used to generate the semiquantitative and quantitative hemodynamic parameters of DCE-MRI. The between-group differences were analyzed using the Wilcoxon rank sum test, and the correlations between the pharmacokinetic parameters and BASDAI score were analyzed using Spearman's correlation coefficient. The efficacies of different parameters in differentiating the active and inactive phase of sacroiliitis were evaluated and compared using receiver operator characteristics (ROC) curve analysis. K trans , K ep , V e , time to peak (TTP), max concentration (MAX Conc), and area under the curve (AUC) of the active group were significantly higher than those of the inactive stage group (P 0.05), except between AUC and MAX Conc (P = 0.0012). Quantitative DCE-MRI parameters can differentiate between active and inactive ankylosing spondylitis. Among those, K trans had the highest correlation coefficient with the BASDAI score. 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:71-78. © 2016 International Society for Magnetic Resonance in Medicine.

  16. Effectiveness of rifampicin chemoprophylaxis in preventing leprosy in patient contacts: a systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Ferreira, Silvana Margarida Benevides; Yonekura, Tatiana; Ignotti, Eliane; Oliveira, Larissa Bertacchini de; Takahashi, Juliana; Soares, Cassia Baldini

    2017-10-01

    Individuals in contact with patients who have leprosy have an increased risk of disease exposure, which reinforces the need for chemoprophylactic measures, such as the use of rifampicin. The objective of the review was to synthesize the best available evidence regarding the effectiveness of rifampicin chemoprophylaxis for contacts with patients with leprosy, and to synthesize the best available evidence on the experience and acceptability of rifampicin chemoprophylaxis as reported by the contacts and health professionals involved in the treatment of leprosy or Hansen's disease. In the quantitative component, individuals in contact with leprosy patients were included. In the qualitative component, in addition to contacts, health professionals who were in the practice of treating leprosy were included. The quantitative component considered as an intervention rifampicin at any dose, frequency and mode of administration, and rifampicin combination regimens.The qualitative component considered as phenomena of interest the experience and acceptability of rifampicin chemoprophylaxis. The quantitative component considered experimental and observational studies whereas the qualitative component considered studies that focused on qualitative data, including but not limited to, designs such as phenomenology, grounded theory, ethnography and action-research. The quantitative component considered studies that reported on outcomes such as the development of clinical leprosy in the contacts of patients who had leprosy, incidence rates, adverse effects and safety/harmful effects of the intervention. A three-step strategy for published and unpublished literature was used. The search for published studies included: PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, National Institute for Health and Clinical Excellence, Latin American and Caribbean Health Sciences Literature; and Google Scholar and EVIPnet for unpublished

  17. Single Breath-Hold Physiotherapy Technique; Effective tool for T2* magnetic resonance imaging in young patients with thalassaemia major

    Directory of Open Access Journals (Sweden)

    Surekha T. Mevada

    2016-02-01

    Full Text Available Magnetic resonance imaging using T2* (MRI T2* is a highly sensitive and non-invasive technique for the detection of tissue iron load. Although the single breath-hold multi-echo T2* technique has been available at the Sultan Qaboos University Hospital (SQUH, Muscat, Oman, since 2006, it could not be performed on younger patients due to their inability to hold their breath after expiration. This study was carried out between May 2007 and May 2015 and assessed 50 SQUH thalassaemic patients aged 7‒17 years old. Seven of these patients underwent baseline and one-year follow-up MRI T2* scans before receiving physiotherapy training. Subsequently, all patients were trained by a physiotherapist to hold their breath for approximately 15‒20 seconds at the end of expiration before undergoing baseline and one-year follow-up MRI T2* scans. Failure rates for the pre- and post-training groups were 6.0% and 42.8%, respectively. These results indicate that the training of thalassaemic patients in breathhold techniques is beneficial and increases rates of compliance for MRI T2* scans.

  18. A qualitative and quantitative analysis of the characteristics of gout patient education resources.

    Science.gov (United States)

    Robinson, Philip C; Schumacher, H Ralph

    2013-06-01

    Patient education is an important aspect of gout management, but there is evidence that many patients lack adequate knowledge of their condition. Our aim was to examine the characteristics of gout patient education resources. Ten gout patient information resources were examined for readability (Flesch-Kincaid reading level, the Simple Measure of Gobbledygook measure and the Flesch Reading Ease Score), qualitative characteristics such as figure and jargon use and whether they included information on the major points of gout. The median readability grade level of the examined resources was 8.5. The difference in readability grade level between the highest and the lowest education resource was 6.3 grade levels. The information content of the resources was high with an average of only 3.9 proposed criteria of 19 (19 %) absent from the resources. Jargon use was low and concepts were usually explained. However, important information regarding acute flare prophylaxis during urate-lowering therapy initiation and titration and treating serum uric acid to target was absent from 60 % of the patient education resources. There was poor use of key messages at the start. Gout patient resources have a wide range of readability. Thirty percent of resources were above the average reading level of rheumatology outpatients reported in previous studies. Sixty percent of gout patient resources omit education items that could impact on patient adherence and in turn patient outcomes. Further research is needed into the literacy levels and education requirements of patients with gout.

  19. Quantitative assessment of whole-body tumor burden in adult patients with neurofibromatosis.

    Science.gov (United States)

    Plotkin, Scott R; Bredella, Miriam A; Cai, Wenli; Kassarjian, Ara; Harris, Gordon J; Esparza, Sonia; Merker, Vanessa L; Munn, Lance L; Muzikansky, Alona; Askenazi, Manor; Nguyen, Rosa; Wenzel, Ralph; Mautner, Victor F

    2012-01-01

    Patients with neurofibromatosis 1 (NF1), NF2, and schwannomatosis are at risk for multiple nerve sheath tumors and premature mortality. Traditional magnetic resonance imaging (MRI) has limited ability to assess disease burden accurately. The aim of this study was to establish an international cohort of patients with quantified whole-body internal tumor burden and to correlate tumor burden with clinical features of disease. We determined the number, volume, and distribution of internal nerve sheath tumors in patients using whole-body MRI (WBMRI) and three-dimensional computerized volumetry. We quantified the distribution of tumor volume across body regions and used unsupervised cluster analysis to group patients based on tumor distribution. We correlated the presence and volume of internal tumors with disease-related and demographic factors. WBMRI identified 1286 tumors in 145/247 patients (59%). Schwannomatosis patients had the highest prevalence of tumors (P = 0.03), but NF1 patients had the highest median tumor volume (P = 0.02). Tumor volume was unevenly distributed across body regions with overrepresentation of the head/neck and pelvis. Risk factors for internal nerve sheath tumors included decreasing numbers of café-au-lait macules in NF1 patients (P = 0.003) and history of skeletal abnormalities in NF2 patients (P = 0.09). Risk factors for higher tumor volume included female gender (P = 0.05) and increasing subcutaneous neurofibromas (P = 0.03) in NF1 patients, absence of cutaneous schwannomas in NF2 patients (P = 0.06), and increasing age in schwannomatosis patients (p = 0.10). WBMRI provides a comprehensive phenotype of neurofibromatosis patients, identifies distinct anatomic subgroups, and provides the basis for investigating molecular biomarkers that correlate with unique disease manifestations.

  20. Quantitative comparison of low dose and standard dose radioiodine therapy effectiveness in patients with low risk differentiated thyroid cancer.

    Science.gov (United States)

    Abdulrezzak, Ummuhan; Tutus, Ahmet; Isik, Ilknur; Kurt, Yurdagul; Kula, Mustafa

    2017-09-01

    The aim of this paper was to compare the results of postoperative I-131 remnant ablation therapy using a quantitative data in the low activity (1110 MBq) and standard dose (3700 MBq). The study included two groups of patients with low risk differentiated thyroid cancer (DTC): Group L (low dose group) included 54 patients who were treated with 1110 MBq I-131 and Group S (standard dose group) included 61 patients treated with 3700 MBq. The postoperative thyroid remnants were assessed with the pretreatment thyroid uptake test (PTUT) and the whole body scans (WBS) were performed in the 7th day after the ablation treatment. We obtained the average count per pixel from the standard region of interest analysis of the thyroid bed (Tavc), liver (Lavc), thigh (Thavc) and whole body (WBkc). At the sixth month after the treatment, WBS were performed to 106 patients (45 patients from Group L and 61 patients from Group S) to evaluate the success of ablation treatment. A significant difference in PTUT and Tavc was not found between the two groups (P>0.05). However, Lavc, Thavc and WBkc were significantly higher in Group S compared with Group L (P0.05). In low risk DTC patients, low dose radioactive iodine can ablate thyroid remnants as effectively as a higher dose with less radiation exposure to other non-target organs and the whole body.

  1. Virtual Patients in a Behavioral Medicine Massive Open Online Course (MOOC): A Qualitative and Quantitative Analysis of Participants' Perceptions.

    Science.gov (United States)

    Berman, Anne H; Biguet, Gabriele; Stathakarou, Natalia; Westin-Hägglöf, Beata; Jeding, Kerstin; McGrath, Cormac; Zary, Nabil; Kononowicz, Andrzej A

    2017-10-01

    The purpose of this article is to explore learners' perceptions of using virtual patients in a behavioral medicine Massive Open Online Course (MOOCs) and thereby describe innovative ways of disseminating knowledge in health-related areas. A 5-week MOOC on behavioral medicine was hosted on the edX platform. The authors developed two branched virtual patients consisting of video recordings of a live standardized patient, with multiple clinical decision points and narration unfolding depending on learners' choices. Students interacted with the virtual patients to treat stress and sleep problems. Answers to the exit survey and participant comments from the discussion forum were analyzed qualitatively and quantitatively. In total, 19,236 participants enrolled in the MOOC, out of which 740 received the final certificate. The virtual patients were completed by 2317 and 1640 participants respectively. Among survey respondents (n = 442), 83.1% agreed that the virtual patient exercise was helpful. The qualitative analysis resulted in themes covering what it was like to work with the virtual patient, with subthemes on learner-centered education, emotions/eustress, game comparisons, what the participants learned, what surprised them, how confident participants felt about applying interventions in practice, suggestions for improvement, and previous experiences of virtual patients. Students were enthusiastic about interacting with the virtual patients as a means to apply new knowledge about behavioral medicine interventions. The most common suggestion was to incorporate more interactive cases with various levels of complexity. Further research should include patient outcomes and focus on interprofessional aspects of learning with virtual patients in a MOOC.

  2. Quantitative histopathology in the prognostic evaluation of patients with transitional cell carcinoma of the urinary bladder

    DEFF Research Database (Denmark)

    Sasaki, M; Sørensen, Flemming Brandt; Fukuzawa, S

    1993-01-01

    was documented between nuclear vV and NI (r = -0.63). Estimates of nuclear volume fraction showed no correlation with nuclear vV. Comparisons between categorical and quantitative data revealed the following: a decrease in averaged estimates of NI for tumors in advanced T-stage and malignancy grade (2P ....0008); and nuclear vV and aH(nuc) increased on average, in tumors of high T-stage and malignancy grade. Estimates of MI were also positively correlated with the T-stage and the malignancy grade (+0.42 showed prognostic effect of T-stage, grade of malignancy, and, apart...

  3. The polyomaviruses WUPyV and KIPyV: a retrospective quantitative analysis in patients undergoing hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Motamedi Nasim

    2012-09-01

    Full Text Available Abstract Background The polyomaviruses WUPyV and KIPyV have been detected in various sample types including feces indicating pathogenicity in the gastrointestinal (GI system. However, quantitative viral load data from other simultaneously collected sample types are missing. As a consequence, primary replication in the GI system cannot be differentiated from swallowed virus from the respiratory tract. Here we present a retrospective quantitative longitudinal analysis in simultaneously harvested specimens from different organ sites of patients undergoing hematopoietic stem cell transplantation (HSCT. This allows the definition of sample types where deoxyribonucleic acid (DNA detection can be expected and, as a consequence, the identification of their primary replication site. Findings Viral DNA loads from 37 patients undergoing HSCT were quantified in respiratory tract secretions (RTS, stool and urine samples as well as in leukocytes (n = 449. Leukocyte-associated virus could not be found. WUPyV was found in feces, RTS and urine samples of an infant, while KIPyV was repeatedly detected in RTS and stool samples of 4 adult patients. RTS and stool samples were matched to determine the viral load difference showing a mean difference of 2.3 log copies/ml (p  Conclusions The data collected in this study suggest that virus detection in the GI tract results from swallowed virus from the respiratory tract (RT. We conclude that shedding from the RT should be ruled out before viral DNA detection in the feces can be correlated to GI symptoms.

  4. Quantitative benefit-harm assessment for setting research priorities: the example of roflumilast for patients with COPD.

    Science.gov (United States)

    Puhan, Milo A; Yu, Tsung; Boyd, Cynthia M; Ter Riet, Gerben

    2015-07-02

    When faced with uncertainties about the effects of medical interventions regulatory agencies, guideline developers, clinicians, and researchers commonly ask for more research, and in particular for more randomized trials. The conduct of additional randomized trials is, however, sometimes not the most efficient way to reduce uncertainty. Instead, approaches such as value of information analysis or other approaches should be used to prioritize research that will most likely reduce uncertainty and inform decisions. In situations where additional research for specific interventions needs to be prioritized, we propose the use of quantitative benefit-harm assessments that illustrate how the benefit-harm balance may change as a consequence of additional research. The example of roflumilast for patients with chronic obstructive pulmonary disease shows that additional research on patient preferences (e.g., how important are exacerbations relative to psychiatric harms?) or outcome risks (e.g., what is the incidence of psychiatric outcomes in patients with chronic obstructive pulmonary disease without treatment?) is sometimes more valuable than additional randomized trials. We propose that quantitative benefit-harm assessments have the potential to explore the impact of additional research and to identify research priorities Our approach may be seen as another type of value of information analysis and as a useful approach to stimulate specific new research that has the potential to change current estimates of the benefit-harm balance and decision making.

  5. Helicity and Vorticity of Pulmonary Arterial Flow in Patients With Pulmonary Hypertension: Quantitative Analysis of Flow Formations.

    Science.gov (United States)

    Schäfer, Michal; Barker, Alex J; Kheyfets, Vitaly; Stenmark, Kurt R; Crapo, James; Yeager, Michael E; Truong, Uyen; Buckner, J Kern; Fenster, Brett E; Hunter, Kendall S

    2017-12-20

    Qualitative and quantitative flow hemodynamic indexes have been shown to reflect right ventricular (RV) afterload and function in pulmonary hypertension (PH). We aimed to quantify flow hemodynamic formations in pulmonary arteries using 4-dimensional flow cardiac magnetic resonance imaging and the spatial velocity derivatives helicity and vorticity in a heterogeneous PH population. Patients with PH (n=35) and controls (n=10) underwent 4-dimensional flow magnetic resonance imaging study for computation of helicity and vorticity in the main pulmonary artery (MPA), the right pulmonary artery, and the RV outflow tract. Helicity and vorticity were correlated with standard RV volumetric and functional indexes along with MPA stiffness assessed by measuring relative area change. Patients with PH had a significantly decreased helicity in the MPA (8 versus 32 m/s 2 ; P flow hemodynamic character in patients with PH assessed via quantitative analysis is considerably different when compared with healthy and normotensive controls. A strong association between helicity in pulmonary arteries and ventricular-vascular coupling suggests a relationship between the mechanical and flow hemodynamic domains. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  6. Hepatic and pancreatic involvement in hereditary hemorrhagic telangiectasia: quantitative and qualitative evaluation with 64-section CT in asymptomatic adult patients

    Energy Technology Data Exchange (ETDEWEB)

    Barral, Matthias; Sirol, Marc; Hamzi, Lounis; Gayat, Etienne; Boudiaf, Mourad [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Place, Vinciane [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Universite Diderot-Paris 7, UFR de Medecine, Paris (France); Borsik, Michel [Hopital Lariboisiere-APHP, Deparment of Ear, Nose and Throat, Paris (France); Soyer, Philippe [Hopital Lariboisiere-APHP, Department of Abdominal Imaging, Paris (France); Universite Diderot-Paris 7, UFR de Medecine, Paris (France); Unite 965 INSERM/Paris7, Hopital Lariboisiere-APHP, Paris (France)

    2012-01-15

    To analyse quantitatively and qualitatively asymptomatic hepatic and pancreatic involvement in hereditary haemorrhagic telangiectasia (HHT) using 64-section helical CT. The 64-section helical CT examinations of 19 patients with HHT (8 men, 11 women; mean age, 58.6 years) were quantitatively and qualitatively analysed and compared to those of 19 control subjects who were matched for age and sex. Comparisons were made using univariate analysis. Dilated and tortuous intrahepatic arterial branches was the most discriminating independent variable (P < 0.0001) and had the highest specificity (100%; 19/19; 95%CI: 82%-100%) and accuracy (97%; 37/38; 95%CI: 86%-100%) for the diagnosis of HHT. Heterogeneous enhancement of hepatic parenchyma, intrahepatic telangiectases, hepatic artery to hepatic vein shunting, hepatic artery enlargement (i.e. diameter > 6.5 mm) and portal vein enlargement (i.e. diameter > 13 mm) were other variables that strongly correlated with the presence of HHT. Intrapancreatic telangiectases and arteriovenous malformations were found in 42% and 16% of patients with HHT, respectively. Liver and pancreatic involvement in asymptomatic HHT patients is associated with myriad suggestive findings on 64-section helical CT. It can be anticipated that familiarity with these findings would result in more confident diagnosis of HHT. (orig.)

  7. Patients' experiences of changes in health after removal of dental amalgam - quantitative and qualitative approaches

    OpenAIRE

    Sjursen, Therese Thornton

    2016-01-01

    Patients with medically unexplained health complaints attributed to dental amalgam often wish to have their amalgam fillings replaced with other materials. The main purpose of this thesis was to explore how patients with health complaints attributed to dental amalgam experienced changes in health after removal of all amalgam fillings. Forty patients with health complaints attributed to dental amalgam were included and assigned to a treatment group (n=20; amalgam removal) and a reference gr...

  8. A Compressed Sensing-Based Wearable Sensor Network for Quantitative Assessment of Stroke Patients

    Directory of Open Access Journals (Sweden)

    Lei Yu

    2016-02-01

    Full Text Available Clinical rehabilitation assessment is an important part of the therapy process because it is the premise for prescribing suitable rehabilitation interventions. However, the commonly used assessment scales have the following two drawbacks: (1 they are susceptible to subjective factors; (2 they only have several rating levels and are influenced by a ceiling effect, making it impossible to exactly detect any further improvement in the movement. Meanwhile, energy constraints are a primary design consideration in wearable sensor network systems since they are often battery-operated. Traditionally, for wearable sensor network systems that follow the Shannon/Nyquist sampling theorem, there are many data that need to be sampled and transmitted. This paper proposes a novel wearable sensor network system to monitor and quantitatively assess the upper limb motion function, based on compressed sensing technology. With the sparse representation model, less data is transmitted to the computer than with traditional systems. The experimental results show that the accelerometer signals of Bobath handshake and shoulder touch exercises can be compressed, and the length of the compressed signal is less than 1/3 of the raw signal length. More importantly, the reconstruction errors have no influence on the predictive accuracy of the Brunnstrom stage classification model. It also indicated that the proposed system can not only reduce the amount of data during the sampling and transmission processes, but also, the reconstructed accelerometer signals can be used for quantitative assessment without any loss of useful information.

  9. A Compressed Sensing-Based Wearable Sensor Network for Quantitative Assessment of Stroke Patients.

    Science.gov (United States)

    Yu, Lei; Xiong, Daxi; Guo, Liquan; Wang, Jiping

    2016-02-05

    Clinical rehabilitation assessment is an important part of the therapy process because it is the premise for prescribing suitable rehabilitation interventions. However, the commonly used assessment scales have the following two drawbacks: (1) they are susceptible to subjective factors; (2) they only have several rating levels and are influenced by a ceiling effect, making it impossible to exactly detect any further improvement in the movement. Meanwhile, energy constraints are a primary design consideration in wearable sensor network systems since they are often battery-operated. Traditionally, for wearable sensor network systems that follow the Shannon/Nyquist sampling theorem, there are many data that need to be sampled and transmitted. This paper proposes a novel wearable sensor network system to monitor and quantitatively assess the upper limb motion function, based on compressed sensing technology. With the sparse representation model, less data is transmitted to the computer than with traditional systems. The experimental results show that the accelerometer signals of Bobath handshake and shoulder touch exercises can be compressed, and the length of the compressed signal is less than 1/3 of the raw signal length. More importantly, the reconstruction errors have no influence on the predictive accuracy of the Brunnstrom stage classification model. It also indicated that the proposed system can not only reduce the amount of data during the sampling and transmission processes, but also, the reconstructed accelerometer signals can be used for quantitative assessment without any loss of useful information.

  10. A Compressed Sensing-Based Wearable Sensor Network for Quantitative Assessment of Stroke Patients

    Science.gov (United States)

    Yu, Lei; Xiong, Daxi; Guo, Liquan; Wang, Jiping

    2016-01-01

    Clinical rehabilitation assessment is an important part of the therapy process because it is the premise for prescribing suitable rehabilitation interventions. However, the commonly used assessment scales have the following two drawbacks: (1) they are susceptible to subjective factors; (2) they only have several rating levels and are influenced by a ceiling effect, making it impossible to exactly detect any further improvement in the movement. Meanwhile, energy constraints are a primary design consideration in wearable sensor network systems since they are often battery-operated. Traditionally, for wearable sensor network systems that follow the Shannon/Nyquist sampling theorem, there are many data that need to be sampled and transmitted. This paper proposes a novel wearable sensor network system to monitor and quantitatively assess the upper limb motion function, based on compressed sensing technology. With the sparse representation model, less data is transmitted to the computer than with traditional systems. The experimental results show that the accelerometer signals of Bobath handshake and shoulder touch exercises can be compressed, and the length of the compressed signal is less than 1/3 of the raw signal length. More importantly, the reconstruction errors have no influence on the predictive accuracy of the Brunnstrom stage classification model. It also indicated that the proposed system can not only reduce the amount of data during the sampling and transmission processes, but also, the reconstructed accelerometer signals can be used for quantitative assessment without any loss of useful information. PMID:26861337

  11. Quantitative assessment of interactions between hospitalized patients and portable medical equipment and other fomites.

    Science.gov (United States)

    Suwantarat, Nuntra; Supple, Laura A; Cadnum, Jennifer L; Sankar, Thriveen; Donskey, Curtis J

    2017-11-01

    In an observational study, we demonstrated that hospitalized patients frequently had direct or indirect interactions with medical equipment and other fomites that are shared among patients, and these items were often contaminated with health care-associated pathogens. There is a need for protocols to ensure routine cleaning of shared portable equipment. Published by Elsevier Inc.

  12. Prognostic value of a quantitative analysis of lipoarabinomannan in urine from patients with HIV-associated tuberculosis.

    Directory of Open Access Journals (Sweden)

    Andrew D Kerkhoff

    Full Text Available Detection of the mycobacterial cell wall antigen lipoarabinomannan (LAM in urine can be used to diagnose HIV-associated tuberculosis (TB using a qualitative (positive/negative read-out. However, it is not known whether the quantity of LAM present in urine provides additional prognostic information.Consecutively recruited adult outpatients initiating antiretroviral therapy (ART in South Africa were investigated for TB regardless of clinical symptoms using sputum smear microscopy and liquid culture (reference standard. Urine samples were tested using the Clearview TB-ELISA for LAM and the Xpert MTB/RIF assay. The ELISA optical densities (OD were used as a quantitative assessment of urine LAM. Among 514 patients with complete sputum and urine LAM OD results, culture-confirmed TB was diagnosed in 84 patients. Twenty-three (27.3% were LAM-positive with a median LAM OD of 0.68 (IQR 0.16-2.43; range, 0.10-3.29 and 61 (72.6% were LAM negative (LAM OD <0.1 above background. Higher LAM ODs were associated with a range of prognostic indices, including lower CD4 cell counts, lower haemoglobin levels, higher blood neutrophil counts and higher mycobacterial load as assessed using both sputum and urine samples. The median LAM OD among patients who died was more than 6.8-fold higher than that of patients who remained alive at 3 months (P<0.001. The small number of deaths, however, precluded adequate assessment of mortality risk stratified according to urine LAM OD.In patients with HIV-associated TB, concentrations of LAM in urine were strongly associated with a range of poor prognostic characteristics known to be associated with mortality risk. Urine LAM assays with a semi-quantitative (negative vs. low-positive vs. high-positive read-out may have improved clinical utility over assays with a simple binary result.

  13. Deferasirox, deferiprone and desferrioxamine treatment in thalassemia major patients: cardiac iron and function comparison determined by quantitative magnetic resonance imaging

    Science.gov (United States)

    Pepe, Alessia; Meloni, Antonella; Capra, Marcello; Cianciulli, Paolo; Prossomariti, Luciano; Malaventura, Cristina; Putti, Maria Caterina; Lippi, Alma; Romeo, Maria Antonietta; Bisconte, Maria Grazia; Filosa, Aldo; Caruso, Vincenzo; Quarta, Antonella; Pitrolo, Lorella; Missere, Massimiliano; Midiri, Massimo; Rossi, Giuseppe; Positano, Vincenzo; Lombardi, Massimo; Maggio, Aurelio

    2011-01-01

    Background Oral deferiprone was suggested to be more effective than subcutaneous desferrioxamine for removing heart iron. Oral once-daily chelator deferasirox has recently been made commercially available but its long-term efficacy on cardiac iron and function has not yet been established. Our study aimed to compare the effectiveness of deferasirox, deferiprone and desferrioxamine on myocardial and liver iron concentrations and bi-ventricular function in thalassemia major patients by means of quantitative magnetic resonance imaging. Design and Methods From the first 550 thalassemia subjects enrolled in the Myocardial Iron Overload in Thalassemia network, we retrospectively selected thalassemia major patients who had been receiving one chelator alone for longer than one year. We identified three groups of patients: 24 treated with deferasirox, 42 treated with deferiprone and 89 treated with desferrioxamine. Myocardial iron concentrations were measured by T2* multislice multiecho technique. Biventricular function parameters were quantitatively evaluated by cine images. Liver iron concentrations were measured by T2* multiecho technique. Results The global heart T2* value was significantly higher in the deferiprone (34±11ms) than in the deferasirox (21±12 ms) and the desferrioxamine groups (27±11 ms) (P=0.0001). We found higher left ventricular ejection fractions in the deferiprone and the desferrioxamine versus the deferasirox group (P=0.010). Liver iron concentration, measured as T2* signal, was significantly lower in the desferrioxamine versus the deferiprone and the deferasirox group (P=0.004). Conclusions The cohort of patients treated with oral deferiprone showed less myocardial iron burden and better global systolic ventricular function compared to the patients treated with oral deferasirox or subcutaneous desferrioxamine. PMID:20884710

  14. Endobronchial valves in severe emphysematous patients: CT evaluation of lung fissures completeness, treatment radiological response and quantitative emphysema analysis

    Energy Technology Data Exchange (ETDEWEB)

    Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br, E-mail: marcelk46@usp.b [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas da Faculdade de Medicina; Paula, Wagner Diniz de [University of Brasilia (UnB), DF (Brazil). Brasilia University Hospital; Gompelmann, Daniela [University of Heidelberg (Germany). Department of Pneumology and Respiratory Medicine of the Chest Clinic (Thoraxklinik); Kauczor, Hans-Ulrich [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology; Heussel, Claus Peter; Puderbach, Michael [University of Heidelberg (Germany). Department of Diagnostic and Interventional Radiology with Nuclear Medicine of the Chest Clinic (Thoraxklinik)

    2013-01-15

    Objective: To evaluate lung fissures completeness, post-treatment radiological response and quantitative CT analysis (QCTA) in a population of severe emphysematous patients submitted to endobronchial valves (EBV) implantation. Materials and Methods: Multi-detectors CT exams of 29 patients were studied, using thin-section low dose protocol without contrast. Two radiologists retrospectively reviewed all images in consensus; fissures completeness was estimated in 5% increments and post-EBV radiological response (target lobe atelectasis/volume loss) was evaluated. QCTA was performed in pre and post-treatment scans using a fully automated software. Results: CT response was present in 16/29 patients. In the negative CT response group, all 13 patients presented incomplete fissures, and mean oblique fissures completeness was 72.8%, against 88.3% in the other group. QCTA most significant results showed a reduced post-treatment total lung volume (LV) (mean 542 ml), reduced EBV-submitted LV (700 ml) and reduced emphysema volume (331.4 ml) in the positive response group, which also showed improved functional tests. Conclusion: EBV benefit is most likely in patients who have complete interlobar fissures and develop lobar atelectasis. In patients with no radiological response we observed a higher prevalence of incomplete fissures and a greater degree of incompleteness. The fully automated QCTA detected the post-treatment alterations, especially in the treated lung analysis. (author)

  15. Quantitative gait analysis in patients with Parkinson treated with deep brain stimulation: the effects of a robotic gait training.

    Science.gov (United States)

    Nardo, Alice; Anasetti, Federica; Servello, Domenico; Porta, Mauro

    2014-01-01

    Despite Deep Brain Stimulation (DBS) improves cardinal symptoms of Parkinson's Disease (PD), its effect on walking impairment is less evident. Robotic-assisted rehabilitation systems could serve as "add-on" physical therapy for PD patients. This systems are able to anticipate and correct the trajectory of patients' motion to improve their motor function recovery. Aim of the present study was the quantitative assessment of the effects of a Robotic-Assisted Rehabilitation Protocol (RARP) on gait patterns by means of three-dimensional gait analysis on PD patients treated with DBS. 9 patients with PD treated with DBS were submitted to 5 weeks robotic-assisted rehabilitation sessions. Three-dimensional gait analysis was performed before the starting session, and one day after the last session using an optoelectronic system with passive markers. The RARP showed significant improvements on spatio-temporal gait parameters and on the Unified Parkinson's Disease Rating Scale motor score. The RARP with Lokomat may have positive effects on spatio-temporal gait parameters of PD patients and it could be an adjunct therapy for patients treated with DBS. On the other hand kinematic and kinetic gait parameters did not show significant improvements, remaining almost comparable before and after the RARP.

  16. Reliability of intraoral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls – a multicenter study

    Science.gov (United States)

    Baad-Hansen, Lene; Pigg, Maria; Yang, Guangju; List, Thomas; Svensson, Peter; Drangsholt, Mark

    2014-01-01

    Summary The reliability of comprehensive intraoral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic orofacial pain. The aim of the present multi-center study was to examine test-retest and inter-examiner reliability of intraoral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Forty-five AO patients and 68 healthy controls were subjected to bilateral intraoral gingival QST and unilateral extratrigeminal QST (thenar) on three occasions (twice on one day by two different examiners and once approximately one week later by one of the examiners). Intraclass correlation coefficients and kappa values for inter-examiner and test-retest reliability were computed. Most of the standardized intraoral QST measures showed fair to excellent inter-examiner (9–12 of 13 measures) and test-retest (7–11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between AO patients and the healthy reference group. These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intraoral QST is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region. PMID:25284726

  17. Reliability of intra-oral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls - a multicentre study.

    Science.gov (United States)

    Baad-Hansen, L; Pigg, M; Yang, G; List, T; Svensson, P; Drangsholt, M

    2015-02-01

    The reliability of comprehensive intra-oral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic oro-facial pain. The aim of the present multicentre study was to examine test-retest and interexaminer reliability of intra-oral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Forty-five patients with AO and 68 healthy controls were subjected to bilateral intra-oral gingival QST and unilateral extratrigeminal QST (thenar) on three occasions (twice on 1 day by two different examiners and once approximately 1 week later by one of the examiners). Intra-class correlation coefficients and kappa values for interexaminer and test-retest reliability were computed. Most of the standardised intra-oral QST measures showed fair to excellent interexaminer (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between patients with AO and the healthy reference group. These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intra-oral QST is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region. © 2014 John Wiley & Sons Ltd.

  18. Quantitative phase-contrast MRI study of cerebrospinal fluid flow: a method for identifying patients with normal-pressure hydrocephalus.

    Science.gov (United States)

    Forner Giner, J; Sanz-Requena, R; Flórez, N; Alberich-Bayarri, A; García-Martí, G; Ponz, A; Martí-Bonmatí, L

    2014-03-01

    The aim of this study is to evaluate the use of phase-contrast MR imaging to diagnose normal pressure hydrocephalus (NPH) and differentiate it from other neurological disorders with similar clinical symptoms. The study included 108 subjects, of whom 61 were healthy controls and 47, patients; in the patient group, 19 had cerebrovascular disease (CVD) and 28 had NPH. All patients underwent a phase-contrast MRI study and several CSF flow and velocity parameters were measured at the aqueduct of Sylvius. Discriminant analyses were performed to evaluate the classification capacity of both individual parameters and the combination of different parameters. Maximum diastolic velocity, mean flow, and stroke volume showed statistically significant differences that could be used to distinguish between NPH and CVD patients (P<.001). Stroke volume and mean flow showed no false positive results and successful classification rates of 86% and 79%, respectively. No other parameters or combination produced better results. Phase-contrast MR imaging is a useful tool for the early diagnosis of patients with NPH. CSF flow quantitative parameters, along with morphological features in a conventional MR study, enable us to differentiate between NPH and CVD patients. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  19. Quantitative CT assessment in chronic obstructive pulmonary disease patients: Comparison of the patients with and without consistent clinical symptoms and pulmonary function results

    International Nuclear Information System (INIS)

    Nam, Boda; Hwang, Jung Hwa; Lee, Young Mok; Park, Jai Soung; Jou, Sung Shick; Kim, Young Bae

    2015-01-01

    We compared the clinical and quantitative CT measurement parameters between chronic obstructive pulmonary disease (COPD) patients with and without consistent clinical symptoms and pulmonary function results. This study included 60 patients having a clinical diagnosis of COPD, who underwent chest CT scan and pulmonary function tests. These 60 patients were classified into typical and atypical groups, which were further sub-classified into 4 groups, based on their dyspnea score and the result of pulmonary function tests [typical 1: mild dyspnea and pulmonary function impairment (PFI); typical 2: severe dyspnea and PFI; atypical 1: mild dyspnea and severe PFI; atypical 2: severe dyspnea and mild PFI]. Quantitative measurements of the CT data for emphysema, bronchial wall thickness and air-trapping were performed using software analysis. Comparative statistical analysis was performed between the groups. The CT emphysema index correlated well with the results of the pulmonary functional test (typical 1 vs. atypical 1, p = 0.032), and the bronchial wall area ratio correlated with the dyspnea score (typical 1 vs. atypical 2, p = 0.033). CT air-trapping index also correlated with the results of the pulmonary function test (typical 1 vs. atypical 1, p = 0.012) and dyspnea score (typical 1 vs. atypical 2, p = 0.000), and was found to be the most significant parameter between the typical and atypical groups. Quantitative CT measurements for emphysema and airways correlated well with the dyspnea score and pulmonary function results in patients with COPD. Air-trapping was the most significant parameter between the typical vs. atypical group of COPD patients

  20. Quantitative CT assessment in chronic obstructive pulmonary disease patients: Comparison of the patients with and without consistent clinical symptoms and pulmonary function results

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Boda; Hwang, Jung Hwa [Dept. of Radiology, Soonchunhyang University Hospital, Seoul (Korea, Republic of); Lee, Young Mok [Bangbae GF Allergy Clinic, Seoul (Korea, Republic of); Park, Jai Soung [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Jou, Sung Shick [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of); Kim, Young Bae [Dept. of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of)

    2015-09-15

    We compared the clinical and quantitative CT measurement parameters between chronic obstructive pulmonary disease (COPD) patients with and without consistent clinical symptoms and pulmonary function results. This study included 60 patients having a clinical diagnosis of COPD, who underwent chest CT scan and pulmonary function tests. These 60 patients were classified into typical and atypical groups, which were further sub-classified into 4 groups, based on their dyspnea score and the result of pulmonary function tests [typical 1: mild dyspnea and pulmonary function impairment (PFI); typical 2: severe dyspnea and PFI; atypical 1: mild dyspnea and severe PFI; atypical 2: severe dyspnea and mild PFI]. Quantitative measurements of the CT data for emphysema, bronchial wall thickness and air-trapping were performed using software analysis. Comparative statistical analysis was performed between the groups. The CT emphysema index correlated well with the results of the pulmonary functional test (typical 1 vs. atypical 1, p = 0.032), and the bronchial wall area ratio correlated with the dyspnea score (typical 1 vs. atypical 2, p = 0.033). CT air-trapping index also correlated with the results of the pulmonary function test (typical 1 vs. atypical 1, p = 0.012) and dyspnea score (typical 1 vs. atypical 2, p = 0.000), and was found to be the most significant parameter between the typical and atypical groups. Quantitative CT measurements for emphysema and airways correlated well with the dyspnea score and pulmonary function results in patients with COPD. Air-trapping was the most significant parameter between the typical vs. atypical group of COPD patients.

  1. Quantitative analysis of the factors responsible for over or under dose of 131I therapy patients of hyperthyroidism

    International Nuclear Information System (INIS)

    Muhammad, W.; Faaruq, S.; Hussain, A.; Kakakhail, M. B.; Fatmi, S.; Matiullah

    2008-01-01

    Radioiodine ( 131 I) therapy has been in use for more than 60 y. Several protocols have been suggested and used for prescribing the activity to be administered to the patients for the treatment of hyperthyroidism; application of these protocols may result in an under or over dose of the hyperthyroid patients. The main objective of this study was to carry out quantitative analysis of the factors responsible for possible under or over dosage of the patients. In this regard, a total of 59 patients [15 diffuse goitre (DG) and 44 nodular goitre (NG) cases] were studied. In order to compare the thyroid doses calculated by using different protocols, the dosimetric approach was followed. 131 I uptakes were measured after 24 and 48 h, respectively, by giving 0.5 MBq of 131 I to each patient. Thyroid mass and effective half-life were also calculated for each patient and the variations in the thyroid doses were analysed. According to the results 28 and 54% patients were under dosed and 72 and 46% patients were over dosed with DG and NG, respectively. The protocols, which have not taken into account the thyroid mass, multi pre-therapeutic 131 I uptakes and the effective half-life of 131 I of the individual patient, showed a higher degree of deviation from the required thyroid dose. Besides these parameters, some fundamental factors such as radiosensitivity, previous exposure to thyroid drugs and duration of the disease are recommended to be incorporated, which can certainly affect the clinical out comes. (authors)

  2. Distress associated with radiotherapy for malignant disease: a quantitative analysis based on patients perceptions

    International Nuclear Information System (INIS)

    Munro, A.J.; Biruls, R.; Griffin, A.V.; Thomas, H.; Vallis, K.A.

    1989-01-01

    Distress associated with attendance at a radiotherapy department was assessed in 80 consecutive patients. All patients were interviewed within 24 h of their first fraction of radiotherapy; 31 patients were also interviewed at the end of treatment. The problem identified at first interview as causing the most distress was worry about the effects of disease and its treatment upon the patient's family. At second interview the dominant complaint was of not being allowed to wash. Psychological problems, including anxiety and sleep disturbances, caused more overall distress than did physical symptoms. The method used in this study for eliciting information on the side-effects of therapy is straightforward and has yielded data that are provocative and suggest interesting avenues for further investigation. (author)

  3. Effects of plasma magnesium and prolactin on quantitative ultrasound measurements of heel bone among schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Renn Jenn-Huei

    2010-02-01

    Full Text Available Abstract Background Osteoporosis is a bone disease that can reduce both bone mass and bone strength. It can cause serious fractures of bones, along with causing significant and even devastating physical, psychological and financial consequences for patients and their family members. Many reports have revealed that the prevalence of decreased bone density is higher in schizophrenic patients than in the non-psychological diseased population. The previous report of our group revealed that chronic schizophrenia patients have poorer BUA levels since they were young as compared to the general community population. Hyperprolactinemia and antipsychotics are reported to be among the risk factors for osteoporosis in chronic schizophrenic patients. Methods 93 schizophrenic patients with severely poor adjusted BUA values and 93 age and gender matched patients with normal adjusted BUA values from a previous survey study were selected. Data were collected via questionnaires and via reviews of antipsychotic medications. Blood samples were drawn, and serum levels of prolactin, estradiol, testosterone, magnesium, calcium, phosphate, osteocalcin, Cross-linked N-teleopeptide of type I collagen (NTX, thyroid hormone and parathyroid hormone were checked. The association between BUA levels and serum levels of the above items, along with the type of received antipsychotic medication, was evaluated. Results There was no significant association found between reduced BUA levels and serum prolactin, calcium, phosphate, osteocalcin, NTX, thyroid stimulating hormone and parathyroid hormone levels. There was also no association between BUA levels and types of currently received antipsychotics. There was no association between BUA levels and menstruation condition in female patients. Hypermagnesemia had a borderline association with classical and combined (classical and atypical antipsychotic medications in male patients. Nevertheless, hypermagnesemia is a significant

  4. Quantitative near-infrared spectroscopy on patients with peripheral vascular disease

    OpenAIRE

    Franceschini, MA; Fantini, S; Palumbo, R; Pasqualini, L; Vaudo, G; Franceschini, E; Gratton, E; Palumbo, B; Innocente, S; Mannarino, E

    1997-01-01

    We have used near-infrared spectroscopy to measure the hemoglobin saturation at rest and during exercise on patients affected by peripheral vascular disease (PVD). The instrument used in our study is a frequency-domain tissue oximeter which employs intensity modulated (110 MHz) laser diodes. We examined 9 subjects, 3 of which were controls and 6 were patients affected by stage II PVD. The optical probe was located on the calf muscle of the subjects. The measurement protocol consisted of: (1) ...

  5. Quantitative Analysis of Swallowing Function Between Dysphagia Patients and Healthy Subjects Using High-Resolution Manometry

    OpenAIRE

    Park, Chul-Hyun; Kim, Don-Kyu; Lee, Yong-Taek; Yi, Youbin; Lee, Jung-Sang; Kim, Kunwoo; Park, Jung Ho; Yoon, Kyung Jae

    2017-01-01

    Objective To compare swallowing function between healthy subjects and patients with pharyngeal dysphagia using high resolution manometry (HRM) and to evaluate the usefulness of HRM for detecting pharyngeal dysphagia. Methods Seventy-five patients with dysphagia and 28 healthy subjects were included in this study. Diagnosis of dysphagia was confirmed by a videofluoroscopy. HRM was performed to measure pressure and timing information at the velopharynx (VP), tongue base (TB), and upper esophage...

  6. Quantitative and Qualitative Changes of Bone in Psoriasis and Psoriatic Arthritis Patients.

    Science.gov (United States)

    Kocijan, Roland; Englbrecht, Matthias; Haschka, Judith; Simon, David; Kleyer, Arnd; Finzel, Stephanie; Kraus, Sebastian; Resch, Heinrich; Muschitz, Christian; Engelke, Klaus; Sticherling, Michael; Rech, Jürgen; Schett, Georg

    2015-10-01

    Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by periarticular bone loss and new bone formation. Current data regarding systemic bone loss and bone mineral density (BMD) in PsA are conflicting. The aim of this study was to evaluate bone microstructure and volumetric BMD (vBMD) in patients with PsA and psoriasis. We performed HR-pQCT scans at the ultradistal and periarticular radius in 50 PsA patients, 30 psoriasis patients, and 70 healthy, age- and sex-related controls assessing trabecular bone volume (BV/TV), trabecular number (Tb.N), inhomogeneity of the trabecular network, cortical thickness (Ct.Th), and cortical porosity (Ct.Po), as well as vBMD. Trabecular BMD (Tb.BMD, p = 0.021, 12.0%), BV/TV (p = 0.020, -11.9%), and Tb.N (p = 0.035, 7.1%) were significantly decreased at the ultradistal radius and the periarticular radius in PsA patients compared to controls. In contrast, bone architecture of the ultradistal radius and periarticular radius was similar in patients with psoriasis and healthy controls. Duration of skin disease was associated with low BV/TV and Tb.N in patients with PsA. These data suggest that trabecular BMD and bone microstructure are decreased in PsA patients. The observation that duration of skin disease determines bone loss in PsA supports the concept of subclinical musculoskeletal disease in psoriasis patients. © 2015 American Society for Bone and Mineral Research.

  7. Reduced Number of Pigmented Neurons in the Substantia Nigra of Dystonia Patients? Findings from Extensive Neuropathologic, Immunohistochemistry, and Quantitative Analyses

    Directory of Open Access Journals (Sweden)

    Diego Iacono

    2015-05-01

    Full Text Available Background: Dystonias (Dys represent the third most common movement disorder after essential tremor (ET and Parkinson's disease (PD. While some pathogenetic mechanisms and genetic causes of Dys have been identified, little is known about their neuropathologic features. Previous neuropathologic studies have reported generically defined neuronal loss in various cerebral regions of Dys brains, mostly in the basal ganglia (BG, and specifically in the substantia nigra (SN. Enlarged pigmented neurons in the SN of Dys patients with and without specific genetic mutations (e.g., GAG deletions in DYT1 dystonia have also been described. Whether or not Dys brains are associated with decreased numbers or other morphometric changes of specific neuronal types is unknown and has never been addressed with quantitative methodologies. Methods: Quantitative immunohistochemistry protocols were used to estimate neuronal counts and volumes of nigral pigmented neurons in 13 SN of Dys patients and 13 SN of age‐matched control subjects (C. Results: We observed a significant reduction (∼20% of pigmented neurons in the SN of Dys compared to C (p<0.01. Neither significant volumetric changes nor evident neurodegenerative signs were observed in the remaining pool of nigral pigmented neurons in Dys brains. These novel quantitative findings were confirmed after exclusion of possible co‐occurring SN pathologies including Lewy pathology, tau‐neurofibrillary tangles, β‐amyloid deposits, ubiquitin (ubiq, and phosphorylated‐TAR DNA‐binding protein 43 (pTDP43‐positive inclusions. Discussion: A reduced number of nigral pigmented neurons in the absence of evident neurodegenerative signs in Dys brains could indicate previously unconsidered pathogenetic mechanisms of Dys such as neurodevelopmental defects in the SN.

  8. Lymphoblastogenesis in response to phytohemagglutinin in radium patients: quantitative aspects and reproducibility

    International Nuclear Information System (INIS)

    Serio, C.S.; Henning, C.B.; Lloyd, E.L.

    1978-01-01

    Lymphocyte stimulation by different concentrations of phytohemmagglutinin (PHA) provided a profile of lymphocyte responsiveness in 5 normal subjects and 40 radium dial painters. This profile will, hopefully, improve detection of lymphocyte defects in patients with impairment of cellular immunity. When a suboptimal dose (0.15 μg PHA-protein) was used, decreased lymphocyte responsiveness was observed in patients with high body burdens of 226 Ra (> 0.1 μCi) compared with patients with low body burdens (< 0.1 μCi) and normal subjects. At all other PHA concentrations, the lymphocyte responsiveness was not significantly different in these three groups. A decrease in lymphocyte response was found with age in both normal controls and in the radium patients, but the decrease appeared to be somewhat greater in the radium patients above 50 years of age. To test the significance of these findings, larger numbers of control subjects in the higher age groups and low body burden radium patients known not to be on any type of medication will have to be examined

  9. Quantitative Sensory Testing and Current Perception Threshold Testing in Patients With Chronic Pain Following Lower Extremity Fracture.

    Science.gov (United States)

    Griffioen, Mari A; Greenspan, Joel D; Johantgen, Meg; Von Rueden, Kathryn; O'Toole, Robert V; Dorsey, Susan G; Renn, Cynthia L

    2018-01-01

    Chronic pain is a significant problem for patients with lower extremity injuries. While pain hypersensitivity has been identified in many chronic pain conditions, it is not known whether patients with chronic pain following lower extremity fracture report pain hypersensitivity in the injured leg. To quantify and compare peripheral somatosensory function and sensory nerve activation thresholds in persons with chronic pain following lower extremity fractures with a cohort of persons with no history of lower extremity fractures. This was a cross-sectional study where quantitative sensory testing and current perception threshold testing were conducted on the injured and noninjured legs of cases and both legs of controls. A total of 14 cases and 28 controls participated in the study. Mean time since injury at the time of testing for cases was 22.3 (standard deviation = 12.1) months. The warmth detection threshold ( p = .024) and nerve activation thresholds at 2,000 Hz ( p testing and current perception threshold testing.

  10. Bone Structure and Estimated Bone Strength in Obese Patients Evaluated by High-Resolution Peripheral Quantitative Computed Tomography

    DEFF Research Database (Denmark)

    Andersen, Stine; Frederiksen, Katrine Diemer; Hansen, Stinus

    2014-01-01

    Obesity is associated with high bone mineral density (BMD), but whether obesity-related higher bone mass increases bone strength and thereby protect against fractures is uncertain. We estimated effects of obesity on bone microarchitecture and estimated strength in 36 patients (12 males and 24...... females, age 25-56 years and BMI 33.2-57.6 kg/m(2)) matched with healthy controls (age 25-54 years and BMI 19.5-24.8 kg/m(2)) in regard to gender, menopausal status, age (±6 years) and height (±6 cm) using high resolution peripheral quantitative computed tomography and dual energy X-ray absorptiometry...... patients compared with controls in radius and tibia with higher trabecular number (p = 0.002 and p estimated failure load (FL) was higher in tibia (p

  11. Digital X-ray radiogrammetry better identifies osteoarthritis patients with a low bone mineral density than quantitative ultrasound

    International Nuclear Information System (INIS)

    Goerres, Gerhard W.; Frey, Diana; Studer, Annina; Hauser, Dagmar; Zilic, Nathalie; Hany, Thomas F.; Seifert, Burkhardt; Haeuselmann, Hans J.; Michel, Beat A.; Uebelhart, Daniel; Hans, Didier

    2007-01-01

    This study assessed the ability of quantitative ultrasound (QUS) and digital X-ray radiogrammetry (DXR) to identify osteopenia and osteoporosis in patients with knee osteoarthritis (OA). One hundred and sixty-one patients with painful knee OA (81 men, 80 women; age 62.6±9.2 years, range 40-82 years) were included in this cross-sectional study and underwent dual-energy X-ray absorptiometry (DXA) of both hips and the lumbar spine, QUS of the phalanges and calcanei of both hands and heels, and DXR using radiographs of both hands. Unpaired t-test, Mann-Whitney U test, ROC analysis and Spearman's rank correlation were used for comparisons and correlation of methods. Using DXA as the reference standard, we defined a low bone mineral density (BMD) as a T-score ≤-1.0 at the lumbar spine or proximal femur. In contrast to phalangeal or calcaneal QUS, DXR was able to discriminate patients with a low BMD at the lumbar spine (p<0.0001) or hips (p<0.0001). ROC analysis showed that DXR had an acceptable predictive power in identifying OA patients a low hip BMD (sensitivity 70%, specificity 71%). Therefore, DXR used as a screening tool could help in identifying patients with knee OA for DXA. (orig.)

  12. Quantitative changes in flow density in patients with adult-onset foveomacular vitelliform dystrophy: an OCT angiography study.

    Science.gov (United States)

    Treder, Maximilian; Lauermann, Jost Lennart; Alnawaiseh, Maged; Heiduschka, Peter; Eter, Nicole

    2018-01-01

    To quantitatively compare the flow density, the retinal thickness, and the area of the foveal avascular zone (FAZ) between patients with adult-onset foveomacular vitelliform dystrophy (AOFVD) and a healthy controls. Thirteen eyes (eight patients) with AOFVD and 13 matched eyes (13 patients) without any ocular pathology were included in this study. A 6 × 6 mm optical coherence tomography angiography (OCTA) scan was performed for every included eye. The flow density (superficial retinal vascular layer, deep retinal vascular layer and choriocapillary layer), retinal thickness and FAZ (superficial retinal vascular layer and deep retinal vascular layer) were subsequently analyzed. The mean flow density was decreased in the AOFVD patients in all measured vascular layers. The difference from the control group was statistically significant in the parafoveal sector of the deep retinal vascular layer (P = 0.02), and a clear trend was found in the superficial retinal vascular layer (P = 0.05). Both groups had comparable FAZs in the superficial and deep retinal vascular layers. The retinal thickness values were higher in the fovea (P = 0.840) and lower in the parafoveal sectors (P = 0.125). The difference was significant in the superior parafoveal sector (P = 0.034). Flow densities as measured by OCTA are decreased in the superficial retinal vascular layer and the deep retinal vascular layer in patients with AOFVD. These findings could be helpful for diagnosing and understanding the pathogenesis of this disease.

  13. Quantitation of cell-associated borrelial DNA in the blood of Lyme disease patients with erythema migrans.

    Science.gov (United States)

    Liveris, D; Schwartz, I; McKenna, D; Nowakowski, J; Nadelman, R B; DeMarco, J; Iyer, R; Cox, M E; Holmgren, D; Wormser, G P

    2012-05-01

    Bloodstream invasion is an important event in the pathogenesis of the more serious manifestations of Lyme disease. The number of spirochetes in the blood of infected patients, however, has not been determined, and, therefore, it is unknown whether the number of spirochetes can be correlated with particular clinical or laboratory features. This study was designed to measure the level of Borrelia burgdorferi in the plasma of Lyme disease patients and correlate these levels with selected clinical and laboratory findings. Nested and quantitative polymerase chain reaction (qPCR) was employed to detect cell-associated flaB gene DNA in the plasma of untreated early Lyme disease patients with erythema migrans (EM). Twenty-nine (45.3%) of 64 patients had evidence of B. burgdorferi in their plasma by at least one of the PCR methods. For the 22 qPCR-positive patients, the mean number of flaB gene copies per mL of plasma was 4,660, with a range of 414 to 56,000. The number of flaB gene copies did not significantly correlate with any of the clinical, demographic, or laboratory variables assessed. For reasons discussed, we suggest caution in extrapolating an estimate of the number of viable Borrelia in plasma from the observed number of flaB copies.

  14. Assessment of Nutritional Status of Nepalese Hemodialysis Patients by Anthropometric Examinations and Modified Quantitative Subjective Global Assessment.

    Science.gov (United States)

    Sedhain, Arun; Hada, Rajani; Agrawal, Rajendra Kumar; Bhattarai, Gandhi R; Baral, Anil

    2015-01-01

    To assess the nutritional status of patients on maintenance hemodialysis by using modified quantitative subjective global assessment (MQSGA) and anthropometric measurements. We Conducted a cross sectional descriptive analytical study to assess the nutritional status of fifty four patients with chronic kidney disease undergoing maintenance hemodialysis by using MQSGA and different anthropometric and laboratory measurements like body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), triceps skin fold (TSF) and biceps skin fold (BSF), serum albumin, C-reactive protein (CRP) and lipid profile in a government tertiary hospital at Kathmandu, Nepal. Based on MQSGA criteria, 66.7% of the patients suffered from mild to moderate malnutrition and 33.3% were well nourished. None of the patients were severely malnourished. CRP was positive in 56.3% patients. Serum albumin, MAC and BMI were (mean + SD) 4.0 + 0.3 mg/dl, 22 + 2.6 cm and 19.6 ± 3.2 kg/m(2) respectively. MQSGA showed negative correlation with MAC (r = -0.563; P = hemodialysis. Anthropometric measurements like BMI, MAC, MAMC, BSF and TSF were negatively correlated with MQSGA. Anthropometric and laboratory assessment tools could be used for nutritional assessment as they are relatively easier, cheaper and practical markers of nutritional status.

  15. Digital X-ray radiogrammetry better identifies osteoarthritis patients with a low bone mineral density than quantitative ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Goerres, Gerhard W. [University Hospital Zurich, Institute of Diagnostic Radiology, Department of Medical Radiology, Zurich (Switzerland); University Hospital Zurich, Osteoporosis Center, Zurich (Switzerland); Frey, Diana; Studer, Annina; Hauser, Dagmar; Zilic, Nathalie [University Hospital Zurich, Osteoporosis Center, Zurich (Switzerland); Hany, Thomas F. [University Hospital Zurich, Institute of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland); Haeuselmann, Hans J. [Center for Rheumatology and Bone Disease, Klinik im Park, Zurich (Switzerland); Michel, Beat A.; Uebelhart, Daniel [University Hospital Zurich, Osteoporosis Center, Zurich (Switzerland); University Hospital Zurich, Department of Rheumatology and Institute of Physical Medicine, Zurich (Switzerland); Hans, Didier [University Hospital Geneva, Division of Nuclear Medicine, Geneva (Switzerland)

    2007-04-15

    This study assessed the ability of quantitative ultrasound (QUS) and digital X-ray radiogrammetry (DXR) to identify osteopenia and osteoporosis in patients with knee osteoarthritis (OA). One hundred and sixty-one patients with painful knee OA (81 men, 80 women; age 62.6{+-}9.2 years, range 40-82 years) were included in this cross-sectional study and underwent dual-energy X-ray absorptiometry (DXA) of both hips and the lumbar spine, QUS of the phalanges and calcanei of both hands and heels, and DXR using radiographs of both hands. Unpaired t-test, Mann-Whitney U test, ROC analysis and Spearman's rank correlation were used for comparisons and correlation of methods. Using DXA as the reference standard, we defined a low bone mineral density (BMD) as a T-score {<=}-1.0 at the lumbar spine or proximal femur. In contrast to phalangeal or calcaneal QUS, DXR was able to discriminate patients with a low BMD at the lumbar spine (p<0.0001) or hips (p<0.0001). ROC analysis showed that DXR had an acceptable predictive power in identifying OA patients a low hip BMD (sensitivity 70%, specificity 71%). Therefore, DXR used as a screening tool could help in identifying patients with knee OA for DXA. (orig.)

  16. Quantitative assessment of pulmonary regurgitation in patients with and without right ventricular tract obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Spiewak, Mateusz, E-mail: mspiewak@ikard.pl [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Biernacka, Elzbieta K., E-mail: kbiernacka@ikard.pl [Department of Congenital Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Malek, Lukasz A., E-mail: lmalek@ikard.pl [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Department of Interventional Cardiology and Angiology, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Misko, Jolanta, E-mail: jmisko@wp.pl [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Department of Radiology, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Kowalski, Miroslaw, E-mail: mkowalski@ikard.pl [Department of Congenital Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Milosz, Barbara, E-mail: barbara-milosz@o2.pl [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Department of Radiology, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Petryka, Joanna, E-mail: joannapetryka@hotmail.com [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Zabicka, Magdalena, E-mail: mzabicka@onet.eu [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Dept. of Radiology, Inst. of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland); Ruzyllo, Witold, E-mail: wruzyllo@ikard.pl [Inst. of Cardiology, ul. Alpejska 42, 04-628 Warsaw (Poland)

    2011-11-15

    Background: There are concerns whether there is a difference in clinical utility of pulmonary regurgitation (PR) fraction (PRF) and PR volume (PRV) in subgroups of patients with isolated PR and individuals with combined PR and right ventricular outflow tract obstruction (RVOTO). The aim of the study was to compare PRF and PRV in patients with or without RVOTO. Methods and results: 82 consecutive patients after repair of tetralogy of Fallot (TOF) who underwent cardiovascular magnetic resonance and echocardiography were studied. There was no difference in PRF between patients with moderate and severe right ventricular (RV) dilatation (32 {+-} 13% vs. 37 {+-} 12%; p = 0.18). Significant difference in PRV was observed between these groups (23 {+-} 10 ml/m{sup 2} vs. 31 {+-} 12 ml/m{sup 2}, respectively; p = 0.02). PRV had better ability than PRF in identification of severe RV dilatation, both in group with RVOTO [area under the curve (AUC) 0.82 vs. 0.72, p = 0.005] and in patients without RVOTO (AUC 0.83 vs. 0.77, p = 0.04). A strong correlation was seen between PRF and PRV both in patients with and without RVOTO [r = 0.93, p < 0.0001 and r = 0.92, p < 0.0001, respectively]. In both subgroups high variability of PRF was found in subjects with similar degree of PRV. Conclusions: PRV shows better ability than PRF in evaluating influence of PR on RV in patients after TOF repair, both in population with and without concomitant RVOTO.

  17. Quantitative assessment of pulmonary regurgitation in patients with and without right ventricular tract obstruction

    International Nuclear Information System (INIS)

    Spiewak, Mateusz; Biernacka, Elzbieta K.; Malek, Lukasz A.; Misko, Jolanta; Kowalski, Miroslaw; Milosz, Barbara; Petryka, Joanna; Zabicka, Magdalena; Ruzyllo, Witold

    2011-01-01

    Background: There are concerns whether there is a difference in clinical utility of pulmonary regurgitation (PR) fraction (PRF) and PR volume (PRV) in subgroups of patients with isolated PR and individuals with combined PR and right ventricular outflow tract obstruction (RVOTO). The aim of the study was to compare PRF and PRV in patients with or without RVOTO. Methods and results: 82 consecutive patients after repair of tetralogy of Fallot (TOF) who underwent cardiovascular magnetic resonance and echocardiography were studied. There was no difference in PRF between patients with moderate and severe right ventricular (RV) dilatation (32 ± 13% vs. 37 ± 12%; p = 0.18). Significant difference in PRV was observed between these groups (23 ± 10 ml/m 2 vs. 31 ± 12 ml/m 2 , respectively; p = 0.02). PRV had better ability than PRF in identification of severe RV dilatation, both in group with RVOTO [area under the curve (AUC) 0.82 vs. 0.72, p = 0.005] and in patients without RVOTO (AUC 0.83 vs. 0.77, p = 0.04). A strong correlation was seen between PRF and PRV both in patients with and without RVOTO [r = 0.93, p < 0.0001 and r = 0.92, p < 0.0001, respectively]. In both subgroups high variability of PRF was found in subjects with similar degree of PRV. Conclusions: PRV shows better ability than PRF in evaluating influence of PR on RV in patients after TOF repair, both in population with and without concomitant RVOTO.

  18. Gait characteristics of post-poliomyelitis patients: standardization of quantitative data reporting.

    Science.gov (United States)

    Portnoy, S; Schwartz, I

    2013-10-01

    To evaluate the differences in gait characteristics and gait symmetry of post-polio syndrome (PPS) patients ambulating with or without shoes and between subgroups walking with different walking aids and orthoses, study the correlation of these data with personal data, illness condition, physical health, frequency of using aids and orthotics and frequency of falls, and derive recommendations for standardization of reporting these data. Twenty-six PPS subjects ambulated with their own walking devices. We calculated spatio-temporal parameters and symmetry indices (SI) of gait using a data acquired by a motion capture system. We compared inter-subject differences in gait pattern for PPS groups that differed by questionnaire-obtained data of demographics, physical activity, polio history, falls and walking aids. Additional inter-subject comparisons were performed between normal subjects (n=16), PPS patients walking with shoes with/without an ankle-foot-orthosis (n=11), PPS patients walking with knee-ankle-foot-orthosis (n=5), and PPS patients walking with a walker/crutches (n=10). We also compared intra-subject variability in PPS subjects who were able to repeat the trials barefoot. Our main results show that subjects who reported participating in physical activity twice a week or more had significantly better step time and double support symmetry. Subjects who use walking aids on a daily basis had significantly higher gait cadence and shorter stride time. Also, subjects that do not require knee-ankle-foot orthoses and/or walking aids walked with a smaller base width and better symmetry in stance and swing durations than PPS subjects who require these aids. The gait pattern of PPS patients is related to numerous intrinsic and extrinsic factors. Standardization of the reporting protocol of gait-related data of PPS patients is crucial for patient evaluation and treatment design. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Complement in patients receiving maintenance hemodialysis: functional screening and quantitative analysis

    Directory of Open Access Journals (Sweden)

    Horikoshi Satoshi

    2010-12-01

    Full Text Available Abstract Background The complement system is vital for innate immunity and is implicated in the pathogenesis of inflammatory diseases and the mechanism of host defense. Complement deficiencies occasionally cause life-threatening diseases. In hemodialysis (HD patients, profiles on complement functional activity and deficiency are still obscure. The objectives of the present study were to measure the functional complement activities of the classical pathway (CP, lectin pathway (LP and alternative pathway (AP using a novel method and consequently to elucidate the rates of deficiencies among HD patients. Methods In the present study, 244 HD patients at one dialysis center and 204 healthy controls were enrolled. Functional complement activities were measured simultaneously using the Wielisa®-kit. The combination of the results of these three pathway activities allows us to speculate which candidate complement is deficient; subsequently, the deficient complement was determined. Results All three functional complement activities were significantly higher in the HD patients than in the control group (P ®-kit, 16 sera (8.8% with mannose-binding lectin (MBL deficiency, 1 serum (0.4% with C4 deficiency, 1 serum (0.4% with C9 deficiency, and 1 serum (0.4% with B deficiency were observed in the HD group, and 18 sera (8.8% with MBL deficiency and 1 serum (0.5% with B deficiency were observed in the control group. There were no significant differences in the 5-year mortality rate between each complement-deficient group and the complement-sufficient group among the HD patients. Conclusion This is the first report that profiles complement deficiencies by simultaneous measurement of functional activities of the three complement pathways in HD patients. Hemodialysis patients frequently suffer from infections or malignancies, but functional complement deficiencies do not confer additional risk of mortality.

  20. How patients use access to their electronic GP record--a quantitative study.

    Science.gov (United States)

    Bhavnani, Vanita; Fisher, Brian; Winfield, Marlene; Seed, Paul

    2011-04-01

    Record access is likely to become an integral part of routine care in the UK. While existing research suggests that record access improves self-care and improves relationships between patients and clinicians, little is known about how patients make use of their ability to access their records or the impact that this has on health behaviour. To explore patients' use of access to their electronic GP record and the impact of that process on their health behaviour. Self-administered postal questionnaire mailed from three general practice surgeries to patients registered to use PAERS record access system. Data were analysed using SPSS. Content analysis was used to analyse free-text responses. Two hundred and thirty-one of 610 patients responded. Frequent users of Record Access were those in poor health. Record access was used to look at test results and to read letters from those involved in health care. Forty-two per cent reported a positive impact on following medication advice and 64% a positive impact on following lifestyle advice. Just over half the sample felt accessing records prior to appointments saved time and wanted to share records with other health care providers. Approximately a third reported difficulties with understanding their records. Record access appears to have a number of positive outcomes and very few negative ones, although further work is needed to confirm this. It is used by patients to help practices improve efficiency and to improve compliance. It has the potential to promote and reinforce collaborative relationships between clinicians and patients.

  1. Quantitative Analysis of Serum Lipid Profile in Gallstone Patients and Controls

    International Nuclear Information System (INIS)

    Channa, N.A.; Ghanghro, A.B.; Soomro, A.M.

    2010-01-01

    The present study was undertaken to explore the possible role of serum lipid profile in gallstone formation. For this serum lipid profile such as total, free and bound cholesterol, LDL cholesterol, HDL cholesterol, triacylglycerols and total lipids were determined in 109 gallstone patients and 100 controls (matched for age, sex and with negative personal or family history of gallstones) treated at Liaquat University Hospital, Jamshoro, Pakistan. Comparison for serum lipid profile between different groups of gallstone patients and controls revealed no significant variation except for the triacylglycerols and total lipids, which were differed significantly between females of up to 45 and above 45 years age. Comparison for serum lipid profile between pure cholesterol and mixed composition gallstone formers showed no significant difference (p>0.05) between the two groups. The serum lipid profile significantly varied between gallstone patients and controls except bound cholesterol level. Comparison of total cholesterol, free cholesterol, LDL cholesterol, HDL cholesterol, triacylglycerols and total lipids between gallstone patients and controls revealed that there was a significant difference between gallstone patients and controls for (a) females with or without gallstones, (b) females of up to 45 years age and (c) females having more than 3 children. HDL cholesterol is significantly decreased in all the groups of gallstone patients as compared to controls, whereas, bound cholesterol remained non significant in all the groups of gallstone patients when compared with controls. In conclusion, elevated serum total cholesterol, free cholesterol, LDL cholesterol, triacylglycerols and decreased levels of HDL cholesterol seem to play major contributing role in the pathogenesis of gallstones in females of up to 45 years age with more than three children. (author)

  2. [The effects of art therapy on the somatic and emotional situation of the patients--a quantitative and qualitative analysis].

    Science.gov (United States)

    Plecity, Daniel M; Danner-Weinberger, Alexandra; Szkura, Lubow; von Wietersheim, Jörn

    2009-01-01

    In this pilot study, changes in the patients' current mood during art therapy sessions in a psychosomatic day hospital as well as the meaning of the pictures generated during art therapy are assessed. The sample consisted of 26 patients. The average participant had 16 sessions of art therapy, which was conducted in a group setting. To measure their mood and somatic symptoms, patients were given standardized questionnaires (B-L and ASTS, a German modification of POMS) at the beginning and the end of every art therapy session. In addition, 15 patients were interviewed about the pictures they had created during the art therapy sessions (104 interviews in total). The quantitative evaluations showed a statistically significant reduction in somatic symptoms and a tendency to be in a more positive mood during the course of the day treatment. However, there were no significant differences from the beginning to the end of every therapy session. The evaluation of the interviews showed that the paintings mainly dealt with the patients' own (current, problematic) issues. The colours that were chosen for the painting were particularly important to most patients, and often there is no connection to paintings created during the previous sessions. The patients' problems are often depicted in a symbolic manner. Subjectively, the patients felt better after the art therapy session. They indicated that they mostly use art therapy as a way to express their problems, and only very few also named other goals of art therapy, such as creativity or relaxation. Georg Thieme Verlag KG Stuttgart-New York.

  3. Dosimetry for quantitative analysis of low dose ionizing radiation effects on humans in radiation therapy patients

    Energy Technology Data Exchange (ETDEWEB)

    Lehmann, J; Stern, R L; Daly, T P; Schwieter, C W; Jones, G E; Arnold, M L; Hartmann-Siantar, C L; Goldberg, Z

    2004-04-20

    We have successfully developed a practical approach to predicting the location of skin surface dose at potential biopsy sites that receive 1 cGy and 10 cGy, respectively, in support of in vivo biologic dosimetry in humans. This represents a significant technical challenge as the sites lie on the patient surface out side the radiation fields. The PEREGRINE Monte Carlo simulation system was used to model radiation dose delivery and TLDs were used for validation on a phantom and confirmation during patient treatment. In the developmental studies the Monte Carlo simulations consistently underestimated the dose at the biopsy site by approximately 15% for a realistic treatment configuration, most likely due to lack of detail in the simulation of the linear accelerator outside the main beam line. Using a single, thickness-independent correction factor for the clinical calculations, the average of 36 measurements for the predicted 1 cGy point was 0.985 cGy (standard deviation: 0.110 cGy) despite patient breathing motion and other real world challenges. Since the 10 cGy point is situated in the region of high dose gradient at the edge of the field, patient motion had a greater effect and the six measured points averaged 5.90 cGy (standard deviation: 1.01 cGy), a difference that is equivalent to approximately a 6 mm shift on the patient's surface.

  4. Quantitative assessment of S. mutans and C. albicans in patients with Haas and Hyrax expanders

    Directory of Open Access Journals (Sweden)

    Matheus Melo Pithon

    2012-06-01

    Full Text Available OBJECTIVE: To assess and compare the number of Streptococcus mutans and Candida albicans colonies in patients with Haas and Hyrax appliances before and after insertion. METHODS: The sample consisted of 84 patients requiring orthodontic treatment. For all patients a midpalatal suture expansion was indicated. Patients were randomly divided into Group HA, who used the Haas appliance (n = 42 and Group HY, who used the Hyrax appliance (n = 42. Initially and thirty days after appliance insertion all patients were submitted to saliva collections. The saliva was diluted followed by seeding in Mitis Salivarius and CHROMagar media, for growth of S. mutans and C. albicans respectively. RESULTS: Results showed statistically significant difference between groups HA and HY for Streptococcus mutans and Candida albicans (p <0.05. Haas appliance promoted greater S. mutans and C. albicans proliferation when compared to Hyrax appliance. CONCLUSION: The Haas appliance favored greater proliferation of S. mutans and C. albicans when compared with the Hyrax appliance. Insertion of the appliances resulted in greater buildup of microorganisms.

  5. Dual core quantum dots for highly quantitative ratiometric detection of trypsin activity in cystic fibrosis patients

    Science.gov (United States)

    Castelló Serrano, Iván; Stoica, Georgiana; Matas Adams, Alba; Palomares, Emilio

    2014-10-01

    We present herein two colour encoded silica nanospheres (2nanoSi) for the fluorescence quantitative ratiometric determination of trypsin in humans. Current detection methods for cystic fibrosis diagnosis are slow, costly and suffer from false positives. The 2nanoSi proved to be a highly sensitive, fast (minutes), and single-step approach nanosensor for the screening and diagnosis of cystic fibrosis, allowing the quantification of trypsin concentrations in a wide range relevant for clinical applications (25-350 μg L-1). Furthermore, as trypsin is directly related to the development of cystic fibrosis (CF), different human genotypes, i.e. CF homozygotic, CF heterozygotic, and unaffected, respectively, can be determined using our 2nanoSi nanospheres. We anticipate the 2nanoSi system to be a starting point for non-invasive, easy-to-use and cost effective ratiometric fluorescent biomarkers for recessive genetic diseases like human cystic fibrosis. In a screening program in which the goal is to detect disease and also the carrier status, early diagnosis could be of great help.We present herein two colour encoded silica nanospheres (2nanoSi) for the fluorescence quantitative ratiometric determination of trypsin in humans. Current detection methods for cystic fibrosis diagnosis are slow, costly and suffer from false positives. The 2nanoSi proved to be a highly sensitive, fast (minutes), and single-step approach nanosensor for the screening and diagnosis of cystic fibrosis, allowing the quantification of trypsin concentrations in a wide range relevant for clinical applications (25-350 μg L-1). Furthermore, as trypsin is directly related to the development of cystic fibrosis (CF), different human genotypes, i.e. CF homozygotic, CF heterozygotic, and unaffected, respectively, can be determined using our 2nanoSi nanospheres. We anticipate the 2nanoSi system to be a starting point for non-invasive, easy-to-use and cost effective ratiometric fluorescent biomarkers for

  6. Bone age estimation and prediction of final height in patients with {beta}-thalassaemia major: a comparison between the two most common methods

    Energy Technology Data Exchange (ETDEWEB)

    Christoforidis, Athanasios; Katzos, George; Athanassiou-Metaxa, Miranda [Aristotle University of Thessaloniki, 1st Paediatric Department, Thessaloniki (Greece); Badouraki, Maria [Ippokratio Hospital, Paediatric Radiology Department, Thessaloniki (Greece)

    2007-12-15

    Thalassaemic patients are in need of frequent assessment of bone age because of growth failure and pubertal disorders. To compare the ''rapid'' Greulich and Pyle (G and P) method with the third edition of the Tanner and Whitehouse (TW3) method for determining skeletal maturity and predicting final height in thalassaemic patients. A total of 191 radiographs from 58 patients (28 male, 30 female) were retrospectively evaluated by two investigators, one for each method. In 47 radiographs from 15 patients having attained their adult height, predicted final height was calculated according to each method. The mean bone ages determined by both the G and P and TW3 methods were lower than mean chronological age, although the differences were not statistically significant (10.04 {+-} 3.69 years and 9.98 {+-} 3.39 years vs. 10.78 {+-} 3.96 years, respectively). Both methods had a tendency to over-estimate final height. Overall, the TW3 method seemed to be more accurate than the G and P method (mean absolute error 3.21 {+-} 2.51 years vs. 3.99 {+-} 2.99 years, respectively, P=0.048). The same method should be used when serial assessments are performed, as both methods provide similarly reliable, although not equivalent, results. The TW3 height prediction method seemed to be more accurate in patients with {beta}-thalassaemia major than the G and P method, albeit with a large confidence interval. (orig.)

  7. Quantitative near-infrared spectroscopy on patients with peripheral vascular disease

    Science.gov (United States)

    Franceschini, Maria-Angela; Fantini, Sergio; Palumbo, Renato; Pasqualini, Leonella; Vaudo, Gaetano; Franceschini, Edoardo; Gratton, Enrico; Palumbo, Barbara; Innocente, Salvatore; Mannarino, Elmo

    1998-01-01

    We have used near-infrared spectroscopy to measure the hemoglobin saturation at rest and during exercise on patients affected by peripheral vascular disease (PVD). The instrument used in our study is a frequency-domain tissue oximeter which employs intensity modulated (110 MHz) laser diodes. We examined 9 subjects, 3 of which were controls and 6 were patients affected by stage II PVD. The optical probe was located on the calf muscle of the subjects. The measurement protocol consisted of: (1) baseline (approximately 5 min); (2) stationary bicycle exercise (approximately 5 min); (3) recovery (approximately 15 min). The change in hemoglobin saturation during exercise ((Delta) Y) and the recovery time after exercise (trec) were significantly greater in the PVD patients ((Delta) Y equals -21 +/- 3%, trec equals 5.9 +/- 3.8 min) than in the control subjects ((Delta) Y equals 2 +/- 3%, trec equals 0.6 +/- 0.1 min).

  8. Quantitative magnetic resonance imaging study on patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Senzaki, Akira; Okubo, Yoshiro; Matsuura, Masato; Toru, Michio; Abe, Tetsuo; Asai, Kunihiko; Moriiwa, Motoi.

    1993-01-01

    In 30 patients with temporal lobe epilepsy who had no visual abnormality on either CT or MRI, cerebral changes especially in the mesial temporal region were examined. The findings were compared with those in 20 normal volunteers. In epileptic patients, the mesial temporal region was significantly smaller and T1-weighted values in this region were significantly higher, as compared with the controls. In the group of epilepsy, atrophy especially in the hippocampal and tonsillar regions and increased water content were suggested. Regarding the bilateral difference in the size of the mesial temporal region, there was no significant difference between the group of epilepsy and the control group. The group of epilepsy seemed to have bilateral changes in the mesial temporal region. In 9 patients with the present or past history of organic delusional (schizophrenia-like) disorder, the coronal section of the third ventricle was significantly large, suggesting the likelihood of structural changes surrounding the third ventricle. (N.K.)

  9. Assessing the Financial Value of Patient Engagement: A Quantitative Approach from CTTI's Patient Groups and Clinical Trials Project.

    Science.gov (United States)

    Levitan, Bennett; Getz, Kenneth; Eisenstein, Eric L; Goldberg, Michelle; Harker, Matthew; Hesterlee, Sharon; Patrick-Lake, Bray; Roberts, Jamie N; DiMasi, Joseph

    2018-03-01

    While patient groups, regulators, and sponsors are increasingly considering engaging with patients in the design and conduct of clinical development programs, sponsors are often reluctant to go beyond pilot programs because of uncertainty in the return on investment. We developed an approach to estimate the financial value of patient engagement. Expected net present value (ENPV) is a common technique that integrates the key business drivers of cost, time, revenue, and risk into a summary metric for project strategy and portfolio decisions. We assessed the impact of patient engagement on ENPV for a typical oncology development program entering phase 2 or phase 3. For a pre-phase 2 project, the cumulative impact of a patient engagement activity that avoids one protocol amendment and improves enrollment, adherence, and retention is an increase in net present value (NPV) of $62MM ($65MM for pre-phase 3) and an increase in ENPV of $35MM ($75MM for pre-phase 3). Compared with an investment of $100,000 in patient engagement, the NPV and ENPV increases can exceed 500-fold the investment. This ENPV increase is the equivalent of accelerating a pre-phase 2 product launch by 2½ years (1½ years for pre-phase 3). Risk-adjusted financial models can assess the impact of patient engagement. A combination of empirical data and subjective parameter estimates shows that engagement activities with the potential to avoid protocol amendments and/or improve enrollment, adherence, and retention may add considerable financial value. This approach can help sponsors assess patient engagement investment decisions.

  10. Quantitative muscle hardness as a noninvasive means for detecting patients at risk of compartment syndromes

    International Nuclear Information System (INIS)

    Steinberg, Bruce; Riel, Ryan; Armitage, Marshal; Berrey, Hudson

    2011-01-01

    The purpose of this project was to study the efficacy of quantitative muscle hardness (QH) curve analysis for noninvasive measurement of muscle compartment interstitial pressure (IMP), and to eliminate the need for a comparison normal QH measurement to determine a pathologic reading. Elevation of IMP may lead to limb compartment syndrome, which may result in irreversible dysfunction, chronic pain and contracture. Two studies were performed by two separate independent examiners on male volunteers, where IMP measurements and QH curves were obtained. QH curves were divided into three parts comparing the third part to the second part using the coefficient of determination (R 2 ). In 205 limb compartments, there were 1432 comparison readings of the IMP versus R 2 . Using receiver operator characteristic curve analysis for all data from both studies, an R 2 cutoff of 0.974 best corresponded to a pathologic IMP of 50 mmHg. For both sets of data and for each compartment tested, the mean IMP values were statistically different (t-test: P < 0.0001) for the group with R 2 values less than 0.974 compared to the group of R 2 values greater than or equal to 0.974. In addition, a pressure prediction model was formulated with a strong overall correlation coefficient of 0.78. The data of this study support that QH analysis is potentially useful for the monitoring of IMP elevation in compartment syndrome

  11. Quantitative multichannel EEG measure predicting the optimal weaning from ventilator in ICU patients with acute respiratory failure.

    Science.gov (United States)

    Papadelis, Christos; Maglaveras, Nikos; Kourtidou-Papadeli, Chrysoula; Bamidis, Panagiotis; Albani, Maria; Chatzinikolaou, Kyriazis; Pappas, Konstantinos

    2006-04-01

    The objective of this study was to develop a novel quantitative multichannel EEG (qEEG) based analysis method, called Global Field Damping Time (GFDT), in order to detect potential EEG changes of patients admitted to the ICU with acute respiratory failure, and correlate them to the patients' recovery outcome predicting the optimal time-point to disconnect the patient from mechanical ventilation. Twenty-nine adult patients with acute respiratory failure out of 98 admitted to the Intensive Care Unit of Saint Paul General Hospital were enrolled, and among them only 15 completed the study. The patients were classified in 3 groups according to their outcome after 3 months follow-up. The patients were intubated with fraction of inspired oxygen (FiO2) of 100%. Neurological Deficit Scores (NDS) were measured 24 h after intubation to assess patients' neurological condition. Twenty-four hours after patient's intubation, FiO2 was decreased to 40% (weaning session), followed by a 5 min early recovery session, a 5 min recovery 1 session and a 5 min recovery 2 session. EEG recordings were performed during this experimental procedure. Multichannel EEG segments were processed and fitted into a multivariate autoregressive (mAR) model, and single channel EEG segments into a scalar autoregressive (sAR) model. The mAR and the sAR models of arbitrary order p were decomposed into mp and p oscillators and relaxators, respectively. Damping time of each oscillator and each relaxator, and the Global Field Damping Time (GFDT) as a weighted damping time were estimated for both mAR and sAR models. A statistically significant increase of mAR model's GFDT during the weaning session was observed in the subjects of all groups. Comparing the 3 patients' groups, statistically significant differences for mAR model's GFDT were observed for the weaning and early recovery session. Linear regression analysis between NDS and mean mAR model's GFDT showed statistical significance during weaning session

  12. FUNGAL SPECIATION USING QUANTITATIVE POLYMERASE CHAIN REACTION (QPCR) IN PATIENTS WITH AND WITHOUT CHRONIC RHINOSINUSITIS

    Science.gov (United States)

    Objectives/Hypothesis: 1. to determine the mycology of the middle meatus using an endoscopically guided brush sampling technique and polymerase chain reaction laboratory processing of nasal mucous. 2. To compare the mycology of the middle meatus in patients with sinus disease to...

  13. Genesis of the professional-patient relationship in early practical experience: qualitative and quantitative study

    NARCIS (Netherlands)

    Scavenius, Michael; Schmidt, Sonja; Klazinga, Niek

    2006-01-01

    CONTEXT: As a rule, undergraduate medical students experience everyday work in health care as spectators. They are not allowed to participate in real-life interaction between professionals and patients. We report on an exception to this rule. OBJECTIVES: The aim of this study was to examine

  14. Quantitative evaluation of capillaroscopic microvascular changes in patients with established coronary heart disease.

    Science.gov (United States)

    Sanchez-Garcia, M Esther; Ramirez-Lara, Irene; Gomez-Delgado, Francisco; Yubero-Serrano, Elena M; Leon-Acuña, Ana; Marin, Carmen; Alcala-Diaz, Juan F; Camargo, Antonio; Lopez-Moreno, Javier; Perez-Martinez, Pablo; Tinahones, Francisco José; Ordovas, Jose M; Caballero, Javier; Blanco-Molina, Angeles; Lopez-Miranda, Jose; Delgado-Lista, Javier

    2018-02-23

    Microcirculation disturbances have been associated to most of the cardiovascular risk factors as well as to multiple inflammatory diseases. However, whether these abnormalities are specifically augmented in patients with coronary heart disease is still unknown. We aimed to evaluate if there is a relationship between the presence of coronary heart disease and the existence of functional and structural capillary abnormalities evaluated in the cutaneous microcirculation by videocapillaroscopy. Two matched samples of 30 participants with and without coronary heart disease but with similar clinical and anthropometric characteristics were evaluated by videocapillaroscopy at the dorsal skin of the third finger of the non-dominant hand. We calculated basal capillary density as well as capillary density after a period of arterial and venous occlusion in order to evaluate functionality and maximum capillary density. We also measured capillary recruitment. Microvascular capillary density at rest was significantly lower in patients suffering from coronary heart disease than in controls. This fact was also found after dynamic tests (arterial and venous occlusion), suggesting functional impairments. Capillary recruitment of the samples was not different in our sample. In our study, patients with coronary heart disease exhibit functional and structural microvascular disturbances. Although this is a very preliminary study, these findings open the door for further studying the microvascular functionality in coronary patients and how it relates to the response to treatment and/or the prognosis of the disease. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Quantitative analysis of upper-limb ataxia in patients with spinocerebellar degeneration.

    Science.gov (United States)

    Ueda, Naohisa; Hakii, Yasuhito; Koyano, Shigeru; Higashiyama, Yuichi; Joki, Hideto; Baba, Yasuhisa; Suzuki, Yume; Kuroiwa, Yoshiyuki; Tanaka, Fumiaki

    2014-07-01

    Spinocerebellar degeneration (SCD) is a progressive neurodegenerative disorder in which cerebellar ataxia causes motor disability. There are no widely applicable methods for objective evaluation of ataxia in SCD. An objective system to evaluate ataxia is necessary for use in clinical trials of newly developed medication and rehabilitation. The aim of this study was to develop a simple method to quantify the degree of upper-limb ataxia. Forty-nine patients with SCD participated in this study. Patients were instructed to trace an Archimedean spiral template, and the gap between the template spiral and the drawn spiral (gap area; GA) was measured using Image J software. Ataxia was rated using the Scale for the Assessment and Rating of Ataxia (SARA) and cerebellar volume was evaluated in 37 patients using an axial cross-section of magnetic resonance images that were obtained within 6 months of clinical evaluation. Regression analysis was performed to assess the relation between GA and patient age, disease duration, SARA score, and cerebellar volume. GA was significantly related to total SARA score (r = 0.660, p ataxia, especially upper-limb ataxia, and can be widely adopted in various settings, including clinical trials.

  16. Qualitative and Quantitative Coronary Angiography in patients with Acute Coronary Syndrome (ACS

    Directory of Open Access Journals (Sweden)

    Ahmed H.H. El-Adawey

    2012-07-01

    Conclusion: The qualitative angiographic assessment represents an essential tool in the evaluation and risk stratification of patients with ACS, through the demonstration of the presence of thrombus and lumen irregularity that correlated more with ACS than the other studded criteria. In addition, QCA although added accurate assessment of the degree of luminal narrowing, thus helping in assessment of the severity of the disease.

  17. Quantitative and functional analysis of CD69+T regulatory lymphocytes in patients with periodontal disease.

    Science.gov (United States)

    Vitales-Noyola, Marlen; Martínez-Martínez, Rita; Loyola-Rodríguez, Juan P; Baranda, Lourdes; Niño-Moreno, Perla; González-Amaro, Roberto

    2017-08-01

    Periodontal disease is chronic inflammatory process that affects the attachment structures of the teeth and constitutes a significant cause of tooth loss in adults. Although different bacteria play an important role in the triggering of this condition, the progression and severity of the disease are strongly affected by the host immune response, which is under the control of different immune regulatory mechanisms, including T regulatory (Treg) cells. The aim of this study was to assess the frequency and function of CD69 + Treg lymphocytes in patients with chronic periodontal disease. Peripheral blood samples (n = 33) and gingival tissue (n = 9) were obtained from patients with chronic periodontal disease. Blood samples from 25 healthy individuals were also studied. Levels of CD69 + Treg lymphocytes in peripheral blood and gingival tissue were determined by six-color multiparametric flow cytometry, immunofluorescence, and immunohistochemistry. The immune regulatory function of CD69 + Treg cells was tested by an in vitro assay of inhibition of lymphocyte activation. Percentages of CD69 + Treg cells were significantly higher in the peripheral blood from patients with active periodontal disease compared to healthy controls, and these percentages inversely correlated with the periodontal attachment loss. Increased numbers of these Treg cells were detected in the gingival tissue from active PD patients compared to their peripheral blood. However, the suppressive function of CD69 + Treg cells was significantly diminished in patients with periodontal disease compared to healthy controls. Our data suggest that CD69 + Treg cells seem to be another important piece in the complex immunopathogenesis of periodontal disease. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Baseline hepatitis B surface antigen quantitation can predict virologic response in entecavir-treated chronic hepatitis B patients.

    Science.gov (United States)

    Wang, Chia-Chi; Tseng, Tai-Chung; Wang, Pin-Chao; Lin, Hans Hsienhong; Kao, Jia-Horng

    2014-11-01

    Several anti-viral drugs are approved for the treatment of hepatitis B virus (HBV) infection. However, whether quantitative hepatitis B surface antigen (qHBsAg) can predict the therapeutic response during long-term entecavir treatment remains unclear. Fifty-five chronic hepatitis B (CHB) patients who received entecavir for more than 2 years were enrolled. The serum qHBsAg level was measured by HBsAg II quant immunoassay. A significant decline in the qHBsAg level was defined as > 1 log reduction from baseline to 6 months of entecavir treatment. Of the 55 patients (41 males and 14 females with a mean age of 48.3 ± 11.4 years), 23 patients were positive for hepatitis B e antigen (HBeAg). The median treatment period was 34 months, and ranged from 26 months to 43 months. A total of 288 serum samples were used to determine the qHBsAg levels. At year 3 of entecavir therapy, one (1.8%) patient had HBsAg seroclearance. A high qHBsAg level was defined as greater than 10,000 IU/mL. Patients with a high baseline qHBsAg level had a lower rate of virologic response at year 1 (37.5% vs. 89.7%, p response in all patients. The baseline serum qHBsAg level can predict virologic response in entecavir-treated CHB patients. However, a significant decline in the qHBsAg level cannot predict serologic or virologic response of entecavir treatment. Copyright © 2013. Published by Elsevier B.V.

  19. Calcaneal quantitative ultrasound-bone mineral density value for evaluating bone metabolism and bone turnover in patients with osteoporotic fracture

    Directory of Open Access Journals (Sweden)

    Hong-Wei Yan

    2017-09-01

    Full Text Available Objective: To study the calcaneal quantitative ultrasound-bone mineral density (QUS-BMD value for evaluating bone metabolism and bone turnover in patients with osteoporotic fracture. Methods: A total of 150 patients who were diagnosed with osteoporotic fracture in Nuclear Industry 417 Hospital between January 2010 and March 2017 were selected as the fracture group of the research, and 70 subjects with normal bone mineral density confirmed by physical examination during the same period were selected as the control group of the research. QUSBMD apparatus was used to measure bone mineral density of calcaneus, and the serum was collected to determine the biochemical indexes of bone metabolism and bone turnover. Results: QUS-BMD value as well as serum BALP, OC, OPG levels of fracture group was significantly lower than those of control group while serum TRACP5b, RANKL, PINP, PICP, CTX and NTX levels were significantly higher than those of control group; serum BALP, OC, OPG levels of patients with osteoporosis and osteopenia were significantly lower than those of subjects with normal bone mass while TRACP5b, RANKL, PINP, PICP, CTX and NTX levels were significantly higher than those of subjects with normal bone mass; serum BALP, OC, OPG levels of patients with osteoporosis was significantly lower than those of patients with osteoporosis while TRACP5b, RANKL, PINP, PICP, CTX and NTX levels were significantly higher than those of patients with osteoporosis. Conclusion: Calcaneal QUS-BMD is valuable for evaluating the bone metabolism activity and bone turnover process in patients with osteoporotic fracture.

  20. Ultratrace level determination and quantitative analysis of kidney injury biomarkers in patient samples attained by zinc oxide nanorods

    Science.gov (United States)

    Singh, Manpreet; Alabanza, Anginelle; Gonzalez, Lorelis E.; Wang, Weiwei; Reeves, W. Brian; Hahm, Jong-In

    2016-02-01

    Determining ultratrace amounts of protein biomarkers in patient samples in a straightforward and quantitative manner is extremely important for early disease diagnosis and treatment. Here, we successfully demonstrate the novel use of zinc oxide nanorods (ZnO NRs) in the ultrasensitive and quantitative detection of two acute kidney injury (AKI)-related protein biomarkers, tumor necrosis factor (TNF)-α and interleukin (IL)-8, directly from patient samples. We first validate the ZnO NRs-based IL-8 results via comparison with those obtained from using a conventional enzyme-linked immunosorbent method in samples from 38 individuals. We further assess the full detection capability of the ZnO NRs-based technique by quantifying TNF-α, whose levels in human urine are often below the detection limits of conventional methods. Using the ZnO NR platforms, we determine the TNF-α concentrations of all 46 patient samples tested, down to the fg per mL level. Subsequently, we screen for TNF-α levels in approximately 50 additional samples collected from different patient groups in order to demonstrate a potential use of the ZnO NRs-based assay in assessing cytokine levels useful for further clinical monitoring. Our research efforts demonstrate that ZnO NRs can be straightforwardly employed in the rapid, ultrasensitive, quantitative, and simultaneous detection of multiple AKI-related biomarkers directly in patient urine samples, providing an unparalleled detection capability beyond those of conventional analysis methods. Additional key advantages of the ZnO NRs-based approach include a fast detection speed, low-volume assay condition, multiplexing ability, and easy automation/integration capability to existing fluorescence instrumentation. Therefore, we anticipate that our ZnO NRs-based detection method will be highly beneficial for overcoming the frequent challenges in early biomarker development and treatment assessment, pertaining to the facile and ultrasensitive quantification

  1. Quantitative analyses at baseline and interim PET evaluation for response assessment and outcome definition in patients with malignant pleural mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Lopci, Egesta; Chiti, Arturo [Humanitas Research Hospital, Nuclear Medicine Department, Rozzano, Milan (Italy); Zucali, Paolo Andrea; Perrino, Matteo; Gianoncelli, Letizia; Lorenzi, Elena; Gemelli, Maria; Santoro, Armando [Humanitas Research Hospital, Oncology, Rozzano (Italy); Ceresoli, Giovanni Luca [Humanitas Gavazzeni, Oncology, Bergamo (Italy); Giordano, Laura [Humanitas Research Hospital, Biostatistics, Rozzano (Italy)

    2015-04-01

    Quantitative analyses on FDG PET for response assessment are increasingly used in clinical studies, particularly with respect to tumours in which radiological assessment is challenging and complete metabolic response is rarely achieved after treatment. A typical example is malignant pleural mesothelioma (MPM), an aggressive tumour originating from mesothelial cells of the pleura. We present our results concerning the use of semiquantitative and quantitative parameters, evaluated at the baseline and interim PET examinations, for the prediction of treatment response and disease outcome in patients with MPM. We retrospectively analysed data derived from 131 patients (88 men, 43 women; mean age 66 years) with MPM who were referred to our institution for treatment between May 2004 and July 2013. Patients were investigated using FDG PET at baseline and after two cycles of pemetrexed-based chemotherapy. Responses were determined using modified RECIST criteria based on the best CT response after treatment. Disease control rate, progression-free survival (PFS) and overall survival (OS) were calculated for the whole population and were correlated with semiquantitative and quantitative parameters evaluated at the baseline and interim PET examinations; these included SUV{sub max}, total lesion glycolysis (TLG), percentage change in SUV{sub max} (ΔSUV{sub max}) and percentage change in TLG (ΔTLG). Disease control was achieved in 84.7 % of the patients, and median PFS and OS for the entire cohort were 7.2 and 14.3 months, respectively. The log-rank test showed a statistically significant difference in PFS between patients with radiological progression and those with partial response (PR) or stable disease (SD) (1.8 vs. 8.6 months, p < 0.001). Baseline SUV{sub max} and TLG showed a statistically significant correlation with PFS and OS (p < 0.001). In the entire population, both ΔSUV{sub max} and ΔTLG were correlated with disease control based on best CT response (p < 0

  2. Elevated host lipid metabolism revealed by iTRAQ-based quantitative proteomic analysis of cerebrospinal fluid of tuberculous meningitis patients

    Energy Technology Data Exchange (ETDEWEB)

    Mu, Jun [Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Yang, Yongtao [Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing (China); Chen, Jin; Cheng, Ke; Li, Qi; Wei, Yongdong; Zhu, Dan; Shao, Weihua; Zheng, Peng [Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Xie, Peng, E-mail: xiepeng@cqmu.edu.cn [Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing (China); Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing (China); Chongqing Key Laboratory of Neurobiology, Chongqing (China); Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing (China)

    2015-10-30

    Purpose: Tuberculous meningitis (TBM) remains to be one of the most deadly infectious diseases. The pathogen interacts with the host immune system, the process of which is largely unknown. Various cellular processes of Mycobacterium tuberculosis (MTB) centers around lipid metabolism. To determine the lipid metabolism related proteins, a quantitative proteomic study was performed here to identify differential proteins in the cerebrospinal fluid (CSF) obtained from TBM patients (n = 12) and healthy controls (n = 12). Methods: CSF samples were desalted, concentrated, labelled with isobaric tags for relative and absolute quantitation (iTRAQ™), and analyzed by multi-dimensional liquid chromatography-tandem mass spectrometry (LC-MS/MS). Gene ontology and proteomic phenotyping analysis of the differential proteins were conducted using Database for Annotation, Visualization, and Integrated Discovery (DAVID) Bioinformatics Resources. ApoE and ApoB were selected for validation by ELISA. Results: Proteomic phenotyping of the 4 differential proteins was invloved in the lipid metabolism. ELISA showed significantly increased ApoB levels in TBM subjects compared to healthy controls. Area under the receiver operating characteristic curve analysis demonstrated ApoB levels could distinguish TBM subjects from healthy controls and viral meningitis subjects with 89.3% sensitivity and 92% specificity. Conclusions: CSF lipid metabolism disregulation, especially elevated expression of ApoB, gives insights into the pathogenesis of TBM. Further evaluation of these findings in larger studies including anti-tuberculosis medicated and unmedicated patient cohorts with other center nervous system infectious diseases is required for successful clinical translation. - Highlights: • The first proteomic study on the cerebrospinal fluid of tuberculous meningitis patients using iTRAQ. • Identify 4 differential proteins invloved in the lipid metabolism. • Elevated expression of ApoB gives

  3. How physicians, patients and observers compare on the use of qualitative and quantitative measures of physician-patient communication

    Science.gov (United States)

    Gordon, Howard.S.; Street, Richard.L.

    2016-01-01

    The purpose of this study was to compare several different measures of physician-patient communication. We compared data derived from different measures of three communication behaviors: patient participation; physician information-giving; and physician participatory decision making (PDM) style, from 83 outpatient visits to oncology or thoracic surgery clinics for pulmonary nodules or lung cancer. Communication was measured with rating scales completed by patients and physicians after the consultation and by two different groups of external observers who used rating scales or coded the frequency of communication behaviors, respectively, after listening to an audio-recording of the consultation. Measures were compared using Pearson correlations. Correlations of patients’ and physicians’ ratings of patient participation (r=0.04) and physician PDM style (r=0.03) were low and not significant (P>0.0083 Bonferroni-adjusted). Correlations of observers’ ratings with patients’ or physicians’ ratings for patient participation and physician PDM style were moderate or low (r=0.15, 0.27, 0.07, and 0.01, respectively), but were not statistically significant (P>0.0083 Bonferroni-adjusted). Correlations between observers’ ratings and frequency measures were 0.31, 0.52, and 0.63, and were statistically significant with p-values 0.005, communication to more labor intensive frequency measures. PMID:26755527

  4. Quantitative analysis by MRI on condylar motion of the temporomandibular joint in patients applied with occlusal splints

    International Nuclear Information System (INIS)

    Saito, Hiroki

    1999-01-01

    The purpose of this study was to assess the feasibility of a newly developed quantitative motion analysis method for the mandibular condyle before and after application of occlusal splints. The subjects were 50 consecutive patients with internal derangement. Stabilization type splints were applied in 23 cases (46%), anterior repositioning type in 18 cases (36%) and pivot type in 9 cases (18%). All patients underwent MR imaging with a 1.5-T MR unit with a 3-inch dual surface coil. Pseudodynamic MR study of the opening cycle was obtained using multiplanar GRASS sequence (MPGR). Incremental and decremental sagittal MR images before and after splint application were transferred to the workstation. Software originally developed by Nakasato and Katsuragawa was used to analyze the condylar motion and path. After splint application, normalized position of displaced discs was seen in 11 cases (22%), and occurred most frequently with anterior repositioning type splints. In patients with anterior repositioning type splints, improvement in the condylar motion was most significant, In patients with normalized disc position after application of occlusal splints, abnormal figure-eight-shaped'' condylar paths were corrected in 9 of 10 cases. In the case with normalized disc position after application of anterior repositioning splint, the maximum rotational angle before application of the splint is larger than that of the case without normalized disc position. Rotational function of the condyle in the inferior joint space may be associated with disc recapturing. (K.H.)

  5. A retrospective cross-sectional quantitative molecular approach in biological samples from patients with syphilis.

    Science.gov (United States)

    Pinto, Miguel; Antelo, Minia; Ferreira, Rita; Azevedo, Jacinta; Santo, Irene; Borrego, Maria José; Gomes, João Paulo

    2017-03-01

    Syphilis is the sexually transmitted disease caused by Treponema pallidum, a pathogen highly adapted to the human host. As a multistage disease, syphilis presents distinct clinical manifestations that pose different implications for diagnosis. Nevertheless, the inherent factors leading to diverse disease progressions are still unknown. We aimed to assess the association between treponemal loads and dissimilar disease outcomes, to better understand syphilis. We retrospectively analyzed 309 DNA samples distinct anatomic sites associated with particular syphilis manifestations. All samples had previously tested positive by a PCR-based diagnostic kit. An absolute quantitative real-time PCR procedure was used to precisely quantify the number of treponemal and human cells to determine T. pallidum loads in each sample. In general, lesion exudates presented the highest T. pallidum loads in contrast with blood-derived samples. Within the latter, a higher dispersion of T. pallidum quantities was observed for secondary syphilis. T. pallidum was detected in substantial amounts in 37 samples of seronegative individuals and in 13 cases considered as syphilis-treated. No association was found between treponemal loads and serological results or HIV status. This study suggests a scenario where syphilis may be characterized by: i) heterogeneous and high treponemal loads in primary syphilis, regardless of the anatomic site, reflecting dissimilar duration of chancres development and resolution; ii) high dispersion of bacterial concentrations in secondary syphilis, potentially suggesting replication capability of T. pallidum while in the bloodstream; and iii) bacterial evasiveness, either to the host immune system or antibiotic treatment, while remaining hidden in privileged niches. This work highlights the importance of using molecular approaches to study uncultivable human pathogens, such as T. pallidum, in the infection process. Copyright © 2017 Elsevier Ltd. All rights

  6. Quantitative measurements of brain iron deposition in cirrhotic patients using susceptibility mapping.

    Science.gov (United States)

    Xia, Shuang; Zheng, Gang; Shen, Wen; Liu, Saifeng; Zhang, Long Jiang; Haacke, E Mark; Lu, Guang Ming

    2015-03-01

    Susceptibility-weighted imaging (SWI) has been used to detect micro-bleeds and iron deposits in the brain. However, no reports have been published on the application of SWI in studying iron changes in the brain of cirrhotic patients. To compare the susceptibility of different brain structures in cirrhotic patients with that in healthy controls and to evaluate susceptibility as a potential biomarker and correlate the measured susceptibility and cadaveric brain iron concentration for a variety of brain structures. Forty-three cirrhotic patients (27 men, 16 women; mean age, 50 ± 9 years) and 34 age- and sex-matched healthy controls (22 men, 12 women; mean age, 47 ± 7 years) were included in this retrospective study. Susceptibility was measured in the frontal white matter, basal ganglia, midbrain, and dentate nucleus and compared with results gathered from two postmortem brain studies. Correlation between susceptibility and clinical biomarkers and neuropsychiatric tests scores was calculated. In cirrhotic patients, the susceptibility of left frontal white matter, bilateral caudate head, and right substantia nigra was higher than that in healthy controls (P brain study (r = 0.835, P = 0.01) in eight deep grey matter structures and another in five brain structures (r = 0.900, P = 0.03). The susceptibility of right caudate head (r = 0.402) and left caudate head (r = 0.408) correlated with neuropsychological test scores (both P brain regions appears to reflect neurocognitive changes. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. A quantitative readability analysis of patient education resources from gastroenterology society websites.

    Science.gov (United States)

    Hansberry, David R; Patel, Sahil R; Agarwal, Prateek; Agarwal, Nitin; John, Elizabeth S; John, Ann M; Reynolds, James C

    2017-06-01

    The lay public frequently access and rely on online information as a source of their medical knowledge. Many medical societies are unaware of national patient education material guidelines and subsequently fail to meet them. The goal of the present study was to evaluate the readability of patient education materials within the medical field of gastroenterology. Two hundred fourteen articles pertaining to patient education materials were evaluated with ten well-established readability scales. The articles were available on the websites for the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society of Gastrointestinal Endoscopy (ASGE), the British Society of Gastroenterology (BSG), and the NIH section National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). One-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) post hoc analysis were conducted to determine any differences in level of readability between websites. The 214 articles were written at an 11.8 ± 2.1 grade level with a range of 8.0 to 16.0 grade level. A one-way ANOVA and Tukey's HSD post hoc analysis determined the ACG was written at a significantly (p < 0.05) more difficult level when compared to the AGA, the BSG, and the NIDDK websites. No differences were noted when comparing the ASGE website. None of the patient education materials were written at a level that met national guidelines. If the materials are redrafted, the general American public will likely have a greater understanding of the gastroenterology content.

  8. Aggression and Quantitative MRI Measures of Caudate in Patients With Chronic Schizophrenia or Schizoaffective Disorder

    OpenAIRE

    Hoptman, Matthew J.; Volavka, Jan; Czobor, Pál; Gerig, Guido; Chakos, Miranda; Blocher, Joseph; Citrome, Leslie L.; Sheitman, Brain; Lindenmayer, Jean-Pierre; Lieberman, Jeffrey A.; Bilder, Robert M.

    2006-01-01

    Caudate dysfunction is implicated in schizophrenia. However, little is known about the relationship between aggression and caudate volumes. Forty-nine patients received magnetic resonance imaging scanning in a double-blind treatment study in which aggression was measured. Caudate volumes were computed using a semiautomated method. The authors measured aggression with the Overt Aggression Scale and the Positive and Negative Syndrome Scale. Larger caudate volumes were associated with greater le...

  9. Quantitative Determination of Fibrinogen of Patients with Coronary Heart Diseases through Piezoelectric Agglutination Sensor

    OpenAIRE

    Chen; Hua; Fu; Liu; Chen; Cai

    2010-01-01

    Fibrinogen can transform fibrin through an agglutination reaction, finally forming fibrin polymer with grid structure. The density and viscosity of the reaction system changes drastically during the course of agglutination. In this research, we apply an independently-developed piezoelectric agglutination sensor to detect the fibrinogen agglutination reaction in patients with coronary heart diseases. The terminal judgment method of determining plasma agglutination reaction through piezoelectri...

  10. Qualitative and quantitative exfoliative cytology of normal oral mucosa in type 2 diabetic patients

    OpenAIRE

    Shareef, Ban Tawfeek; Ang, Kok Teong; Naik, Venkatesh Ramasamy

    2008-01-01

    Objective: The main purpose of this study is to emphasize the relevance of exfoliative cytology as an additional tool to aid in the diagnosis of diabetes mellitus. Materials and Methods: This is a comparative cross-sectional study. Oral smears were obtained from 10 diabetic patients and 10 healthy individuals. These smears were stained with Papanicolaou stain. The nuclear (NA) and cytoplasmic (CA) areas of 20 integral cells predominant in the buccal mucosa were measured using the Leica Qw...

  11. Quantitative Aortic Distensibility Measurement Using CT in Patients with Abdominal Aortic Aneurysm: Reproducibility and Clinical Relevance

    Directory of Open Access Journals (Sweden)

    Yunfei Zha

    2017-01-01

    Full Text Available Purpose. To investigate the reproducibility of aortic distensibility (D measurement using CT and assess its clinical relevance in patients with infrarenal abdominal aortic aneurysm (AAA. Methods. 54 patients with infrarenal abdominal aortic aneurysm were studied to determine their distensibility by using 64-MDCT. Aortic cross-sectional area changes were determined at two positions of the aorta, immediately below the lowest renal artery (level 1. and at the level of its maximal diameter (level 2. by semiautomatic segmentation. Measurement reproducibility was assessed using intraclass correlation coefficient (ICC and Bland-Altman analyses. Stepwise multiple regression analysis was performed to assess linear associations between aortic D and anthropometric and biochemical parameters. Results. A mean distensibility of Dlevel  1.=(1.05±0.22×10-5  Pa-1 and Dlevel  2.=(0.49±0.18×10-5  Pa-1 was found. ICC proved excellent consistency between readers over two locations: 0.92 for intraobserver and 0.89 for interobserver difference in level 1. and 0.85 and 0.79 in level 2. Multivariate analysis of all these variables showed sac distensibility to be independently related (R2=0.68 to BMI, diastolic blood pressure, and AAA diameter. Conclusions. Aortic distensibility measurement in patients with AAA demonstrated high inter- and intraobserver agreement and may be valuable when choosing the optimal dimensions graft for AAA before endovascular aneurysm repair.

  12. Changes in the psychological characteristics of oral cancer patients in the perioperative period: a quantitative evaluation.

    Science.gov (United States)

    Koizumi, Aya; Matsushima, Eisuke; Mochizuki, Yumi; Omura, Ken; Amagasa, Teruo

    2013-03-01

    We examined the changes in psychological distress and quality of life (QOL) during the perioperative period in oral cancer patients undergoing surgery and investigated the relationship between patient's psychological distress and QOL. Methods. Fifty patients participated. The Hospital Anxiety and Depression Scale (HADS; Japanese version), as a psychological test and the Functional Assessment of Cancer Therapy General (FACT-G); and Head and Neck (FACT-H&N), as quality of life (QOL) surveys were administered preoperatively, after surgery, and 1 month after leaving the hospital. Results. Anxiety was highest pre-operation and depression was highest post-operation, but improvements in both were seen post-discharge. At the pre-operation time point, anxiety and depression low-score groups had significantly high scores on Emotional well-being and Functional well-being. At the post-operation time point, anxiety and depression low-score groups had significantly high scores on all QOL subscales. Conclusion. Providing psychological support while considering anxiety might be particularly useful preoperatively whereas providing psychological support while considering depression might be particularly useful postoperatively.

  13. Xp21 contiguous gene syndromes: Deletion quantitation with bivariate flow karyotyping allows mapping of patient breakpoints

    Energy Technology Data Exchange (ETDEWEB)

    McCabe, E.R.B.; Towbin, J.A. (Baylor College of Medicine, Houston, TX (United States)); Engh, G. van den; Trask, B.J. (Lawrence Livermore National Lab., CA (United States))

    1992-12-01

    Bivariate flow karyotyping was used to estimate the deletion sizes for a series of patients with Xp21 contiguous gene syndromes. The deletion estimates were used to develop an approximate scale for the genomic map in Xp21. The bivariate flow karyotype results were compared with clinical and molecular genetic information on the extent of the patients' deletions, and these various types of data were consistent. The resulting map spans >15 Mb, from the telomeric interval between DXS41 (99-6) and DXS68 (1-4) to a position centromeric to the ornithine transcarbamylase locus. The deletion sizing was considered to be accurate to [plus minus]1 Mb. The map provides information on the relative localization of genes and markers within this region. For example, the map suggests that the adrenal hypoplasia congenita and glycerol kinase genes are physically close to each other, are within 1-2 Mb of the telomeric end of the Duchenne muscular dystrophy (DMD) gene, and are nearer to the DMD locus than to the more distal marker DXS28 (C7). Information of this type is useful in developing genomic strategies for positional cloning in Xp21. These investigations demonstrate that the DNA from patients with Xp21 contiguous gene syndromes can be valuable reagents, not only for ordering loci and markers but also for providing an approximate scale to the map of the Xp21 region surrounding DMD. 44 refs., 3 figs.

  14. Quantitative Analysis of MR Imaging to Assess Treatment Response for Patients with Multiple Myeloma by Using Dynamic Intensity Entropy Transformation: A Preliminary Study.

    Science.gov (United States)

    Zhou, Chuan; Chan, Heang-Ping; Dong, Qian; Couriel, Daniel R; Pawarode, Attaphol; Hadjiiski, Lubomir M; Wei, Jun

    2016-02-01

    To develop a quantitative measure of bone marrow changes in magnetic resonance (MR) images and investigate its capability for assessment of treatment response for patients with multiple myeloma (MM). This study was retrospective, institutional review board approved, and HIPAA compliant. Informed consent was waived. Patients (n = 64; mean age, 58.8 years [age range, 27-75 years]) who were diagnosed with MM and underwent autologous bone marrow stem cell transplantation (BMT) were evaluated. A pair of spinal MR examinations performed before and after BMT was collected from each patient's records. A three-dimensional dynamic intensity entropy transformation (DIET) method was developed to transform MR T1-weighted signal voxel by voxel to a quantitative entropy enhancement value (qEEV), from which predictor variables were derived to train a linear discriminant analysis classifier by using a leave-one-out method. The output of the linear discriminant analysis provided a qEEV-based response index for quantitative assessment of treatment response. The performance of quantitative response index for the discrimination of responder and nonresponder patients was evaluated by receiver operating characteristic curve analysis. Among the 46 and 18 clinically diagnosed responder and nonresponder patients, the quantitative response index at a chosen decision threshold correctly identified 42 responder and 17 nonresponder patients. The agreement between the DIET method and the clinical outcome reached 0.922 (59 of 64; κ = 0.816; area under the receiver operating characteristic curve, 0.886 ± 0.042). This study demonstrated the feasibility of quantitative response index to differentiate responder and nonresponder patients and had substantial agreement with clinical outcomes, which indicated that this quantitative measure has the potential to be an image biomarker to assess MM treatment response. © RSNA, 2015.

  15. Assessment of Nutritional Status of Nepalese Hemodialysis Patients by Anthropometric Examinations and Modified Quantitative Subjective Global Assessment

    Directory of Open Access Journals (Sweden)

    Arun Sedhain

    2015-01-01

    Full Text Available Objective To assess the nutritional status of patients on maintenance hemodialysis by using modified quantitative subjective global assessment (MQSGA and anthropometric measurements. Method We Conducted a cross sectional descriptive analytical study to assess the nutritional status of fifty four patients with chronic kidney disease undergoing maintenance hemodialysis by using MQSGA and different anthropometric and laboratory measurements like body mass index (BMI, mid-arm circumference (MAC, mid-arm muscle circumference (MAMC, triceps skin fold (TSF and biceps skin fold (BSF, serum albumin, C-reactive protein (CRP and lipid profile in a government tertiary hospital at Kathmandu, Nepal. Results Based on MQSGA criteria, 66.7% of the patients suffered from mild to moderate malnutrition and 33.3% were well nourished. None of the patients were severely malnourished. CRP was positive in 56.3% patients. Serum albumin, MAC and BMI were (mean + SD 4.0 + 0.3 mg/dl, 22 + 2.6 cm and 19.6 ± 3.2 kg/m 2 respectively. MQSGA showed negative correlation with MAC ( r = −0.563; P = < 0.001, BMI ( r = −0.448; P = < 0.001, MAMC ( r = −0.506; P = < .0001, TSF ( r = −0.483; P = < .0002, and BSF ( r = −0.508; P = < 0.0001. Negative correlation of MQSGA was also found with total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol without any statistical significance. Conclusion Mild to moderate malnutrition was found to be present in two thirds of the patients undergoing hemodialysis. Anthropometric measurements like BMI, MAC, MAMC, BSF and TSF were negatively correlated with MQSGA. Anthropometric and laboratory assessment tools could be used for nutritional assessment as they are relatively easier, cheaper and practical markers of nutritional status.

  16. Transcranial magnetic stimulation in the semi-quantitative, pre-operative assessment of patients undergoing spinal deformity surgery.

    Science.gov (United States)

    Glasby, Michael A; Tsirikos, Athanasios I; Henderson, Lindsay; Horsburgh, Gillian; Jordan, Brian; Michaelson, Ciara; Adams, Christopher I; Garrido, Enrique

    2017-08-01

    To compare measurements of motor evoked potential latency stimulated either magnetically (mMEP) or electrically (eMEP) and central motor conduction time (CMCT) made pre-operatively in conscious patients using transcranial and intra-operatively using electrical cortical stimulation before and after successful instrumentation for the treatment of adolescent idiopathic scoliosis. A group initially of 51 patients with adolescent idiopathic scoliosis aged 12-19 years was evaluated pre-operatively in the outpatients' department with transcranial magnetic stimulation. The neurophysiological data were then compared statistically with intra-operative responses elicited by transcranial electrical stimulation both before and after successful surgical intervention. MEPs were measured as the cortically evoked compound action potentials of Abductor hallucis. Minimum F-waves were measured using conventional nerve conduction methods and the lower motor neuron conduction time was calculated and this was subtracted from MEP latency to give CMCT. Pre-operative testing was well tolerated in our paediatric/adolescent patients. No neurological injury occurred in any patient in this series. There was no significant difference in the values of mMEP and eMEP latencies seen pre-operatively in conscious patients and intra-operatively in patients under anaesthetic. The calculated quantities mCMCT and eCMCT showed the same statistical correlations as the quantities mMEP and eMEP latency. The congruency of mMEP and eMEP and of mCMCT and eCMCT suggests that these measurements may be used comparatively and semi-quantitatively for the comparison of pre-, intra-, and post-operative spinal cord function in spinal deformity surgery.

  17. Iron deposition in the precentral grey matter in patients with multiple sclerosis: A quantitative study using susceptibility-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rumzan, Reshiana, E-mail: minouchka_16@yahoo.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Wang, Jing-jie, E-mail: jingjiewang@126.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Zeng, Chun, E-mail: zengchun19840305@163.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Chen, Xuan, E-mail: martha860831@sina.com [Department of Imaging, The Second People' s Hospital of Sichuan, 55 Renmin South Road, Chengdu 610041 (China); Li, Yongmei, E-mail: lymzhang70@yahoo.com.cn [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Luo, Tianyou, E-mail: ltychy@sina.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Lv, Fajin, E-mail: fajinlv@hotmail.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Wang, Zhong-ping, E-mail: wzp20551015@126.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Hou, Huanxin, E-mail: newt948@foxmail.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China); Huang, Fuhong, E-mail: fuhonghuang@163.com [Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016 (China)

    2013-02-15

    Purpose: Several studies suggest that iron deposition may play a role in multiple sclerosis (MS) pathology. Three-dimensional (3D) enhanced T2*-weighted angiography (ESWAN) at 3T was used to quantify iron deposition in the precentral grey matter in MS and its relationship with disease duration, atrophy and Expanded Disability Status Scale (EDSS) scores. Methods: We recruited 33 patients with diagnosis of clinically definite MS and 31 age- and sex-matched healthy controls who underwent conventional brain MRI, 3D-ESWAN and 3D T1sequences. We obtained the mean phase values (MPVs) of the precentral grey matter on ESWAN-filtered phase images and volume of the precentral gyrus on 3D T1 images. We investigated the correlation between precentral grey matter MPVs, precentral gyrus volume, disease duration and EDSS scores of MS patients and healthy controls. Results: The precentral grey matter MPVs in MS patients and controls were 1870.83 ± 56.61 and 1899.22 ± 51.73 respectively and had significant difference in the MS group vs. the control group (t = −2.09, P = 0.04). There was significant negative correlation between precentral grey matter MPVs and disease duration (r = −0.365, P = 0.03). No correlation was found between MPVs and EDSS scores. Mean precentral gyrus volume in MS patients was 4368.55 ± 867.78 whereas in controls was 5701.00 ± 1184.03 with significant difference between volume of the precentral gyrus in MS patients compared to healthy controls (t = −5.167, P < 0.001). There was a positive correlation between MPVs and precentral gyrus volume (r = 0.291, P = 0.020). Conclusions: Our study demonstrated that quantitative assessment of abnormal iron deposition in the precentral grey matter in MS patients can be measured using 3D-ESWAN.

  18. Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.

    Science.gov (United States)

    Monti, Lucia; Menci, Elisabetta; Ulivelli, Monica; Cerase, Alfonso; Bartalini, Sabina; Piu, Pietro; Marotti, Nicola; Leonini, Sara; Galluzzi, Paolo; Romano, Daniele G; Casasco, Alfredo E; Venturi, Carlo

    2011-01-01

    Internal Jugular Veins (IJVs) are the principle outflow pathway for intracranial blood in clinostatism condition. In the seated position, IJVs collapse, while Vertebral Veins (VVs) increase the venous outflow and partially compensate the venous drainage. Spinal Epidural Veins are an additional drainage pathway in the seated position. Colour- Doppler-Sonography (CDS) examination is able to demonstrate IJVs and VVs outflow in different postural and respiratory conditions. The purpose of this study was to evaluate CDS quantification of the cerebral venous outflow (CVF) in healthy subjects and patients with multiple sclerosis (MS). In a group of 27 healthy adults (13 females and 14 males; mean age 37.8 ± 11.2 years), and 52 patients with MS (32 females and 20 males; mean age 42.6 ± 12.1 years), CVF has been measured in clinostatism and in the seated position as the sum of the flow in IJVs and VVs. The difference between CVF in clinostatism and CVF in the seated position (ΔCVF) has been correlated with patients' status (healthy or MS), and a number of clinical variables in MS patients. Statistical analysis was performed by Fisher's exact test, non-parametric Mann-Whitney U test, ANOVA Kruskal-Wallis test, and correntropy coefficient. The value of ΔCVF was negative in 59.6% of patients with MS and positive in 96.3% of healthy subjects. Negative ΔCVF values were significantly associated with MS (p<0.0001). There was no significant correlation with clinical variables. Negative ΔCVF has a hemodynamic significance, since it reflects an increased venous return in the seated position. This seems to be a pathologic condition. In MS patients, a vascular dysregulation resulting from involvement of the autonomous nervous system may be supposed. ΔCVF value should be included in the quantitative CDS evaluation of the cerebral venous drainage, in order to identify cerebral venous return abnormalities.

  19. Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.

    Directory of Open Access Journals (Sweden)

    Lucia Monti

    Full Text Available Internal Jugular Veins (IJVs are the principle outflow pathway for intracranial blood in clinostatism condition. In the seated position, IJVs collapse, while Vertebral Veins (VVs increase the venous outflow and partially compensate the venous drainage. Spinal Epidural Veins are an additional drainage pathway in the seated position. Colour- Doppler-Sonography (CDS examination is able to demonstrate IJVs and VVs outflow in different postural and respiratory conditions. The purpose of this study was to evaluate CDS quantification of the cerebral venous outflow (CVF in healthy subjects and patients with multiple sclerosis (MS.In a group of 27 healthy adults (13 females and 14 males; mean age 37.8 ± 11.2 years, and 52 patients with MS (32 females and 20 males; mean age 42.6 ± 12.1 years, CVF has been measured in clinostatism and in the seated position as the sum of the flow in IJVs and VVs. The difference between CVF in clinostatism and CVF in the seated position (ΔCVF has been correlated with patients' status (healthy or MS, and a number of clinical variables in MS patients. Statistical analysis was performed by Fisher's exact test, non-parametric Mann-Whitney U test, ANOVA Kruskal-Wallis test, and correntropy coefficient. The value of ΔCVF was negative in 59.6% of patients with MS and positive in 96.3% of healthy subjects. Negative ΔCVF values were significantly associated with MS (p<0.0001. There was no significant correlation with clinical variables.Negative ΔCVF has a hemodynamic significance, since it reflects an increased venous return in the seated position. This seems to be a pathologic condition. In MS patients, a vascular dysregulation resulting from involvement of the autonomous nervous system may be supposed. ΔCVF value should be included in the quantitative CDS evaluation of the cerebral venous drainage, in order to identify cerebral venous return abnormalities.

  20. Parasite to patient: A quantitative risk model for Trichinella spp. in pork and wild boar meat.

    Science.gov (United States)

    Franssen, Frits; Swart, Arno; van der Giessen, Joke; Havelaar, Arie; Takumi, Katsuhisa

    2017-01-16

    Consumption of raw or inadequately cooked pork meat may result in trichinellosis, a human disease due to nematodes of the genus Trichinella. In many countries worldwide, individual control of pig carcasses at meat inspection is mandatory but incurs high costs in relation to absence of positive carcasses from pigs reared under controlled housing. EU regulation 2015/1375 implements an alternative risk-based approach, in view of absence of positive findings in pigs under controlled housing conditions. Moreover, Codex Alimentarius guidelines for the control of Trichinella spp. in meat of suidae have been published (CAC, 2015) and used in conjunction with the OIE terrestrial Animal health code, to provide guidance to governments and industry on risk based control measures to prevent human exposure to Trichinella spp. and to facilitate international pork trade. To further support such a risk-based approach, we model the risk of human trichinellosis due to consumption of meat from infected pigs, raised under non-controlled housing and wild boar, using Quantitative Microbial Risk Assessment (QMRA) methods. Our model quantifies the distribution of Trichinella muscle larve (ML) in swine, test sensitivity at carcass control, partitioning of edible pork parts, Trichinella ML distribution in edible muscle types, heat inactivation by cooking and portion sizes. The resulting exposure estimate is combined with a dose response model for Trichinella species to estimate the incidence of human illness after consumption of infected meat. Paramater estimation is based on experimental and observational datasets. In Poland, which served as example, we estimated an average incidence of 0.90 (95%CI: 0.00-3.68) trichinellosis cases per million persons per year (Mpy) due to consumption of pork from pigs that were reared under non-controlled housing, and 1.97 (95%CI: 0.82-4.00) cases per Mpy due to consumption of wild boar. The total estimated incidence of human trichinellosis attributed to

  1. Quantitative changes in anaerobic subgingival microbiota in patients, before and during fixed orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Amit Sidana

    2017-01-01

    Full Text Available Aim: The aim of this study was to compare the growth of Actinobacillus actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, and Veillonella before and during fixed orthodontic treatment. Materials and Methods: The study sample consisted of 40 patients (20 males, 20 females. The patients were divided into two groups, Group 1 (pretreatment group before any fixed orthodontic treatment and Group 2 (active treatment group 6 months into fixed treatment. A. actinomycetemcomitans was cultured on tryptic soy bacitracin vancomycin agar, and for the rest and total aerobic count, Columbia agar was used. The culture plates were incubated anaerobically for 72 h. Bacteria were identified by their physical and microscopic appearances. Further, specific bacteria were identified by VITEK 2 Compact Automated Identification System (Biomerieux. Using the magnifying glass, the total number of bacteria was determined. Result: For all the microbes, P. gingivalis, P. intermedia, Veillonella (excepting A. actinomycetemcomitans, a significant increase in count was observed. Mean change was highest for P. intermedia (0.64 ± 0.74 × 104 CFU/ml and minimum for P. gingivalis (0.12 ± 0.35 × 104 CFU/ml. For A. actinomycetemcomitans, at both before and active treatment phases, the count was 0 ± 0 × 104 CFU/ml. For different microbes, change in microbial count ranged from 18.8% (P. gingivalis to 52% (P. intermedia. For Veillonella, the change was 51.4%. Conclusion: Orthodontic appliance serves as different loci for bacterial growth. In this in vivo study, significant differences were noted between the bacterial count in pretreatment group and active treatment group. Adequate oral prophylaxis instructions should be given to patients before starting fixed orthodontic treatment so that oral hygiene can be maintained.

  2. Quantitative radionuclide angiography in assessment of hemodynamic changes during upright exercise: observations in normal subjects, patient with coronary artery disease and patients with aortic regurgitation

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Kane, S.A.; Segal, B.L.

    1981-01-01

    Quantitative radionuclide angiography was used to evaluate hemodynamic changes in three subject groups during symptom-limited upright exercise. The 12 normal subjects had significant increases in heart rate, stroke volume, left ventricular ejection fraction and cardiac output during exercise; changes in end-diastolic and end-systolic volumes were not significant. In the 24 patients with coronary artery disease there were significant increases in heart rate and cardiac output during exercise, but insignificant changes in end-diastolic, end-systolic and stroke volumes and ejection fraction. The change in diastolic volume in these patients was determined by the extent of coronary artery disease, propranolol therapy, end point of exercise and presence of collateral vessels. Furthermore, patients with previous myocardial infarction had a lower ejection fraction and higher end-diastolic and end-systolic volumes during exercise than those without myocardial infarction. In the 12 patients with chronic aortic regurgitation of moderate to severe degree, there was a decrease in the end-diastolic volume during exercise. This response was distinctly different from that of the normal subjects or the patients with coronary artery disease. All three groups had a significant decrease in pulmonary transit time during exercise. It is concluded that changes in cardiac output in normal subjects during upright exercise are related to augmentation of stroke volume and tachycardia, whereas in patients with coronary artery disease they are related mainly to tachycardia

  3. Aggression and quantitative MRI measures of caudate in patients with chronic schizophrenia or schizoaffective disorder.

    Science.gov (United States)

    Hoptman, Matthew J; Volavka, Jan; Czobor, Pál; Gerig, Guido; Chakos, Miranda; Blocher, Joseph; Citrome, Leslie L; Sheitman, Brain; Lindenmayer, Jean-Pierre; Lieberman, Jeffrey A; Bilder, Robert M

    2006-01-01

    Caudate dysfunction is implicated in schizophrenia. However, little is known about the relationship between aggression and caudate volumes. Forty-nine patients received magnetic resonance imaging scanning in a double-blind treatment study in which aggression was measured. Caudate volumes were computed using a semiautomated method. The authors measured aggression with the Overt Aggression Scale and the Positive and Negative Syndrome Scale. Larger caudate volumes were associated with greater levels of aggression. The relationship between aggression and caudate volumes may be related to the iatrogenic effects of long-term treatment with typical antipsychotic agents or to a direct effect of schizophrenic processes on the caudate.

  4. Quantitative t2 values predict time from symptom onset in acute stroke patients

    DEFF Research Database (Denmark)

    Siemonsen, Susanne; Mouridsen, Kim; Holst, Brigitte

    2009-01-01

    ) within 6 hours after symptom onset. Regions of decreased apparent diffusion coefficient defined and superimposed onto the corresponding T2 map and the unaffected side in the horizontally flipped maps. Differences of T2/apparent diffusion coefficient values between affected...... and unaffected side were calculated (differences of T2/differences of apparent diffusion coefficient). Fluid-attenuated inversion recovery images were rated for lesion visibility. RESULTS: Differences of T2 showed a significant correlation with time from symptom onset (R=0.580; P... in patients with visible fluid-attenuated inversion recovery lesions were significantly higher than in those without visible hyperintensity (P

  5. Quantitive study for retinal function before and after photocoagulation in patients with diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Rui-Xue Sun

    2017-03-01

    Full Text Available AIM: To study the retinal function in patients with diabetic macular edema after photocoagulation. METHODS: A total of 30 eyes in 19 patients with diabetic macular edema(DME, who were diagnosed through fundus fluorescein angiography, consecutively recruited from March 2010 to March 2014 and were treated with macular grid pattern photocoagulation. Multifocal electroretinogram(mfERGsystem(version 3.15was performed before and after photocoagulation therapy for 3mo. All data were statistically analyzed. RESULTS: The amplitude densities of a-ware and b-ware for the fovea increased after macular grid pattern photocoagulation therapy, and there were significantly changes relative to its preoperation(t=-3.7683, Pt=-3.6570, Pt=1.7103, P>0.05; t=1.5623, P>0.05 . Compared with pretreatment, the amplitude densities of a-ware and b-ware at macular were statistically larger(t=4.8337, Pt=-2.0376, Pt=-2.1892, Pt=-3.5024, Pt=-1.4387, P>0.05; t=-0.1766, P>0.05. It was significant longer in the latency of a-wave and b-wave at paramacular after photocoagulation(t=-2.0905, Pt=-2.5646, PCONCLUSION: The laser photocoagulation treatment for DME can improve the retinal function at fovea, which benefits the vision acuity. Unfortunately,it induces extensively damaging effects on the macula and paramacular.

  6. Distribution and Quantitative Estimates of Variant Creutzfeldt-Jakob Disease Prions in Tissues of Clinical and Asymptomatic Patients.

    Science.gov (United States)

    Douet, Jean Y; Lacroux, Caroline; Aron, Naima; Head, Mark W; Lugan, Séverine; Tillier, Cécile; Huor, Alvina; Cassard, Hervé; Arnold, Mark; Beringue, Vincent; Ironside, James W; Andréoletti, Olivier

    2017-06-01

    In the United-Kingdom, ≈1 of 2,000 persons could be infected with variant Creutzfeldt-Jakob disease (vCJD). Therefore, risk of transmission of vCJD by medical procedures remains a major concern for public health authorities. In this study, we used in vitro amplification of prions by protein misfolding cyclic amplification (PMCA) to estimate distribution and level of the vCJD agent in 21 tissues from 4 patients who died of clinical vCJD and from 1 asymptomatic person with vCJD. PMCA identified major levels of vCJD prions in a range of tissues, including liver, salivary gland, kidney, lung, and bone marrow. Bioassays confirmed that the quantitative estimate of levels of vCJD prion accumulation provided by PMCA are indicative of vCJD infectivity levels in tissues. Findings provide critical data for the design of measures to minimize risk for iatrogenic transmission of vCJD.

  7. Quantitative sensory testing somatosensory profiles in patients with cervical radiculopathy are distinct from those in patients with nonspecific neck-arm pain.

    Science.gov (United States)

    Tampin, Brigitte; Slater, Helen; Hall, Toby; Lee, Gabriel; Briffa, Noelle Kathryn

    2012-12-01

    The aim of this study was to establish the somatosensory profiles of patients with cervical radiculopathy and patients with nonspecific neck-arm pain associated with heightened nerve mechanosensitivity (NSNAP). Sensory profiles were compared to healthy control (HC) subjects and a positive control group comprising patients with fibromyalgia (FM). Quantitative sensory testing (QST) of thermal and mechanical detection and pain thresholds, pain sensitivity and responsiveness to repetitive noxious mechanical stimulation was performed in the maximal pain area, the corresponding dermatome and foot of 23 patients with painful C6 or C7 cervical radiculopathy, 8 patients with NSNAP in a C6/7 dermatomal pain distribution, 31 HC and 22 patients with FM. For both neck-arm pain groups, all QST parameters were within the 95% confidence interval of HC data. Patients with cervical radiculopathy were characterised by localised loss of function (thermal, mechanical, vibration detection P<.009) in the maximal pain area and dermatome (thermal detection, vibration detection, pressure pain sensitivity P<.04), consistent with peripheral neuronal damage. Both neck-arm pain groups demonstrated increased cold sensitivity in their maximal pain area (P<.03) and the foot (P<.009), and this was also the dominant sensory characteristic in patients with NSNAP. Both neck-arm pain groups differed from patients with FM, the latter characterised by a widespread gain of function in most nociceptive parameters (thermal, pressure, mechanical pain sensitivity P<.027). Despite commonalities in pain characteristics between the 2 neck-arm pain groups, distinct sensory profiles were demonstrated for each group. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  8. Facial Phenotyping by Quantitative Photography Reflects Craniofacial Morphology Measured on Magnetic Resonance Imaging in Icelandic Sleep Apnea Patients

    Science.gov (United States)

    Sutherland, Kate; Schwab, Richard J.; Maislin, Greg; Lee, Richard W.W.; Benedikstdsottir, Bryndis; Pack, Allan I.; Gislason, Thorarinn; Juliusson, Sigurdur; Cistulli, Peter A.

    2014-01-01

    Study Objectives: (1) To determine whether facial phenotype, measured by quantitative photography, relates to underlying craniofacial obstructive sleep apnea (OSA) risk factors, measured with magnetic resonance imaging (MRI); (2) To assess whether these associations are independent of body size and obesity. Design: Cross-sectional cohort. Setting: Landspitali, The National University Hospital, Iceland. Participants: One hundred forty patients (87.1% male) from the Icelandic Sleep Apnea Cohort who had both calibrated frontal and profile craniofacial photographs and upper airway MRI. Mean ± standard deviation age 56.1 ± 10.4 y, body mass index 33.5 ± 5.05 kg/m2, with on-average severe OSA (apnea-hypopnea index 45.4 ± 19.7 h-1). Interventions: N/A. Measurements and Results: Relationships between surface facial dimensions (photos) and facial bony dimensions and upper airway soft-tissue volumes (MRI) was assessed using canonical correlation analysis. Photo and MRI craniofacial datasets related in four significant canonical correlations, primarily driven by measurements of (1) maxillary-mandibular relationship (r = 0.8, P photography and MRI. This study confirms that facial photographic phenotype reflects underlying aspects of craniofacial skeletal abnormalities associated with OSA. Therefore, facial photographic phenotyping may be a useful tool to assess intermediate phenotypes for OSA, particularly in large-scale studies. Citation: Sutherland K, Schwab RJ, Maislin G, Lee RW, Benedikstdsottir B, Pack AI, Gislason T, Juliusson S, Cistulli PA. Facial phenotyping by quantitative photography reflects craniofacial morphology measured on magnetic resonance imaging in icelandic sleep apnea patients. SLEEP 2014;37(5):959-968. PMID:24790275

  9. Quantitative drug-susceptibility in patients treated for multidrug-resistant tuberculosis in Bangladesh: implications for regimen choice.

    Directory of Open Access Journals (Sweden)

    Scott K Heysell

    Full Text Available Multidrug-resistant tuberculosis (MDR-TB treatment in Bangladesh is empiric or based on qualitative drug-susceptibility testing (DST by comparative growth in culture media with and without a single drug concentration.Adult patients were enrolled throughout Bangladesh during the period of 2011-2013 at MDR-TB treatment initiation. Quantitative DST by minimum inhibitory concentration (MIC testing for 12 first and second-line anti-TB drugs was compared to pretreatment clinical characteristics and treatment outcomes. MIC values at or one dilution lower than the resistance breakpoint used for qualitative DST were categorized as borderline susceptible, and MIC values one or two dilutions greater as borderline resistant.Seventy-four patients were enrolled with a mean age of 35 ± 15 years, and 51 (69% were men. Of the rifampin isolates with MIC >1.0 μg/ml, 12 (19% were fully susceptible or borderline susceptible to rifabutin (MIC ≤ 0.5 μg/ml. Amikacin was fully susceptible in 73 isolates (99%, but kanamycin in only 54 (75% (p<0.001. Ofloxacin was borderline susceptible in 64%, and fully susceptible in only 14 (19% compared to 60 (81% of isolates fully susceptible for moxifloxacin (p<0.001. Kanamycin non-susceptibility and receipt of the WHO Category IV regimen trended with interim treatment failure: adjusted odd ratios respectively of 5.4 [95% CI 0.82-36.2] (p = 0.08 and 7.2 [0.64-80.7] (p = 0.11.Quantitative MIC testing could impact MDR-TB regimen choice in Bangladesh. Comparative trials of higher dose or later generation fluoroquinolone, within class change from kanamycin to amikacin, and inclusion of rifabutin appear warranted.

  10. Effectiveness of quantitative real time PCR in long-term follow-up of chronic myeloid leukemia patients

    International Nuclear Information System (INIS)

    Savasoglu, K.; Berber, B.

    2015-01-01

    To determine the use of the Quantitative Real Time PCR (RQ-PCR) assay follow-up with Chronic Myeloid Leukemia (CML) patients. Study Design: Cross-sectional observational. Place and Duration of Study: Izmir Ataturk Education and Research Hospital, Izmir, Turkey, from 2009 to 2013. Methodology: Cytogenetic, FISH, RQ-PCR test results from 177 CML patients materials selected between 2009 - 2013 years was set up for comparison analysis. Statistical analysis was performed to compare between FISH, karyotype and RQ-PCR results of the patients. Karyotyping and FISH specificity and sensitivity rates determined by ROC analysis compared with RQ-PCR results. Chi-square test was used to compare test failure rates. Results:Sensitivity and specificity values were determined for karyotyping 17.6 - 98% (p=0.118, p > 0.05) and for FISH 22.5 - 96% (p=0.064, p > 0.05) respectively. FISH sensitivity was slightly higher than karyotyping but there was calculated a strong correlation between them (p < 0.001). RQ-PCR test failure rate did not correlate with other two tests (p > 0.05); however, karyotyping and FISH test failure rate was statistically significant (p < 0.001). Conclusion: Besides, the situation needed for karyotype analysis, RQ-PCR assay can be used alone in the follow-up of CML disease. (author)

  11. Sexual difference in bone geometry of adult patients with classical congenital adrenal hyperplasia: data using peripheral quantitative computed tomography.

    Science.gov (United States)

    Bechtold, Susanne; Beyerlein, Andreas; Bonfig, Walter; Dalla Pozza, Robert; Putzker, Stephanie; Otto, Ragna; Schmidt, Heinrich; Schwarz, Hans Peter

    2014-01-01

    Glucocorticoid treatment may influence bone and muscle development in patients with congenital adrenal hyperplasia (CAH). This study evaluated bone mineral density (BMD), bone geometry and muscle mass. 73 adult patients with classical CAH were followed. BMD, bone geometry and muscle mass were measured using peripheral quantitative computed tomography (pQCT). Glucocorticoid-equivalent doses throughout life were calculated and at the time pQCT androgen levels were measured. In males the mean standard deviation (SD) score for trabecular BMD (-0.33 ± 0.71) was reduced, whereas mean cortical BMD (1.05 ± 1.11) was elevated. Mean total (0.86 ± 1.12) and medullary cross-sectional area (CSA; 1.12 ± 1.17) were significantly increased (p difference with enlarged total and medullary CSA in females, whereas in males trabecular BMD was reduced and cortical BMD elevated. Cortical thickness and muscle CSA were reduced in all CAH patients with a possible long-term impact on bone development and stability. Monitoring of bone and muscle development might be warranted. © 2014 S. Karger AG, Basel.

  12. Quantitative Risk Assessment of Patient Manual Handling in Wards of One of the Hospitals of Tehran using MAPO Method, Iran

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    Sajad Ataei

    2017-05-01

    Full Text Available Background and Objectives: Manual handling of disabled patients is one of the important and effective factors in acute low back pain among exposed nurses. The present study was conducted with the objective of quantitative risk assessment of patient manual handling among nurses in wards of one of the hospitals in Tehran using MAPO method. Methods: The present study was conducted as an analytical-cross-sectional study in 26 wards of one of the hospitals in Tehran city. Samples were selected by census method from nurses and paramedics of different wards of hospital. Data collection was performed using demographic information and MAPO checklist. Results: The highest score of MAPO were, respectively, related to wards of DI clinic (score, 14.7, men orthopedic (score, 6.3, and general operating room (score, 57. 53.8% of hospital wards were at the level 2 corrective action, which indicated that the risk of musculoskeletal disorder is 2.4 times higher than level 1 corrective action. Conclusion: Given that the proportion of disabled patient in cooperation and/or partial cooperation, lifting tools, auxiliary, wheelchair, and training have the most role among risk factors for above-mentioned wards, increasing the number of human resources and wheelchair, use of lifting and auxiliary tools and training reduce MAPO score and consequently the risk of musculoskeletal disorders.

  13. Adrenal suppression by inhaled corticosteroids in patients with asthma: A systematic review and quantitative analysis.

    Science.gov (United States)

    Kowalski, Marek L; Wojciechowski, Piotr; Dziewonska, Marta; Rys, Przemyslaw

    2016-01-01

    Inhaled corticosteroids used for treating persistent asthma can suppress adrenal cortisol secretion. This inhibition of endogenous cortisol secretion is an important marker of systemic steroid activity. Although meta-analyses have demonstrated a dose-dependent suppression of cortisol by inhaled corticosteroids, regardless of inhaler type, the impact of novel freon-free inhaled corticosteroid preparations has not been reviewed. The aim of this study was to synthesize all currently available studies on novel inhaled corticosteroid preparations, including ciclesonide, beclomethasone dipropionate, budesonide, and fluticasone propionate. In particular, we aimed to compare the effect of ciclesonide on cortisol suppression with other existing preparations. We carried out a systematic review of the medical data bases on cortisol suppression in patients due to inhaled corticosteroids. A multivariate regression model was used to determine dose-dependent relationships between each inhaled corticosteroid and cortisol suppression with respect to age, type of inhaler, and study design. From analysis of 64 studies identified in the review, the strongest dose-response urinary cortisol suppression was observed in patients treated with beclomethasone (8.4% per 100 μg; p = 0.029), followed by fluticasone (3.2% per 100 μg; p < 0.001), and budesonide (3.1% per 100 μg; p = 0.001). No significant urinary cortisol suppression was associated with ciclesonide treatment (1.8% per 100 μg; p = 0.267). Although ciclesonide did not affect cortisol levels, this appeared to be due to its unique pharmacokinetic properties rather than the use of a novel formulation. Our findings indicated that the introduction of novel freon-free delivery technologies for inhaled corticosteroids had not eliminated adverse adrenal suppression of cortisol secretion.

  14. Long-term follow-up of MRI changes in thigh muscles of patients with Facioscapulohumeral dystrophy: A quantitative study.

    Directory of Open Access Journals (Sweden)

    Farzad Fatehi

    Full Text Available Facioscapulohumeral muscular dystrophy (FSHD is one of the most common hereditary muscular disorders. Currently FSHD has no known effective treatment and detailed data on the natural history are lacking. Determination of the efficacy of a given therapeutic approach might be difficult in FSHD given the slow and highly variable disease progression. Magnetic resonance imaging (MRI has been widely used to qualitatively and quantitatively evaluate in vivo the muscle alterations in various neuromuscular disorders. The main aim of the present study was to investigate longitudinally the time-dependent changes occurring in thigh muscles of FSHD patients using quantitative MRI and to assess the potential relationships with the clinical findings. Thirty-five FSHD1 patients (17 females were enrolled. Clinical assessment tools including manual muscle testing using medical research council score (MRC, and motor function measure (MFM were recorded each year for a period ranging from 1 to 2 years. For the MRI measurements, we used a new quantitative index, i.e., the mean pixel intensity (MPI calculated from the pixel-intensity distribution in T1 weighted images. The corresponding MPI scores were calculated for each thigh, for each compartment and for both thighs totally (MPItotal. The total mean pixel intensity (MPItotal refers to the sum of each pixel signal intensity divided by the corresponding number of pixels. An increased MPItotal indicates both a raised fat infiltration together with a reduced muscle volume thereby illustrating disease progression. Clinical scores did not change significantly over time whereas MPItotal increased significantly from an initial averaged value of 39.6 to 41.1 with a corresponding rate of 0.62/year. While clinical scores and MPItotal measured at the start of the study were significantly related, no correlation was found between the rate of MPItotal and MRC sum score changes, MFMtotal and MFM subscores. The relative rate of

  15. Evaluation of the lymphocyte interphase nuclei phenotype by quantitative phase imaging (QPI in patients with endometrial ovarian cysts

    Directory of Open Access Journals (Sweden)

    S. A. Gasparyan

    2017-01-01

    Full Text Available Rationale: Ovarian endometriosis is a progressive disease with growing prevalence and severity. Therefore, the development of robust non-invasive laboratory screening methods for early diagnosis on the out-patient basis seems quite relevant. Aim: To assess a potential of the quantitative phase imaging technique for early diagnosis of ovarian endometrial cysts and post-operative relapses of the disease. Materials and methods: We analyzed 1578 nuclei of the peripheral blood lymphocytes from 82 patients with ovarian endometrial cysts, aged 21 to 37 years (mean age 26.4 ± 3.6 years. The patients were follow-up in a gynecology out-patient clinic (the town of Yessentuki, Russia. Assessments were made longitudinally, i.e., before a laparoscopic cystectomy, at 6 and 12 months in the post-operative period with or without treatment with dienogest-containing agents. Morphological and functional status of the nuclei from the peripheral blood lymphocytes was assessed in the real-time mode by quantitative phase imaging (QPI with the phase-interference microscopy module of the Bioni hardware and software complex (Westgrade Ltd., Moscow for clinical and laboratory diagnostics, and the morphodensitometric segmentation technology. Results: The comparative analysis of morphometric parameters of CD3+ cells taken from peripheral blood of healthy non-pregnant women and patients with ovarian endometrial cysts before surgery showed a significant increase of the calculated functional activities of the lymphocyte nuclei (0.898 vs 0.783, p < 0.05. Assessment of changes overt time in the differential diagnostic criteria of the nuclear response in the peripheral blood lymphocytes from patients with endometrial ovarian cysts showed the following. Compared to the parameters obtained before treatment, at 6 and 12 months of the post-operative period the relative intensity of nuclear segments (ΔI decreased by 10.3 and 14.7, 10.6 and 12.9% in the group treated with and without

  16. Quantitative Analysis of Lateral Pinch Force in Quadriplegic Patients Using Functional Neuromuscular Stimulation with Computer Stimulation

    Directory of Open Access Journals (Sweden)

    Ali Esteki

    2004-10-01

    Full Text Available Objective: In some applications of functional neuromuscular stimulation (FNS, the distal joint of the thumb (IP in quadriplegic patients is sometimes surgically fused at zero degrees and the FPL is stimulated. This prevents hyperextension and extreme flexion of the IP joint during lateral pinch. However, IP joint fusion removes one degree of freedom from the thumb and may reduce the grip force. An alternative approach, preferably without surgical alterations, using sufficient electrical stimulation of selected muscles was investigated. A 3D model of prehensile lateral pinch was developed. Computer simulation of the model was used to find an approach providing the appropriate posture and adequate lateral grip force for quadriplegic patients using FNS. Materials & Methods: The model consists of a multi-rigid-body system connected by one or two degree(s of freedom joints acted upon by passive resistive moments, active muscle moments and moments of external contact forces. Passive resistive moments were measured at each joint, active muscle moments were computed using a simple muscle model, and moments of external force were computed based on a force-displacement relationship for finger pads. In addition to the current strategy, two possible alternatives were studied: increasing the fused joint angle and activation of multiple muscles without joint fusion. Normal component of the grip force and its angle with respect to the horizontal plane were computed and compared for the studied cases. Results: Results showed, by using the current FNS strategy, a convenient posture and a grip force of 10.1 (N are achieved which is comparable to what is measured experimentally and introduced in the literature. Increasing the joint fusion angle from 0 to 15 and 30 degrees in parallel with the activation of FPL increased the grip force from 10.1 to 10.7 and 11.2 (N, respectively, but resulted in inconvenient posture. Among all different combinations of the muscles

  17. Quantitative evaluation of patient-specific quality assurance using online dosimetry system

    Science.gov (United States)

    Jung, Jae-Yong; Shin, Young-Ju; Sohn, Seung-Chang; Min, Jung-Whan; Kim, Yon-Lae; Kim, Dong-Su; Choe, Bo-Young; Suh, Tae-Suk

    2018-01-01

    In this study, we investigated the clinical performance of an online dosimetry system (Mobius FX system, MFX) by 1) dosimetric plan verification using gamma passing rates and dose volume metrics and 2) error-detection capability evaluation by deliberately introduced machine error. Eighteen volumetric modulated arc therapy (VMAT) plans were studied. To evaluate the clinical performance of the MFX, we used gamma analysis and dose volume histogram (DVH) analysis. In addition, to evaluate the error-detection capability, we used gamma analysis and DVH analysis utilizing three types of deliberately introduced errors (Type 1: gantry angle-independent multi-leaf collimator (MLC) error, Type 2: gantry angle-dependent MLC error, and Type 3: gantry angle error). A dosimetric verification comparison of physical dosimetry system (Delt4PT) and online dosimetry system (MFX), gamma passing rates of the two dosimetry systems showed very good agreement with treatment planning system (TPS) calculation. For the average dose difference between the TPS calculation and the MFX measurement, most of the dose metrics showed good agreement within a tolerance of 3%. For the error-detection comparison of Delta4PT and MFX, the gamma passing rates of the two dosimetry systems did not meet the 90% acceptance criterion with the magnitude of error exceeding 2 mm and 1.5 ◦, respectively, for error plans of Types 1, 2, and 3. For delivery with all error types, the average dose difference of PTV due to error magnitude showed good agreement between calculated TPS and measured MFX within 1%. Overall, the results of the online dosimetry system showed very good agreement with those of the physical dosimetry system. Our results suggest that a log file-based online dosimetry system is a very suitable verification tool for accurate and efficient clinical routines for patient-specific quality assurance (QA).

  18. Quantitation of the reconstruction quality of a four-dimensional computed tomography process for lung cancer patients

    International Nuclear Information System (INIS)

    Lu Wei; Parikh, Parag J.; El Naqa, Issam M.; Nystrom, Michelle M.; Hubenschmidt, James P.; Wahab, Sasha H.; Mutic, Sasa; Singh, Anurag K.; Christensen, Gary E.; Bradley, Jeffrey D.; Low, Daniel A.

    2005-01-01

    We have developed a four-dimensional computed tomography (4D CT) technique for mapping breathing motion in radiotherapy treatment planning. A multislice CT scanner (1.5 mm slices) operated in cine mode was used to acquire 12 contiguous slices in each couch position for 15 consecutive scans (0.5 s rotation, 0.25 s between scans) while the patient underwent simultaneous quantitative spirometry measurements to provide a sorting metric. The spirometry-sorted scans were used to reconstruct a 4D data set. A critical factor for 4D CT is quantifying the reconstructed data set quality which we measure by correlating the metric used relative to internal-object motion. For this study, the internal air content within the lung was used as a surrogate for internal motion measurements. Thresholding and image morphological operations were applied to delineate the air-containing tissues (lungs, trachea) from each CT slice. The Hounsfield values were converted to the internal air content (V). The relationship between the air content and spirometer-measured tidal volume (ν) was found to be quite linear throughout the lungs and was used to estimate the overall accuracy and precision of tidal volume-sorted 4D CT. Inspection of the CT-scan air content as a function of tidal volume showed excellent correlations (typically r>0.99) throughout the lung volume. Because of the discovered linear relationship, the ratio of internal air content to tidal volume was indicative of the fraction of air change in each couch position. Theoretically, due to air density differences within the lung and in room, the sum of these ratios would equal 1.11. For 12 patients, the mean value was 1.08±0.06, indicating the high quality of spirometry-based image sorting. The residual of a first-order fit between ν and V was used to estimate the process precision. For all patients, the precision was better than 8%, with a mean value of 5.1%±1.9%. This quantitative analysis highlights the value of using spirometry

  19. Quantitative modeling of the accuracy in registering preoperative patient-specific anatomic models into left atrial cardiac ablation procedures.

    Science.gov (United States)

    Rettmann, Maryam E; Holmes, David R; Kwartowitz, David M; Gunawan, Mia; Johnson, Susan B; Camp, Jon J; Cameron, Bruce M; Dalegrave, Charles; Kolasa, Mark W; Packer, Douglas L; Robb, Richard A

    2014-02-01

    In cardiac ablation therapy, accurate anatomic guidance is necessary to create effective tissue lesions for elimination of left atrial fibrillation. While fluoroscopy, ultrasound, and electroanatomic maps are important guidance tools, they lack information regarding detailed patient anatomy which can be obtained from high resolution imaging techniques. For this reason, there has been significant effort in incorporating detailed, patient-specific models generated from preoperative imaging datasets into the procedure. Both clinical and animal studies have investigated registration and targeting accuracy when using preoperative models; however, the effect of various error sources on registration accuracy has not been quantitatively evaluated. Data from phantom, canine, and patient studies are used to model and evaluate registration accuracy. In the phantom studies, data are collected using a magnetically tracked catheter on a static phantom model. Monte Carlo simulation studies were run to evaluate both baseline errors as well as the effect of different sources of error that would be present in a dynamic in vivo setting. Error is simulated by varying the variance parameters on the landmark fiducial, physical target, and surface point locations in the phantom simulation studies. In vivo validation studies were undertaken in six canines in which metal clips were placed in the left atrium to serve as ground truth points. A small clinical evaluation was completed in three patients. Landmark-based and combined landmark and surface-based registration algorithms were evaluated in all studies. In the phantom and canine studies, both target registration error and point-to-surface error are used to assess accuracy. In the patient studies, no ground truth is available and registration accuracy is quantified using point-to-surface error only. The phantom simulation studies demonstrated that combined landmark and surface-based registration improved landmark-only registration

  20. Quantitative modeling of the accuracy in registering preoperative patient-specific anatomic models into left atrial cardiac ablation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Rettmann, Maryam E., E-mail: rettmann.maryam@mayo.edu; Holmes, David R.; Camp, Jon J.; Cameron, Bruce M.; Robb, Richard A. [Biomedical Imaging Resource, Mayo Clinic College of Medicine, Rochester, Minnesota 55905 (United States); Kwartowitz, David M. [Department of Bioengineering, Clemson University, Clemson, South Carolina 29634 (United States); Gunawan, Mia [Department of Biochemistry and Molecular and Cellular Biology, Georgetown University, Washington D.C. 20057 (United States); Johnson, Susan B.; Packer, Douglas L. [Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905 (United States); Dalegrave, Charles [Clinical Cardiac Electrophysiology, Cardiology Division Hospital Sao Paulo, Federal University of Sao Paulo, 04024-002 Brazil (Brazil); Kolasa, Mark W. [David Grant Medical Center, Fairfield, California 94535 (United States)

    2014-02-15

    Purpose: In cardiac ablation therapy, accurate anatomic guidance is necessary to create effective tissue lesions for elimination of left atrial fibrillation. While fluoroscopy, ultrasound, and electroanatomic maps are important guidance tools, they lack information regarding detailed patient anatomy which can be obtained from high resolution imaging techniques. For this reason, there has been significant effort in incorporating detailed, patient-specific models generated from preoperative imaging datasets into the procedure. Both clinical and animal studies have investigated registration and targeting accuracy when using preoperative models; however, the effect of various error sources on registration accuracy has not been quantitatively evaluated. Methods: Data from phantom, canine, and patient studies are used to model and evaluate registration accuracy. In the phantom studies, data are collected using a magnetically tracked catheter on a static phantom model. Monte Carlo simulation studies were run to evaluate both baseline errors as well as the effect of different sources of error that would be present in a dynamicin vivo setting. Error is simulated by varying the variance parameters on the landmark fiducial, physical target, and surface point locations in the phantom simulation studies. In vivo validation studies were undertaken in six canines in which metal clips were placed in the left atrium to serve as ground truth points. A small clinical evaluation was completed in three patients. Landmark-based and combined landmark and surface-based registration algorithms were evaluated in all studies. In the phantom and canine studies, both target registration error and point-to-surface error are used to assess accuracy. In the patient studies, no ground truth is available and registration accuracy is quantified using point-to-surface error only. Results: The phantom simulation studies demonstrated that combined landmark and surface-based registration improved

  1. Quantitative Detection of Shiga Toxins Directly from Stool Specimens of Patients Associated with an Outbreak of Enterohemorrhagic Escherichia coli in Japan--Quantitative Shiga toxin detection from stool during EHEC outbreak.

    Science.gov (United States)

    Yamasaki, Eiki; Watahiki, Masanori; Isobe, Junko; Sata, Tetsutaro; Nair, G Balakrish; Kurazono, Hisao

    2015-10-27

    Detection of Shiga toxins (Stx) is important for accurate diagnosis of Enterohemorrhagic Escherichia coli infection. In this study, we quantitatively analyzed Stx protein in nine patients' stool during an outbreak that occurred in Japan. Highly sensitive immunoassay (bead enzyme-linked immunosorbent assay (bead-ELISA)) revealed that the concentrations of toxins in stool of patients ranged from 0.71 to 10.44 ng/mL for Stx1 and 2.75 to 51.61 ng/mL for Stx2. To our knowledge, this is the first report that reveals the range of Stx protein concentrations in human stools.

  2. Correlation between quantitative EEG and cerebral blood flow and oxygen metabolism in patients with dementia of Alzheimer type

    International Nuclear Information System (INIS)

    Kudoh, Masako; Takahashi, Satoshi; Yonezawa, Hisashi

    1997-01-01

    Quantitative scalp EEG and cerebral blood flow (CBF) and oxygen metabolism (CMRO 2 ) measured by the steady-state 15 O technique and positron emission tomography were studied in 19 patients with mild to moderate dementia of Alzheimer type (DAT) and age-matched controls (EEG=19, PET=6). Scalp electrodes were placed according to the international 10-20 method except for Cz, T3, and T4. To evaluate the relative changes in power for each frequency band between the two groups, the percentage power fraction (percentage power for each frequency band at a site compared to the total power at that site; %delta for 2.0-3.8 Hz, %theta for 4.0-7.8 Hz, %alpha for 8.0-12.8 Hz, %beta for 13.0-25.4 Hz) was calculated. Compared with controls, DAT patients showed a significant decrease in %alpha, while significant increases in %theta at all electrodes, and significant increases in %delta at the temporal, parietal and occipital electrodes were observed. The patient group displayed a significant decrease in rCBF and rCMRO 2 in the parietal, temporal and frontal cortices, but the reduction in rCMRO 2 was less remarkable than that of rCBF. %Theta at P3, O1 and O2 showed a significant negative correlation with rCBF, and %theta at P3, O1showed a significant negative correlation with rCMRO 2 . %Delta at P3, P4 and T5 was significantly negatively correlated with rCBF in the corresponding regions, and %alpha at almost all the electrodes (except O1, F3, P3) was significantly positively correlated with rCBF in the corresponding regions. %Delta and %alpha did not show any significant correlation with rCMRO 2 . (author)

  3. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    International Nuclear Information System (INIS)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine; Hinz, Kerstin; Prokein, Jana; Becker, Hartmut

    2009-01-01

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  4. Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Soeylen, Bahar; Schmidtke, Joerg; Arslan-Kirchner, Mine [Hannover Medical School, Institute of Human Genetics, Hannover (Germany); Hinz, Kerstin [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Vivantes Klinikum Neukoelln, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Prokein, Jana [Hannover Medical School, Institute for Biometrics, Hannover (Germany); Becker, Hartmut [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany)

    2009-06-15

    This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described. (orig.)

  5. Interim-treatment quantitative PET parameters predict progression and death among patients with hodgkin's disease

    International Nuclear Information System (INIS)

    Tseng, Diane; Tran, Phuoc T; Rachakonda, Leelanand P; Su, Zheng; Advani, Ranjana; Horning, Sandra; Hoppe, Richard T; Quon, Andrew; Graves, Edward E; Loo, Billy W Jr

    2012-01-01

    We hypothesized that quantitative PET parameters may have predictive value beyond that of traditional clinical factors such as the International Prognostic Score (IPS) among Hodgkin's disease (HD) patients. Thirty HD patients treated at presentation or relapse had staging and interim-treatment PET-CT scans. The majority of patients (53%) had stage III-IV disease and 67% had IPS ≥ 2. Interim-treatment scans were performed at a median of 55 days from the staging PET-CT. Chemotherapy regimens used: Stanford V (67%), ABVD (17%), VAMP (10%), or BEACOPP (7%). Hypermetabolic tumor regions were segmented semiautomatically and the metabolic tumor volume (MTV), mean standardized uptake value (SUVmean), maximum SUV (SUVmax) and integrated SUV (iSUV) were recorded. We analyzed whether IPS, absolute value PET parameters or the calculated ratio of interim- to pre-treatment PET parameters were associated with progression free survival (PFS) or overall survival (OS). Median follow-up of the study group was 50 months. Six of the 30 patients progressed clinically. Absolute value PET parameters from pre-treatment scans were not significant. Absolute value SUVmax from interim-treatment scans was associated with OS as determined by univariate analysis (p < 0.01). All four calculated PET parameters (interim/pre-treatment values) were associated with OS: MTV int/pre (p < 0.01), SUVmean int/pre (p < 0.05), SUVmax int/pre (p = 0.01), and iSUV int/pre (p < 0.01). Absolute value SUVmax from interim-treatment scans was associated with PFS (p = 0.01). Three calculated PET parameters (int/pre-treatment values) were associated with PFS: MTV int/pre (p = 0.01), SUVmax int/pre (p = 0.02) and iSUV int/pre (p = 0.01). IPS was associated with PFS (p < 0.05) and OS (p < 0.01). Calculated PET metrics may provide predictive information beyond that of traditional clinical factors and may identify patients at high risk of treatment failure early for treatment intensification

  6. Quantitative measurement of elasticity of the appendix using shear wave elastography in patients with suspected acute appendicitis.

    Directory of Open Access Journals (Sweden)

    Seung-Whan Cha

    Full Text Available Shear wave elastography (SWE has not been studied for diagnosing appendicitis. We postulated that an inflamed appendix would become stiffer than a normal appendix. We evaluated the elastic modulus values (EMV by SWE in healthy volunteers, patients without appendicitis, and patients with appendicitis. We also evaluated diagnostic ability of SWE for differentiating an inflamed from a normal appendix in patients with suspected appendicitis.Forty-one patients with clinically suspected acute appendicitis and 11 healthy volunteers were prospectively enrolled. Gray-scale ultrasonography (US, SWE and multi-slice computed tomography (CT were performed. The EMV was measured in the anterior, medial, and posterior appendiceal wall using SWE, and the highest value (kPa was recorded.Patients were classified into appendicitis (n = 30 and no appendicitis groups (n = 11. One case of a negative appendectomy was detected. The median EMV was significantly higher in the appendicitis group (25.0 kPa compared to that in the no appendicitis group (10.4 kPa or in the healthy controls (8.3 kPa (p<0.001. Among SWE and other US and CT features, CT was superior to any conventional gray-scale US feature or SWE. Either the CT diameter criterion or combined three CT features predicted true positive in 30 and true negative in 11 cases and yielded 100% sensitivity and 100% specificity. An EMV of 12.5 kPa for the stiffest region of the appendix predicted true positive in 28, true negative in 11, and false negative in two cases. The EMV (≥12.5 kPa yielded 93% sensitivity and 100% specificity.Our results suggest that EMV by SWE helps distinguish an inflamed from a normal appendix. Given that SWE has high specificity, quantitative measurement of the elasticity of the appendix may provide complementary information, in addition to morphologic features on gray-scale US, in the diagnosis of appendicitis.

  7. Value of quantitative magnetic resonance imaging T1-relaxometry in predicting contrast-enhancement in glioblastoma patients.

    Science.gov (United States)

    Hattingen, Elke; Müller, Andreas; Jurcoane, Alina; Mädler, Burkhard; Ditter, Philip; Schild, Hans; Herrlinger, Ulrich; Glas, Martin; Kebir, Sied

    2017-08-08

    The repetitive usage of gadolinium-based contrast agents (GBCA) is critical for magnetic resonance imaging (MRI) evaluation of tumor burden in glioblastoma patients. It is also a crucial tool for determination of radiographical response to treatment. GBCA injection, however, comes with a 2.4% rate of adverse events including life-threatening conditions such as nephrogenic systemic fibrosis (NSF). Moreover, GBCA have been shown to be deposited in brain tissue of patients even with an intact blood-brain barrier (BBB). The present study explores quantitative T1 relaxometry as an alternative non-invasive imaging technique detection of tumor burden and determination of radiographical response. This technique exploits specific properties of brain tissue with impaired BBB. With a sensitivity and specificity as high as 86% and 80%, respectively, quantitative T1-relaxometry allows for detecting contrast-enhancing areas without the use of GBCA. This method could make it unnecessary to subject patients to the risk of adverse events associated with the use of GBCA. Nonetheless, a large-scale analysis is needed to confirm our findings. Gadolinium-based contrast agents (GBCA) are crucial for magnetic resonance imaging (MRI)-based evaluation of tumor burden in glioblastoma (GBM). Serious adverse events of GBCA, even though uncommon, and gadolinium deposition in brain tissue could be avoided by novel imaging techniques not requiring GBCA. Altered tissue composition in areas with impaired blood-brain-barrier also alters the quantified T1 relaxation time (qT1), so that qT1 analysis could replace GBCA-based MRI for the analysis of tumor burden and response. As a part of a prospective pilot MRI-relaxometry trial, patients with newly-diagnosed GBM who relapsed under standard radiochemotherapy were selected for this study. At recurrence, subtraction of qT1 maps pre and post-GBCA application (ΔqT1 maps) was used to determine areas of contrast-enhancement. With the contrast

  8. Are we effectively informing patients? A quantitative analysis of on-line patient education resources from the American Society of Neuroradiology.

    Science.gov (United States)

    Hansberry, D R; Agarwal, N; Gonzales, S F; Baker, S R

    2014-07-01

    The ubiquitous use of the Internet by the public in an attempt to better understand their health care requires the on-line resources written at an appropriate level to maximize comprehension for the average user. The National Institutes of Health and the American Medical Association recommend on-line patient education resources written at a third-to-seventh grade level. We evaluated the readability of the patient education resources provided on the Web site of the American Society of Neuroradiology (http://www.asnr.org/patientinfo/). All patient education material from the ASNR Web site and the Society of Neurointerventional Surgery Web site were downloaded and evaluated with the computer software, Readability Studio Professional Edition, by using 10 quantitative readability scales: the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Coleman-Liau Index, Gunning Fog Index, New Dale-Chall, FORCAST Formula, Fry Graph, Raygor Reading Estimate, and New Fog Count. An unpaired t test was used to compare the readability level of resources available on the American Society of Neuroradiology and the Society of Neurointerventional Surgery Web sites. The 20 individual patient education articles were written at a 13.9 ± 1.4 grade level with only 5% written at Neuroradiology and Society of Neurointerventional Surgery Web sites. The patient education resources on these Web sites fail to meet the guidelines of the National Institutes of Health and American Medical Association. Members of the public may fail to fully understand these resources and would benefit from revisions that result in more comprehensible information cast in simpler language. © 2014 by American Journal of Neuroradiology.

  9. Validity and sensitivity to change of the semi-quantitative OMERACT ultrasound scoring system for tenosynovitis in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Naredo, Esperanza

    2016-01-01

    OBJECTIVES: The aim was to evaluate the metric properties of the semi-quantitative OMERACT US scoring system vs a novel quantitative US scoring system for tenosynovitis, by testing its intra- and inter-reader reliability, sensitivity to change and comparison with clinical tenosynovitis scoring...... in a 6-month follow-up study. METHODS: US and clinical assessments of the tendon sheaths of the clinically most affected hand and foot were performed at baseline, 3 and 6 months in 51 patients with RA. Tenosynovitis was assessed using the semi-quantitative scoring system (0-3) proposed by the OMERACT US...... tenosynovitis score was performed, calculating a sum score per patient. RESULTS: The intra- and inter-observer agreements for US tenosynovitis assessments were very good at baseline and for change for GS and CD, but less good for PI. The smallest detectable change was 0.97 for GS, 0.93 for CD and 30.1 for PI...

  10. Detection of Haemophilus influenzae in respiratory secretions from pneumonia patients by quantitative real-time polymerase chain reaction.

    Science.gov (United States)

    Abdeldaim, Guma M K; Strålin, Kristoffer; Kirsebom, Leif A; Olcén, Per; Blomberg, Jonas; Herrmann, Björn

    2009-08-01

    A quantitative real-time polymerase chain reaction (PCR) based on the omp P6 gene was developed to detect Haemophilus influenzae. Its specificity was determined by analysis of 29 strains of 11 different Haemophilus spp. and was compared with PCR assays having other target genes: rnpB, 16S rRNA, and bexA. The method was evaluated on nasopharyngeal aspirates from 166 adult patients with community-acquired pneumonia. When 10(4) DNA copies/mL was used as cutoff limit for the method, P6 PCR had a sensitivity of 97.5% and a specificity of 96.0% compared with the culture. Of 20 culture-negative but P6 PCR-positive cases, 18 were confirmed by fucK PCR as H. influenzae. Five (5.9%) of 84 nasopharyngeal aspirates from adult controls tested PCR positive. We conclude that the P6 real-time PCR is both sensitive and specific for identification of H. influenzae in respiratory secretions. Quantification facilitates discrimination between disease-causing H. influenzae strains and commensal colonization.

  11. Quantitative MRI for hepatic fat fraction and T2* measurement in pediatric patients with non-alcoholic fatty liver disease

    International Nuclear Information System (INIS)

    Deng, Jie; Rigsby, Cynthia K.; Donaldson, James S.; Fishbein, Mark H.; Zhang, Gang; Schoeneman, Samantha E.

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. The gold standard for diagnosis is liver biopsy. MRI is a non-invasive imaging method to provide quantitative measurement of hepatic fat content. The methodology is particularly appealing for the pediatric population because of its rapidity and radiation-free imaging techniques. To develop a multi-point Dixon MRI method with multi-interference models (multi-fat-peak modeling and bi-exponential T2* correction) for accurate hepatic fat fraction (FF) and T2* measurements in pediatric patients with NAFLD. A phantom study was first performed to validate the accuracy of the MRI fat fraction measurement by comparing it with the chemical fat composition of the ex-vivo pork liver-fat homogenate. The most accurate model determined from the phantom study was used for fat fraction and T2* measurements in 52 children and young adults referred from the pediatric hepatology clinic with suspected or identified NAFLD. Separate T2* values of water (T2* W ) and fat (T2* F ) components derived from the bi-exponential fitting were evaluated and plotted as a function of fat fraction. In ten patients undergoing liver biopsy, we compared histological analysis of liver fat fraction with MRI fat fraction. In the phantom study the 6-point Dixon with 5-fat-peak, bi-exponential T2* modeling demonstrated the best precision and accuracy in fat fraction measurements compared with other methods. This model was further calibrated with chemical fat fraction and applied in patients, where similar patterns were observed as in the phantom study that conventional 2-point and 3-point Dixon methods underestimated fat fraction compared to the calibrated 6-point 5-fat-peak bi-exponential model (P W (27.9 ± 3.5 ms) decreased, whereas T2* F (20.3 ± 5.5 ms) increased; and T2* W and T2* F became increasingly more similar when fat fraction was higher than 15-20%. Histological fat fraction measurements in

  12. Quantitative MRI for hepatic fat fraction and T2* measurement in pediatric patients with non-alcoholic fatty liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Jie; Rigsby, Cynthia K.; Donaldson, James S. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States); Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago, IL (United States); Fishbein, Mark H. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Division of Gastroenterology, Hepatology, and Nutrition, Chicago, IL (United States); Zhang, Gang [Ann and Robert H. Lurie Children' s Hospital of Chicago, Biostatistics Research Core, Chicago, IL (United States); Schoeneman, Samantha E. [Ann and Robert H. Lurie Children' s Hospital of Chicago, Department of Medical Imaging, Chicago, IL (United States)

    2014-11-15

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. The gold standard for diagnosis is liver biopsy. MRI is a non-invasive imaging method to provide quantitative measurement of hepatic fat content. The methodology is particularly appealing for the pediatric population because of its rapidity and radiation-free imaging techniques. To develop a multi-point Dixon MRI method with multi-interference models (multi-fat-peak modeling and bi-exponential T2* correction) for accurate hepatic fat fraction (FF) and T2* measurements in pediatric patients with NAFLD. A phantom study was first performed to validate the accuracy of the MRI fat fraction measurement by comparing it with the chemical fat composition of the ex-vivo pork liver-fat homogenate. The most accurate model determined from the phantom study was used for fat fraction and T2* measurements in 52 children and young adults referred from the pediatric hepatology clinic with suspected or identified NAFLD. Separate T2* values of water (T2*{sub W}) and fat (T2*{sub F}) components derived from the bi-exponential fitting were evaluated and plotted as a function of fat fraction. In ten patients undergoing liver biopsy, we compared histological analysis of liver fat fraction with MRI fat fraction. In the phantom study the 6-point Dixon with 5-fat-peak, bi-exponential T2* modeling demonstrated the best precision and accuracy in fat fraction measurements compared with other methods. This model was further calibrated with chemical fat fraction and applied in patients, where similar patterns were observed as in the phantom study that conventional 2-point and 3-point Dixon methods underestimated fat fraction compared to the calibrated 6-point 5-fat-peak bi-exponential model (P < 0.0001). With increasing fat fraction, T2*{sub W} (27.9 ± 3.5 ms) decreased, whereas T2*{sub F} (20.3 ± 5.5 ms) increased; and T2*{sub W} and T2*{sub F} became increasingly more similar when fat

  13. QUANTITATIVE KARYOLOGICAL ANALYSIS OF IMMATURE GERM CELLS FROM EJACULATE AS PART OF EXAMINATION OF PATIENTS WITH INFERTILITY IN MARRIAGE

    Directory of Open Access Journals (Sweden)

    M. V. Andreeva

    2017-01-01

    Full Text Available Male factor contributes significantly to the problem of infertile marriages. Alterations of morphological and/or functional characteristics of germ cells can result in infertility. We analyzed 122 semen samples – 55 samples with normal (≥ 15 million/ml sperm concentration (group I and 67 samples with cryptozoospermia or severe oligozoospermia (concentration < 1 million/ml, group II. Standard semen analysis and quantitative karyological analysis of immature germ cells from ejaculate (QKA IGC (patent L.F. Kurilo № 2328736, 2007 were performed for all samples. The results of QKA IGC are significantly different in the two groups analyzed. The proportion of IGC at stages of preleptotene-zygotene and pachytene is verified to be higher (p < 0.01 in the sperm samples with normal concentration (group 1, indicating spermatogenesis arrest at prophase I of meiosis. In the semen samples of group 2 (patients with cryptozoospermia or with severe oligozoospermia, sperm concentration < 1 million/ml proportion of spermatocytes II and spermatids is significantly higher than in the group with normal sperm concentration, that indicates the spermatogenesis arrest at the stage of sperm formation (spermiogenesis. IGC index in 58 % of the samples from the group I is higher than normal IGC index. For the majority of the samples from the group II the IGC index was not estimated because of lack of spermatozoa. In all sperm samples with suspected azoospermia examined through QKA IGC spermatozoa were identified (44 samples from group II. Thus, if azoospermia is suspected, QKA IGC can be recommended to patients as an alternative to diagnostic testicular or epididimal biopsy. QKA IGC is unique in the assessment of the of spermatogenesis dynamics, as it is precise, safe, non-invasive and time-saving method that allows multiple repeated evaluation of IGC at different stages of spermatogenesis. 

  14. The role of quantitative estrogen receptor status in predicting tumor response at surgery in breast cancer patients treated with neoadjuvant chemotherapy.

    Science.gov (United States)

    Raphael, Jacques; Gandhi, Sonal; Li, Nim; Lu, Fang-I; Trudeau, Maureen

    2017-07-01

    Estrogen receptor (ER) negative (-) breast cancer (BC) patients have better tumor response rates than ER-positive (+) patients after neoadjuvant chemotherapy (NCT). We conducted a retrospective review using the institutional database "Biomatrix" to assess the value of quantitative ER status in predicting tumor response at surgery and to identify potential predictors of survival outcomes. Univariate followed by multivariable regression analyses were conducted to assess the association between quantitative ER and tumor response assessed as tumor size reduction and pathologic complete response (pCR). Predictors of recurrence-free survival (RFS) were identified using a cox proportional hazards model (CPH). A log-rank test was used to compare RFS between groups if a significant predictor was identified. 304 patients were included with a median follow-up of 43.3 months (Q1-Q3 28.7-61.1) and a mean age of 49.7 years (SD 10.9). Quantitative ER was inversely associated with tumor size reduction and pCR (OR 0.99, 95% CI 0.99-1.00, p = 0.027 and 0.98 95% CI 0.97-0.99, p Quantitative ER status is inversely associated with tumor response in BC patients treated with NCT. A cut-off of 60 and 80% predicts best the association with tumor size reduction and pCR, respectively. Therefore, patients with an ER status higher than the cut-off might benefit from a neoadjuvant endocrine therapy approach. Patients with pCR had better survival outcomes independently of their tumor phenotype. Further prospective studies are needed to validate the clinical utility of quantitative ER as a predictive marker of tumor response.

  15. The effectiveness of clinical networks in improving quality of care and patient outcomes: a systematic review of quantitative and qualitative studies.

    Science.gov (United States)

    Brown, Bernadette Bea; Patel, Cyra; McInnes, Elizabeth; Mays, Nicholas; Young, Jane; Haines, Mary

    2016-08-08

    Reorganisation of healthcare services into networks of clinical experts is increasing as a strategy to promote the uptake of evidence based practice and to improve patient care. This is reflected in significant financial investment in clinical networks. However, there is still some question as to whether clinical networks are effective vehicles for quality improvement. The aim of this systematic review was to ascertain the effectiveness of clinical networks and identify how successful networks improve quality of care and patient outcomes. A systematic search was undertaken in accordance with the PRISMA approach in Medline, Embase, CINAHL and PubMed for relevant papers between 1 January 1996 and 30 September 2014. Established protocols were used separately to examine and assess the evidence from quantitative and qualitative primary studies and then integrate findings. A total of 22 eligible studies (9 quantitative; 13 qualitative) were included. Of the quantitative studies, seven focused on improving quality of care and two focused on improving patient outcomes. Quantitative studies were limited by a lack of rigorous experimental design. The evidence indicates that clinical networks can be effective vehicles for quality improvement in service delivery and patient outcomes across a range of clinical disciplines. However, there was variability in the networks' ability to make meaningful network- or system-wide change in more complex processes such as those requiring intensive professional education or more comprehensive redesign of care pathways. Findings from qualitative studies indicated networks that had a positive impact on quality of care and patients outcomes were those that had adequate resources, credible leadership and efficient management coupled with effective communication strategies and collaborative trusting relationships. There is evidence that clinical networks can improve the delivery of healthcare though there are few high quality quantitative

  16. Large-Scale Survey Findings Inform Patients' Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment.

    Science.gov (United States)

    Haun, Jolie N; Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-12-21

    Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users' experiences in using secure email messaging. To quantitatively assess veteran patients' experiences in using secure email messaging in a large patient sample. A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations' Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy-to-use (P≤.001) communication tool, compared

  17. Retrospective analysis of quantitative parameters obtained on myocardial perfusion SPECT imaging (ECTB software) in heart failure patients and their comparison with 2D-echocardiography results

    International Nuclear Information System (INIS)

    Pruthi, A.; Asopa, R.; Rajan, M.G.R.; Basu, S.

    2010-01-01

    The objectives of the study are to study the quantitative parameters obtained on Gated MPI SPECT on ECTB software in patients of fixed defects on myocardial perfusion imaging and their comparison between individuals showing evidence of hibernating myocardium and patients without any evidence of hibernating myocardium and to do the comparative analysis of quantitative parameters such as LVEF, EDV, ESV and SV obtained in the aforementioned patients on Gated MPI SPECT (ECTB) and 2D ECHOCARDIOGRAPHY. It is concluded that the present findings are consistent with the nature of hibernating myocardium i.e. non-contractile and dysfunctional myocardium. The noticeable difference in the EDV and ESV in category 'SRS 0-10' is indicative of evidence of early diastolic dysfunction in this group of patients. The trends in the LVEF, EDV and ESV are suggestive of deteriorating myocardial function with increasing extent of ischemia. The increase in left ventricular EDV and ESV with increasing ischemia is suggestive of increasing incidence of gross morphological LV cavity dilatation or 'Dilated ischemic cardiomyopathy (DCMP)' in these patients. The quantitative parameters obtained on ECTB software on MPI study shows good correlation with 2D Echocardiography results

  18. Personal history and quality of life in chronic myeloid leukemia patients: a cross-sectional study using narrative medicine and quantitative analysis.

    Science.gov (United States)

    Breccia, Massimo; Graffigna, Guendalina; Galimberti, Sara; Iurlo, Alessandra; Pungolino, Ester; Pizzuti, Michele; Maggi, Alessandro; Falzetti, Franca; Capalbo, Silvana Franca; Intermesoli, Tamara; Maffioli, Margherita; Elena, Chiara; Melosi, Alessandro; Simonetti, Federico; Capochiani, Enrico; Seta, Roberta Della; Pacilli, Matteo; Luppi, Mario; Di Renzo, Nicola; Mastrullo, Lucia; Trabacchi, Elena; Vallisa, Daniele; Rapezzi, Davide; Orlandi, Ester Maria; Gambacorti-Passerini, Carlo; Efficace, Fabio; Alimena, Giuliana

    2016-11-01

    Tyrosine kinase inhibitors (TKIs) drastically changed the outcome of patients diagnosed with chronic myeloid leukemia (CML). Several reports indicated the advantage of continue long-term adherence associated with positive outcome. Therefore, it is important to better understand from the patient's standpoint the experience of living with the disease and the related treatment. In this study, quantitative analysis and narrative medicine were combined to get insights on this issue in a population of 257 patients with CML in chronic phase treated with TKIs (43 % men, with a median age of 58 years, 27 % aged 31-50 years), followed for a median time of 5 years. Sixty-one percent of patients enrolled were treated in first line, whereas 37 % were treated in second line. The results showed more positive perceptions and acceptance in males compared to females, without impact of disease on relationships. Level of positive acceptance was more evident in elderly compared to younger patients, with a close connection with median time from diagnosis. Overall, female patients reported negative perceptions and an impact of disease on family daily living. The majority of patients understood the importance of continue adherence to treatment, with 27 % resulting less adherent (60 % for forgetfulness), even if well informed and supported by his/her physician. Narrative medicine, in association to quantitative analysis, can help physicians to understand needs of their patients in order to improve communication.

  19. Bone Status in a Patient with Insulin-Like Growth Factor-1 Receptor Deletion Syndrome: Bone Quality and Structure Evaluation Using Dual-Energy X-Ray Absorptiometry, Peripheral Quantitative Computed Tomography, and Quantitative Ultrasonography.

    Science.gov (United States)

    Pelosi, Paola; Lapi, Elisabetta; Cavalli, Loredana; Verrotti, Alberto; Pantaleo, Marilena; de Martino, Maurizio; Stagi, Stefano

    2017-01-01

    Haploinsufficiency of the insulin-like growth factor ( IGF )-1 receptor ( IGF1R ) gene is a rare, probably under-diagnosed, cause of short stature. However, the effects of IGF1R haploinsufficiency on glucose metabolism, bone status, and metabolism have rarely been investigated. We report the case of a patient referred to our center at the age of 18 months for short stature, failure to thrive, and Silver-Russell-like phenotype. Genetic analysis did not show hypomethylation of the 11p15.5 region or uniparental disomy of chromosome 7. Growth hormone (GH) stimulation tests revealed GH deficiency, whereas IGF-1 was 248 ng/mL. r-hGH treatment showed only a slight improvement (from -4.4 to -3.5 SDS). At 10 years of age, the child was re-evaluated: CGH-array identified a heterozygous de novo 4.92 Mb deletion in 15q26.2, including the IGF1R gene. Dual-energy X-ray absorptiometry showed a normal bone mineral density z -score, while peripheral quantitative computed tomography revealed reduced cortical and increased trabecular elements. A phalangeal bone quantitative ultrasonography showed significantly reduced amplitude-dependent speed of sound and bone transmission time values. The changes in bone architecture, quality, and metabolism in heterozygous IGF1R deletion patients, support the hypothesis that IGF-1 can be a key factor in bone modeling and accrual.

  20. Bone Status in a Patient with Insulin-Like Growth Factor-1 Receptor Deletion Syndrome: Bone Quality and Structure Evaluation Using Dual-Energy X-Ray Absorptiometry, Peripheral Quantitative Computed Tomography, and Quantitative Ultrasonography

    Directory of Open Access Journals (Sweden)

    Paola Pelosi

    2017-09-01

    Full Text Available Haploinsufficiency of the insulin-like growth factor (IGF-1 receptor (IGF1R gene is a rare, probably under-diagnosed, cause of short stature. However, the effects of IGF1R haploinsufficiency on glucose metabolism, bone status, and metabolism have rarely been investigated. We report the case of a patient referred to our center at the age of 18 months for short stature, failure to thrive, and Silver–Russell-like phenotype. Genetic analysis did not show hypomethylation of the 11p15.5 region or uniparental disomy of chromosome 7. Growth hormone (GH stimulation tests revealed GH deficiency, whereas IGF-1 was 248 ng/mL. r-hGH treatment showed only a slight improvement (from −4.4 to −3.5 SDS. At 10 years of age, the child was re-evaluated: CGH-array identified a heterozygous de novo 4.92 Mb deletion in 15q26.2, including the IGF1R gene. Dual-energy X-ray absorptiometry showed a normal bone mineral density z-score, while peripheral quantitative computed tomography revealed reduced cortical and increased trabecular elements. A phalangeal bone quantitative ultrasonography showed significantly reduced amplitude-dependent speed of sound and bone transmission time values. The changes in bone architecture, quality, and metabolism in heterozygous IGF1R deletion patients, support the hypothesis that IGF-1 can be a key factor in bone modeling and accrual.

  1. Quantitative study of the cervical spinal cord damage in patients with multiple sclerosis and neuromyelitis optica using diffusion tensor imaging

    International Nuclear Information System (INIS)

    Hou Huanxin; Li Yongmei; Lu Fajin; Luo Tianyou; Ouyang Yu; Zeng Chun; Zhang Zhiwei

    2012-01-01

    Objective: To investigate the changes of the cervical spinal cord in patients with relapsing-remitting multiple sclerosis (RRMS) and relapsing neuromyelitis optica (RNMO) using diffusion tensor imaging (DTI) and to analyze its correlations with clinical disability scores. Methods: Thirty patients with MS (MS group),28 patients with NMO (NMO group) and 20 healthy volunteers were imaged using DTI on a 3.0 Tesla scanner. DTI indices of cervical spinal cord from all participants were measured, including mean diffusivity (MD) and fractional anisotropy (FA), and the correlations between the DTI metrics and the expanded disability status scale (EDSS) scores were assessed. One-way ANOVA, Dunnett-t test and Spearman correlation analysis were used for statistics. Results: (1) The values of MD among three groups were different at C3 level for left lateral and dorsal columns, C4 level for the central gray substance and dorsal columns, and C5-C6 level for all structures. There were significant differences among them (F=4.006-36.814, P<0.05). The values of FA were significantly different at all levels (F=5.561-98.128, P<0.05). (2) Compared with the control group, the values of MD were increased and FA were decreased for both MS and NMO groups, there were significant differences among them (t=-0.320-3.138, P<0.05). In MS and NMO groups, there were no significant differences of MD (t=-1.183-0.069, P>0.05), while the FA at C4-C6 levels (including the central gray substance, dorsal columns,right lateral columns and left lateral columns) for NMO group were 0.57 ± 0.09, 0.56 ± 0.11, 0.54 ±0.10, 0.57±0.09, 0.55 ±0.11, 0.52 ±0.13, 0.55 ±0.11, 0.54 ±0.13, 0.54±0.10, 0.54±0.11, 0.53 ±0.13, 0.52 ±0.11; and for MS group were 0.67 ±0.10, 0.68 ±0.10, 0.68 ±0.10, 0.70 ±0.12, 0.68 ±0.11, 0.69±0.10, 0.68 ±0.11, 0.69 ±0.12, 0.67 ±0.14, 0.68 ±0.15, 0.69 ±0.14, 0.69 ±0.16, and there were significant differences between two groups (t=-0.011-0.169, P<0.05). (3) Univariate

  2. TDF and quantitative ultrasound bone quality in African patients on second line ART, ANRS 12169 2LADY sub-study.

    Science.gov (United States)

    Kabore, Firmin Nongodo; Eymard-Duvernay, Sabrina; Zoungrana, Jacques; Badiou, Stéphanie; Bado, Guillaume; Héma, Arsène; Diouf, Assane; Delaporte, Eric; Koulla-Shiro, Sinata; Ciaffi, Laura; Cournil, Amandine

    2017-01-01

    Bone demineralization, which leads to osteoporosis and increased fracture risk, is a common metabolic disorder in HIV-infected individuals. In this study, we aimed to assess the change in bone quality using quantitative ultrasound (QUS) over 96 weeks of follow-up after initiation of second-line treatment, and to identify factors associated with change in bone quality. In a randomized trial (ANRS 12169), TDF and PI-naïve participants failing standard first-line treatment, from Burkina Faso, Cameroon, and Senegal were randomized to receive either TDF/FTC/LPVr, ABC/ddI/LPVr or TDF/FTC/DRVr. Their bone quality was assessed using calcaneal QUS at baseline and every 24 weeks until week 96. Stiffness index (SI) was used to measure bone quality. Out of 228 participants, 168 (74%) were women. At baseline, median age was 37 years (IQR: 33-46 years) and median T-CD4 count was 199 cells/μl (IQR: 113-319 cells/μl). The median duration of first-line antiretroviral treatment (ART) was 52 months (IQR: 36-72 months) and the median baseline SI was 101 (IQR: 87-116). In multivariable analysis, factors associated with baseline SI were sex (β = -10.8 [-18.1,-3.5] for women), age (β = -8.7 [-12.4,-5.1] per 10 years), body mass index (BMI) (β = +0.8 [0.1,1.5] per unit of BMI), and study site (β = +12.8 [6.5,19.1] for Cameroon). After 96 weeks of second-line therapy, a reduction of 7.1% in mean SI was observed, as compared with baseline. Factors associated with SI during the follow-up were similar to those found at baseline. Exposure to TDF was not associated with a greater loss of bone quality over time. Bone quality decreased after second-line ART initiation in African patients independently of TDF exposure. Factors associated with bone quality include age, sex, baseline BMI, study site, and duration of follow-up.

  3. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

    Directory of Open Access Journals (Sweden)

    Rasha Khatib

    Full Text Available BACKGROUND: Although the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers. METHODS: Electronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints. FINDINGS: Twenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers. CONCLUSIONS: This review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi

  4. Everyday life and social relations in home-living patients with mild Alzheimer's disease and their caregivers: Quantitative and qualitative analyses

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes

    2007-01-01

    Everyday life and social relations in home-living patients with mild Alzheimer’s disease (AD) and their caregivers: quantitative and qualitative analyses. This PhD project was carried out between April 2004 and March 2007 during my employment as project coordinator in the Memory Disorder Research......, and the impact of a psychosocial intervention programme on patients and caregivers. To meet the objective three studies were conducted: 1) to investigate social participation in patients with mild AD, and to analyse predictors of low social participation; 2) to analyse how patients with mild AD cope...... with the changes they face in relation to everyday life and social relations; and 3) to identify and analyse the experience of patients and their spousal caregivers concerning the impact of an intensive psychosocial intervention programme with tailored counselling, education courses and support groups, conducted...

  5. Everyday life and social relations in home-living patients with mild Alzheimer's disease and their caregivers: Quantitative and qualitative analyses

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes

    2007-01-01

    when planning everyday life, psychosocial interventions, and care; and that early psychosocial intervention may offer important support to improve coping with everyday life and social relations in patients with mild AD and their caregivers. Future studies should focus on the long-term perspective......Everyday life and social relations in home-living patients with mild Alzheimer’s disease (AD) and their caregivers: quantitative and qualitative analyses. This PhD project was carried out between April 2004 and March 2007 during my employment as project coordinator in the Memory Disorder Research......, and the impact of a psychosocial intervention programme on patients and caregivers. To meet the objective three studies were conducted: 1) to investigate social participation in patients with mild AD, and to analyse predictors of low social participation; 2) to analyse how patients with mild AD cope...

  6. Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity

    International Nuclear Information System (INIS)

    Santos, Marcel Koenigkam; Cruvinel, Danilo Lemos; Menezes, Marcelo Bezerra de; Teixeira, Sara Reis; Vianna, Elcio de Oliveira; Elias Junior, Jorge; Martinez, Jose Antonio Baddini

    2016-01-01

    Objective: To perform a quantitative analysis of the airways using automated software, in computed tomography images of patients with cystic fibrosis, correlating the results with spirometric findings. Materials and methods: Thirty-four patients with cystic fibrosis were studied-20 males and 14 females; mean age 18 ± 9 years - divided into two groups according to the spirometry findings: group I (n = 21), without severe airflow obstruction (forced expiratory volume in first second [FEV1] > 50% predicted), and group II (n = 13), with severe obstruction (FEV1 ≤ 50% predicted). The following tracheobronchial tree parameters were obtained automatically: bronchial diameter, area, thickness, and wall attenuation. Results: On average, 52 bronchi per patient were studied. The number of bronchi analyzed was higher in group II. The correlation with spirometry findings, especially between the relative wall thickness of third to eighth bronchial generation and predicted FEV1, was better in group I. Conclusion: Quantitative analysis of the airways by computed tomography can be useful for assessing disease severity in cystic fibrosis patients. In patients with severe airflow obstruction, the number of bronchi studied by the method is higher, indicating more bronchiectasis. In patients without severe obstruction, the relative bronchial wall thickness showed a good correlation with the predicted FEV1. (author)

  7. Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcel Koenigkam; Cruvinel, Danilo Lemos; Menezes, Marcelo Bezerra de; Teixeira, Sara Reis; Vianna, Elcio de Oliveira; Elias Junior, Jorge; Martinez, Jose Antonio Baddini, E-mail: marcelk46@yahoo.com.br [Universidade de Sao Paulo (HC/FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    2016-11-15

    Objective: To perform a quantitative analysis of the airways using automated software, in computed tomography images of patients with cystic fibrosis, correlating the results with spirometric findings. Materials and methods: Thirty-four patients with cystic fibrosis were studied-20 males and 14 females; mean age 18 ± 9 years - divided into two groups according to the spirometry findings: group I (n = 21), without severe airflow obstruction (forced expiratory volume in first second [FEV1] > 50% predicted), and group II (n = 13), with severe obstruction (FEV1 ≤ 50% predicted). The following tracheobronchial tree parameters were obtained automatically: bronchial diameter, area, thickness, and wall attenuation. Results: On average, 52 bronchi per patient were studied. The number of bronchi analyzed was higher in group II. The correlation with spirometry findings, especially between the relative wall thickness of third to eighth bronchial generation and predicted FEV1, was better in group I. Conclusion: Quantitative analysis of the airways by computed tomography can be useful for assessing disease severity in cystic fibrosis patients. In patients with severe airflow obstruction, the number of bronchi studied by the method is higher, indicating more bronchiectasis. In patients without severe obstruction, the relative bronchial wall thickness showed a good correlation with the predicted FEV1. (author)

  8. The diagnosis and prognosis of impingement syndrome in the shoulder with using quantitative SPECT assessment: a prospective study of 73 patients and 24 volunteers.

    Science.gov (United States)

    Park, Jin-Young; Park, Seok-Gun; Keum, Jung-Sup; Oh, Jung-Hwan; Park, Joon-Suk

    2009-12-01

    Diagnosing impingement syndrome without rotator cuff tear usually depends on the physical examination and roentgenography, and obtaining objective evidence for this condition is at best difficult. The purpose of this study was to ascertain whether quantitatively assessing this condition with using single photon emission computerized tomography (SPECT) can diagnose impingement syndrome and predict the postoperative results. Before executing arthroscopic or open treatment, SPECT was performed on 73 patients and 24 volunteers and these people were followed up for 2 years. Any increased uptake on SPECT was investigated by using the axial view, which demonstrated the greatest uptake for the acromion, distal clavicle, greater tuberosity, lesser tuberosity and the coracoid process of the operated and non-operated sides. The patients who were diagnosed as having impingement syndrome with or without rotator cuff tear showed increased uptake on the operative side compared to the non-operated side in the assessed locations. The greater tuberosity of the humerus could be used for quantitative measurement as a postoperative prognostic factor. The bone SPECT method is useful for making the diagnosis of patients with impingement syndrome, and the results of quantitative assessment at the greater tuberosity can be used for evaluating the prognosis following the operation.

  9. A quantitative method for detecting deposits of amyloid A protein in aspirated fat tissue of patients with arthritis

    NARCIS (Netherlands)

    Hazenberg, BPC; Limburg, PC; Bijzet, J.; van Rijswijk, M.H.

    Objective-To describe a new, quantitative, and reproducible method for detecting deposits of amyloid A protein in aspirated fat tissue and to compare it with smears stained with Congo red. Methods-After extraction of at least 30 mg of abdominal fat tissue in guanidine, the amyloid A protein

  10. The effect of qualitative vs. quantitative presentation of probability estimates on patient decision‐making: a randomized trial

    OpenAIRE

    Man‐Son‐Hing, Malcolm; O'Connor, Annette M.; Drake, Elizabeth; Biggs, Jennifer; Hum, Valerie; Laupacis, Andreas

    2002-01-01

    Background  Given the greater uncertainty surrounding probability estimates associated with qualitative (use of words or phrases) descriptions, the use of quantitative (numerical) information to communicate the risks and benefits of therapies is recommended but the impact of its use in decision aids is unexplored.

  11. Stress Myocardial Perfusion CT in Patients Suspected of Having Coronary Artery Disease: Visual and Quantitative Analysis-Validation by Using Fractional Flow Reserve.

    Science.gov (United States)

    Yang, Dong Hyun; Kim, Young-Hak; Roh, Jae-Hyung; Kang, Joon-Won; Han, Dongjin; Jung, Joonho; Kim, Namkug; Lee, Jung Bok; Ahn, Jung-Min; Lee, Jong-Young; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Lee, Cheol Whan; Park, Seong-Wook; Park, Seung-Jung; Lim, Tae-Hwan

    2015-09-01

    To assess the diagnostic accuracy of stress myocardial perfusion computed tomography (CT) by using visual and quantitative analytic methods in patients with coronary artery disease, with fractional flow reserve (FFR) as a reference standard. The institutional review board approved the study, and written informed consent was obtained from all patients. The diagnostic accuracy of myocardial perfusion CT was assessed for 75 patients who underwent myocardial perfusion CT and conventional coronary angiography with reference to hemodynamically significant stenosis, defined as the presence of an FFR of 0.8 or less or an angiographically severe (≥90%) stenosis. Results of quantitative analysis of myocardial perfusion CT data were compared with those of visual analysis by using areas under the receiver operating characteristic curve (AUCs). Among the 75 patients and 210 epicardial arteries, 61 patients (81%) with 86 arteries (41%) had hemodynamically significant stenosis. The per-patient sensitivity and specificity of the visual assessment of myocardial perfusion CT data for all patients were 89% and 86%, respectively. At per-vessel analysis, the sensitivities and specificities, respectively, of myocardial perfusion CT were 80% and 95% for all vessels, 85% and 100% for 63 vessels with severe coronary calcification (defined as an Agatston score > 400), and 76% and 91% for 56 vessels in patients with multivessel disease. In severely calcified vessels, visual assessment of myocardial perfusion CT data in combination with CT angiography provided incremental value over CT angiography alone for the detection of myocardial ischemia (integrated discrimination improvement index, 0.38; P perfusion ratio had a lower AUC than visual analysis of myocardial perfusion CT (0.759 vs 0.877, P = .002). Stress myocardial perfusion CT provides incremental value over CT angiography in patients with a high calcium score for the detection of myocardial ischemia as defined by FFR.

  12. Glycosyltransferases as marker genes for the quantitative polymerase chain reaction-based detection of circulating tumour cells from blood samples of patients with breast cancer undergoing adjuvant therapy.

    Science.gov (United States)

    Kölbl, Alexandra C; Hiller, Roman A; Ilmer, Mathias; Liesche, Friederike; Heublein, Sabine; Schröder, Lennard; Hutter, Stefan; Friese, Klaus; Jeschke, Udo; Andergassen, Ulrich

    2015-08-01

    Altered glycosylation is a predominant feature of tumour cells; it serves for cell adhesion and detachment, respectively, and facilitates the immune escape of these cells. Therefore changes in the expression of glycosyltransferase genes could help to identify circulating tumour cells (CTCs) in the blood samples of cancer patients using a quantitative polymerase chain reaction (PCR) approach. Blood samples of healthy donors were inoculated with certain numbers of established breast cancer cell line cells, thus creating a model system. These samples were analysed by quantitative PCR for the expression of six different glycosyltransferase genes. The three genes with the best results in the model system were consecutively applied to samples from adjuvant breast cancer patients and of healthy donors. FUT3 and GALNT6 showed the highest increase in relative expression, while GALNT6 and ST3GAL3 were the first to reach statistically significant different ∆CT-values comparing the sample with and without addition of tumour cells. These three genes were applied to patient samples, but did not show any significant results that may suggest the presence of CTCs in the blood. Although the relative expression of some of the glycosyltransferase genes exhibited reasonable results in the model system, their application to breast cancer patient samples will have to be further improved, e.g. by co-analysis of patient blood samples by gold-standard methods.

  13. A new quantitative evaluation method of spiral drawing for patients with Parkinson’s disease based on a polar coordinate system with varying origin

    Science.gov (United States)

    Wang, Min; Wang, Bei; Zou, Junzhong; Nakamura, Masatoshi

    2012-09-01

    Parkinson's disease (PD) is a common disease of the central nervous system among the elderly, and its complex symptoms bring up challenges for the clinical diagnosis. In this paper, a new method based on a polar coordinate system with varying origin was proposed in order to quantitatively evaluate the performance in spiral drawing tasks for patients with Parkinson's disease, since this method can assess the movement ability of spiral drawing before and after deep brain stimulation (DBS) among the patients. In this paper, three normal subjects and twelve PD patients participated in spiral drawing experiment. The hand movements of patients, before and after DBS, were recorded by a digitized tablet respectively in this experiment. And the variation of origin, radius, degree and other characteristics of hand movements were evaluated by introducing a set of parameters for feature extraction. The result showed that the proposed polar coordinate system embraced good performance in the quantitative evaluation of spiral drawing. Therefore, the proposed method overcame the limitation of data processes with fixed origin for diagnosis and evaluation, and by combining with extraction and analysis of characteristic parameters it had clinical significance in measuring the effectiveness of operation or treatment for the PD patients.

  14. Comparison of contrast and noncontrast magnetic resonance angiography for quantitative analysis of thoracic arteries in young patients with congenital heart defects

    Directory of Open Access Journals (Sweden)

    Pasqua Alessia

    2011-01-01

    Full Text Available Background : Contrast MRA (C-MRA is the standard for quantitative analysis of thoracic vessels. We evaluated a noncontrast MRA (NC-MRA sequence (3-D EKG and navigator-gated SSFP for quantitative evaluation of the thoracic aorta and branch pulmonary arteries in young patients with congenital heart disease. Objective : To compare contrast and noncontrast magnetic resonance angiography for quantitative analysis of thoracic arteries in young patients with congenital heart defects. Methods : Measurements of thoracic aorta and branch pulmonary arteries were obtained from C-MRA and NC-MRA images in 51 patients, ages 2-35 years. Vessel diameters were compared using correlation and Bland-Altman analysis. Interobserver variability was assessed using percent variation. Results : C-MRA and NC-MRA measurements were highly correlated (r = 0.91-0.98 except for the right pulmonary artery (r = 0.74, 0.78. Agreement of measurements was excellent (mean difference -0.07 to -0.53 mm; mean % difference -1.8 to -4.9% except for the right pulmonary artery which was less good (mean difference 0.73, -1.38 mm; -3, -10%. Interobserver variability ranged from 5% to 8% for aortic and from 10% to 16% for pulmonary artery measures. The worse agreement and greater variability of the pulmonary artery measures appears due to difficulty standardizing the measurements in patients with abnormal and irregular vessels. Conclusion : These data indicate that C-MRA and NC-MRA measures are comparable and could be used interchangeably, avoiding administration of contrast in selected patients.

  15. Use of quantitative SPECT/CT reconstruction in99mTc-sestamibi imaging of patients with renal masses.

    Science.gov (United States)

    Jones, Krystyna M; Solnes, Lilja B; Rowe, Steven P; Gorin, Michael A; Sheikhbahaei, Sara; Fung, George; Frey, Eric C; Allaf, Mohamad E; Du, Yong; Javadi, Mehrbod S

    2018-02-01

    Technetium-99m ( 99m Tc)-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has previously been shown to allow for the accurate differentiation of benign renal oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) apart from other malignant renal tumor histologies, with oncocytomas/HOCTs showing high uptake and renal cell carcinoma (RCC) showing low uptake based on uptake ratios from non-quantitative single-photon emission computed tomography (SPECT) reconstructions. However, in this study, several tumors fell close to the uptake ratio cutoff, likely due to limitations in conventional SPECT/CT reconstruction methods. We hypothesized that application of quantitative SPECT/CT (QSPECT) reconstruction methods developed by our group would provide more robust separation of hot and cold lesions, serving as an imaging framework on which quantitative biomarkers can be validated for evaluation of renal masses with 99m Tc-sestamibi. Single-photon emission computed tomography data were reconstructed using the clinical Flash 3D reconstruction and QSPECT methods. Two blinded readers then characterized each tumor as hot or cold. Semi-quantitative uptake ratios were calculated by dividing lesion activity by background renal activity for both Flash 3D and QSPECT reconstructions. The difference between median (mean) hot and cold tumor uptake ratios measured 0.655 (0.73) with the QSPECT method and 0.624 (0.67) with the conventional method, resulting in increased separation between hot and cold tumors. Sub-analysis of 7 lesions near the separation point showed a higher absolute difference (0.16) between QPSECT and Flash 3D mean uptake ratios compared to the remaining lesions. Our finding of improved separation between uptake ratios of hot and cold lesions using QSPECT reconstruction lays the foundation for additional quantitative SPECT techniques such as SPECT-UV in the setting of renal 99m Tc-sestamibi and other SPECT/CT exams. With robust

  16. Quantitative perfusion parameters in a cohort of patients with no known ischemic heart disease and normal myocardial perfusion imaging studied by 82Rb-PET

    DEFF Research Database (Denmark)

    Hoff, Camilla; Balche, Abdallah; Majgaard, J

    -month period were screened for eligibility. One hundred and eighty patients with no prior history of ischemic heart disease, a normal MPI scan defined by visual interpretation and no coronary events for a follow-up period of 6 months were included as normal. Quantitative parameters were calculated using.......86 mL/g/min. Global coronary flow reserve (CFR) was 2.81 (±SD 0.71). EF at rest was 65.3% (±SD 10) and during stress 69% (±SD 12.3), yielding an EF reserve of 4.5%. TPD at rest and stress was 6% (±SD 4). Conclusion Based on a representative population of patients in which coronary artery disease......Purpose 82Rb perfusion PET allows for visual as well as quantitative interpretation of myocardial function. Whereas visual interpretation relies on intra-individual redistribution of the tracer between rest and stress studies, quantitative interpretation of absolute flow values requires robust...

  17. Quantitative MRI shows cerebral microstructural damage in hemolytic-uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Weissenborn, Karin; Worthmann, Hans; Heeren, Meike [Hannover Medical School, Clinic for Neurology, Hannover (Germany); Bueltmann, Eva; Donnerstag, Frank; Giesemann, Anja M.; Goetz, Friedrich; Lanfermann, Heinrich; Ding, Xiao-Qi [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Kielstein, Jan; Schwarz, Anke [Hannover Medical School, Clinic for Nephrology and Hypertension, Hannover (Germany)

    2013-07-15

    Severe neurological symptoms in Shiga toxin-producing Escherichia coli infection associated hemolytic-uremic syndrome (STEC-HUS) are often accompanied by none or only mild alterations of cerebral magnetic resonance imaging (MRI). This study aims to analyze if quantitative MRI is able to reveal cerebral pathological alterations invisible for conventional MRI. In nine patients with STEC-HUS associated severe neurological symptoms but inconspicuous cerebral MRI findings maps of the parameters T2 relaxation time, relative proton density (PD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were generated. Quantitative values of these parameters were measured at the basal ganglia, thalamus, and white matter of the frontal and parietal lobe and compared to those of nine age- and sex-matched controls. Significant T2 prolongation (p < 0.01) was found in the basal ganglia of all patients compared to controls. PD and ADC were not significantly altered. A significant reduction of FA in patients was seen at caput nuclei caudati (p < 0.01). Prolonged T2 relaxation time indicates cerebral microstructural damages in these patients despite their inconspicuous MRI findings. T2 relaxometry could be used as a complementary tool for the assessment of metabolic-toxic brain syndromes. (orig.)

  18. Clinical value of acoustic radiation force impulse in quantitative prediction of the degree of esophageal varices in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    CHEN Min

    2018-01-01

    Full Text Available Objective To investigate the clinical value of acoustic radiation force impulse (ARFI in quantitative prediction of the degree of esophageal varices in patients with cirrhotic portal hypertension. Methods A total of 116 patients with liver cirrhosis who were admitted to 302 Hospital of PLA from October 2014 to February 2016 were enrolled. ARFI was used to measure real-time liver and spleen stiffness for all patients. With the degree of esophageal varices determined by gastroscopy as the gold standard for diagnosis, these patients were divided into non-varices group (EV0, 16 patients, mild varices group (EV1, 39 patients, moderate varices group (EV2, 26 patients, and severe varices group (EV3, 35 patients. The receiver operating characteristic (ROC curve was used to analyze the clinical value of liver/spleen ARFI in predicting the degree of esophageal varices. An analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups, and the least significant difference Mann-Whitney U test was used for further comparison between any two groups; the chi-square test was used for comparison of categorical data between groups. The Spearman correlation analysis was used to investigate the correlation between the stiffness measured by ARFI and the degree of esophageal varices. Results The ARFI value of the spleen was 2.54±0.34 m/s for EV0 patients, 3.05±0.34 m/s for EV1 patients, 3.48±0.50 m/s for EV2 patients, and 3.69±0.33 m/s for EV3 patients (χ2=60.121,P<0.001. The ARFI value of the spleen was positively correlated with the grade of esophageal varices (r=0.713, P<0.001. The areas under the ROC curve for the ARFI value of the spleen in the diagnosis of ≥EV1, ≥EV2, or EV3 esophageal varices were 0.93, 0.88, and 0.83, respectively. There was no significant difference in the ARFI value of the liver between groups (P=0.085, and the ARFI value of the liver was not correlated with the degree of

  19. Detection of herpes simplex-1 and -2 and varicella zoster virus by quantitative real-time polymerase chain reaction in corneas from patients with bacterial keratitis.

    Science.gov (United States)

    Nascimento, Heloisa; Watanabe, Aripuanã; Vieira, Ana Carolina Cabreira; Pelegrini, Andrea; Yu, Maria Cecília; Bispo, Paulo José Martins; Granato, Celso Francisco Hernandes; Höfling-Lima, Ana Luisa

    2017-01-01

    Bacterial keratitis occurs worldwide, and despite recent developments, it remains a potentially blinding condition. This study assesses the presence of herpes simplex virus (HSV-1 and -2) and varicella zoster virus (VZV) by quantitative real-time polymerase chain reaction (qPCR) in corneal scrapings from patients with bacterial keratitis. A total of 65 patients with clinical diagnoses of infectious corneal ulcers prospectively underwent clinical eye examinations. Corneal scrapings were investigated by Gram staining, Giemsa staining, culture, and qPCR (the study group). Risk factors and epidemiological data were recorded. The control group comprising 25 eyes with typical herpes dendritic keratitis was also analyzed by qPCR. From the study group (n=65), nine patients (13.8%) had negative smears, cultures, and qPCR findings. Fifty-six (86.2%) patients had positive cultures: 51 for bacteria, 4 for fungi, and 1 for amoebae. Of the patients who had positive bacterial cultures, qPCR identified 10 patients who were also positive for virus: one for VZV and nine for HSV-1. Of the 25 patients in the control group, 21 tested positive for HSV-1 by qPCR analysis. Herpes may be present in patients with bacterial corneal ulcers, and qPCR may be useful in its detection.

  20. Quantitative detection of HER2 protein concentration in breast cancer tissue does not increase the number of patients eligible for adjuvant HER2-targeted therapy

    DEFF Research Database (Denmark)

    Bechmann, Troels; Olsen, Dorte Aalund; Jakobsen, Erik Hugger

    2013-01-01

    Human epidermal growth factor receptor-2 (HER2) is overexpressed in 15-20% of breast cancer patients and is associated with an aggressive tumor and a poor prognosis. Currently, patients are selected for adjuvant HER2-targeted therapy based on HER2 status by immunohistochemistry (IHC) and fluoresc......Human epidermal growth factor receptor-2 (HER2) is overexpressed in 15-20% of breast cancer patients and is associated with an aggressive tumor and a poor prognosis. Currently, patients are selected for adjuvant HER2-targeted therapy based on HER2 status by immunohistochemistry (IHC...... by Centaur, but not treated with adjuvant HER2-targeted therapy, compared to patients defined as HER2-positive by IHC/FISH and therefore treated with adjuvant HER2-targeted therapy. Tumor tissue was obtained at primary surgery from 415 breast cancer patients between 2004 and 2010. HER2 status was determined...... by quantitative immunoassay of fresh-frozen tissue and by IHC/FISH of corresponding paraffin-embedded tissue. We compared the clinical outcome in four groups of patients defined by tissue HER2 status and adjuvant HER2-targeted therapy. The final analysis included 379 patients after a median follow-up of 3.9 years...

  1. Role of quantitative and qualitative characteristics of free circulating DNA in the management of patients with non-small cell lung cancer.

    Science.gov (United States)

    Ulivi, Paola; Silvestrini, Rosella

    2013-12-01

    The release of DNA into peripheral blood is a common event in cancer patients, occurring as a consequence of necrotic and apoptotic processes typical of tumor cells. However, free circulating DNA (fcDNA) is also present in patients with benign diseases and in healthy individuals. Both quantitative and qualitative aspects of fcDNA have been studied as potential biomarkers in a number of tumor types. In particular, quantitative analysis of fcDNA has been shown to play an important role in the diagnosis of non-small cell lung cancer (NSCLC), because of its ability to discriminate between healthy subjects and individuals with NSCLC. Additionally, fcDNA in cancer patients derives predominantly from tumor tissue and, as such, it can be used for the molecular characterization of the primary tumor. Targeted therapies in NSCLC have, in recent years, produced promising results, highlighting the importance of molecular profiling of the primary cancer lesions. Considering that little or no tumor material is available for at least some of the patients, the possibility of using fcDNA for molecular analysis becomes increasingly important. In the present review we evaluated several quantitative and qualitative aspects of fcDNA that could be instrumental for the differential diagnosis of lung disease. There is ample evidence in the literature to support the possible use of peripheral blood-derived fcDNA in the early diagnosis and molecular characterization of lung cancer. This non-invasive method may also turn out to be valuable in monitoring drug response and in identifying induced mechanisms of drug resistance. Before it can be implemented in routine clinical practice, however, additional efforts are needed to standardize the methodology.

  2. Quantitative culture of endotracheal aspirate and BAL fluid samples in the management of patients with ventilator-associated pneumonia: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ricardo de Amorim Corrêa

    2014-12-01

    Full Text Available OBJECTIVE: To compare 28-day mortality rates and clinical outcomes in ICU patients with ventilator-associated pneumonia according to the diagnostic strategy used. METHODS: This was a prospective randomized clinical trial. Of the 73 patients included in the study, 36 and 37 were randomized to undergo BAL or endotracheal aspiration (EA, respectively. Antibiotic therapy was based on guidelines and was adjusted according to the results of quantitative cultures. RESULTS: The 28-day mortality rate was similar in the BAL and EA groups (25.0% and 37.8%, respectively; p = 0.353. There were no differences between the groups regarding the duration of mechanical ventilation, antibiotic therapy, secondary complications, VAP recurrence, or length of ICU and hospital stay. Initial antibiotic therapy was deemed appropriate in 28 (77.8% and 30 (83.3% of the patients in the BAL and EA groups, respectively (p = 0.551. The 28-day mortality rate was not associated with the appropriateness of initial therapy in the BAL and EA groups (appropriate therapy: 35.7% vs. 43.3%; p = 0.553; and inappropriate therapy: 62.5% vs. 50.0%; p = 1.000. Previous use of antibiotics did not affect the culture yield in the EA or BAL group (p = 0.130 and p = 0.484, respectively. CONCLUSIONS: In the context of this study, the management of VAP patients, based on the results of quantitative endotracheal aspirate cultures, led to similar clinical outcomes to those obtained with the results of quantitative BAL fluid cultures.

  3. The clinical utility of circulating tumor cells in breast cancer patients: detection by a quantitative assay of h-MAM gene expression.

    Science.gov (United States)

    Cheng, Min; Chen, Yongyan; Zou, Dehong; Shen, Guodong; Bian, Geng; Shen, Gan; Hu, Shilian

    2014-09-30

    The aim of this study was to evaluate tumor markers of molecular abnormalities that display tissue specificity, as to detect circulating tumor cells (CTCs) in breast cancer patients. Quantitative real-time RT-PCR was used to determine h-MAM, BCSG1, CK19, and c-erbB2 mRNA levels in peripheral blood (PB) of breast cancer patients. Results were compared with other epithelial cancers (lung or esophagus cancer), benign breast disease, and healthy individuals. We found that h-MAM mRNA was only detectable in the PB of patients with breast cancer (49 of 65, 75.4%), but not in patients with other epithelial cancers, benign breast disease, or healthy individuals. No significant differences in the expression level and positive detection rate of BCSG1, CK19, and c-erbB2 mRNA were observed between breast cancer and other epithelial cancers. Furthermore, the expression level and positive detection rate of h-MAM mRNA in PB were significantly correlated to the breast cancer pathologic stage (p=0.012 and p=0.015, respectively). Chemotherapy, radiotherapy, or total tumor resection (after 7 days of treatment) resulted in a significant decrease in the expression level of h-MAM mRNA in PB compared to the levels prior to the treatment (pMAM mRNA expression was detected in patients immediately after surgery, as well as 3 days post-surgery. These results indicate that the quantitative analysis of h-MAM mRNA is a useful tool for detecting CTCs in breast cancer patients, and can have a potential diagnostic utility in early micrometastasis, clinical evaluation of cancer treatment efficacy, and post-treatment monitoring of breast cancer patients.

  4. Radiologic-Pathologic Analysis of Contrast-enhanced and Diffusion-weighted MR Imaging in Patients with HCC after TACE: Diagnostic Accuracy of 3D Quantitative Image Analysis

    Science.gov (United States)

    Chapiro, Julius; Wood, Laura D.; Lin, MingDe; Duran, Rafael; Cornish, Toby; Lesage, David; Charu, Vivek; Schernthaner, Rüdiger; Wang, Zhijun; Tacher, Vania; Savic, Lynn Jeanette; Kamel, Ihab R.

    2014-01-01

    Purpose To evaluate the diagnostic performance of three-dimensional (3Dthree-dimensional) quantitative enhancement-based and diffusion-weighted volumetric magnetic resonance (MR) imaging assessment of hepatocellular carcinoma (HCChepatocellular carcinoma) lesions in determining the extent of pathologic tumor necrosis after transarterial chemoembolization (TACEtransarterial chemoembolization). Materials and Methods This institutional review board–approved retrospective study included 17 patients with HCChepatocellular carcinoma who underwent TACEtransarterial chemoembolization before surgery. Semiautomatic 3Dthree-dimensional volumetric segmentation of target lesions was performed at the last MR examination before orthotopic liver transplantation or surgical resection. The amount of necrotic tumor tissue on contrast material–enhanced arterial phase MR images and the amount of diffusion-restricted tumor tissue on apparent diffusion coefficient (ADCapparent diffusion coefficient) maps were expressed as a percentage of the total tumor volume. Visual assessment of the extent of tumor necrosis and tumor response according to European Association for the Study of the Liver (EASLEuropean Association for the Study of the Liver) criteria was performed. Pathologic tumor necrosis was quantified by using slide-by-slide segmentation. Correlation analysis was performed to evaluate the predictive values of the radiologic techniques. Results At histopathologic examination, the mean percentage of tumor necrosis was 70% (range, 10%–100%). Both 3Dthree-dimensional quantitative techniques demonstrated a strong correlation with tumor necrosis at pathologic examination (R2 = 0.9657 and R2 = 0.9662 for quantitative EASLEuropean Association for the Study of the Liver and quantitative ADCapparent diffusion coefficient, respectively) and a strong intermethod agreement (R2 = 0.9585). Both methods showed a significantly lower discrepancy with pathologically measured necrosis (residual

  5. Semi-quantitative metabolic values on FDG PET/CT including extracardiac sites of disease as a predictor of treatment course in patients with cardiac sarcoidosis.

    Science.gov (United States)

    Ishiyama, Mitsutomi; Soine, Laurie A; Vesselle, Hubert J

    2017-08-18

    Cardiac sarcoidosis is associated with major adverse cardiac events including cardiac arrest, for which anti-inflammatory treatment is indicated. Oral corticosteroid is the mainstay among treatment options; however, adverse effects are a major concern with long-term use. It would be beneficial for providers to predict treatment response and prognosis for proper management strategy of sarcoidosis, though it remains challenging. Fluorine (F)-18 fluorodeoxyglucose (FDG)-positron emission tomography(PET)/computed tomography(CT) has an advantage over anatomical imaging in providing semi-quantitative functional parameters such as standard uptake value (SUV), metabolic volume, and total lesion glycolysis (TLG), which are well-established biomarkers in oncology. However, the relationship between these parameters and treatment response has not been fully investigated in cardiac sarcoidosis. Also, the prognostic value of extracardiac active inflammation noted on FDG-PET/CT in the setting of cardiac sarcoidosis is unclear. The aim of this retrospective study was to investigate the prognostic value of semi-quantitative values of both cardiac and extracardiac disease sites derived from FDG-PET/CT in predicting treatment course in cardiac sarcoidosis. Sixteen consecutive patients with suspected cardiac sarcoidosis, who demonstrated abnormal myocardial activity on cardiac-inflammation FDG-PET/CT encompassing the entire chest/upper abdomen and subsequently underwent corticosteroid therapy for diagnosis of active cardiac sarcoidosis, were included. Semi-quantitative values of hypermetabolic lesions were derived from all visualized organ system and were compared to daily corticosteroid dose at 6 months.  Of the 16 patients, 81.3% (13/16) of the patients showed extracardiac involvement. The lesion with the greatest SUV was identified in the heart in 11 patients (68.7%), in the liver in 1 patient (6.3%), and in lymph nodes in 4 patients (25%). The maximum SUV across all visualized

  6. Everyday life and social relations in home-living patients with mild Alzheimer's disease and their caregivers: Quantitative and qualitative analyses

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes

    2007-01-01

    with the changes they face in relation to everyday life and social relations; and 3) to identify and analyse the experience of patients and their spousal caregivers concerning the impact of an intensive psychosocial intervention programme with tailored counselling, education courses and support groups, conducted...... interviews with 10 couples before and after the intervention programme. For the analysis, a template organising style of interpretation was used. Patients and caregivers found good support for coping with everyday life and social relations by participating in the intervention programme. Early counselling......Everyday life and social relations in home-living patients with mild Alzheimer’s disease (AD) and their caregivers: quantitative and qualitative analyses. This PhD project was carried out between April 2004 and March 2007 during my employment as project coordinator in the Memory Disorder Research...

  7. Everyday life and social relations in home-living patients with mild Alzheimer's disease and their caregivers: Quantitative and qualitative analyses

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes

    2007-01-01

    Everyday life and social relations in home-living patients with mild Alzheimer’s disease (AD) and their caregivers: quantitative and qualitative analyses. This PhD project was carried out between April 2004 and March 2007 during my employment as project coordinator in the Memory Disorder Research...... Group, Department of Neurology, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark, as part of the DAISY study. The overarching objective of the PhD project was to investigate patients’ perspectives of the impact of mild AD on coping with everyday life and social relations...... and support may improve patients and caregivers opportunities to adapt to the challenges of the progressive AD, and to maintain well-being. The studies suggest that impaired social participation is an important aspect of deficits in mild AD; that the perspective of the patients should be taken into account...

  8. Quantitative analysis of skeletal muscle mass in patients with rheumatic diseases under glucocorticoid therapy--comparison among bioelectrical impedance analysis, computed tomography, and magnetic resonance imaging.

    Science.gov (United States)

    Hosono, Osamu; Yoshikawa, Noritada; Shimizu, Noriaki; Kiryu, Shigeru; Uehara, Masaaki; Kobayashi, Hiroshi; Matsumiya, Ryo; Kuribara, Akiko; Maruyama, Takako; Tanaka, Hirotoshi

    2015-03-01

    To determine the availability of bioelectrical impedance analysis (BIA), computed tomography (CT), and magnetic resonance imaging (MRI) for measurement of skeletal muscle mass in patients with rheumatic diseases and quantitatively assess skeletal muscle loss after glucocorticoid (GC) treatment. The data from 22 patients with rheumatic diseases were retrospectively obtained. The muscle mass of body segments was measured with a BIA device in terms of skeletal muscle mass index (SMI). Cross-sectional area (CSA) was obtained from CT and MRI scans at the mid-thigh level using the image analysis program. We further assessed the data of three different measurements before and after GC treatment in 7 patients with rheumatic diseases. SMI of whole body was significantly correlated with estimated muscle volume and mid-thigh muscle CSA with CT and MRI (p rheumatic diseases, and CT and MRI appeared to be more accurate than BIA.

  9. Increased brain iron deposition is a risk factor for brain atrophy in patients with haemodialysis: a combined study of quantitative susceptibility mapping and whole brain volume analysis.

    Science.gov (United States)

    Chai, Chao; Zhang, Mengjie; Long, Miaomiao; Chu, Zhiqiang; Wang, Tong; Wang, Lijun; Guo, Yu; Yan, Shuo; Haacke, E Mark; Shen, Wen; Xia, Shuang

    2015-08-01

    To explore the correlation between increased brain iron deposition and brain atrophy in patients with haemodialysis and their correlation with clinical biomarkers and neuropsychological test. Forty two patients with haemodialysis and forty one age- and gender-matched healthy controls were recruited in this prospective study. 3D whole brain high resolution T1WI and susceptibility weighted imaging were scanned on a 3 T MRI system. The brain volume was analyzed using voxel-based morphometry (VBM) in patients and to compare with that of healthy controls. Quantitative susceptibility mapping was used to measure and compare the susceptibility of different structures between patients and healthy controls. Correlation analysis was used to investigate the relationship between the brain volume, iron deposition and neuropsychological scores. Stepwise multiple regression analysis was used to explore the effect of clinical biomarkers on the brain volumes in patients. Compared with healthy controls, patients with haemodialysis showed decreased volume of bilateral putamen and left insular lobe (All P brain iron deposition is negatively correlated with the decreased volume of bilateral putamen (P brain iron deposition and dialysis duration was risk factors for brain atrophy in patients with haemodialysis. The decreased gray matter volume of the left insular lobe was correlated with neurocognitive impairment.

  10. Employment-related difficulties and distressed living condition in patients with hepatitis B virus: A qualitative and quantitative study.

    Science.gov (United States)

    Oka, Taeko; Enoki, Hiroaki; Tokimoto, Yukari; Kawanishi, Teruaki; Minami, Meguru; Okuizumi, Takahiro; Katahira, Kiyohiko

    2017-06-12

    In Japan, an estimated 400,000 people have the hepatitis B virus (HBV), many of whom were infected as a result of group vaccinations. People with HBV face many challenges, including disease progression, employment-related difficulties, and increased medical expenses. The relationship between HBV victims' daily life suffering and poverty associated with HBV-related employment changes has not been examined. We aimed to clarify the employment-related hardships experienced by Japanese HBV victims, and the relationships between these hardships and daily life suffering, including poverty, through qualitative and quantitative analyses. The study population comprised 11,046 people infected with HBV via group vaccination who filed lawsuits in Japan's District Courts by 2014. First, we conducted a qualitative study (2013) using the KJ method, with 107 participants (68 men, mean age 58.9 years; 39 women, mean age 55.3 years). Semi-structured interviews were conducted covering participants' current condition, treatment, medical expenses, and life difficulties (employment- and family-related problems). In 2014, we conducted a quantitative study. We mailed questionnaires to the entire study population, investigating the topics covered in the interviews (response rate 60.1%). Daily life suffering was determined by responses to the question "What do you think about your everyday life situation?" We performed binomial logistic regression analyses to verify the relationships between daily life suffering and disease, employment, and income status. Interview data were integrated into seven islands: intention to work, lack of understanding of HBV in the workplace, inability to buy life insurance, burden due to medical expenses, life failure, dissatisfaction with the system, and wishing for life balance. The quantitative analyses showed significant positive correlations between daily life suffering and liver cancer (odds ratio [OR] 1.47, 95% confidence interval [CI]: 1.00-2.17, p

  11. Quantitative T2, T2*, and T2' MR imaging in patients with ischemic leukoaraiosis might detect microstructural changes and cortical hypoxia

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Marlies; Helfrich, Michael; Magerkurth, Joerg; Blasel, Stella; Porto, Luciana; Jurcoane, Alina; Hattingen, Elke [University Hospital, Goethe-University, Institute of Neuroradiology, Frankfurt am Main, Frankfurt (Germany); Volz, Steffen; Deichmann, Ralf [University Hospital, Goethe-University, Brain Imaging Center, Frankfurt (Germany); Singer, Oliver C. [University Hospital, Goethe-University, Department of Neurology, Frankfurt (Germany)

    2015-10-15

    Quantitative MRI with T2, T2*, and T2' mapping has been shown to non-invasively depict microstructural changes (T2) and oxygenation status (T2* and T2') that are invisible on conventional MRI. Therefore, we aimed to assess whether T2 and T2' quantification detects cerebral (micro-)structural damage and chronic hypoxia in lesions and in normal appearing white matter (WM) and gray matter (GM) of patients with ischemic leukoaraiosis (IL). Measurements were complemented by the assessment of the cerebral blood flow (CBF) and the degree of GM and WM atrophy. Eighteen patients with IL and 18 age-matched healthy controls were included. High-resolution, motion-corrected T2, T2*, and T2' mapping, CBF mapping (pulsed arterial spin labeling, PASL), and segmentation of GM and WM were used to depict specific changes in both groups. All parameters were compared between patients and healthy controls, using t testing. Values of p < 0.05 were accepted as statistically significant. Patients showed significantly increased T2 in lesions (p < 0.01) and in unaffected WM (p = 0.045) as well as significantly increased T2* in lesions (p = 0.003). A significant decrease of T2' was detected in patients in unaffected WM (p = 0.027), while no T2' changes were observed in GM (p = 0.13). Both unaffected WM and GM were significantly decreased in volume in the patient-group (p < 0.01). No differences of PASL-based CBF could be shown. Non-invasive quantitative MRI with T2, T2*, and T2' mapping might be used to detect subtle structural and metabolic changes in IL. Assessing the grade of microstructural damage and hypoxia might be helpful to monitor disease progression and to perform risk assessment. (orig.)

  12. Quantitative Evaluation of the Hepatic Parenchymal Change in Patients with Chronic Liver Disease Using Gd- EOB-DTPA-enhanced MRI: Comparison with Normal Liver

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woo Jin; Cha, Sang Hoon; Kim, Min Yeong; Chung, Hwan Hoon; Lee, Seung Wha; Yi, Ann; Je, Bo Kyung; Kim, Baek Hyun [Korea University Ansan Hospital, Ansan (Korea, Republic of)

    2011-01-15

    We wanted to evaluate the capability of Gd-EOB-DTPA-enhanced MRI for diagnosing chronic liver disease by comparing the signal intensity change (SIC) of the hepatic parenchyma of patients with chronic liver disease with that of patients with a normal liver. This retrospective study included 50 patients who were pathologically confirmed as having liver cirrhosis (n=41) or chronic hepatitis (n=9) by surgery (n=9) or biopsy (n=41), and they all underwent Gd-EOB-DTPA-enhanced MRI between June 2008 and May 2010 (i.e., the patient group). We also analyzed 30 patients with normal livers as the control group. Quantitative image analysis was performed by measuring the signal-to-noise ratios for the pre-contrast images and the post-contrast 2-, 3-, 10-, 20-min delay images and then calculating the SIC of the precontrast and post-contrast images. We performed a detailed analysis of the collected data, which was transformed into a logarithmic form. The SICs of the two groups were compared by Greenhouse-Geisser sphericity correction. Comparison of the SIC between the two groups showed a significant difference on the hepatocyte-phase 20-min image (p<0.0001). The mean SICs with log transformation for the patient and normal groups were 1.90 {+-} 0.10 and 2.23 {+-} 0.13, respectively, and the optimal cut-off value of the SIC with log transformation on the 20-min delay hepatocyte-phase image was 2.17 (sensitivity: 66.7%, specificity: 84.0%, positive predictive value: 71.4%, negative predictive value: 80.8%). Quantitative measurement of the SIC on the hepatocyte-phase image by Gd-EOB-DTPA-enhanced MRI could provide a convenient method to noninvasively diagnose chronic liver disease

  13. Identification and Quantitation of Phenylalanine in the Brain of Patients with Phenylketonuria by Means of Localized in Vivo1H Magnetic-Resonance Spectroscopy

    Science.gov (United States)

    Kreis, R.; Pietz, J.; Penzien, J.; Herschkowitz, N.; Boesch, C.

    Localized proton MR spectroscopy was used to identify phenylalanine (PHE) and to quantitate its cerebral concentration in patients with type I phenylketonuria (PKU). Data acquisition was optimized for the detection of low-concentration metabolites, using a short TE (20 ms) double Hahn-echo localization sequence for large volumes within the head coil and for smaller volumes using a surface coil, Previously described methods to quantitate localized MR spectra were extended to cover the case of low-concentration metabolites, unevenly distributed in three brain compartments and measured in difference spectra only. PHE content was determined in difference spectra of four PKU patients with respect to normals and in one patient before and after an oral load of L-PHE, PHE concentrations of 0.3 to 0.6 mmol/kg brain tissue were obtained, resulting in a concentration gradient for PHE between blood and brain tissue of 2.4 to 3.0, No significant changes were found for the abundant metabolites in gray or white matter. Previously reported MRI changes were confirmed to be due to increased cerebro-spinal-fluid-like spaces.

  14. Quantitative research.

    Science.gov (United States)

    Watson, Roger

    2015-04-01

    This article describes the basic tenets of quantitative research. The concepts of dependent and independent variables are addressed and the concept of measurement and its associated issues, such as error, reliability and validity, are explored. Experiments and surveys – the principal research designs in quantitative research – are described and key features explained. The importance of the double-blind randomised controlled trial is emphasised, alongside the importance of longitudinal surveys, as opposed to cross-sectional surveys. Essential features of data storage are covered, with an emphasis on safe, anonymous storage. Finally, the article explores the analysis of quantitative data, considering what may be analysed and the main uses of statistics in analysis.

  15. Quantitation of blood-brain barrier defect by magnetic resonance imaging and gadolinium-DTPA in patients with multiple sclerosis and brain tumors

    DEFF Research Database (Denmark)

    Larsson, H B; Stubgaard, M; Frederiksen, J L

    1990-01-01

    In this study quantitation of the degree of deficiency of the blood-brain barrier (BBB) in patients with multiple sclerosis or brain tumors, by using MRI, is shown to be possible. As a measure of permeability of the BBB to Gadolinium-DTPA (Gd-DTPA) the flux per unit of distribution volume per unit...... of brain mass was used. This quantity was found by introducing the longitudinal relaxation rate (R1) as a measure of concentration of Gd-DTPA in the brain tissue in the mathematical model for the transcapillary transport over the BBB. High accordance between the observed data points and the model was found...

  16. SU-F-J-207: Non-Small Cell Lung Cancer Patient Survival Prediction with Quantitative Tumor Textures Analysis in Baseline CT

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Y; Zou, J; Murillo, P; Nosher, J; Amorosa, J; Bramwit, M; Yue, N; Jabbour, S; Foran, D [Rutgers University, New Brunswick, NJ (United States)

    2016-06-15

    Purpose: Chemo-radiation therapy (CRT) is widely used in treating patients with locally advanced non-small cell lung cancer (NSCLC). Determination of the likelihood of patient response to treatment and optimization of treatment regime is of clinical significance. Up to date, no imaging biomarker has reliably correlated to NSCLC patient survival rate. This pilot study is to extract CT texture information from tumor regions for patient survival prediction. Methods: Thirteen patients with stage II-III NSCLC were treated using CRT with a median dose of 6210 cGy. Non-contrast-enhanced CT images were acquired for treatment planning and retrospectively collected for this study. Texture analysis was applied in segmented tumor regions using the Local Binary Pattern method (LBP). By comparing its HU with neighboring voxels, the LBPs of a voxel were measured in multiple scales with different group radiuses and numbers of neighbors. The LBP histograms formed a multi-dimensional texture vector for each patient, which was then used to establish and test a Support Vector Machine (SVM) model to predict patients’ one year survival. The leave-one-out cross validation strategy was used recursively to enlarge the training set and derive a reliable predictor. The predictions were compared with the true clinical outcomes. Results: A 10-dimensional LBP histogram was extracted from 3D segmented tumor region for each of the 13 patients. Using the SVM model with the leave-one-out strategy, only 1 out of 13 patients was misclassified. The experiments showed an accuracy of 93%, sensitivity of 100%, and specificity of 86%. Conclusion: Within the framework of a Support Vector Machine based model, the Local Binary Pattern method is able to extract a quantitative imaging biomarker in the prediction of NSCLC patient survival. More patients are to be included in the study.

  17. SU-F-J-207: Non-Small Cell Lung Cancer Patient Survival Prediction with Quantitative Tumor Textures Analysis in Baseline CT

    International Nuclear Information System (INIS)

    Wu, Y; Zou, J; Murillo, P; Nosher, J; Amorosa, J; Bramwit, M; Yue, N; Jabbour, S; Foran, D

    2016-01-01

    Purpose: Chemo-radiation therapy (CRT) is widely used in treating patients with locally advanced non-small cell lung cancer (NSCLC). Determination of the likelihood of patient response to treatment and optimization of treatment regime is of clinical significance. Up to date, no imaging biomarker has reliably correlated to NSCLC patient survival rate. This pilot study is to extract CT texture information from tumor regions for patient survival prediction. Methods: Thirteen patients with stage II-III NSCLC were treated using CRT with a median dose of 6210 cGy. Non-contrast-enhanced CT images were acquired for treatment planning and retrospectively collected for this study. Texture analysis was applied in segmented tumor regions using the Local Binary Pattern method (LBP). By comparing its HU with neighboring voxels, the LBPs of a voxel were measured in multiple scales with different group radiuses and numbers of neighbors. The LBP histograms formed a multi-dimensional texture vector for each patient, which was then used to establish and test a Support Vector Machine (SVM) model to predict patients’ one year survival. The leave-one-out cross validation strategy was used recursively to enlarge the training set and derive a reliable predictor. The predictions were compared with the true clinical outcomes. Results: A 10-dimensional LBP histogram was extracted from 3D segmented tumor region for each of the 13 patients. Using the SVM model with the leave-one-out strategy, only 1 out of 13 patients was misclassified. The experiments showed an accuracy of 93%, sensitivity of 100%, and specificity of 86%. Conclusion: Within the framework of a Support Vector Machine based model, the Local Binary Pattern method is able to extract a quantitative imaging biomarker in the prediction of NSCLC patient survival. More patients are to be included in the study.

  18. Quantitative detection of Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae in patients with new influenza A (H1N1)/2009 and influenza A/2010 virus infection.

    Science.gov (United States)

    Safaeyan, Firouzeh; Nahaei, Mohammad Reza; Seifi, Sirus Jedary; Kafil, Hossein Samadi; Sadeghi, Javid

    2015-01-01

    Viral influenza is a seasonal infection associated with significant morbidity and mortality. In the United States more than 35,000 deaths and 200,000 hospitalizations are recorded annually due to influenza. Secondary bacterial infections or co-infections associated with cases of influenza are a leading cause of severe morbidity and mortality, especially among high-risk groups such as the elderly and young children. The aim of the present study was the quantitative detection of S. aureus, S. pneumoniae and H. influenzae in a group of patients with seasonal influenza A, influenza A (H1N1) pandemic 2009, and patients with symptoms of respiratory infection, but the negative for H1N1 serving as control group. In total, 625 patients suspected respiratory infection from April 2009 to April 2010 were studied. There were 58 patients with influenza A H1N1 and 567 patients negative for influenza A H1N1. From November 2010 to February 2011, 158 patients with respiratory symptoms were analyzed for seasonal influenza A. There were 25 patients with seasonal influenza A. To check the colonization status among the healthy individuals 62 healthy persons were further investigated. Individual were screened in parallel. The choices of special genes were amplified from clinical specimens using real-time PCR with a cutoff of 10(4) CFU/mL to differentiate colonization from infection in respiratory tract. S. aureus, S. pneumoniae and H. influenzae were detected in 12%, 26% and 33% of patients with H1N1, while the corresponding figures were 9%, 19%, and 31% for H1N1 negative patients. Among patients with seasonal influenza A 12% S. aureus, 24% S. pneumoniae, and 32% H. influenzae co-infections were detected, while influenza negative control group yielded 5% S. aureus, 11% S. pneumoniae, and 10% H. influenzae, respectively. The results of this study indicated that the serotype of pandemic H1N1 2009 did not increase incidence of secondary infection with S. aureus, S. pneumoniae and H

  19. Quantitative analysis of TEM-8 and CEA tumor markers indicating free tumor cells in the peripheral blood of colorectal cancer patients.

    Science.gov (United States)

    Raeisossadati, Reza; Farshchian, Moein; Ganji, Azita; Tavassoli, Alieza; Velayati, Arash; Dadkhah, Ezzat; Chavoshi, Somaye; Mehrabi Bahar, Mostafa; Memar, Bahram; Rajabi Mashhadi, Mohammad Taghi; Naseh, Hossein; Forghanifard, Mohammad Mahdi; Moghbeli, Meysam; Moaven, Omeed; Abbaszadegan, Mohammad Reza

    2011-10-01

    Colorectal cancer (CRC) remains the third most common cancer in the world. Approximately in 50 percent of patients, metastatic disease is a major cause of death. Therefore, early diagnosis of CRC is crucial for a successful outcome. For the detection of circulating cancer cells, this study applied a sensitive method that employed specific tumor markers for early detection. A total of 80 blood samples from 40 CRC patients and 40 age-matched healthy controls were collected for the study. The circulating mRNA levels of two CRC tumor markers, tumor endothelial marker 8 (TEM-8) and carcinoembryogenic antigen (CEA) were evaluated using an absolute quantitative real-time PCR assay in a Stratagene Mx-3000P real-time PCR system. GAPDH was used as the endogenous control. TEM-8 and CEA were primarily detected more in the CRC patients rather than in the controls: 22/40 vs 9/40, p=0.009 and 30/40 vs 11/40, p=0.00054, respectively. In the CRC patients, the mRNA level of these markers was significantly higher in comparison to the normal controls (p=0.018 and 0.01). The overall sensitivity of this panel was 65% with a specificity of 75%. Statistical analysis for demographic variants did not reach significant values. TEM-8 and CEA markers were detected more frequently and in significantly higher levels in the blood samples of patients compared with samples from age-matched healthy controls. The copy number of CEA and TEM-8 mRNA, as detected by a real-time quantitative PCR, appears to be a promising marker for evaluating the risk of tumor spread.

  20. Quantitative evaluation of the viscoelastic properties of the ankle joint complex in patients suffering from ankle sprain by the anterior drawer test.

    Science.gov (United States)

    Lin, Che-Yu; Shau, Yio-Wha; Wang, Chung-Li; Chai, Huei-Ming; Kang, Jiunn-Horng

    2013-06-01

    Biological tissues such as ligaments exhibit viscoelastic behaviours. Injury to the ligament may induce changes of these viscoelastic properties, and these changes could serve as biomarkers to detect the injury. In the present study, a novel instrument was developed to non-invasive quantify the viscoelastic properties of the ankle in vivo by the anterior drawer test. The purpose of the study was to investigate the reliability of the instrument and to compare the viscoelastic properties of the ankle between patients suffering from ankle sprain and controls. Eight patients and eight controls participated in the present study. The reliability test was performed on three randomly chosen subjects. In patient and control test, both ankles of each subject were tested to evaluate the viscoelastic properties of the ankle. The viscosity index was defined for quantitatively evaluating the viscosity of the ankle. Greater viscosity index was associated with lower viscosity. Injured and uninjured ankles of patient and both ankles of controls were compared. The instrument exhibited excellent test-retest reliability (r > 0.9). Injured ankles exhibited significantly less viscosity than uninjured ankles, since injured ankles of patients had significantly higher viscosity index (8,148 ± 5,266) compared with uninjured ankles of patients (948 ± 617; p = 0.008) and controls (1,326 ± 613; p ankle can serve as sensitive and useful clinical biomarkers to differentiate between injured and uninjured ankles. The method may provide a clinical examination for objectively evaluating lateral ankle ligament injuries.

  1. Patient-centered early pregnancy care: a systematic review of quantitative and qualitative studies on the perspectives of women and their partners.

    Science.gov (United States)

    van den Berg, M M J; Dancet, E A F; Erlikh, T; van der Veen, F; Goddijn, M; Hajenius, P J

    2018-01-01

    Early pregnancy complications, defined as miscarriage, recurrent miscarriage or ectopic pregnancy, affect the physical and psychological well-being of intended parents. Research in this field so far has focused mainly on improving accuracy of diagnostic tests and safety and effectiveness of therapeutic management. An overview of aspects of care valued by women and/or their partners is missing. This systematic review aims to provide an overview of aspects of care valued by women and/or their partners faced with early pregnancy complications and to identify potential targets for improvement in early pregnancy healthcare. We searched five electronic databases for empirical quantitative or qualitative studies on patients' perspectives of early pregnancy care in July 2017. We first identified aspects of early pregnancy care valued by women and/or their partners based on qualitative and quantitative data and organized these aspects of care according to the eight dimensions of patient-centered care. Second, we extracted the assessment of service quality from women and/or their partners on each of these aspects of care based on quantitative data. Third, we combined the findings on patients' values with the findings of service quality assessment to identify potential targets for improvement in five groups according to how likely these targets are to require improvement. The search yielded 6240 publications, of which 27 studies were eligible for inclusion in this review. All included studies focused on miscarriage or recurrent miscarriage care. We identified 24 valued aspects of care, which all covered the eight dimensions of patient-centered care. The most frequently reported valued aspect was 'being treated as an individual person experiencing a significant life event rather than a common condition'. Assessment of service quality from women and/or their partners was available for 13 of the 24 identified aspects of care. Quantitative studies all documented service quality

  2. Quantitative evaluation for spasticity of calf muscle after botulinum toxin injection in patients with cerebral palsy: a pilot study.

    Science.gov (United States)

    Lin, Yu-Ching; Lin, I-Ling; Chou, Te-Feng Arthur; Lee, Hsin-Min

    2016-03-12

    Cerebral palsy (CP) is the most common pediatric disease to cause motor disability. Two common symptoms in CP are spasticity and contracture. If this occurred in the ankle plantar flexors of children with CP, it will impair their gait and active daily living profoundly. Most children with CP receive botulinum toxin type A (BoNT-A) injection to reduce muscle tone, but a knowledge gap exists in the understanding of changes of neural and non-neural components of spasticity after injection. The purpose of this study was to determine if our device for quantitative modified Tardieu approach (QMTA) is a valid method to assess spasticity of calf muscles after botulinum toxin injection. In this study, we intended to develop a device for quantitative measurement of spasticity in calf muscles based on the modified Tardieu scale (MTS) and techniques of biomedical engineering. Our QMTA measures the angular displacement and resistance of stretched joint with a device that is light, portable and can be operated similar to conventional approaches for MTS. The static (R2), dynamic (R1) and R2-R1 angles derived from the reactive signals collected by the miniature sensors are used to represent the non-neural and neural components of stretched spastic muscles. Four children with CP were recruited to assess the change in spasticity in their gastrocnemius muscles before and 4 weeks after BoNT-A injection. A simulated ankle model validated the performance of our device in measuring joint displacement and estimating the angle of catch. Data from our participants with CP showed that R2 and R2-R1 improved significantly after BoNT-A administration. It indicates both neural and non-neural components of the spastic gastrocnemius muscles improved at four weeks after BoNT-A injection in children with CP. Our device for QMTA can objectively measure the changes in spasticity of the gastrocnemius muscle in children with cerebral palsy after BoNT-A injection.

  3. Quantitative three-phase bone scintigraphy in the evaluation of intravenous regional blockade treatment in patients with stage-I reflex sympathetic dystrophy of upper extremity.

    Science.gov (United States)

    Oztürk, Emel; Möhür, Haydar; Arslan, Nuri; Entok, Emre; Tan, Kenan; Ozgüven, Mehmet Ali

    2004-12-01

    To investigate the role of quantitative three phase bone scintigraphy (QTPBS) in the evaluation of efficacy of intravenous regional blockade treatment in patients having reflex sympathetic dystrophy (RSD) of the upper extremity. Twenty-six patients with stage-I RSD were focused on in this study. Patients were treated with physical therapy and intravenous (I.V.) regional blockade therapy consisting of dexamethasone and lidocaine. All patients were clinically evaluated before and 1 month after the completion of the therapy protocol. QTPBS was applied to patients before therapy and 1 month after the therapy. As a control group, 11 healthy subjects also underwent QTPBS. Perfusion, hyperemic and fixation indices were calculated from three-phase bone scintigraphy. All patients showed statistically significant clinical improvement after the therapy (p < 0.01). Pre-treatment, perfusion (1.67 +/- 0.63), hyperemic (1.44 +/- 0.48) and fixation (1.69 +/- 0.48) indices of patients were higher than those of healthy subjects (PI: 0.95 +/- 0.05, HI: 0.94 +/- 0.06, FI: 1.01 +/- 0.2) (p < 0.01) and all indices significantly decreased after the treatment (PI: 1.33 +/- 0.46, HI: 1.18 +/- 0.23, FI: 1.42 +/- 0.26) (p < 0.01). I.V. regional blockade therapy combined with corticosteroids is a simple, safe and effective method for the treatment of patients with stage-I RSD in the upper extremity. QTPBS is a valuable and objective method to evaluate the response to therapy and may be useful for staging of patients and predicting the response to therapy.

  4. Comparative analysis of intraperitoneal minimal free cancer cells between colorectal and gastric cancer patients using quantitative RT-PCR: possible reason for rare peritoneal recurrence in colorectal cancer.

    Science.gov (United States)

    Hara, Masayasu; Nakanishi, Hayao; Jun, Qian; Kanemitsu, Yukihide; Ito, Seiji; Mochizuki, Yoshinari; Yamamura, Yoshitaka; Kodera, Yasuhiro; Tatematsu, Masae; Hirai, Takashi; Kato, Tomoyuki

    2007-01-01

    Peritoneal recurrence has a much lower incidence in colorectal cancer (CRC) patients than gastric cancer (GC) patients. The aim of this study is to clarify the reason for the rare peritoneal recurrence in CRC as compared with GC. The incidence and the abundance of free tumor cells in the peritoneal lavages from 102 CRC and 126 GC patients who underwent curative surgery were assessed by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) with carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) as genetic markers. Prognostic significance of CEA and CK20 mRNA was also compared between CRC and GC after 2 years of follow-up by Kaplan-Meyer method with overall and peritoneal recurrence-free survival as endpoints. Positivity rate and average values of CEA and CK20 mRNA in peritoneal lavages of CRC patients, which are correlated to the depth of tumor invasion (pT category), were essentially the same as those of GC cases. Overall survival was significantly (marginally) worse in CEA mRNA (CK20 mRNA)-positive CRC patients than negatives like GC. However, peritoneal recurrence-free survival was not different between CEA (CK20) mRNA-positive and -negative CRC patients, in quite contrast to GC cases. Multivariate analysis showed that CEA mRNA was an independent prognostic factor for overall survival in GC patients, but not in CRC patients. These results suggest that the rare peritoneal recurrence in CRC patients is not due to the low incidence or the small number of intraperitoneal free cancer cells, but more likely reflects due to the low-peritoneal metastatic potential of CRC cells.

  5. Quantitative and Qualitative Composition of Colonic Content Microbiota in Diabetes Mellitus Type 1 Patients with Concomitant Chronic Purulent Maxillary Sinusitis

    Directory of Open Access Journals (Sweden)

    O.A. Mazur

    2015-03-01

    The obtained results could be a basis for studying a clinical course and optimization of treatment of inflammatory diseases of ear, nose, throat, including chronic purulent and purulent polypous sinusitis in patients with DM type 1 using lacto- and bifidobacteriums.

  6. Quantitative sensory testing in classical trigeminal neuralgia-a blinded study in patients with and without concomitant persistent pain

    DEFF Research Database (Denmark)

    Younis, Samaira; Maarbjerg, Stine; Reimer, Maren

    2016-01-01

    The diagnostic criteria of the third International Classification of Headache Disorders state that there should be no neurological deficits in patients with classical trigeminal neuralgia (TN) at clinical examination. However, studies demonstrating sensory abnormalities at bedside examination in TN...

  7. Assessment of goals and priorities in patients with a chronic condition: a secondary quantitative analysis of determinants across 11 countries.

    Science.gov (United States)

    Vermunt, Neeltje P C A; Westert, Gert P; Olde Rikkert, Marcel G M; Faber, Marjan J

    2018-03-01

    To assess the impact of patient characteristics, patient-professional engagement, communication and context on the probability that healthcare professionals will discuss goals or priorities with older patients. Secondary analysis of cross-sectional data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults. 11 western countries. Community-dwelling adults, aged 55 or older. Assessment of goals and priorities. The final sample size consisted of 17,222 respondents, 54% of whom reported an assessment of their goals and priorities (AGP) by healthcare professionals. In logistic regression model 1, which was used to analyse the entire population, the determinants found to have moderate to large effects on the likelihood of AGP were information exchange on stress, diet or exercise, or both. Country (living in Sweden) and continuity of care (no regular professional or organisation) had moderate to large negative effects on the likelihood of AGP. In model 2, which focussed on respondents who experienced continuity of care, country and information exchange on stress and lifestyle were the main determinants of AGP, with comparable odds ratios to model 1. Furthermore, a professional asking questions also increased the likelihood of AGP. Continuity of care and information exchange is associated with a higher probability of AGP, while people living in Sweden are less likely to experience these assessments. Further study is required to determine whether increasing information exchange and professionals asking more questions may improve goal setting with older patients. Key points   A patient goal-oriented approach can be beneficial for older patients with chronic conditions or multimorbidity; however, discussing goals with these patients is not a common practice. The likelihood of discussing goals varies by country, occurring most commonly in the USA, and least often in Sweden. Country-level differences in continuity of care and questions asked by a

  8. A semi-quantitative World Health Organization grading scheme evaluating worst tumor differentiation predicts disease-free survival in oral squamous carcinoma patients.

    Science.gov (United States)

    Jain, Dhruv; Tikku, Gargi; Bhadana, Pallavi; Dravid, Chandrashekhar; Grover, Rajesh Kumar

    2017-08-01

    We investigated World Health Organization (WHO) grading and pattern of invasion based histological schemes as independent predictors of disease-free survival, in oral squamous carcinoma patients. Tumor resection slides of eighty-seven oral squamous carcinoma patients [pTNM: I&II/III&IV-32/55] were evaluated. Besides examining various patterns of invasion, invasive front grade, predominant and worst (highest) WHO grade were recorded. For worst WHO grading, poor-undifferentiated component was estimated semi-quantitatively at advancing tumor edge (invasive growth front) in histology sections. Tumor recurrence was observed in 31 (35.6%) cases. The 2-year disease-free survival was 47% [Median: 656; follow-up: 14-1450] days. Using receiver operating characteristic curves, we defined poor-undifferentiated component exceeding 5% of tumor as the cutoff to assign an oral squamous carcinoma as grade-3, when following worst WHO grading. Kaplan-Meier curves for disease-free survival revealed prognostic association with nodal involvement, tumor size, worst WHO grading; most common pattern of invasion and invasive pattern grading score (sum of two most predominant patterns of invasion). In further multivariate analysis, tumor size (>2.5cm) and worst WHO grading (grade-3 tumors) independently predicted reduced disease-free survival [HR, 2.85; P=0.028 and HR, 3.37; P=0.031 respectively]. The inter-observer agreement was moderate for observers who semi-quantitatively estimated percentage of poor-undifferentiated morphology in oral squamous carcinomas. Our results support the value of semi-quantitative method to assign tumors as grade-3 with worst WHO grading for predicting reduced disease-free survival. Despite limitations, of the various histological tumor stratification schemes, WHO grading holds adjunctive value for its prognostic role, ease and universal familiarity. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Quantitative MRI comparison of systemic hemodynamics in Mustard/Senning repaired patients and healthy volunteers at rest

    International Nuclear Information System (INIS)

    Laffon, Eric; Jimenez, Maria; Choussat, Alain; Latrabe, Valerie; Ducassou, Dominique; Marthan, Roger; Laurent, Francois

    2004-01-01

    The purpose of the present study was to non-invasively compare ascending aortic blood flow and cross-sectional area (CSA) variations vs time in Mustard or Senning repaired (MSR) patients against those of healthy volunteers at rest. Velocity-encoded MR imaging was performed in 10 male patients (age range 18-24 years, median age 20.5 years) late after a Mustard or Senning correction, and in 10 male healthy volunteers (age range 21-25 years, median age 22.5 years), at the upper part of the ascending aorta. Both aortic cross-sectional area (CSA) and blood-flow variations were recorded over a complete cardiac cycle, with a 30-ms time of resolution. The body-surface area (BSA), the mean CSA over the systolic phase, and the BSA-normalized systemic ventricle power and work were significantly lower in the patient series compared with those of the volunteer series. The BSA-normalized right ventricle (RV) power and work of MSR patients were equal to 87 and 83% on average of those of the left ventricle (LV) of healthy volunteers. We conclude that, at rest, the mechanical performance of the systemic RV in MSR patients is significantly lower than that of the LV in healthy volunteers. Furthermore, the significantly lower aortic CSA found in MSR patients than in healthy volunteers may reveal an increase in the vasomotor tone. (orig.)

  10. Impact of diabetes on the risk of bedsore in patients undergoing surgery: an updated quantitative analysis of cohort studies.

    Science.gov (United States)

    Liang, Mining; Chen, Qiongni; Zhang, Yang; He, Li; Wang, Jianjian; Cai, Yiwen; Li, Lezhi

    2017-02-28

    Diabetes is a major cause of morbidity for patients undergoing surgery and can increase the incidence of some postoperative complications such as bedsores. We conducted a meta-analysis of observational studies to examine whether patients with diabetes undergoing surgery had high risk of bedsore. We performed a systematic literature search in Pubmed, Embase and the Cochrane Library Central Register of Controlled Trials database from inception to November 2016. Studies were selected if they reported estimates of the relative risk (RR) for bedsore risk in postoperative diabetic patients compared with that of in non-diabetic patients. Random-effects meta-analysis was conducted to pool the estimates. A total of 16 studies with 24,112 individuals were included in our meta-analysis. The pooled RR of bedsore development for patients with diatetes was 1.77 (95% CI 1.45 to 2.16). The results of subgroup analyses were consistent when stratified by surgery type, study design, research region, sample size, inclusion period, analysis method and study quality. There was evidence of publication bias among studies and a sensitivity analysis using the Duval and Tweedie "trim-and-fill" method did not significantly alter the pooled results (adjusted RR 1.17, 95% CI 1.02 to 1.36).This meta-analysis provides indications that diabetic patients undergoing surgery could have a higher risk of developing bedsores. Further large-scale prospective trials should be implemented to comfirm the association.

  11. Everyday life and social relations in home-living patients with mild Alzheimer's disease and their caregivers: Quantitative and qualitative analyses

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes

    2007-01-01

    interviews with 10 couples before and after the intervention programme. For the analysis, a template organising style of interpretation was used. Patients and caregivers found good support for coping with everyday life and social relations by participating in the intervention programme. Early counselling......Everyday life and social relations in home-living patients with mild Alzheimer’s disease (AD) and their caregivers: quantitative and qualitative analyses. This PhD project was carried out between April 2004 and March 2007 during my employment as project coordinator in the Memory Disorder Research...... Group, Department of Neurology, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark, as part of the DAISY study. The overarching objective of the PhD project was to investigate patients’ perspectives of the impact of mild AD on coping with everyday life and social relations...

  12. Everyday life and social relations in home-living patients with mild Alzheimer's disease and their caregivers: Quantitative and qualitative analyses

    DEFF Research Database (Denmark)

    Sørensen, Lisbeth Villemoes

    2007-01-01

    Everyday life and social relations in home-living patients with mild Alzheimer’s disease (AD) and their caregivers: quantitative and qualitative analyses. This PhD project was carried out between April 2004 and March 2007 during my employment as project coordinator in the Memory Disorder Research...... when planning everyday life, psychosocial interventions, and care; and that early psychosocial intervention may offer important support to improve coping with everyday life and social relations in patients with mild AD and their caregivers. Future studies should focus on the long-term perspective...... Group, Department of Neurology, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark, as part of the DAISY study. The overarching objective of the PhD project was to investigate patients’ perspectives of the impact of mild AD on coping with everyday life and social relations...

  13. Quantitative Approach Based on Wearable Inertial Sensors to Assess and Identify Motion and Errors in Techniques Used during Training of Transfers of Simulated c-Spine-Injured Patients

    Directory of Open Access Journals (Sweden)

    Karina Lebel

    2018-01-01

    Full Text Available Patients with suspected spinal cord injuries undergo numerous transfers throughout treatment and care. Effective c-spine stabilization is crucial to minimize the impacts of the suspected injury. Healthcare professionals are trained to perform those transfers using simulation; however, the feedback on the manoeuvre is subjective. This paper proposes a quantitative approach to measure the efficacy of the c-spine stabilization and provide objective feedback during training. Methods. 3D wearable motion sensors are positioned on a simulated patient to capture the motion of the head and trunk during a training scenario. Spatial and temporal indicators associated with the motion can then be derived from the signals. The approach was developed and tested on data obtained from 21 paramedics performing the log-roll, a transfer technique commonly performed during prehospital and hospital care. Results. In this scenario, 55% of the c-spine motion could be explained by the difficulty of rescuers to maintain head and trunk alignment during the rotation part of the log-roll and their difficulty to initiate specific phases of the motion synchronously. Conclusion. The proposed quantitative approach has the potential to be used for personalized feedback during training sessions and could even be embedded into simulation mannequins to provide an innovative training solution.

  14. Preoperative Quantitative MR Tractography Compared with Visual Tract Evaluation in Patients with Neuropathologically Confirmed Gliomas Grades II and III: A Prospective Cohort Study

    International Nuclear Information System (INIS)

    Delgado, Anna F.; Nilsson, Markus; Latini, Francesco; Mårtensson, Johanna; Zetterling, Maria; Berntsson, Shala G.; Alafuzoff, Irina; Lätt, Jimmy; Larsson, Elna-Marie

    2016-01-01

    Background and Purpose. Low-grade gliomas show infiltrative growth in white matter tracts. Diffusion tensor tractography can noninvasively assess white matter tracts. The aim was to preoperatively assess tumor growth in white matter tracts using quantitative MR tractography (3T). The hypothesis was that suspected infiltrated tracts would have altered diffusional properties in infiltrated tract segments compared to noninfiltrated tracts. Materials and Methods. Forty-eight patients with suspected low-grade glioma were included after written informed consent and underwent preoperative diffusion tensor imaging in this prospective review-board approved study. Major white matter tracts in both hemispheres were tracked, segmented, and visually assessed for tumor involvement in thirty-four patients with gliomas grade II or III (astrocytomas or oligodendrogliomas) on postoperative neuropathological evaluation. Relative fractional anisotropy (rFA) and mean diffusivity (rMD) in tract segments were calculated and compared with visual evaluation and neuropathological diagnosis. Results. Tract segment infiltration on visual evaluation was associated with a lower rFA and high rMD in a majority of evaluated tract segments (89% and 78%, resp.). Grade II and grade III gliomas had similar infiltrating behavior. Conclusion. Quantitative MR tractography corresponds to visual evaluation of suspected tract infiltration. It may be useful for an objective preoperative evaluation of tract segment involvement

  15. Improved Quantitation of Gluten in Wheat Starch for Celiac Disease Patients by Gel-Permeation High-Performance Liquid Chromatography with Fluorescence Detection (GP-HPLC-FLD).

    Science.gov (United States)

    Scherf, Katharina Anne; Wieser, Herbert; Koehler, Peter

    2016-10-12

    Purified wheat starch (WSt) is commonly used in gluten-free products for celiac disease (CD) patients. It is mostly well-tolerated, but doubts about its safety for CD patients persist. One reason may be that most ELISA kits primarily recognize the alcohol-soluble gliadin fraction of gluten, but insufficiently target the alcohol-insoluble glutenin fraction. To address this problem, a new sensitive method based on the sequential extraction of gliadins, glutenins, and gluten from WSt followed by gel-permeation high-performance liquid chromatography with fluorescence detection (GP-HPLC-FLD) was developed. It revealed that considerable amounts of glutenins were present in most WSt. The gluten contents quantitated by GP-HPLC-FLD as sum of gliadins and glutenins were higher than those by R5 ELISA (gluten as gliadin content multiplied by a factor of 2) in 19 out of 26 WSt. Despite its limited selectivity, GP-HPLC-FLD may be applied as confirmatory method to ELISA to quantitate gluten in WSt.

  16. Does involving volunteers in the provision of palliative care make a difference to patient and family wellbeing? A systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Candy, Bridget; France, Rachel; Low, Joe; Sampson, Liz

    2015-03-01

    Despite the extent of volunteers' contribution to palliative care, and their role in direct patient care, there has been no systematic evaluation of the evidence-base on volunteers in relation to patient and family wellbeing. To critically review research, on the impact of volunteers involved in the direct care of palliative patients and their families. We searched for studies, reporting patient and family data on the impact of volunteer services in palliative care in thirteen citation databases up to May 2013. We included quantitative comparative studies. We also noted any non-comparative studies, enabling us to give a comprehensive review of the existing research. We also included qualitative studies that explored the experiences of patients and families who received volunteer support, potentially illustrating which aspects of volunteer activities patients and families value. We applied quality appraisal criteria to all studies meeting inclusion criteria. Two researchers undertook key review processes. We found eight studies. Only two studies were undertaken outside of North America; one in the Netherlands and the other in Uganda. All studies were in adult palliative care services. All evaluated volunteers were in home care settings, three of the studies included other settings such as hospitals and nursing homes. All of the studies fulfilled our quality appraisal criteria. Six of them were quantitative studies and two were comparative: one found that those families who experienced greater (as opposed to lesser) volunteer involvement were significantly more satisfied with care; the other found that patients survived significantly longer if they had received home visits from a volunteer. Four cross-sectional studies focused on satisfaction ratings. No study considered possible disadvantages or adverse effects of volunteer involvement. Two qualitative studies were identified; both highlighted the uniqueness of the role volunteers may fulfil in care support, from

  17. Correlation analysis between bone density measured by quantitative CT and blood sugar level of aged patients with non-insulin-dependent diabetes mellitus

    International Nuclear Information System (INIS)

    Wang Guizhi; Liang Ping; Qiao Junhua; Liu Chunyan

    2008-01-01

    Objective: To approach the correlation between the bone density measured by quantitative CT and the blood sugar level of the aged patients with non-insulin-dependent diabetes mellitus, and observe the effects of the blood sugar level on the bone density. Methods: The lumbar bone densities and the blood sugar levels of 160 aged patients with non-insulin-dependent diabetes mellitus (hyperglycemia group 80 cases, euglycemia group 80 cases ) and the healthy aged people (80 cases) were detected by quantitative CT and serum biochemical detection; the correlation between the blood sugar level and the bone density and the osteoporosis occurrence status of aged people in various groups were analyzed. Results: The bone density in the non-insulin-dependent diabetes and hyperglycemia group was lower than those in normal (control) group and non-insulin-dependent diabetes and euglycemia group (P<0.05); the morbility of osteoporosis in the non-insulin-dependent diabetes and hyperglycemia group was higher than those in normal (control) group and non-insulin-dependent diabetes and euglycemia group (P<0.05); negative correlation was found between the bone density and the blood sugar level (aged male group: r=-0.7382, P=0.0013; aged female group: r=-0.8343, P=0.0007). Conclusion: The blood sugar level affects the bone density of the aged patients with non-insulin-dependent diabetes mellitus; the higher the blood sugar level, the lower the bone density. The non-insulin-dependent diabetes aged patients with hyperglycemia have the liability of osteoporosis. (authors)

  18. Quantitative Modeling of the Mitral Valve by Three-Dimensional Transesophageal Echocardiography in Patients Undergoing Mitral Valve Repair: Correlation with Intraoperative Surgical Technique.

    Science.gov (United States)

    Calleja, Anna; Poulin, Frédéric; Woo, Anna; Meineri, Massimiliano; Jedrzkiewicz, Sean; Vannan, Mani A; Rakowski, Harry; David, Tirone; Tsang, Wendy; Thavendiranathan, Paaladinesh

    2015-09-01

    Mitral valve (MV) repair is the procedure of choice for patients with degenerative MV disease (DMVD) with severe mitral regurgitation. The aim of this study was to identify specific quantitative MV parameters from preoperative three-dimensional (3D) transesophageal echocardiography that are associated with the length of the mitral annuloplasty band implanted and the performance of leaflet resection in patients with DMVD undergoing MV repair. Ninety-four patients (mean age, 60 ± 11 years; 68% men) referred for MV surgery with adequate-quality preoperative 3D transesophageal echocardiographic studies were retrospectively identified. Parametric maps of the MV were generated using semiautomated MV modeling software. Annular and valvular parameters were measured and indexed to body surface area. The implanted annuloplasty band size and leaflet resection were determined on the basis of surgical reports. Three-dimensional annular circumference correlated best (r = 0.74) with the implanted annuloplasty band length and remained an independent predictor on multivariate linear regression analysis. A third of our cohort (n = 33) had posterior leaflet resection. On receiver operating characteristic curve analysis, P2 segment length ≥ 20 mm (area under the curve, 0.86; sensitivity, 88%; specificity, 74%) and P2 leaflet area ≥ 3.4 cm(2) (area under the curve, 0.84; sensitivity, 85%; specificity, 74%) best discriminated the need for leaflet resection. In DMVD, quantitative 3D annular circumference obtained from semiautomatically generated parametric maps of the MV from 3D transesophageal echocardiographic data was associated with the surgically implanted annuloplasty band length, while P2 leaflet length ≥ 20 mm and area ≥ 3.4 cm(2) were associated with the performance of leaflet resection. These parameters should be further investigated for preoperative planning in patients with DMVD undergoing MV repair. Copyright © 2015 American Society of Echocardiography

  19. Use of scatter correction in quantitative I-123 MIBG scintigraphy for differentiating patients with Parkinsonism: Results from Phantom experiment and clinical study

    International Nuclear Information System (INIS)

    Bai, J.; Hashimoto, J.; Suzuki, T.; Nakahara, T.; Kubo, A.; Ohira, M.; Takao, M.; Ogawa, K.

    2007-01-01

    The aims of this study were to elucidate the feasibility of scatter correction in improving the quantitative accuracy of the Heart-to-Mediastinum (H/M) ratio in I-123 MIBG imaging and to clarify whether the H/M ratio calculated from the scatter corrected image improves the accuracy of differentiating patients with Parkinsonism from other neurological disorders. The H/M ratio was calculated using the counts from planar images processed with and without scatter correction in the phantom and on patients. The triple energy window (TEW) method was used for scatter correction. Fifty five patients were enrolled in the clinical study. The Receiver Operating Characteristic (ROC) Curve analysis was used to evaluate diagnostic performance. The H/M ratio was found to be increased after scatter correction in the phantom simulating normal cardiac uptake, while no changes were observed in the phantom simulating no uptake. It was observed that scatter correction stabilized the H/M ratio by eliminating the influence of scatter photons originating from the liver, especially in the condition of no cardiac uptake. Similarly, scatter correction increased the H/M ratio in conditions other than Parkinson's disease but did not show any change in Parkinson's disease itself to widen the differences in the H/M ratios between the two groups. The overall power of the test did not show any significant improvement after scatter correction in differentiating patients with Parkinsonism. Based on the results of this study it has been concluded that scatter correction improves the quantitative accuracy of H/M ratio in MIBG imaging, but it does not offer any significant incremental diagnostic value over conventional imaging (without scatter correction). Nevertheless it is felt that the scatter correction technique deserves special consideration in order to make the test more robust and obtain stable H/M ratios. (author)

  20. Biochemical evaluation of articular cartilage in patients with osteochondrosis dissecans by means of quantitative T2- and T2*-mapping at 3 T MRI: A feasibility study

    International Nuclear Information System (INIS)

    Marik, W.; Apprich, S.; Welsch, G.H.; Mamisch, T.C.; Trattnig, S.

    2012-01-01

    Objective: To perform an in vivo evaluation comparing overlying articular cartilage in patients suffering from osteochondrosis dissecans (OCD) in the talocrural joint and healthy volunteers using quantitative T2 mapping at 3.0 T. Method and materials: Ten patients with OCD of Grade II or lower and 9 healthy age matched volunteers were examined at a 3.0 T whole body MR scanner using a flexible multi-element coil. In all investigated persons MRI included proton-density (PD)-FSE and 3D GRE (TrueFisp) sequences for morphological diagnosis and location of anatomical site and quantitative T2 and T2* maps. Region of interest (ROI) analysis was performed for the cartilage layer above the OCD and for a morphologically healthy graded cartilage layer. Mean T2 and T2* values were then statistically analysed. Results: The cartilage layer of healthy volunteers showed mean T2 and T2* values of 29.4 ms (SD 4.9) and 11.8 ms (SD 2.7), respectively. In patients with OCD of grade I and II lesions mean T2 values were 40.9 ms (SD 6.6), 48.7 ms (SD 11.2) and mean T2* values were 16.1 ms (SD 3.2), 16.2 ms (SD 4.8). Therefore statistically significantly higher mean T2 and T2* values were found in patients suffering from OCD compared to healthy volunteers. Conclusion: T2 and T2* mapping can help assess the microstructural composition of cartilage overlying osteochondral lesions.

  1. Molecular detection of host cytokine expression in Helicobacter pylori infected patients via semi-quantitative RT-PCR

    Directory of Open Access Journals (Sweden)

    Hosseini M

    2010-01-01

    Full Text Available Background: Helicobacter pylori (Hp is a bacterium recognised as a main causative agent for the development of chronic active gastritis, peptic ulcer disease, gastric adenocarcinoma and primary gastric lymphoma. Objective: Determination of the levels of IFN-γ (pro-inflammatory and IL-4 (anti inflammatory cytokine expression as indicators of Th1 and Th2 immune responses in gastric cancer (GC and non gastric cancer (Non GC dyspeptic patients by gene specific RT-PCR. Materials and Methods: Biopsy specimens were collected from three groups of gastric cancer (GC=18, non ulcer dyspepsia (NUD = 38 and peptic ulcer patients (PUD=20. Total RNA was extracted and complementary DNA was synthesised. PCR amplification was performed for HPRT, IFN-γ and IL-4 cytokines and the intensity of each band was measured by densitometry and normalized against HPRT expression as a house keeping gene. Results: Comparison of the results from different groups of patients indicated that IFN-γ gene expression was similar in nonGC dyspeptic patients (NUD and PUD groups; 3.38 ± 0.57,3.43 ± 0.41, respectively whereas, in GC patients, it was significantly higher than others (5.52 ± 0.59; P < 0.0001. On the other hand, IL-4 gene expression showed no significant difference between NUD and GC patients (2.81 ± 0.43,2.3 ± 0.12 respectively, whereas the expression rate of this cytokine was significantly higher in PUD patients (3.7 ± 0.1; P 0.05. Our data indicate an association between Th1 and Th2 immune responses and the development of gastric cancer and peptic ulcer disease respectively.

  2. Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Matsuura, Yukiko, E-mail: matsuyuki_future@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Kawata, Naoko, E-mail: chumito_03@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Yanagawa, Noriyuki, E-mail: yanagawa@ho.chiba-u.ac.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sugiura, Toshihiko, E-mail: sugiura@js3.so-net.ne.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sakurai, Yoriko, E-mail: yoliri@nifty.com [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sato, Misuzu, E-mail: mis_misuzu@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Iesato, Ken, E-mail: iesato_k@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Terada, Jiro, E-mail: jirotera@chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sakao, Seiichiro, E-mail: sakao@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tada, Yuji, E-mail: ytada@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tanabe, Nobuhiro, E-mail: ntanabe@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Suzuki, Yoichi, E-mail: ysuzuki@faculty.chiba-u.jp [Department of public Health, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tatsumi, Koichiro, E-mail: tatsumi@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan)

    2013-10-01

    Objectives: Structural and functional changes in pulmonary vessels are prevalent at the initial stages of chronic obstructive pulmonary disease (COPD). These vascular alterations can be assessed using cross-sectional area (CSA) of small pulmonary vessels. However, neither in non-COPD smokers nor in COPD patients it has been defined whether the structural changes of pulmonary vessels detected by paired inspiratory and expiratory CT scans are associated with emphysematous changes. We quantified the CSA and low attenuation area (LAA) and evaluated the changes in these parameters in the inspiratory and expiratory phases. Materials and methods: Fifty consecutive non-COPD smokers and COPD patients were subjected to multi detector-row CT and the percentage of vessels with a CSA less than 5 mm{sup 2} as well as the percentage LAA for total lung area (%CSA < 5, %LAA, respectively) were calculated. Results: The %CSA < 5 correlated negatively with %LAA. The %CSA < 5 was lower in COPD patients with emphysema as compared with non-COPD smokers and COPD patients with or without mild emphysema. In addition, the %CSA < 5 was lower in the no/mild emphysema subgroup as compared with non-COPD smokers. The respiratory phase change of %CSA < 5 in COPD patients was greater than that in non-COPD smokers. Conclusion: The percentage of small pulmonary vessels decreased as emphysematous changes increase, and this decrease was observed even in patients with no/mild emphysema. Furthermore, respiratory phase changes in CSA were higher in COPD patients than in non-COPD smokers.

  3. Quantitative assessment of thyroid gland elasticity with shear-wave elastography in pediatric patients with Hashimoto's thyroiditis.

    Science.gov (United States)

    Kandemirli, Sedat Giray; Bayramoglu, Zuhal; Caliskan, Emine; Sari, Zeynep Nur Akyol; Adaletli, Ibrahim

    2018-01-18

    Hashimoto's thyroiditis is the most common autoimmune thyroid disorder in the pediatric age range. Measurement of thyroid gland size is an essential component in evaluation and follow-up of thyroid pathologies. Along with size, tissue elasticity is becoming a more commonly used parameter in evaluation of parenchyma in inflammatory diseases. The aim of the current study was to assess thyroid parenchyma elasticity by shear-wave elastography in pediatric patients with Hashimoto's thyroiditis; and compare the elasticity values to a normal control group. In this study; thyroid glands of 59 patients with a diagnosis of Hashimoto's thyroiditis based on ultrasonographic and biochemical features, and 26 healthy volunteers without autoimmune thyroid disease and thyroid function disorders, were evaluated with shear-wave elastography. Patients with Hashimoto thyroiditis were further subdivided into three categories based on gray-scale ultrasonography findings as focal thyroiditis (grade 1), diffuse thyroiditis (grade 2), and fibrotic thyroid gland (grade 3). Patients with Hashimoto's thyroiditis (n = 59) had significantly higher elasticity values (14. 9 kPa; IQR 12.9-17.8 kPa) than control subjects (10.6 kPa; IQR 9.0-11.3 kPa) (p thyroiditis, 23 patients had focal thyroiditis involving less than 50% of the gland categorized as grade 1, 24 patients had diffuse involvement of the thyroid gland categorized as grade 2, and 12 patients had marked hyperechoic septations and pseudonodular appearance categorized as grade 3 on gray-scale ultrasound. Based on elastography, grade 3 patients had significantly higher elasticity values (19.7 kPa; IQR 17.8-21.5 kPa) than patients with grade 2 (15.5 kPa; IQR 14.5-17.8 kPa) and grade 1 thyroiditis (12.8 kPa; IQR 11.9-13.1 kPa) (p thyroiditis had significantly higher elasticity values than those with grade 1 thyroiditis (p thyroiditis. Our results indicate that shear-wave elastography could be used to evaluate the degree of

  4. Physician's initial impression of elderly breast cancer patients allows appropriate treatment stratification despite lack of quantitative assessment.

    LENUS (Irish Health Repository)

    Prichard, R S

    2012-02-01

    The management of older women with breast cancer is often suboptimal based on perceived patient comorbidities. The aim of this study was to evaluate the choice of treatment modality based on clinicians \\'gut-feeling\\' compared to comorbidity scoring indices. A retrospective review of women over 70 presenting with breast cancer was performed. Presenting comorbidities (Charlson Comorbidity Index and Cumulative Illness Rating Scale) and the treatment received was documented. Sixty-six patients were identified. Forty-six had surgery while twenty patients had primary endocrine manipulation. The mean age of patients having surgery was 76.4 in comparison to 84.4 for the endocrine group (p = 0.001). The CCI scores for the surgical group and endocrine group were 6.62 and 9.26 respectively (p = 0.001). The scores for the CIRS were 8.93 and 22.68 (p = 0.001). This study has demonstrated that physician\\'s "gut feelings\\' are often correct in identifying patients who may benefit from primary hormone therapy.

  5. Maintained Salivary Function after Brachytherapy in Patients with Head and Neck Carcinomas Evaluation Using Quantitative Salivary Gland Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Yuji; Zhang, Lin; Ishida, Ryuji [Tokyo Medical and Dental Univ. (Japan). Dept. of Radiology] [and others

    2002-11-01

    The purpose of this study was to determine whether or not salivary gland dysfunction occurs within the first three months after brachytherapy in patients with head and neck carcinoma. Of the 20 patients with head and neck squamous cell carcinoma included in this study, 11 were treated with brachytherapy and the remaining 9 patients received external irradiation. All the patients underwent a salivary gland scintigraphy before and after radiotherapy. The scintigraphic parameters of each major salivary gland were then compared before and after the radiotherapy. In the brachytherapy group, none of the scintigraphic functional parameters showed a significant change before and after the radiotherapy. In contrast, all of the parameters with the exception of the uptake ratio (UR) of the submandibular glands significantly decreased after external irradiation. This observation was to be expected owing to the different irradiation doses administered by the two techniques. The scintigraphic technique used to evaluate salivary gland function should be used in future intensity-modulated radiation therapy salivary-gland-sparing studies in order to evaluate both the acute and chronic effects of irradiation in head and neck cancer patients.

  6. Early collection of saliva specimens from Bell's palsy patients: quantitative analysis of HHV-6, HSV-1, and VZV.

    Science.gov (United States)

    Turriziani, Ombretta; Falasca, Francesca; Maida, Paola; Gaeta, Aurelia; De Vito, Corrado; Mancini, Patrizia; De Seta, Daniele; Covelli, Edoardo; Attanasio, Giuseppe; Antonelli, Guido

    2014-10-01

    Bell's palsy is the most common cause of facial paralysis. Although it has been associated with diabetes mellitus, hypertension, pregnancy, and preeclampsia, the etiology of Bell's palsy remains unknown. The reactivation of latent herpes simplex virus (HSV) or varicella-zoster virus (VZV) with subsequent inflammation and entrapment of the facial nerve in the narrow labyrinthine segment has been implicated as a cause of facial paralysis, but the active role of these viruses in Bell's palsy is still discussed. This study quantified HSV-1 DNA, VZV DNA, and HHV-6 DNA in 95 saliva samples collected from patients within 48 hr from the onset of paralysis. HSV-1, VZV, and HHV-6 were detected in 13%, 3%, and 61% of patients, respectively. The detection rate did not differ significantly between patients and a control group of healthy donors. Interestingly, however, the value of HHV-6 DNA copies was significantly higher than that detected in healthy donors. In addition, the mean value of HHV-6 DNA recorded in patients who had at least a one grade improvement of palsy at the first visit was significantly lower than that detected in patients who showed no change in facial palsy grade or an increase of at least one grade. These findings call into question the role of HSV-1 and VZV in the etiology of Bell's palsy, and suggest that HHV-6 may be involved in the development of the disease or that the underlying disease mechanism might predispose patients to HHV-6 reactivation. © 2014 Wiley Periodicals, Inc.

  7. Facial paresis in patients with mesial temporal sclerosis: clinical and quantitative MRI-based evidence of widespread disease.

    Science.gov (United States)

    Lin, Katia; Carrete, Henrique; Lin, Jaime; de Oliveira, Pedro Alessandro Leite; Caboclo, Luis Otávio Sales Ferreira; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2007-08-01

    To assess the frequency and significance of facial paresis (FP) in a well-defined cohort of mesial temporal lobe epilepsy (MTLE) patients. One hundred consecutive patients with MRI findings consistent with mesial temporal sclerosis (MTS) and concordant electroclinical data underwent facial motor examination at rest, with voluntary expression, and with spontaneous smiling. Hippocampal, amygdaloid, and temporopolar (TP) volumetric measures were acquired. Thirty healthy subjects, matched according to age and sex, were taken as controls. Central-type FP was found in 46 patients. In 41 (89%) of 46, it was visualized at rest, with voluntary and emotional expression characterizing true facial motor paresis. In 33 (72%) of 46 patients, FP was contralateral to the side of MTS. By using a 2-SD cutoff from the mean of normal controls, we found reduction in TP volume ipsilateral to MTS in 61% of patients with FP and in 33% of those without (p = 0.01). Febrile seizures as initial precipitating injury (IPI) were observed in 34% of the patients and were classified as complex in 12 (26%) of 46 of those with FP and in five (9%) of 54 of those without (p = 0.02). The presence of FP was significantly associated with a shorter latent period and younger age at onset of habitual seizures, in particular, with secondarily generalized tonic-clonic seizures. Facial paresis is a reliable lateralizing sign in MTLE and was associated with history of complex febrile seizures as IPI, younger age at onset of disease, and atrophy of temporal pole ipsilateral to MTS, indicating more widespread disease.

  8. [The quantitative assessment of spinal motor function during the action of hydrogen sulfide baths on patients with lumbar osteochondrosis].

    Science.gov (United States)

    Tysiachnyĭ, N D

    1994-01-01

    300 males experiencing pain and motor dysfunction as a result of lumbar osteochondrosis received sulfide balneotherapy. The baths contained moderate (50-150 mg/l) and high concentrations (150-250 mg/l) of hydrogen sulfide. The effect of the treatment was assessed with repeated goniometry by means of specially devised instruments by 6 parameters. According to the degree measurements, the recovered motility in the lumbar spine in patients on large-concentration baths surpassed that in patients on less concentrated ones 1.5-fold.

  9. Quantitative computed tomography of lung parenchyma in patients with emphysema: analysis of higher-density lung regions

    Science.gov (United States)

    Lederman, Dror; Leader, Joseph K.; Zheng, Bin; Sciurba, Frank C.; Tan, Jun; Gur, David

    2011-03-01

    Quantitative computed tomography (CT) has been widely used to detect and evaluate the presence (or absence) of emphysema applying the density masks at specific thresholds, e.g., -910 or -950 Hounsfield Unit (HU). However, it has also been observed that subjects with similar density-mask based emphysema scores could have varying lung function, possibly indicating differences of disease severity. To assess this possible discrepancy, we investigated whether density distribution of "viable" lung parenchyma regions with pixel values > -910 HU correlates with lung function. A dataset of 38 subjects, who underwent both pulmonary function testing and CT examinations in a COPD SCCOR study, was assembled. After the lung regions depicted on CT images were automatically segmented by a computerized scheme, we systematically divided the lung parenchyma into different density groups (bins) and computed a number of statistical features (i.e., mean, standard deviation (STD), skewness of the pixel value distributions) in these density bins. We then analyzed the correlations between each feature and lung function. The correlation between diffusion lung capacity (DLCO) and STD of pixel values in the bin of -910HU lung parenchyma and lung function, which indicates that similar to the conventional density mask method, the pixel value distribution features in "viable" lung parenchyma areas may also provide clinically useful information to improve assessments of lung disease severity as measured by lung functional tests.

  10. The 2D Hotelling filter - a quantitative noise-reducing principal-component filter for dynamic PET data, with applications in patient dose reduction

    International Nuclear Information System (INIS)

    Axelsson, Jan; Sörensen, Jens

    2013-01-01

    In this paper we apply the principal-component analysis filter (Hotelling filter) to reduce noise from dynamic positron-emission tomography (PET) patient data, for a number of different radio-tracer molecules. We furthermore show how preprocessing images with this filter improves parametric images created from such dynamic sequence. We use zero-mean unit variance normalization, prior to performing a Hotelling filter on the slices of a dynamic time-series. The Scree-plot technique was used to determine which principal components to be rejected in the filter process. This filter was applied to [ 11 C]-acetate on heart and head-neck tumors, [ 18 F]-FDG on liver tumors and brain, and [ 11 C]-Raclopride on brain. Simulations of blood and tissue regions with noise properties matched to real PET data, was used to analyze how quantitation and resolution is affected by the Hotelling filter. Summing varying parts of a 90-frame [ 18 F]-FDG brain scan, we created 9-frame dynamic scans with image statistics comparable to 20 MBq, 60 MBq and 200 MBq injected activity. Hotelling filter performed on slices (2D) and on volumes (3D) were compared. The 2D Hotelling filter reduces noise in the tissue uptake drastically, so that it becomes simple to manually pick out regions-of-interest from noisy data. 2D Hotelling filter introduces less bias than 3D Hotelling filter in focal Raclopride uptake. Simulations show that the Hotelling filter is sensitive to typical blood peak in PET prior to tissue uptake have commenced, introducing a negative bias in early tissue uptake. Quantitation on real dynamic data is reliable. Two examples clearly show that pre-filtering the dynamic sequence with the Hotelling filter prior to Patlak-slope calculations gives clearly improved parametric image quality. We also show that a dramatic dose reduction can be achieved for Patlak slope images without changing image quality or quantitation. The 2D Hotelling-filtering of dynamic PET data is a computer

  11. Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension.

    Science.gov (United States)

    Huang, Yu-Sen; Hsu, Hsao-Hsun; Chen, Jo-Yu; Tai, Mei-Hwa; Jaw, Fu-Shan; Chang, Yeun-Chung

    2014-01-01

    This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R(2) = 0.340, p = 0.023), RV stroke volume (R(2) = 0.406, p = 0.011), and RV cardiac output (R(2) = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.

  12. Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Huang, Yu San; Jaw, Fu Shan; Chen, Jo Yu; Tai, Mei Hwa; Hsu, Hsao Hsun

    2014-01-01

    This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R2 = 0.340, p = 0.023), RV stroke volume (R2 = 0.406, p = 0.011), and RV cardiac output (R2 = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.

  13. Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yu San; Jaw, Fu Shan [Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei (China); Chen, Jo Yu; Tai, Mei Hwa [Dept. of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei (China); Hsu, Hsao Hsun [Dept. of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei (China)

    2014-12-15

    This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R2 = 0.340, p = 0.023), RV stroke volume (R2 = 0.406, p = 0.011), and RV cardiac output (R2 = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.

  14. QUEST-RA: quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Kautiainen, Hannu; Toloza, Sergio

    2007-01-01

    OBJECTIVE: To conduct a cross-sectional review of non-selected consecutive outpatients with rheumatoid arthritis (RA) as part of standard clinical care in 15 countries for an overview of the characteristics of patients with RA. METHODS: The review included current disease activity using data from...

  15. Quantitative sensory testing and pain tolerance in patients with mild to moderate Alzheimer disease compared to healthy control subjects

    DEFF Research Database (Denmark)

    Jensen-Dahm, Christina; Werner, Mads U; Dahl, Jørgen B

    2014-01-01

    Patients with Alzheimer disease (AD) report pain less frequently than their cognitively intact peers. It has been hypothesized that pain processing is altered in AD. The aim of this study was to investigate agreement and reliability of 3 pain sensitivity tests and to examine pain threshold...

  16. Growth disturbance after lengthening of the lower limb and quantitative assessment of physeal closure in skeletally immature patients with achondroplasia.

    Science.gov (United States)

    Song, S H; Kim, S E; Agashe, M V; Lee, H; Refai, M A; Park, Y E; Choi, H J; Park, J H; Song, H R

    2012-04-01

    This study evaluated the effect of limb lengthening on longitudinal growth in patients with achondroplasia. Growth of the lower extremity was assessed retrospectively by serial radiographs in 35 skeletally immature patients with achondroplasia who underwent bilateral limb lengthening (Group 1), and in 12 skeletally immature patients with achondroplasia who did not (Group 2). In Group 1, 23 patients underwent only tibial lengthening (Group 1a) and 12 patients underwent tibial and femoral lengthening sequentially (Group 1b). The mean lengthening in the tibia was 9.2 cm (59.5%) in Group 1a, and 9.0 cm (58.2%) in the tibia and 10.2 cm (54.3%) in the femur in Group 1b. The mean follow-up was 9.3 years (8.6 to 10.3). The final mean total length of lower extremity in Group 1a was 526.6 mm (501.3 to 552.9) at the time of skeletal maturity and 610.1 mm (577.6 to 638.6) in Group 1b, compared with 457.0 mm (411.7 to 502.3) in Group 2. However, the mean actual length, representing the length solely grown from the physis without the length of distraction, showed that there was a significant disturbance of growth after limb lengthening. In Group 1a, a mean decrease of 22.4 mm (21.3 to 23.1) (4.9%) was observed in the actual limb length when compared with Group 2, and a greater mean decrease of 38.9 mm (37.2 to 40.8) (8.5%) was observed in Group 1b when compared with Group 2 at skeletal maturity. In Group 1, the mean actual limb length was 16.5 mm (15.8 to 17.2) (3.6%) shorter in Group 1b when compared with Group 1a at the time of skeletal maturity. Premature physeal closure was seen mostly in the proximal tibia and the distal femur with relative preservation of proximal femur and distal tibia. We suggest that significant disturbance of growth can occur after extensive limb lengthening in patients with achondroplasia, and therefore, this should be included in pre-operative counselling of these patients and their parents.

  17. Relationship between evaluation by quantitative fatty acid myocardial scintigraphy and response to {beta}-blockade therapy in patients with dilated cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Tatsuo; Hoshida, Shiro; Nishino, Masami; Aoi, Toshiyuki; Egami, Yasuyuki; Takeda, Toshihiro; Kawabata, Masayoshi; Tanouchi, Jun; Yamada, Yoshio; Kamada, Takenobu [Div. of Cardiology, Osaka Rosai Hospital (Japan)

    2001-12-01

    Predicting the effect of {beta}-blockade therapy on the clinical outcome of patients with dilated cardiomyopathy (DCM) is difficult prior to the initiation of therapy. Myocardial fatty acid metabolism has been shown to be impaired in patients with DCM. We examined whether the extent of myocardial injury, as assessed by iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) myocardial scintigraphy, is related to the response of patients with DCM to {beta}-blockade therapy. Thirty-seven patients with DCM were examined using BMIPP myocardial scintigraphy before and after 6 months of treatment with metoprolol. Myocardial BMIPP uptake (%BM uptake) was estimated quantitatively as a percentage of the total injected count ratio. The left ventricular end-diastolic and end-systolic dimensions (LVDd, LVDs) and ejection fraction (LVEF) were also evaluated. The patients were divided into two groups according to their functional improvement (>10% elevation of LVEF) after 6 months of metoprolol therapy. Twenty-eight patients responded to the therapy, while nine did not. Prior to the therapy, no significant differences in LVDd, LVDs or LVEF were observed between the responders and non-responders. However, the %BM uptake was significantly lower in the non-responders than in the responders (1.0%{+-}0.2% vs 2.1%{+-}0.5%, P<0.001). The %BM uptake could be used to distinguish the responders from the non-responders with a sensitivity of 0.93 and a specificity of 1.00 at a threshold value of 1.4. After the metoprolol therapy, the %BM uptake improved significantly in the responders (2.5%{+-}0.5%, P<0.01) but did not change in the non-responders. These results indicate that myocardial BMIPP uptake could predict the response of DCM patients to {beta}-blockade therapy. (orig.)

  18. Evaluation of Murex CMV DNA Hybrid Capture Assay for Detection and Quantitation of Cytomegalovirus Infection in Patients following Allogeneic Stem Cell Transplantation

    Science.gov (United States)

    Hebart, Holger; Gamer, Daphne; Loeffler, Juergen; Mueller, Claudia; Sinzger, Christian; Jahn, Gerhard; Bader, Peter; Klingebiel, Thomas; Kanz, Lothar; Einsele, Hermann

    1998-01-01

    Murex hybrid capture DNA assay (HCS) is a solution hybridization antibody capture assay for detection and quantitation of cytomegalovirus (CMV) DNA in leukocytes. To determine whether CMV HCS is sensitive enough to initiate and monitor antiviral therapy after allogeneic stem cell transplantation (SCT), 51 consecutive SCT recipients were prospectively screened for the appearance of CMV infection by HCS, PCR, and culture assays from blood samples. Preemptive antiviral therapy was initiated after the second positive PCR result in all patients, as previously reported, and HCS was not considered for clinical decision making. A total of 417 samples were analyzed. Of these, 21 samples were found to be positive by PCR and HCS, 88 samples were PCR positive but HCS negative, and 308 were negative by both assays. Concordance of results between PCR and HCS and between HCS and blood culture was observed in 78.9 and 95.9% of the samples assayed, respectively. PCR was found to be more sensitive than HCS, and HCS was more sensitive than the blood culture assay (P < 0.0001). Four patients with symptomatic CMV infection were PCR positive prior to the onset of CMV-related symptoms, whereas HCS detected CMV DNA in three patients prior to and one at onset of CMV disease. The numbers of genomes per milliliter of blood were higher in patients with symptomatic CMV infection than in those with asymptomatic CMV infection (P = 0.06). None of the HCS-negative patients developed CMV disease. Thus, all patients with CMV disease were correctly identified by HCS; however, the lower sensitivity limit of the HCS assay may still be insufficient to allow diagnosis of CMV infection early enough to prevent CMV disease in patients following allogeneic SCT. PMID:9574700

  19. Assessing the synergy between cholinomimetics and memantine as augmentation therapy in cognitive impairment in schizophrenia. A virtual human patient trial using quantitative systems pharmacology.

    Science.gov (United States)

    Geerts, Hugo; Roberts, Patrick; Spiros, Athan

    2015-01-01

    While many drug discovery research programs aim to develop highly selective clinical candidates, their clinical success is limited because of the complex non-linear interactions of human brain neuronal circuits. Therefore, a rational approach for identifying appropriate synergistic multipharmacology and validating optimal target combinations is desperately needed. A mechanism-based Quantitative Systems Pharmacology (QSP) computer-based modeling platform that combines biophysically realistic preclinical neurophysiology and neuropharmacology with clinical information is a possible solution. This paper reports the application of such a model for Cognitive Impairment In Schizophrenia (CIAS), where the cholinomimetics galantamine and donepezil are combined with memantine and with different antipsychotics and smoking in a virtual human patient experiment. The results suggest that cholinomimetics added to antipsychotics have a modest effect on cognition in CIAS in non-smoking patients with haloperidol and risperidone and to a lesser extent with olanzapine and aripiprazole. Smoking reduces the effect of cholinomimetics with aripiprazole and olanzapine, but enhances the effect in haloperidol and risperidone. Adding memantine to antipsychotics improves cognition except with quetiapine, an effect enhanced with smoking. Combining cholinomimetics, antipsychotics and memantine in general shows an additive effect, except for a negative interaction with aripiprazole and quetiapine and a synergistic effect with olanzapine and haloperidol in non-smokers and haloperidol in smokers. The complex interaction of cholinomimetics with memantine, antipsychotics and smoking can be quantitatively studied using mechanism-based advanced computer modeling. QSP modeling of virtual human patients can possibly generate useful insights on the non-linear interactions of multipharmacology drugs and support complex CNS R&D projects in cognition in search of synergistic polypharmacy.

  20. Superiority of quantitative exercise thallium-201 variables in determining long-term prognosis in ambulatory patients with chest pain: a comparison with cardiac catheterization

    International Nuclear Information System (INIS)

    Kaul, S.; Finkelstein, D.M.; Homma, S.; Leavitt, M.; Okada, R.D.; Boucher, C.A.

    1988-01-01

    The purpose of this study was to determine the prognostic utility of quantitative exercise thallium-201 imaging and compare it with that of cardiac catheterization in ambulatory patients. Accordingly, long-term (4 to 9 years) follow-up was obtained in 293 patients who underwent both tests for the evaluation of chest pain: 89 had undergone coronary artery bypass graft surgery within 3 months of testing and were excluded from analysis, 119 experienced no cardiac events and 91 had an event (death in 20, nonfatal myocardial infarction in 21 and coronary artery bypass operations performed greater than 3 months after cardiac catheterization in 50). When all variables were analyzed using Cox regression analysis, the quantitatively assessed lung/heart ratio of thallium-201 activity was the most important predictor of a future cardiac event (chi 2 = 40.21). Other significant predictors were the number of diseased vessels (chi 2 = 17.11), patient gender (chi 2 = 9.43) and change in heart rate from rest to exercise (chi 2 = 4.19). Whereas the number of diseased vessels was an important independent predictor of cardiac events, it did not add significantly to the overall ability of the exercise thallium-201 test to predict events. Furthermore, information obtained from thallium-201 imaging alone was marginally superior to that obtained from cardiac catheterization alone (p = 0.04) and significantly superior to that obtained from exercise testing alone (p = 0.02) in determining the occurrence of events. In addition, unlike the exercise thallium-201 test, which could predict the occurrence of all categories of events, catheterization data were not able to predict the occurrence of nonfatal myocardial infarction. The exclusion of bypass surgery and previous myocardial infarction did not alter the results

  1. Quantitative detection of epstein-barr virus DNA in cerebrospinal fluid and blood samples of patients with relapsing-remitting multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Clementina E Cocuzza

    Full Text Available The presence of Epstein-Barr Virus (EBV DNA in cerebrospinal fluid (CSF and peripheral blood (PB samples collected from 55 patients with clinical and radiologically-active relapsing-remitting MS (RRMS and 51 subjects with other neurological diseases was determined using standardized commercially available kits for viral nucleic acid extraction and quantitative EBV DNA detection. Both cell-free and cell-associated CSF and PB fractions were analyzed, to distinguish latent from lytic EBV infection. EBV DNA was detected in 5.5% and 18.2% of cell-free and cell-associated CSF fractions of patients with RRMS as compared to 7.8% and 7.8% of controls; plasma and peripheral blood mononuclear cells (PBMC positivity rates were 7.3% and 47.3% versus 5.8% and 31.4%, respectively. No significant difference in median EBV viral loads of positive samples was found between RRMS and control patients in all tested samples. Absence of statistically significant differences in EBV positivity rates between RRMS and control patients, despite the use of highly sensitive standardized methods, points to the lack of association between EBV and MS disease activity.

  2. Assessment of the Effect of Interferon-Beta1a Therapy on Thyroid and Salivary Gland Functions in Patients with Multiple Sclerosis Using Quantitative Salivary Gland Scintigraphy

    Directory of Open Access Journals (Sweden)

    Seval Erhamamcı

    2014-10-01

    Full Text Available Objective: Interferon-beta (IFN-β is widely used in patients with multiple sclerosis (MS, a demyelinating disease of the central nervous system. High incidence of thyroid dysfunction has been reported after administration of IFN-β in MS patients. The aim of this study was to assess the effect of IFN-β1a therapy on simultaneous thyroid and salivary gland function in patients with MS using quantitative salivary gland scintigraphy (QSGS. Methods: Fifteen relapsing-remitting (RR MS patients treated with IFN-β1a and two control groups consisting of 15 untreated RRMS patients and 20 healthy age and sex-matched individuals were included in the study. The functional status of the salivary and thyroid glands was analysed with the QSGS and laboratory tests, including thyroid function and thyroid antibody. After intravenous administration of 150 MBq Tc-99m pertechnetate, dynamic study was performed for 25 minutes. Salivary gland secretion was stimulated with oral lemon juice at 15 minutes. At the end of dynamic study, a static image in the same projection was taken. Uptake ratios at 12-14 min (UR% and stimulated excretion fraction (EF% of each parotid and submandibular gland were calculated automatically from SGS. Thyroid uptake ratio (TUR of thyroid gland was calculated from the static image. Results: All MS patients treated and untreated with IFN-β1a, and healthy individuals were euthyroid. Anti-thyroid peroxidase antibody (anti-TPO was detected in 4 out of 15 MS patients (26.6% treated with IFN-β1a. There was no significant differences in the UR, EF and TUR values among MS patients treated and untreated with IFN-β1a, and healthy controls (p>0.05. Although the TUR values in MS patients treated with IFN-β1a were less than those of the both control group, the difference was not statistically significant (p>0.05. Conclusion: IFN-β1a therapy was demonstrated to have no effect on thyroid and salivary gland functions using QSGS in patients with MS

  3. Quantitative iTRAQ-Based Proteomic Identification of Candidate Biomarkers for Diabetic Nephropathy in Plasma of Type 1 Diabetic Patients

    DEFF Research Database (Denmark)

    Overgaard, Anne Julie; Thingholm, Tine Engberg; Larsen, Martin R

    2010-01-01

    spectrometry in three identical repetitions using isobaric mass tags (iTRAQ). The results were further analysed with ingenuity pathway analysis. Levels of apolipoprotein A1, A2, B, C3, E and J were analysed and validated by a multiplex immunoassay in 20 type 1 diabetic patients with macroalbuminuria and 10......INTRODUCTION: As part of a clinical proteomics programme focused on diabetes and its complications, it was our goal to investigate the proteome of plasma in order to find improved candidate biomarkers to predict diabetic nephropathy. METHODS: Proteins derived from plasma from a cross......-sectional cohort of 123 type 1 diabetic patients previously diagnosed as normoalbuminuric, microalbuminuric or macroalbuminuric were enriched with hexapeptide library beads and subsequently pooled within three groups. Proteins from the three groups were compared by online liquid chromatography and tandem mass...

  4. Quantitative Magnetic Resonance Imaging of Brainstem Volumes, Plaques, and Surface Area in the Occipital Regions of Patients with Multiple Sclerosis

    International Nuclear Information System (INIS)

    Alper, F.; Kantarci, M.; Altunkaynak, E.; Varoglu, A. O.; Karaman, A.; Oral, E.; Okur, A.

    2006-01-01

    Purpose: To determine brainstem volumes, number of plaques, and surface areas in the occipital lobes of patients with relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), and to investigate whether there is any correlation between brainstem volume and the number/surface areas of plaque in the occipital lobes. Material and Methods: Magnetic resonance imaging was obtained on 14 relapsing-remitting (RR) and 13 secondary progressive (SP) MS patients and 26 female control subjects. The Cavalieri method was used by modern design stereology to measure brainstem volume. The point-counting grid was used to evaluate sclerotic plaque surface areas in the occipital lobe. The number of plaques in the imaging section was calculated. Results: Brainstem volumes for RR and SP with multiple sclerosis and control subjects were 3647 mm 3 , 3515 mm 3 , and 4517 mm 3 , respectively. Mean number of plaques in the right-left occipital lobe was found to be 2.7-3.4 in RR-MS and 5.2-2.8 in SP-MS. Mean plaque surface area in the right-left occipital lobe was determined to be 58.52-88.24 mm 2 in RR MS and 124.3-64.82 mm 2 in SP MS. Brainstem volumes were significantly reduced in both groups of patients with MS compared to controls ( P <0.01). Conclusion: Magnetic-resonance-estimated volume and surface area values in multiple sclerosis may facilitate our understanding of the clinical situation of patients and provide a simple index for evaluating therapeutic efficiency

  5. Health-related quality of life in patients with high-grade gliomas: a quantitative longitudinal study.

    Science.gov (United States)

    Piil, K; Jakobsen, J; Christensen, K B; Juhler, M; Jarden, M

    2015-09-01

    The diagnosis of a high-grade glioma usual is followed by functional impairment(s), cognitive decline and an impaired psycho-social well-being. This might well have a significant and negative impact on the health related quality of life. The purpose of this study was to explore physical activity levels, prevalence and severity of anxiety and depressive symptoms and health-related quality of life among patients with a highgrade glioma. This paper is based on a longitudinal mixed methods study. Patients (n = 30) completed questionnaires at 5 time points from time of diagnosis until the final follow-up after 1 year. Scores of Karnofsky Performance Status (KPS), physical activity, anxiety and depression and health-related quality of life (FACT-Br) are obtained. Patients' physical activity level and KPS decrease during the disease- and treatment trajectory. The majority of patients did not report any depressive symptoms, eight individuals (26.7 %) being depressed at various time points. Among a sub-group of participants who completed all study requirements for the entire study period the level of anxiety decreased significantly during the study. The FACT-Br sub-scale of emotional well-being increased significant, indicating a better HRQOL attend of followup. The diagnosis of a HGG leads to an ongoing functional decline measured as a decline of the KPS and a reduced physical activity during leisure time. Supportive care combined with rehabilitative and palliative approaches might well be valuable along the trajectory especially during the post-surgery period when anxiety is at its highest peak.

  6. Quantitative multivoxel proton MR spectroscopy study of brain metabolites in patients with amnestic mild cognitive impairment: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Zhong-Xian; Cheng, Xiao-Fang; Xu, Zhi-Feng; Cao, Zhen; Xiao, Ye-Yu; You, Ke-Zeng; Liu, Yan-Yan [Medical College of Shantou University, Department of Medical Imaging, The Second Affiliated Hospital, Shantou (China); Huo, Shan-Shan [Science College of Shantou University, Department of Physics, Shantou (China); Zeng, Jie-Xia; Chen, Wei [Medical College of Shantou University, Department of Neurology, The Second Affiliated Hospital, Shantou (China); Wu, Ren-Hua [Medical College of Shantou University, Department of Medical Imaging, The Second Affiliated Hospital, Shantou (China); Medical College of Shantou University, Provincial Key Laboratory of Medical Molecular Imaging, Guangdong, Shantou (China)

    2012-05-15

    The purpose of this study is to investigate brain metabolic changes in patients with amnestic mild cognitive impairment (aMCI) using multivoxel proton MR spectroscopy ({sup 1}H-MVS). Fourteen aMCI patients and fifteen healthy control subjects participated in this experiment. All MR measurements were acquired using a 1.5-T GE scanner. {sup 1}H-MVS point resolved spectroscopy (2D PROBE-CSI PRESS) pulse sequence (TE = 35 ms; TR = 1,500 ms; phase x frequency, 18 x 18) was used for acquiring MRS data. All data were post-processed using Spectroscopy Analysis by General Electric software and linear combination of model (LCModel). The absolute concentrations of N-acetylaspartate (NAA), choline (Cho), myoinositol (MI), creatine (Cr), and the metabolite ratios of NAA/Cr, Cho/Cr, MI/Cr, and NAA/MI were measured bilaterally in the posterior cingulate gyrus (PCG), inferior precuneus (Pr), paratrigonal white matter (PWM), dorsal thalamus (DT), and lentiform nucleus (LN). Patients with aMCI displayed significantly lower NAA levels in the bilateral PCG (p < 0.01), PWM (p < 0.05), and left inferior Pr (p < 0.05). The metabolite ratio of NAA/MI was decreased in the bilateral PCG (p < 0.01) and PWM (p < 0.05) and in the left DT (p < 0.01). NAA/Cr was decreased in the left PCG (p < 0.01), DT (p < 0.05), right PWM (p < 0.05), and LN (p < 0.05). However, MI/Cr was elevated in the right PCG (p < 0.01) and left PWM (p < 0.05). Significantly increased Cho level was also evident in the left PWM (p < 0.05). Our observations of decreased NAA, NAA/Cr, and NAA/MI, in parallel with increased Cho and MI/Cr might be characteristic of aMCI patients. (orig.)

  7. Value of quantitative magnetic resonance imaging T1-relaxometry in predicting contrast-enhancement in glioblastoma patients

    OpenAIRE

    Hattingen, Elke; M?ller, Andreas; Jurcoane, Alina; M?dler, Burkhard; Ditter, Philip; Schild, Hans; Herrlinger, Ulrich; Glas, Martin; Kebir, Sied

    2017-01-01

    SUMMARIZING THE IMPORTANCE OF THE STUDY The repetitive usage of gadolinium-based contrast agents (GBCA) is critical for magnetic resonance imaging (MRI) evaluation of tumor burden in glioblastoma patients. It is also a crucial tool for determination of radiographical response to treatment. GBCA injection, however, comes with a 2.4% rate of adverse events including life-threatening conditions such as nephrogenic systemic fibrosis (NSF). Moreover, GBCA have been shown to be deposited in brain t...

  8. Quantitative and qualitative bone assessment of the posterior mandible in patients with diabetes mellitus: a cone beam computed tomography study.

    Science.gov (United States)

    Nemtoi, A; Ladunca, Oana; Dragan, Eliza; Budacu, C; Mihai, C; Haba, Danisia

    2013-01-01

    Evaluation of mandibular bone features is very important for the diagnosis, treatment planning and management of dental procedures such as osseointegrated implants. To evaluate the bone quantity and quality of the posterior region of the mandible using the CBCT technique for implant planning in patients with diabetes mellitus. Twenty-three patients with diabetes mellitus and 27 control subjects participated in the study. Mandibular bone measurements were performed on the cone beam computed tomography (CBCT) images. One previously calibrated oral radiologist with CBCT experience measured the distance from mandibular canal to alveolar ridge and the distance from bucal to lingual cortical wall. Also, it was assessed the bone quality of each region of interest, by measuring the bone mineral density. The study protocol was approved by the local Ethics Committee. The study revealed the presence of significant correlations between bone quality and values ofglycosylated hemoglobin and a significant association between patient gender and bone type. There is a significant inverse correlation between the values of cortical and trabecular bone density in the posterior region of the mandible and HbA1c. In conclusion the use of CBCT in preoperative bone measurements will help provide valuable information about the quantity and quality of bone before the placement of dental implants.

  9. Fluid retention associated with imatinib treatment in patients with gastroenterol stromal: Quantitative radiologic assessment and implications for management

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Won; Shinagare, Atul B.; Krajewski, Katherine M.; Tirumani, Sree Harsha; Jagannathan, Jyothi P.; Ramaiya, Nikihil H. [Dept. of Imaging, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Pyo, Jun Hee [The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston (United States)

    2015-04-15

    We aimed to describe radiologic signs and time-course of imatinib-associated fluid retention (FR) in patients with gastrointestinal stromal tumor (GIST), and its implications for management. In this Institutional Review Board-approved, retrospective study of 403 patients with GIST treated with imatinib, 15 patients with imaging findings of FR were identified by screening radiology reports, followed by manual confirmation. Subcutaneous edema, ascites, pleural effusion, and pericardial effusion were graded on a four-point scale on CT scans; total score was the sum of these four scores. The most common radiologic sign of FR was subcutaneous edema (15/15, 100%), followed by ascites (12/15, 80%), pleural effusion (11/15, 73%), and pericardial effusion (6/15, 40%) at the time of maximum FR. Two distinct types of FR were observed: 1) acute/progressive FR, characterized by acute aggravation of FR and rapid improvement after management, 2) intermittent/steady FR, characterized by occasional or persistent mild FR. Acute/progressive FR always occurred early after drug initiation/dose escalation (median 1.9 month, range 0.3-4.0 months), while intermittent/steady FR occurred at any time. Compared to intermittent/steady FR, acute/progressive FR was severe (median score, 5 vs. 2.5, p = 0.002), and often required drug-cessation/dose-reduction. Two distinct types (acute/progressive and intermittent/steady FR) of imatinib-associated FR are observed and each type requires different management.

  10. Prognostic value of pretreatment volume-based quantitative {sup 18}F-FDG PET/CT parameters in patients with malignant pleural mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, Hyogo (Japan); Doi, Hiroshi, E-mail: h-doi@hyo-med.ac.jp [Department of Radiology, Hyogo College of Medicine, Hyogo (Japan); Kuribayashi, Kozo, E-mail: kuririn@hyo-med.ac.jp [Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo (Japan); Hashimoto, Masaki, E-mail: kogekogemasaki@gmail.com [Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo (Japan); Tsuchitani, Tatsuya, E-mail: tty-823@hyo-med.ac.jp [Department of Radiological Technology, Hyogo College of Medicine College Hospital, Hyogo (Japan); Tanooka, Masao, E-mail: masao1108@gmail.com [Department of Radiological Technology, Hyogo College of Medicine College Hospital, Hyogo (Japan); Fukushima, Kazuhito, E-mail: fukuchan00106@gmail.com [Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, Hyogo (Japan); Nakano, Takashi, E-mail: t-nakano@hyo-med.ac.jp [Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo (Japan); Hasegawa, Seiki, E-mail: hasegawa@hyo-med.ac.jp [Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo (Japan); Hirota, Shozo, E-mail: hirota-s@hyo-med.ac.jp [Department of Radiology, Hyogo College of Medicine, Hyogo (Japan)

    2017-01-15

    Purpose: To investigate the relationships between pretreatment volume-based quantitative {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters and overall survival (OS) in patients with malignant pleural mesothelioma (MPM). Materials and methods: We retrospectively reviewed data from 201 MPM patients, of whom 38 underwent surgical resection, and calculated the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), including primary tumors and nodal or distant metastatic lesions, on pretreatment {sup 18}F-FDG PET/CT. Relationships between clinicopathological factors (age, sex, performance status, European Organization for Research and Treatment of Cancer [EORTC] score, histological subtype, TNM stage, and treatment strategy), volume-based quantitative PET/CT parameters, and OS were evaluated using a Cox proportional hazards model and log-rank test. Results: The median follow-up was 15 months (range, 1–96 months; median, 17 months). In a univariate analysis of all patients, older age (p < 0.05), high EORTC score (p < 0.001), non-epithelioid histological subtype (p < 0.001), high T stage (p < 0.001), positive N/M status (p < 0.05, p < 0.001), advanced TNM stage (p < 0.001), non-surgical treatment (p < 0.001), and high SUVmax (p < 0.001), MTV (p < 0.001), or TLG (p < 0.001) were associated with significantly shorter OS. A multivariate analysis confirmed non-epithelioid subtype (hazard ratio [HR]: 1.69, 95% confidence interval [CI]: 1.14–2.48; p < 0.05), non-surgical treatment (HR: 0.58, 95% CI: 0.34–0.95; p < 0.05), and high TLG (HR: 1.97, 95% CI: 1.14–3.44; p < 0.05) as independent negative predictors. Conclusions: Pretreatment volume-based quantitative {sup 18}F-FDG PET/CT parameters, especially TLG, could serve as potential surrogate markers for MPM prognosis.

  11. Quantitative T2 evaluation at 3.0 T compared to morphological grading of the lumbar intervertebral disc: A standardized evaluation approach in patients with low back pain

    International Nuclear Information System (INIS)

    Stelzeneder, David; Welsch, Goetz Hannes; Kovács, Balázs Krisztián; Goed, Sabine; Paternostro-Sluga, Tatjana; Vlychou, Marianna; Friedrich, Klaus; Mamisch, Tallal Charles; Trattnig, Siegfried

    2012-01-01

    Background: The purpose of our investigation was to compare quantitative T2 relaxation time measurement evaluation of lumbar intervertebral discs with morphological grading in young to middle-aged patients with low back pain, using a standardized region-of-interest evaluation approach. Patients and methods: Three hundred thirty lumbar discs from 66 patients (mean age, 39 years) with low back pain were examined on a 3.0 T MR unit. Sagittal T1-FSE, sagittal, coronal, and axial T2-weighted FSE for morphological MRI, as well as a multi-echo spin-echo sequence for T2 mapping, were performed. Morphologically, all discs were classified according to Pfirrmann et al. Equally sized rectangular regions of interest (ROIs) for the annulus fibrosus were selected anteriorly and posteriorly in the outermost 20% of the disc. The space between was defined as the nucleus pulposus. To assess the reproducibility of this evaluation, inter- and intraobserver statistics were performed. Results: The Pfirrmann scoring of 330 discs showed the following results: grade I: six discs (1.8%); grade II: 189 (57.3%); grade III: 96 (29.1%); grade IV: 38 (11.5%); and grade V: one (0.3%). The mean T2 values (in milliseconds) for the anterior and the posterior annulus, and the nucleus pulposus for the respective Pfirrmann groups were: I: 57/30/239; II: 44/67/129; III: 42/51/82; and IV: 42/44/56. The nucleus pulposus T2 values showed a stepwise decrease from Pfirrmann grade I to IV. The posterior annulus showed the highest T2 values in Pfirrmann group II, while the anterior annulus showed relatively constant T2 values in all Pfirrmann groups. The inter- and intraobserver analysis yielded intraclass correlation coefficients (ICC) for average measures in a range from 0.82 (anterior annulus) to 0.99 (nucleus). Conclusions: Our standardized method of region-specific quantitative T2 relaxation time evaluation seems to be able to characterize different degrees of disc degeneration quantitatively. The

  12. Quantitative Comparison of the Effect of 10% Phenylephrine Instillation and Manual Elevation in Patients with Involutional Blepharoptosis.

    Science.gov (United States)

    Pereira, Ivana Cardoso; Matayoshi, Suzana

    2017-01-01

    To compare the effect of 10% phenylephrine (PE) instillation and manual elevation (ME) on the upper eyelid position of the tested eye and the contralateral eye in patients with involutional blepharoptosis (IB). IB patients were submitted to two tests followed by observation of the effect on the contralateral eyelid: (1) ME of the more ptotic eyelid; and (2) instillation of two drops of 10% PE (phenylephrine test) in the more ptotic eye. The patients were filmed before and 5, 10, and 15 minutes after instillation. The upper eyelid margin reflex distance (MRD1) was measured using the software Image J, and the results were analyzed with the linear mixed-effects model. The study included 70 patients aged 44-86 years, 64 of whom were female (91.43%), divided into three groups: subjects with unilateral IB, subjects with bilateral IB, and controls. The eye submitted to instillation with 10% PE displayed significant elevation during the first 10 min: from 1.33 ± 0.66 mm to 2.06 ± 0.89 mm (unilateral group), from 1.26 ± 0.63 mm to 2.29 ± 0.86 mm (bilateral group), and from 3.12 ± 0.68 mm to 4.06 ± 0.92 mm (control group). MRD1 decreased in the contralateral eye in IB patients, significantly more so after the phenylephrine test: PE vs. ME = 18.9% versus 17.2% reduction in the unilateral group, and 13.6% versus 10.7% reduction in the bilateral group. The outcome was not influenced by IB severity and the concurrence of IB and eye dominance. Both ME and 10% PE affected the contralateral upper eyelid, but the response was significantly better with the latter.

  13. Relationship between quantitative cardiac neuronal imaging with {sup 123}I-meta-iodobenzylguanidine and hospitalization in patients with heart failure

    Energy Technology Data Exchange (ETDEWEB)

    Parker, Matthew W.; Sood, Nitesh [University of Connecticut, School of Medicine Department of Medicine, Farmington, CT (United States); Hartford Hospital, Division of Cardiology, Hartford, CT (United States); Ahlberg, Alan W. [Hartford Hospital, Division of Cardiology, Hartford, CT (United States); Jacobson, Arnold F. [GE Healthcare, Princeton, NJ (United States); Heller, Gary V. [The Intersocietal Accreditation Commission, Ellicott City, MD (United States); Lundbye, Justin B. [University of Connecticut, School of Medicine Department of Medicine, Farmington, CT (United States); The Hospital of Central Connecticut, Division of Cardiology, New Britain, CT (United States)

    2014-09-15

    Hospitalization in patients with systolic heart failure is associated with morbidity, mortality, and cost. Myocardial sympathetic innervation, imaged by {sup 123}I-meta-iodobenzylguanidine ({sup 123}I-mIBG), has been associated with cardiac events in a recent multicenter study. The present analysis explored the relationship between {sup 123}I-mIBG imaging findings and hospitalization. Source documents from the ADMIRE-HF trial were reviewed to identify hospitalization events in patients with systolic heart failure following cardiac neuronal imaging using {sup 123}I-mIBG. Time to hospitalization was analyzed with the Kaplan-Meier method and compared to the mIBG heart-to-mediastinum (H/M) ratio using multiple-failure Cox regression. During 1.4 years of median follow-up, 362 end-point hospitalizations occurred in 207 of 961 subjects, 79 % of whom had H/M ratio <1.6. Among subjects hospitalized for any cause, 88 % had H/M ratio <1.6 and subjects with H/M ratio <1.6 experienced hospitalization earlier than subjects with higher H/M ratios (log-rank p = 0.003). After adjusting for elevated brain natriuretic peptide (BNP) and time since heart failure diagnosis, a low mIBG H/M ratio was associated with cardiac-related hospitalization (HR 1.48, 95 % CI 1.05 - 2.0; p = 0.02). The mIBG H/M ratio may risk-stratify patients with heart failure for cardiac-related hospitalization, especially when used in conjunction with BNP. Further studies are warranted to examine these relationships. (orig.)

  14. A quantitative analysis of gait patterns in vestibular neuritis patients using gyroscope sensor and a continuous walking protocol.

    Science.gov (United States)

    Kim, Soo Chan; Kim, Joo Yeon; Lee, Hwan Nyeong; Lee, Hwan Ho; Kwon, Jae Hwan; Kim, Nam Beom; Kim, Mi Joo; Hwang, Jong Hyun; Han, Gyu Cheol

    2014-04-11

    Locomotion involves an integration of vision, proprioception, and vestibular information. The parieto-insular vestibular cortex is known to affect the supra-spinal rhythm generators, and the vestibular system regulates anti-gravity muscle tone of the lower leg in the same side to maintain an upright posture through the extra-pyramidal track. To demonstrate the relationship between locomotion and vestibular function, we evaluated the differences in gait patterns between vestibular neuritis (VN) patients and normal subjects using a gyroscope sensor and long-way walking protocol. Gyroscope sensors were attached to both shanks of healthy controls (n=10) and age-matched VN patients (n = 10). We then asked the participants to walk 88.8 m along a corridor. Through the summation of gait cycle data, we measured gait frequency (Hz), normalized angular velocity (NAV) of each axis for legs, maximum and minimum NAV, up-slope and down-slope of NAV in swing phase, stride-swing-stance time (s), and stance to stride ratio (%). The most dominant walking frequency in the VN group was not different compared to normal control. The NAVs of z-axis (pitch motion) were significantly larger than the others (x-, y-axis) and the values in VN patients tended to decrease in both legs and the difference of NAV between both group was significant in the ipsi-lesion side in the VN group only (p=0.03). Additionally, the gait velocity of these individuals was decreased relatively to controls (1.11 ± 0.120 and 0.84 ± 0.061 m/s in control and VN group respectively, p<0.01), which seems to be related to the significantly increased stance and stride time of the ipsi-lesion side. Moreover, in the VN group, the maximum NAV of the lesion side was less, and the minimum one was higher than control group. Furthermore, the down-slope and up-slope of NAV decreased on the impaired side. The walking pattern of VN patients was highly phase-dependent, and NAV of pitch motion was significantly decreased in the ipsi

  15. Quantitative EEG Metrics Differ Between Outcome Groups and Change Over the First 72 h in Comatose Cardiac Arrest Patients.

    Science.gov (United States)

    Wiley, Sara Leingang; Razavi, Babak; Krishnamohan, Prashanth; Mlynash, Michael; Eyngorn, Irina; Meador, Kimford J; Hirsch, Karen G

    2018-02-01

    Forty to sixty-six percent of patients resuscitated from cardiac arrest remain comatose, and historic outcome predictors are unreliable. Quantitative spectral analysis of continuous electroencephalography (cEEG) may differ between patients with good and poor outcomes. Consecutive patients with post-cardiac arrest hypoxic-ischemic coma undergoing cEEG were enrolled. Spectral analysis was conducted on artifact-free contiguous 5-min cEEG epochs from each hour. Whole band (1-30 Hz), delta (δ, 1-4 Hz), theta (θ, 4-8 Hz), alpha (α, 8-13 Hz), beta (β, 13-30 Hz), α/δ power ratio, percent suppression, and variability were calculated and correlated with outcome. Graphical patterns of quantitative EEG (qEEG) were described and categorized as correlating with outcome. Clinical outcome was dichotomized, with good neurologic outcome being consciousness recovery. Ten subjects with a mean age = 50 yrs (range = 18-65) were analyzed. There were significant differences in total power (3.50 [3.30-4.06] vs. 0.68 [0.52-1.02], p = 0.01), alpha power (1.39 [0.66-1.79] vs 0.27 [0.17-0.48], p < 0.05), delta power (2.78 [2.21-3.01] vs 0.55 [0.38-0.83], p = 0.01), percent suppression (0.66 [0.02-2.42] vs 73.4 [48.0-97.5], p = 0.01), and multiple measures of variability between good and poor outcome patients (all values median [IQR], good vs. poor). qEEG patterns with high or increasing power or large power variability were associated with good outcome (n = 6). Patterns with consistently low or decreasing power or minimal power variability were associated with poor outcome (n = 4). These preliminary results suggest qEEG metrics correlate with outcome. In some patients, qEEG patterns change over the first three days post-arrest.

  16. Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction

    International Nuclear Information System (INIS)

    Chen, Ya-Cheng; Liu, Chang-Hsien; Hsu, Hsian-He; Yu, Chih-Yung; Wang, Hong-Hau; Fan, Hsiu-Lung; Chen, Ran-Chou; Chang, Wei-Chou

    2015-01-01

    The objective is to use multidetector computed tomography (MDCT) to differentiate phytobezoar impaction and small-bowel faeces in patients with small-bowel obstruction (SBO). We retrospectively reviewed 91 consecutive SBO patients with surgically proven phytobezoars (n = 31) or adhesion with small-bowel faeces (n = 60). Two readers blinded to the diagnosis recorded the following MDCT features: degree of obstruction, transition point, mesenteric fatty stranding, intraperitoneal fluid, air-fluid level, pneumatosis intestinalis, and portal venous gas. MDCT measurements of the food debris length, attenuation, luminal diameter, and wall thickness of the obstructed bowel were also compared. A higher grade of obstruction with an absence of mesenteric fatty stranding and intraperitoneal fluid was more commonly seen in the phytobezoar group than in the small-bowel faeces group (p < 0.01). The food debris length (phytobezoar, 5.7 ± 2.8 cm; small-bowel feces, 20.3 ± 7.9 cm, p < 0.01) and mean attenuation (phytobezoar, -59.6 ± 43.3 Hounsfield units (HU); small-bowel faeces, 8.5 ± 7.7 HU, p <0.01) were significantly different between the two groups. The ROC curve showed that food debris length <9.5 cm and mean attenuation value < -11.75 HU predicted phytobezoar impaction. MDCT features with measurements of the food debris length and mean attenuation assist the differentiation of phytobezoar impaction and small-bowel faeces. (orig.)

  17. Density measurements with computed tomography in patients with extra-axial hematoma can quantitatively estimate a degree of brain compression.

    Science.gov (United States)

    Nguyen, Ha Son; Li, Luyuan; Patel, Mohit; Mueller, Wade

    2016-10-01

    Extra-axial hematoma can cause significant brain compression. Guidelines for surgical evacuation include imaging findings (midline shift and hematoma thickness/volume) in conjunction with Glasgow Coma Scale (GCS) scores and/or intracranial pressure (ICP) monitoring. Physiologically, overall brain density should also change with compression. In our observational study, we explored whether overall brain density, defined using computed tomography Hounsfield Units (CT HU), changes after surgical evacuation of extra-axial hematoma. Only patients with a surgical acute epidural hematoma or subacute/chronic subdural hematoma were considered. Other exclusion criteria were concurrent intraparenchymal pathology, bilateral pathology, or incomplete follow-up imaging. Between fall 2012 and spring 2015, 22 patients were included in the study. CT head imaging (preoperative, postoperative, and at ∼1- to 2-month clinic visit) were loaded into OsiriX (Pixmeo, Switzerland). All the intracranial regions were selected and all extra-axial features were removed; subsequently, software was used to calculate a global CT HU value. A repeated-measures ANOVA found significant time effect, p brain, can cause an elevation in global CT HU value; moreover, surgical decompression is associated with lower global CT HU values. The use of global CT HU values in selected populations may serve as an adjunct for the evaluation of surgical lesions. © The Author(s) 2016.

  18. Diagnosing Sarcopenia on Thoracic Computed Tomography: Quantitative Assessment of Skeletal Muscle Mass in Patients Undergoing Transcatheter Aortic Valve Replacement.

    Science.gov (United States)

    Nemec, Ursula; Heidinger, Benedikt; Sokas, Claire; Chu, Louis; Eisenberg, Ronald L

    2017-09-01

    This study aims to assess the use of skeletal muscle mass measurements at two thoracic levels to diagnose sarcopenia on computed tomography (CT) chest examinations and to analyze the impact of these measurements on clinical outcome parameters following transcatheter aortic valve replacement. This study retrospectively included 157 patients who underwent preoperative CT examinations. The total muscle area was measured on transverse CT images at the 3rd lumbar and 7th and 12th thoracic levels with skeletal muscle indices (SMIs) calculated at each level. SMIs were then compared to clinical outcome parameters, and thoracic cutoff values for sarcopenia at the 7th and 12th thoracic levels were calculated. Correlation between SMIs at the third lumbar vertebra (L3) and the 12th thoracic vertebra (T12) was stronger (r = 0.724, P sarcopenia and could be used to correlate sarcopenia with outcome parameters in patients undergoing CT limited to the chest. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  19. The evaluation of gallbladder function by quantitative radionuclide cholescintigraphy in patients with noninsulin-dependent diabetes mellitus

    International Nuclear Information System (INIS)

    Kao, C.H.; Tsou, C.T.; Wang, S.J.; Yeh, S.H.

    1993-01-01

    Twenty-nine patients (24 males, 5 females; aged 62.8 ± 10.1 years) with noninsulin-dependent diabetes mellitus (NIDDM) without gallstones and impaired liver function were included in our study. The patients were categorized by blood sugar control and disease duration. Twelve normal controls (10 males, 2 females; aged 62.8 ± 12.4 years) were also studied for comparison. The gallbladder filling fraction (FF) and ejection fraction (EF) were calculated. The results showed no significant difference between (1) NIDDM and normal controls in FF (69.1 ± 29.4 versus 67.5 ± 24.0%) and EF (45.0 ± 23.5 versus 54.8 ± 10.0%) by a t-test, (2) good and poor blood sugar control in FF (64.9 ± 30.9 versus 73.7 ± 26.4%) and EF (42.0 ± 25.4 versus 54.8 ± 10.0%) by a Mann-Whitney U test, (3) long and short disease durations in FF (70.9 ± 29.7 versus 67.9 ± 28.7%) and EF (37.9 ± 20.7 versus 50.0 ± 24.1%) by a Mann-Whitney U test. In conclusion, the results challenge some previous reports and warrant further research. (author)

  20. The evaluation of gallbladder function by quantitative radionuclide cholescintigraphy in patients with noninsulin-dependent diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Kao, C.H.; Tsou, C.T.; Wang, S.J.; Yeh, S.H. (Taichung Veterans General Hospital (Taiwan))

    1993-10-01

    Twenty-nine patients (24 males, 5 females; aged 62.8 [+-] 10.1 years) with noninsulin-dependent diabetes mellitus (NIDDM) without gallstones and impaired liver function were included in our study. The patients were categorized by blood sugar control and disease duration. Twelve normal controls (10 males, 2 females; aged 62.8 [+-] 12.4 years) were also studied for comparison. The gallbladder filling fraction (FF) and ejection fraction (EF) were calculated. The results showed no significant difference between (1) NIDDM and normal controls in FF (69.1 [+-] 29.4 versus 67.5 [+-] 24.0%) and EF (45.0 [+-] 23.5 versus 54.8 [+-] 10.0%) by a t-test, (2) good and poor blood sugar control in FF (64.9 [+-] 30.9 versus 73.7 [+-] 26.4%) and EF (42.0 [+-] 25.4 versus 54.8 [+-] 10.0%) by a Mann-Whitney U test, (3) long and short disease durations in FF (70.9 [+-] 29.7 versus 67.9 [+-] 28.7%) and EF (37.9 [+-] 20.7 versus 50.0 [+-] 24.1%) by a Mann-Whitney U test. In conclusion, the results challenge some previous reports and warrant further research. (author).

  1. Quantitative volumetric functional MR imaging: an imaging biomarker of early treatment response in hypo-vascular liver metastasis patients after yttrium-90 transarterial radioembolization.

    Science.gov (United States)

    Zhu, Xiangyu; Sobhani, Fatemeh; Xu, Chunmiao; Pan, Li; Ghasebeh, Mounes Aliyari; Kamel, Ihab R

    2016-08-01

    To evaluate the value of quantitative volumetric functional MR imaging in early assessment of response to yttrium-90-labeled ((90)Y) transarterial radioembolization (TARE) in patients with hypo-vascular liver metastases. Seventy four metastatic lesions in 14 patients with hypo-vascular liver metastases after TARE were included in this retrospective study. Diffusion and contrast-enhanced MR imaging was performed before and early after treatment. All MR images were analyzed by two experienced radiologists. Response by anatomic metrics (RECIST, mRECIST, EASL) and functional metrics (ADC and arterial and venous enhancement) were reported in targeted and non-targeted lesions. A two-sample paired t test was used to compare the changes after TARE. A p value of <0.05 was considered statistically significant. The anatomic metrics did not show any significant changes in both targeted and non-targeted groups. Targeted lesions demonstrated an increase in mean volumetric ADC (23.4%; p = 0.01), a decrease in arterial and venous enhancement (-22.9% and -6.7%, respectively; p < 0.001 and p = 0.002, respectively) 1 month after treatment. Twenty one responding lesions (42%) by RECIST at 6 months demonstrated a significant increase in volumetric ADC (37.2%; p = 0.01), decrease in arterial and venous enhancement (-58.5% and -23.9%, respectively; p < 0.001) at 1 month post-treatment. Responding lesions did not change significantly by anatomic metrics. RECIST, mRECIST, and EASL criteria failed to stratify lesions into responders and non-responders early after TARE in hypo-vascular liver metastasis. Quantitative volumetric functional MR imaging could be a promising tool as a biomarker for predicting early response and can potentially be utilized in clinical trials.

  2. Quantitative assessment of pulmonary perfusion using dynamic contrast-enhanced CT in patients with chronic obstructive pulmonary disease: correlations with pulmonary function test and CT volumetric parameters.

    Science.gov (United States)

    Guan, Yu; Xia, Yi; Fan, Li; Liu, Shi-yuan; Yu, Hong; Li, Bin; Zhao, Li-ming; Li, Bing

    2015-05-01

    Pulmonary function test (PFT) is commonly used to help diagnose chronic obstructive pulmonary disease (COPD) and other lung diseases. However, it cannot be used to evaluate regional function and morphological abnormalities. To quantitatively evaluate pulmonary perfusion imaging using dynamic contrast-enhanced (DCE) computed tomography (CT) and observe its correlations with PFT and CT volumetric parameters in COPD patients. PFT and CT pulmonary perfusion examination were performed in 63 COPD patients. Perfusion defects were quantitated by calculating the CT value ratio (RHU) between perfusion defects (HUdefect) and normal lung (HUnormal). Volumetric CT data were used to calculate emphysema index (EI), total lung volume (TLV), and total emphysema volume (TEV). Emphysematous parenchyma was defined as the threshold of lung area lower than -950 HU. Correlations between RHU and TLV, TEV, EI, and PFT were assessed using Spearman correlation analysis. The positive rate of perfusion defects on CT perfusion images was higher than that of emphysema on CT mask images (χ(2) = 17.027, P < 0.001). The Spearman correlation test showed that RHU was positively correlated with FEV1 (R = 0.59, P < 0.001), FEV1% Predicted (R = 0.61, P < 0.001), FVC (R = 0.47, P = 0.002), and FEV1/FVC (R = 0.65, P < 0.001), and negatively correlated with EI (R = -0.67, P < 0.001). CT perfusion imaging is more sensitive in detecting emphysema that is inconspicuous on CT images. RHU is correlated with PFT and CT volumetric parameters, suggesting that it is more sensitive in detecting early COPD changes and may prove to be a potential predictor of focal lung function. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. Clinical impact of quantitative left atrial vortex flow analysis in patients with atrial fibrillation: a comparison with invasive left atrial voltage mapping.

    Science.gov (United States)

    Lee, Jung Myung; Hong, Geu-Ru; Pak, Hui-Nam; Shim, Chi Young; Houle, Helene; Vannan, Mani A; Kim, Minji; Chung, Namsik

    2015-08-01

    Recently, left atrial (LA) vortex flow analysis using contrast transesophageal echocardiography (TEE) has been shown to be feasible and has demonstrated significant differences in vortex flow morphology and pulsatility between normal subjects and patients with atrial fibrillation (AF). However, the relationship between LA vortex flow and electrophysiological properties and the clinical significance of LA vortex flow are unknown. The aims of this study were (1) to compare LA vortex flow parameters with LA voltage and (2) to assess the predictive value of LA vortex flow parameters for the recurrence of AF after radiofrequency catheter ablation (RFCA). Thirty-nine patients with symptomatic non-valvular AF underwent contrast TEE before undergoing RFCA for AF. Quantitative LA vortex flow parameters were analyzed by Omega flow (Siemens Medical Solution, Mountain View, CA, USA). The morphology and pulsatility of LA vortex flow were compared with electrophysiologic parameters that were measured invasively. Hemodynamic, electrophysiological, and vortex flow parameters were compared between patients with and without early recurrence of AF after RFCA. Morphologic parameters, including LA vortex depth, length, width, and sphericity index were not associated with LA voltage or hemodynamic parameters. The relative strength (RS), which represents the pulsatility power of LA, was positively correlated with LA voltage (R = 0.53, p = 0.01) and LA appendage flow velocity (R = 0.73, p vortex flow analysis, especially RS, correlated well with LA voltage. Decreased pulsatility strength in the LA was associated with recurrent AF. LA vortex may have incremental value in predicting the recurrence of AF.

  4. An analytic study of central benzodiazepine receptor in the surgically resected tissues of patients with intractable localization-related epilepsy. Quantitative analysis using 125I-iomazenil autoradiography

    International Nuclear Information System (INIS)

    Doi, Toshiaki; Matsuda, Kazumi; Mihara, Tadahiro; Yagi, Kazuichi; Seino, Masakazu

    1998-01-01

    The authors report a quantitative autoradiographic analysis of benzodiazepine receptors using the partial inverse agonist 125 I-iomazenil in surgically resected tissues of 27 patients with intractable partial epilepsies. Pathological diagnosis of these tissues was; 14 mesial temporal sclerosis (MTS), 8 dysembryoplastic neuroepithelial tumor (DNT), 4 cortical dysplasia (CD) and 1 angioma. In MTS patients, the density of benzodiazepine receptors decreased in CA1, CA3 and CA4. The layers of gyrus dentatus were displaced with a thick and high density band. These findings were similar to simultaneous GABA-A stain findings. The decrease of receptor in each hippocampal structure highly correlated to the degree of cell loss in CA1, CA3 and CA4. The receptors were almost absent in the main lesions of DNT and angioma, and showed irregular distributions in the cortex around these lesions. The receptor densities of CD were parallel to Palmini's pathological grading. Nine cases were analyzed using 123 I-iomazenil SPECT before surgery after obtaining informed consent. Eight of them revealed marked low accumulations in the areas corresponding to the epileptogenic foci. We conclude that our results support histochemically the clinical availability of 123 I-iomazenil SPECT as a non-invasive technique for detecting the changes in benzodiazepine receptor densities in patients with partial epilepsies. (author)

  5. Role of quantitative myocardial positron emission tomography for risk stratification in patients with hypertrophic cardiomyopathy: a 2016 reappraisal

    Energy Technology Data Exchange (ETDEWEB)

    Castagnoli, Helga; Passeri, Alessandro; Berti, Valentina; Sciagra, Roberto [University of Florence, Department of Experimental and Clinical Biomedical Sciences - Nuclear Medicine Unit, Firenze (Italy); Ferrantini, Cecilia; Coppini, Raffaele; Baldini, Katia; Cecchi, Franco; Olivotto, Iacopo [Careggi University Hospital, Referral Center for Myocardial Diseases and Genetic Diagnostics Unit, Florence (Italy)

    2016-12-15

    Myocardial blood flow <1.1 mL/min/g following dipyridamole (Dip-MBF) assessed by positron emission tomography (PET) was identified in 2003 as an important outcome predictor in hypertrophic cardiomyopathy (HCM), based on scans performed in the 90s. However, such extreme Dip-MBF impairment is rarely observed in contemporary cohorts. We, therefore, reassessed the Dip-MBF threshold defining high-risk HCM patients. Dip-MBF was measured using {sup 13}N-ammonia in 100 HCM consecutive patients, prospectively enrolled and followed for 4.0 ± 2.2 years. Outcome was assessed based on tertiles of Dip-MBF. The study end-point was a combination of cardiovascular death, progression to severe functional limitation, cardioembolic stroke, life-threatening ventricular arrhythmias. Global Dip-MBF was 1.95 ± 0.85, ranging from 0.7 to 5.9 mL/min/g. Dip-MBF tertile cut-off values were: 0.73 to 1.53 mL/min/g (lowest), 1.54 to 2.13 mL/min/g (middle), and 2.14 to 5.89 mL/min/g (highest). During follow-up, lowest tertile Dip-MBF was associated with sevenfold independent risk of unfavorable outcome compared to the other two tertiles. Dip-MBF 1.35 mL/min/g was identified as the best threshold for outcome prediction. Regional perfusion analysis showed that all cardiac deaths (n = 4) occurred in patients in the lowest tertile of lateral wall Dip-MBF (≤1.72 mL/min/g); septal Dip-MBF was not predictive. Dip-MBF confirms its role as potent predictor of outcome in HCM. However, the threshold for prediction in a contemporary cohort is higher than that reported in earlier studies. Dip-MBF impairment in the lateral wall, possibly reflecting diffuse disease extending to non-hypertrophic regions, is a sensitive predictor of mortality in HCM. (orig.)

  6. Patient perceptions and expectations of an anticoagulation service: a quantitative comparison study of clinic-based testers and patient self-testers.

    Science.gov (United States)

    Money, Arthur G; Barnett, Julie; Kuljis, Jasna; Duffin, Debbie

    2015-12-01

    Government initiatives see the provision of technology-assisted self-care as one of the key areas in which there is capacity for improving quality of care whilst reducing costs. However, levels of patient engagement in self-testing and management (STM) remain low. Little emphasis has been placed on understanding the patients' perspectives of the reasons for this limited engagement. Typically, patient engagement in STM is achieved via the provision of patient education programmes, which aim to enable patients to make the changes necessary to become competent self-carers. However, placing the onus to change on the individual patient is unrealistic. If levels of patient engagement are to be improved, patient needs and expectations of clinical services must be better understood and service provision must be adapted accordingly. Explore patient perceptions and expectations of clinical service provision and their views of having and making choices about care. Participants [N = 191, 103 patient self-tester managers (PSTMs) and 87 clinic-based testers (CBTs)] completed the SERVQUAL and ChQ instruments to capture perspectives on service quality and choice, respectively. A comparative statistical analysis explored the similarities and differences between PSTMs' and CBTs' responses. Clinic-based testers' perceptions of service quality were significantly more positive than PSTMs', as were their expectations of the 'tangible' aspects of service delivery. PSTMs' expectations of service quality were significantly higher than their perceptions. PSTMs attributed significantly more value to making choices compared with CBTs. To close the gap between PSTMs expectations and perceptions of service quality and better cater for their choice preferences, service providers may benefit from taking into account the following practice considerations: maintain frequent, timely, personalised and direct interactions with PSTMs; prioritise investment in resources to facilitate patient

  7. Quantitative analysis of drug effects at the whole-body level: a case study for glucose metabolism in malaria patients.

    Science.gov (United States)

    Snoep, Jacky L; Green, Kathleen; Eicher, Johann; Palm, Daniel C; Penkler, Gerald; du Toit, Francois; Walters, Nicolas; Burger, Robert; Westerhoff, Hans V; van Niekerk, David D

    2015-12-01

    We propose a hierarchical modelling approach to construct models for disease states at the whole-body level. Such models can simulate effects of drug-induced inhibition of reaction steps on the whole-body physiology. We illustrate the approach for glucose metabolism in malaria patients, by merging two detailed kinetic models for glucose metabolism in the parasite Plasmodium falciparum and the human red blood cell with a coarse-grained model for whole-body glucose metabolism. In addition we use a genome-scale metabolic model for the parasite to predict amino acid production profiles by the malaria parasite that can be used as a complex biomarker. © 2015 Authors; published by Portland Press Limited.

  8. MIRD pamphlet No. 23: quantitative SPECT for patient-specific 3-dimensional dosimetry in internal radionuclide therapy.

    Science.gov (United States)

    Dewaraja, Yuni K; Frey, Eric C; Sgouros, George; Brill, A Bertrand; Roberson, Peter; Zanzonico, Pat B; Ljungberg, Michael

    2012-08-01

    In internal radionuclide therapy, a growing interest in voxel-level estimates of tissue-absorbed dose has been driven by the desire to report radiobiologic quantities that account for the biologic consequences of both spatial and temporal nonuniformities in these dose estimates. This report presents an overview of 3-dimensional SPECT methods and requirements for internal dosimetry at both regional and voxel levels. Combined SPECT/CT image-based methods are emphasized, because the CT-derived anatomic information allows one to address multiple technical factors that affect SPECT quantification while facilitating the patient-specific voxel-level dosimetry calculation itself. SPECT imaging and reconstruction techniques for quantification in radionuclide therapy are not necessarily the same as those designed to optimize diagnostic imaging quality. The current overview is intended as an introduction to an upcoming series of MIRD pamphlets with detailed radionuclide-specific recommendations intended to provide best-practice SPECT quantification-based guidance for radionuclide dosimetry.

  9. Quantitative evaluation of Streptococcus mutans and Candida sp and salivary factors in the oral cavity of patients submitted to radiotherapy

    International Nuclear Information System (INIS)

    Spolidorio, Denise Madalena Palomari; Spolidorio, Luis Carlos; Barbeiro, Roberto Henrique; Bernardo, Wagner Luis Carvalho; Pavan, Sabrina; Hoefling, Jose Francisco

    2001-01-01

    The aim of this study was to quantify the microorganisms Streptococcus mutans and Candida sp in the oral cavity of patients with oropharynx carcinoma, before, during and after radiotherapy, and to correlate the results with salivary factors such as pH, buffer capacity and flow rate. Saliva samples were collected, diluted and inoculated in SB-20 agar and in Sabouraud agar, for Streptococcus mutans and Candida sp, respectively. Previously to dilution, the concentrated saliva was analyzed, and the salivary factors were determined. After the growth of colonies, the number of microorganisms was determined in CFU/ml. The analysis of the results allowed to conclude that the salivary factors are related to the presence of microorganisms, and that the number of CFU/ml increased as salivary flow rate decreased. The effects of radiation compromised salivary homeostasis and favored the increase of infection by yeasts and bacteria. (author)

  10. Three-dimensional imaging methods for quantitative analysis of facial soft tissues and skeletal morphology in patients with orofacial clefts: a systematic review.

    Directory of Open Access Journals (Sweden)

    Mette A R Kuijpers

    Full Text Available BACKGROUND: Current guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D evaluation, but three-dimensional (3D imaging methods to assess treatment outcome are steadily rising. OBJECTIVE: To identify 3D imaging methods for quantitative assessment of soft tissue and skeletal morphology in patients with cleft lip and palate. DATA SOURCES: Literature was searched using PubMed (1948-2012, EMBASE (1980-2012, Scopus (2004-2012, Web of Science (1945-2012, and the Cochrane Library. The last search was performed September 30, 2012. Reference lists were hand searched for potentially eligible studies. There was no language restriction. STUDY SELECTION: We included publications using 3D imaging techniques to assess facial soft tissue or skeletal morphology in patients older than 5 years with a cleft lip with/or without cleft palate. We reviewed studies involving the facial region when at least 10 subjects in the sample size had at least one cleft type. Only primary publications were included. DATA EXTRACTION: Independent extraction of data and quality assessments were performed by two observers. RESULTS: Five hundred full text publications were retrieved, 144 met the inclusion criteria, with 63 high quality studies. There were differences in study designs, topics studied, patient characteristics, and success measurements; therefore, only a systematic review could be conducted. Main 3D-techniques that are used in cleft lip and palate patients are CT, CBCT, MRI, stereophotogrammetry, and laser surface scanning. These techniques are mainly used for soft tissue analysis, evaluation of bone grafting, and changes in the craniofacial skeleton. Digital dental casts are used to evaluate treatment and changes over time. CONCLUSION: Available evidence implies that 3D imaging methods can be used for documentation of CLP patients. No data are available yet showing that 3D methods are more informative than conventional 2D methods

  11. Quantitative Analysis of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated With Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Yi [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Song, Jie; Pollom, Erqi; Alagappan, Muthuraman [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Shirato, Hiroki [Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Chang, Daniel T.; Koong, Albert C. [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Stanford Cancer Institute, Stanford, California (United States); Li, Ruijiang, E-mail: rli2@stanford.edu [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Stanford Cancer Institute, Stanford, California (United States)

    2016-09-01

    Purpose: To identify prognostic biomarkers in pancreatic cancer using high-throughput quantitative image analysis. Methods and Materials: In this institutional review board–approved study, we retrospectively analyzed images and outcomes for 139 locally advanced pancreatic cancer patients treated with stereotactic body radiation therapy (SBRT). The overall population was split into a training cohort (n=90) and a validation cohort (n=49) according to the time of treatment. We extracted quantitative imaging characteristics from pre-SBRT {sup 18}F-fluorodeoxyglucose positron emission tomography, including statistical, morphologic, and texture features. A Cox proportional hazard regression model was built to predict overall survival (OS) in the training cohort using 162 robust image features. To avoid over-fitting, we applied the elastic net to obtain a sparse set of image features, whose linear combination constitutes a prognostic imaging signature. Univariate and multivariate Cox regression analyses were used to evaluate the association with OS, and concordance index (CI) was used to evaluate the survival prediction accuracy. Results: The prognostic imaging signature included 7 features characterizing different tumor phenotypes, including shape, intensity, and texture. On the validation cohort, univariate analysis showed that this prognostic signature was significantly associated with OS (P=.002, hazard ratio 2.74), which improved upon conventional imaging predictors including tumor volume, maximum standardized uptake value, and total legion glycolysis (P=.018-.028, hazard ratio 1.51-1.57). On multivariate analysis, the proposed signature was the only significant prognostic index (P=.037, hazard ratio 3.72) when adjusted for conventional imaging and clinical factors (P=.123-.870, hazard ratio 0.53-1.30). In terms of CI, the proposed signature scored 0.66 and was significantly better than competing prognostic indices (CI 0.48-0.64, Wilcoxon rank sum test P<1e-6

  12. Quantitative sensory testing is feasible and is well-tolerated in patients with sickle cell disease following a vaso-occlusive episode

    Directory of Open Access Journals (Sweden)

    Bakshi N

    2018-02-01

    Full Text Available Nitya Bakshi,1 Ines Lukombo,1,2 Inna Belfer,3 Lakshmanan Krishnamurti1 1Division of Pediatric Hematology-Oncology, Department of Pediatrics, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, 2University of Pittsburgh, 3Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA Introduction: Sickle cell disease (SCD is an inherited blood disorder characterized by abnormally shaped sickle cells. The hallmark of this disease is intermittent, painful vaso-occlusive episodes (VOE, but a subset of individuals with SCD experience chronic pain. The mechanism of transition to chronic pain is not well understood in SCD, but there is evidence of altered pain processing in individuals with SCD. The impact of VOE on pain sensitivity is not established. The objective of this study was to determine the feasibility and tolerability of quantitative sensory testing (QST in SCD following a VOE to better understand the contribution of VOE to the development of chronic pain. Methods: As part of a larger pain sensitivity study, pediatric patients with SCD were offered QST following a VOE-related Emergency Room visit or inpatient hospitalization. The feasibility of recruitment and completion of QST was measured, and tolerability of QST was determined using post-QST assessments of pain, and compared with measurements at steady state. Results: Ten participants completed QST following a VOE. The median age was 16.5, and 60% were female. Overall, 10 of 16 (62.5% patients approached for QST following VOE completed QST. This included 8 of 12 patients who had previously completed QST at steady state. There were no statistically significant differences in pain intensity and Gracely Box scores after QST following a VOE, when compared to steady-state QST. Conclusion: QST is feasible and is well-tolerated following a VOE in patients with SCD. Large prospective studies are needed to determine the impact of VOE on experimental pain sensitivity and must

  13. [Detecting HB-1 Expression Level in Bone Marrow of Acute Leukemia Patients by Real-Time Fluorescence Quantitative RT-PCR].

    Science.gov (United States)

    Wang, Qing-Yun; Li, Yuan; Ji, Li; Liang, Ze-Yin; Liu, Wei; Ren, Han-Yun; Qiu, Zhi-Xiang

    2018-02-01

    To investigate the expression level of HB-1 gene in patients with acute lymphoblastic leukemia (ALL) and the significance of HB-1 gene in monitoring of minimal residual disease (MRD). The method of real-time fluorescence quantitative RT-PCR (Taqman probe) was established to detect the expression levels of HB-1 gene; then the sensitivity, specificity and repeatability of this assay were evaluated and verified. The HB-1 gene expression levels in bone marrow of 183 cases of ALL, 70 cases of acute myeloid leukemias (AML), 52 cases of non-malignant hematologic diseases and 24 healthy hematopoietic stem cell donors were detected. The correlation of HB-1 level with diagnosis and relapse was analyzed by detecting bone marrow samples of 33 B-ALL. The sensitivity of this assay reached the 10 -4 level. The coefficient of variation for inter-batch and inter-tube of HB-1 were 6.79% and 4.80%, respectively. It was found that HB-1 gene specifically expressed in acute B lymphoblastic leukemia. The median expression levels of HB-1 gene in newly diagnosed and relapsed B-ALL patients were statistically significantly higher than those in ALL in complete remission(CR), newly diagnosed T-ALL, newly diagnosed AML, non-malignant hematologic diseases, and healthy hematopoietic stem cell donors(33.0% vs 0.68%, 0.07%, 0.02%, 0.58% and 0, respectively) (P0.05). The expression level of HB-1 gene declined sharply when B-ALL patients reached complete remission (0-7.99%, with median level 0.68%), but increased when relapsed (7.69%, 8.08% and 484.0% in 3 relapsed samples), which was in accordance with results of flow cytometry. HB-1 gene specifically expressed in acute B lymphoblastic leukemia cells. The established real-time fluorescence quantitative RT-PCR assay shows good sensitivity, specificity and repeatability, thus, can be used as a biological marker in the clinical detection, monitoring MRD and predicting of early relapse for B-ALL patients.

  14. [Value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma after TACE treatment].

    Science.gov (United States)

    Xing, Gusheng; Wang, Shuang; Li, Chenrui; Zhao, Xinming; Zhou, Chunwu

    2015-03-01

    To investigate the value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoebolization (TACE). Consecutive 32 HCC patients with previous TACE treatment were included in this study. For the follow-up, arterial phase (AP) and venous phase (VP) dual-phase CT scans were performed with a single-source dual-energy CT scanner (Discovery CT 750HD, GE Healthcare). Iodine concentrations were derived from iodine-based material-decomposition images in the liver parenchyma, tumors and coagulation necrosis (CN) areas. The iodine concentration difference (ICD) between the arterial-phase (AP) and venal-phase (VP) were quantitatively evaluated in different tissues.The lesion-to-normal parenchyma iodine concentration ratio (LNR) was calculated. ROC analysis was performed for the qualitative evaluation, and the area under ROC (Az) was calculated to represent the diagnostic ability of ICD and LNR. In all the 32 HCC patients, the region of interesting (ROI) for iodine concentrations included liver parenchyma (n=42), tumors (n=28) and coagulation necrosis (n=24). During the AP the iodine concentration of CNs (median value 0.088 µg/mm(3)) appeared significantly higher than that of the tumors (0.064 µg/mm(3), P=0.022) and liver parenchyma (0.048 µg/mm(3), P=0.005). But it showed no significant difference between liver parenchyma and tumors (P=0.454). During the VP the iodine concentration in hepatic parenchyma (median value 0.181 µg/mm(3)) was significantly higher than that in CNs (0.140 µg/mm(3), P=0.042). There was no significant difference between liver parenchyma and tumors, CNs and tumors (both P>0.05). The median value of ICD in CNs was 0.006 µg/mm(3), significantly lower than that of the HCC (0.201 µg/mm(3), Piodine-based material decomposition images with gemstone spectral CT imaging can improve the diagnostic efficacy of CT imaging

  15. Incorporating patient preferences into drug development and regulatory decision making: Results from a quantitative pilot study with cancer patients, carers, and regulators.

    Science.gov (United States)

    Postmus, D; Mavris, M; Hillege, H L; Salmonson, T; Ryll, B; Plate, A; Moulon, I; Eichler, H-G; Bere, N; Pignatti, F

    2016-05-01

    Currently, patient preference studies are not required to be included in marketing authorization applications to regulatory authorities, and the role and methodology for such studies have not been agreed upon. The European Medicines Agency (EMA) conducted a pilot study to gain experience on how the collection of individual preferences can inform the regulatory review. Using a short online questionnaire, ordinal statements regarding the desirability of different outcomes in the treatment of advanced cancer were elicited from 139 participants (98 regulators, 29 patient or carers, and 12 healthcare professionals). This was followed by face-to-face meetings to gather feedback and validate the individual responses. In this article we summarize the EMA pilot study and discuss the role of patient preference studies within the regulatory review. Based on the results, we conclude that our preference elicitation instrument was easy to implement and sufficiently precise to learn about the distribution of the participants' individual preferences. © 2015 American Society for Clinical Pharmacology and Therapeutics.

  16. Evaluation of outcome prediction and disease extension by quantitative 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography in patients with small cell lung cancer

    International Nuclear Information System (INIS)

    Arslan, N.; Tuncel, M.; Kuzhan, O.; Alagoz, E.; Budakoglu, B.; Ozet, A.; Ozguven, M.A.

    2011-01-01

    The objective of this study is to determine whether 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography (FDG-PET) imaging and quantitative PET parameters can predict outcome and differentiate patients with limited disease (LD) from extensive disease (ED) in patients with small cell lung cancer (SCLC). We retrospectively evaluated data from 25 patients who underwent either initial staging (Group A, n 12) or restaging (Group B, n 13) by conventional imaging methods and FDG-PET according to the simplified staging scheme developed by the Veterans Administration Lung Cancer Study Group-2. FDG-PET images were both visually and quantitatively evaluated with standardized uptake value (SUV) max , SUV ave , total metabolic tumor volume (with SUV max >%50 and SUV max >2.5), total lesion glycolysis (TLG) (with SUV max >%50 and SUV max >2.5). The correlation between quantitative PET parameters, disease stages and survival were analyzed. By conventional methods 14 of 25 (56%) patients were reported to have LD and 11 of 25 (44%) had ED. FDG-PET scan upstaged 9 out of 25 (36%) and downstaged 2 out of 25 (%8) patients. Among the quantitative PET parameters, TLGs were the only PET parameters that differentiated between Group A and Group B patients. FDG-PET staging (p=0.019) could predict significant survival difference between stages on contrary to conventional staging (p=0.055). Moreover, TLG [SUV max >%50] was the only quantitative PET parameter that could predict survival (p=0.027). FDG-PET imaging is a valuable tool in the management of patients with SCLC for a more accurate staging. The use of quantitative PET parameters may have a role in prediction of stage and survival. (author)

  17. Quality of life and satisfaction with life of malaria patients in context of acceptance of the disease: quantitative studies.

    Science.gov (United States)

    Van Damme-Ostapowicz, Katarzyna; Krajewska-Kułak, Elżbieta; Rozwadowska, Emilia; Nahorski, Wacław L; Olszański, Romuald

    2012-06-29

    Health status is one of the basic factors of a high quality of life and the problem of the acceptance of illness is important for adaptation to the limitations imposed by it. The purpose of the study was the evaluation of the quality of life, satisfaction with life and the acceptance of illness by malaria patients, as well as the discovery of a relationship between studied parameters. The study was undertaken in August 2010, on 120 Nigerian patients with confirmed malaria. A method of diagnostic survey, based on standardized scales - Acceptance of Illness Scale, The Satisfaction With Life Scale and a standardized survey questionnaire World Health Organization Quality of Life/BREF - was used in this study. Descriptive statistics, variability range, 95% confidence interval, correlation analysis, Spearman's non-parametric correlation coefficient, Mann-Whitney test and Kruskal-Wallis test were applied and the, so called, test statistics was calculated, followed by the calculation of the test probability p. Results of analyses were presented in a box graph, and a graph of dispersion. A dominating share in the adjective scale of the AIS scale was the category of "no acceptance", given by 71.7% of respondents. The average level of a "somatic domain" was 41.7, and of a "social domain" was 62.8. The mean satisfaction of life evaluation in the SWLS scale was 18 points. The correlation between acceptance of the disease and quality of life for the psychological domain was 0.39***, and between acceptance of the disease and satisfaction with life was 0.40***. The correlation between satisfaction with life and quality of life for the psychological domain was 0.65***, and between satisfaction with life and quality of life for the environment domain was 0.60***. The mean level of AIS for the studied population of men was 16.5, and test probability: p = 0.0014**, and for the environment domain the level was 50, and the test probability: p = 0.0073**. For quality of life in

  18. PET-based compartmental modeling of {sup 124}I-A33 antibody: quantitative characterization of patient-specific tumor targeting in colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zanzonico, Pat; O' Donoghue, Joseph A.; Humm, John L. [Memorial Sloan Kettering Cancer Center, Department of Medical Physics, New York, NY (United States); Carrasquillo, Jorge A.; Pandit-Taskar, Neeta; Ruan, Shutian; Larson, Steven M. [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Smith-Jones, Peter [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Stony Brook School of Medicine, Departments of Psychiatry and Radiology, Stony Brook, NY (United States); Divgi, Chaitanya [Columbia University Medical Center, New York, NY (United States); Scott, Andrew M. [La Trobe University, Olivia Newton-John Cancer Research Institute, Melbourne (Australia); Kemeny, Nancy E.; Wong, Douglas; Scheinberg, David [Memorial Sloan Kettering Cancer Center, Department of Medicine, New York, NY (United States); Fong, Yuman [Memorial Sloan Kettering Cancer Center, Department of Surgery, New York, NY (United States); City of Hope, Department of Surgery, Duarte, CA (United States); Ritter, Gerd; Jungbluth, Achem; Old, Lloyd J. [Memorial Sloan Kettering Cancer Center, Ludwig Institute for Cancer Research, New York, NY (United States)

    2015-10-15

    The molecular specificity of monoclonal antibodies (mAbs) directed against tumor antigens has proven effective for targeted therapy of human cancers, as shown by a growing list of successful antibody-based drug products. We describe a novel, nonlinear compartmental model using PET-derived data to determine the ''best-fit'' parameters and model-derived quantities for optimizing biodistribution of intravenously injected {sup 124}I-labeled antitumor antibodies. As an example of this paradigm, quantitative image and kinetic analyses of anti-A33 humanized mAb (also known as ''A33'') were performed in 11 colorectal cancer patients. Serial whole-body PET scans of {sup 124}I-labeled A33 and blood samples were acquired and the resulting tissue time-activity data for each patient were fit to a nonlinear compartmental model using the SAAM II computer code. Excellent agreement was observed between fitted and measured parameters of tumor uptake, ''off-target'' uptake in bowel mucosa, blood clearance, tumor antigen levels, and percent antigen occupancy. This approach should be generally applicable to antibody-antigen systems in human tumors for which the masses of antigen-expressing tumor and of normal tissues can be estimated and for which antibody kinetics can be measured with PET. Ultimately, based on each patient's resulting ''best-fit'' nonlinear model, a patient-specific optimum mAb dose (in micromoles, for example) may be derived. (orig.)

  19. Quantitative Flow Ratio Identifies Nonculprit Coronary Lesions Requiring Revascularization in Patients With ST-Segment-Elevation Myocardial Infarction and Multivessel Disease.

    Science.gov (United States)

    Spitaleri, Giosafat; Tebaldi, Matteo; Biscaglia, Simone; Westra, Jelmer; Brugaletta, Salvatore; Erriquez, Andrea; Passarini, Giulia; Brieda, Alessandro; Leone, Antonio Maria; Picchi, Andrea; Ielasi, Alfonso; Girolamo, Domenico Di; Trani, Carlo; Ferrari, Roberto; Reiber, Johan H C; Valgimigli, Marco; Sabatè, Manel; Campo, Gianluca

    2018-02-01

    The nonculprit lesion (NCL) management in ST-segment-elevation myocardial infarction patients with multivessel disease is debated. We sought to assess whether quantitative flow ratio (QFR), a noninvasive tool to identify potentially flow-limiting lesions, may be reliable in this scenario. The present proof-of-concept study is based on a 3-step process: (1) identification of the QFR reproducibility in NCLs assessment (cohort A, n=31); (2) prospective validation of QFR diagnostic accuracy in respect to fractional flow reserve (cohort B, n=45); and (3) investigation of long-term clinical outcomes of NCLs stratified according to QFR (cohort C, n=110). A blinded core laboratory computed QFR values for all NCLs. Cohort A showed a good correlation and agreement between QFR values at index (acute) and at staged (subacute, 3-4 days later) procedures ( r =0.98; 95% confidence interval, 0.96-0.99; mean difference, 0.004 [-0.027 to 0.34]). The inter-rater agreement was κ=0.9. In cohort B, fractional flow reserve and QFR identified 16 (33%) and 17 (35%) NCLs potentially flow limiting. Sensitivity, specificity, negative, and positive predictive values were 88%, 97%, 94%, and 94%. The area under the receiver operating characteristics curve was 0.96 (95% confidence interval, 0.89-0.99). Finally, in cohort C, we identified 110 ST-segment-elevation myocardial infarction patients where at least 1 NCL was left untreated. Patients with NCLs showing a QFR value ≤0.80 were at higher risk of adverse events (hazard ratio, 2.3; 95% confidence interval, 1.2-4.5; P =0.01). In a limited and selected study population, our study showed that QFR computation may be a safe and reliable tool to guide coronary revascularization of NCLs in ST-segment-elevation myocardial infarction patients. © 2018 American Heart Association, Inc.

  20. Benefit of combining quantitative cardiac CT parameters with troponin I for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Mathias, E-mail: mr.meyer.mathias@gmail.com [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Fink, Christian, E-mail: Christian.Fink@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Roeger, Susanne, E-mail: susanne.roeger@umm.de [1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Apfaltrer, Paul, E-mail: Paul.Apfaltrer@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Haghi, Dariush, E-mail: dariush.haghi@umm.de [1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Kaminski, Wolfgang E., E-mail: wolfgang.kaminski@umm.de [Department of Clinical Chemistry, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Neumaier, Michael, E-mail: michael.neumaier@medma.uni-heidelberg.de [Department of Clinical Chemistry, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Schoenberg, Stefan O., E-mail: Stefan.Schoenberg@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); and others

    2012-11-15

    Objective: To prospectively evaluate the diagnostic accuracy of quantitative cardiac CT parameters alone and in combination with troponin I for the assessment of right ventricular dysfunction (RVD) and adverse clinical events in patients with acute pulmonary embolism (PE). Materials and results: This prospective study had institutional review board approval and was HIPAA compliant. In total 83 patients with confirmed PE underwent echocardiography and troponin I serum level measurements within 24 h. Three established cardiac CT measurements for the assessment of RVD were obtained (RV/LV{sub axial}, RV/LV{sub 4-CH}, and RV/LV{sub volume}). CT measurements and troponin I serum levels were correlated with RVD found on echocardiography and adverse clinical events according to Management Strategies and Prognosis in Pulmonary Embolism Trial-3 (MAPPET-3 criteria. 31 of 83 patients with PE had RVD on echocardiography and 39 of 83 patients had adverse clinical events. A RV/LV{sub volume} ratio > 1.43 showed the highest area under the curve (AUC) (0.65) for the prediction of adverse clinical events when compared to RV/LV{sub axial}, RV/LV{sub 4Ch} and troponin I. The AUC for the detection of RVD of RV/LV{sub axial}, RV/LV{sub 4Ch}, RV/LV{sub volume}, and troponin I were 0.86, 0.86, 0.92, and 0.69, respectively. Combination of RV/LV{sub axial}, RV/LV{sub 4Ch}, RV/LV{sub volume} with troponin I increased the AUC to 0.87, 0.87 and 0.93, respectively. Conclusion: A combination of cardiac CT parameters and troponin I measurements improves the diagnostic accuracy for detecting RVD and predicting adverse clinical events if compared to either test alone.

  1. Monitoring the response of patients with cutaneous leishmaniasis to treatment with pentamidine isethionate by quantitative real-time PCR, and identification of Leishmania parasites not responding to therapy.

    Science.gov (United States)

    Mans, D R A; Kent, A D; Hu, R V; Lai A Fat, E J; Schoone, G J; Adams, E R; Rood, E J; Alba, S; Sabajo, L O A; Lai A Fat, R F; de Vries, H J C; Schallig, H D F H

    2016-08-01

    Leishmania (Viannia) guyanensis is believed to be the principal cause of cutaneous leishmaniasis (CL) in Suriname. This disease is treated with pentamidine isethionate (PI), but treatment failure has increasingly been reported. To evaluate PI for its clinical efficacy, to compare parasite load, and to assess the possibility of treatment failure due to other infecting Leishmania species. Parasite load of patients with CL was determined in skin biopsies using real-time quantitative PCR before treatment and 6 and 12 weeks after treatment. Clinical responses were evaluated at week 12 and compared with parasite load. In parallel, molecular species differentiation was performed. L. (V.) guyanensis was the main infecting species in 129 of 143 patients (about 90%). PI treatment led to a significant decrease (P < 0.001) in parasite counts, and cured about 75% of these patients. Treatment failure was attributable to infections with Leishmania (Viannia) braziliensis, Leishmania (Leishmania) amazonensis and L. (V.) guyanensis (1/92, 1/92 and 22/92 evaluable cases, respectively). There was substantial agreement beyond chance between the parasite load at week 6 and the clinical outcome at week 12, as indicated by the κ value of 0.61. L. (V.) guyanensis is the main infecting species of CL in Suriname, followed by L. (V.) braziliensis and L. (L.) amazonensis. Furthermore, patient response to PI can be better anticipated based on the parasite load 6 weeks after the treatment rather than on parasite load before treatment. © 2015 The Authors Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists, North American Clinical Dermatologic Society and St Johns Dermatological Society.

  2. The impact of educational interventions on attitudes of emergency department staff towards patients with substance-related presentations: a quantitative systematic review.

    Science.gov (United States)

    Gonzalez, Miriam; Clarke, Diana E; Pereira, Asha; Boyce-Gaudreau, Krystal; Waldman, Celeste; Demczuk, Lisa; Legare, Carol

    2017-08-01

    Visits to emergency departments for substance use/abuse are common worldwide. However, emergency department health care providers perceive substance-using patients as a challenging group to manage which can lead to negative attitudes. Providing education or experience-based exercises may impact positively on behaviors towards this patient population. Whether staff attitudes are similarly impacted by knowledge acquired through educational interventions remains unknown. To synthesize available evidence on the relationship between new knowledge gained through substance use educational interventions and emergency department health care providers' attitudes towards patients with substance-related presentations. Health care providers working in urban and rural emergency departments of healthcare facilities worldwide providing care to adult patients with substance-related presentations. Quantitative papers examining the impact of substance use educational interventions on health care providers' attitudes towards substance using patients. Experimental and non-experimental study designs. Emergency department staff attitudes towards patients presenting with substance use/abuse. A three-step search strategy was conducted in August 2015 with a search update in March 2017. Studies published since 1995 in English, French or Spanish were considered for inclusion. Two reviewers assessed studies for methodological quality using critical appraisal checklists from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Reviewers agreed on JBI-MAStARI methodological criteria a study must meet in order to be included in the review (e.g. appropriate use of statistical analysis). The data extraction instrument from JBI-MAStARI was used. As statistical pooling of the data was not possible, the findings are presented in narrative form. A total of 900 articles were identified as relevant for this review. Following abstract and full text

  3. Incorporating patient preferences into drug development and regulatory decision making : Results from a quantitative pilot study with cancer patients, carers, and regulators

    NARCIS (Netherlands)

    Postmus, D.; Mavris, M.; Hillege, H. L.; Salmonson, T.; Ryll, B.; Plate, A.; Moulon, I.; Eichler, H-G; Bere, N.; Pignatti, F.

    Currently, patient preference studies are not required to be included in marketing authorization applications to regulatory authorities, and the role and methodology for such studies have not been agreed upon. The European Medicines Agency (EMA) conducted a pilot study to gain experience on how the

  4. Quantitation of methylglyoxal bis(guanylhydrazone) in blood plasma and leukemia cells of patients receiving the drug.

    Science.gov (United States)

    Seppänen, P; Alhonen-Hongisto, L; Siimes, M; Jänne, J

    1980-11-15

    Methylglyoxal bis(guanylhydrazone), a cytostatic compound which apparently interferes with the metabolism and/or functions of the natural polyamines (spermidine and spermine), was effectively taken up by cultured human lymphocytic leukemia cells, rapidly resulting in the formation of a concentration gradient of up to 1,000-fold across the cell membrane in cells grown in the presence of micromolar concentrations of the drug. For an anti-proliferative effect on the leukemia cells, an intracellular concentration of more than 0.5 mM was required. The uptake of methylglyoxal bis(guanylhydrazone) was critically dependent on the growth rate of the leukemia cells. Low intracellular concentrations of the drug were present in cells growing slowly, whereas in rapidly dividing cells the intracellular concentration of the drug approached 5mM. When given as repeated intravenous infusions to two leukemic children, methylglyoxal bis(guanylhydrazone) exhibited sharp and transient peaks of plasma concentration, the drug having an apparent half-life in plasma of only 1-2 h. However, as in cultured cells, the drug was rapidly concentrated in the leukemia cells, reaching concentrations that were distinctly anti-proliferative. In contrast to the rapid disappearance of methylglyoxal bis(guanylhydrazone) from plasma, the circulation leukemia cells retained the drug for a period of several days with only minimal decrease in the initial concentrations. Methylglyoxal bis(guanylhydrazone) was given to the patients for 1 to 2 months as intravenous infusions, the timing of which was determined by regular assays of the drug concentrations in the leukemia cells. In agreement with the results obtained with the cultured cells, and intracellular concentration of about 0.5 to 1mM was apparently required for growth-inhibitory action to occur. Regular determination of the cellular drug concentrations indicated that methylglyoxal bis(quanylhydrazone) could be given as weekly infusions. This treatment

  5. Coronary risk factors and myocardial blood flow in patients evaluated for coronary artery disease: a quantitative [15O]H2O PET/CT study

    International Nuclear Information System (INIS)

    Danad, Ibrahim; Appelman, Yolande E.; Haan, Stefan de; Allaart, Cornelis P.; Rossum, Albert C. van; Knaapen, Paul; Raijmakers, Pieter G.; Harms, Hendrik J.; Hoekstra, Otto S.; Lammertsma, Adriaan A.; Lubberink, Mark; Oever, Mijntje L.P. van den; Kuijk, Cornelis van

    2012-01-01

    There has been increasing interest in quantitative myocardial blood flow (MBF) imaging over the last years and it is expected to become a routinely used technique in clinical practice. Positron emission tomography (PET) using [ 15 O]H 2 O is the established gold standard for quantification of MBF in vivo. A fundamental issue when performing quantitative MBF imaging is to define the limits of MBF in a clinically suitable population. The aims of the present study were to determine the limits of MBF and to determine the relationship among coronary artery disease (CAD) risk factors, gender and MBF in a predominantly symptomatic patient cohort without significant CAD. A total of 128 patients (mean age 54 ± 10 years, 50 men) with a low to intermediate pretest likelihood of CAD were referred for noninvasive evaluation of CAD using a hybrid PET/computed tomography (PET/CT) scanner. MBF was quantified with [ 15 O]H 2 O at rest and during adenosine-induced hyperaemia. Obstructive CAD was excluded in these patients by means of invasive or CT-based coronary angiography. Global average baseline MBF values were 0.91 ± 0.34 and 1.09 ± 0.30 ml.min -1 .g -1 (range 0.54-2.35 and 0.59-2.75 ml.min -1 .g -1 ) in men and women, respectively (p -1 .g -1 in men and women, respectively; p = 0.08). Global average hyperaemic MBF values were 3.44 ± 1.20 ml.min -1 .g -1 in the whole study population, and 2.90 ± 0.85 and 3.78 ± 1.27 ml.min -1 .g -1 (range 1.52-5.22 and 1.72-8.15 ml.min -1 .g -1 ) in men and women, respectively (p < 0.001). Multivariate analysis identified male gender, age and body mass index as having an independently negative impact on hyperaemic MBF. Gender, age and body mass index substantially influence reference values and should be corrected for when interpreting hyperaemic MBF values. (orig.)

  6. Semiautomatic determination of arterial input functions for quantitative dynamic contrast-enhanced magnetic resonance imaging in non-small cell lung cancer patients.

    Science.gov (United States)

    Chung, Julius; Kim, Jae-Hun; Lee, Eun Ju; Kim, Yoo Na; Yi, Chin A

    2015-03-01

    The aim of this study was to validate a semiautomatic detection method for the arterial input functions (AIFs) using Kendall coefficient of concordance (KCC) for quantitative analysis of dynamic contrast-enhanced magnetic resonance imaging in non-small cell lung cancer patients. We prospectively enrolled 28 patients (17 men, 11 women; mean age, 62 years) who had biopsy-proven non-small cell lung cancer. All enrolled patients underwent dynamic contrast-enhanced magnetic resonance imaging of the entire thorax. For the quantitative measurement of pharmacokinetic parameters, K and ve, of the lung cancers, AIFs were determined in 2 different ways: a manual method that involved 3 independent thoracic radiologists selecting a region of interest (ROI) within the aortic arch in the 2D coronal plane and a semiautomatic method that used in-house software to establish a KCC score, which provided a measure of similarity to typical AIF pattern. Three independent readers selected voxel clusters with high KCC scores calculated 3-dimensionally across planes in the data set. K and ve were correlated using intraclass correlation coefficients (ICCs), and Bland-Altman plots were used to examine agreement across methods and reproducibility within a method. Arterial input functions were determined using the data from ROI volumes that were significantly larger in the semiautomatic method (mean ± SD, 3360 ± 768 mm) than in the manual method (677 ± 380 mm) (P < 0.001). K showed very strong agreement (ICC, 0.927) and ve showed moderately strong agreement (ICC, 0.718) between the semiautomatic and manual methods. The reproducibility for K (ICCmanual, 0.813 and ICCsemiautomatic, 0.998; P < 0.001) and ve (ICCmanual, 0.455 and ICCsemiautomatic, 0.985, P < 0.001) was significantly better with the semiautomatic method than the manual method. We found semiautomated detection using KCC to be a robust method for determining the AIF. This method allows for larger ROIs specified in 3D across planes

  7. The use and reliability of SymNose for quantitative measurement of the nose and lip in unilateral cleft lip and palate patients.

    Science.gov (United States)

    Mosmuller, David; Tan, Robin; Mulder, Frans; Bachour, Yara; de Vet, Henrica; Don Griot, Peter

    2016-10-01

    It is essential to have a reliable assessment method in order to compare the results of cleft lip and palate surgery. In this study the computer-based program SymNose, a method for quantitative assessment of the nose and lip, will be assessed on usability and reliability. The symmetry of the nose and lip was measured twice in 50 six-year-old complete and incomplete unilateral cleft lip and palate patients by four observers. For the frontal view the asymmetry level of the nose and upper lip were evaluated and for the basal view the asymmetry level of the nose and nostrils were evaluated. A mean inter-observer reliability when tracing each image once or twice was 0.70 and 0.75, respectively. Tracing the photographs with 2 observers and 4 observers gave a mean inter-observer score of 0.86 and 0.92, respectively. The mean intra-observer reliability varied between 0.80 and 0.84. SymNose is a practical and reliable tool for the retrospective assessment of large caseloads of 2D photographs of cleft patients for research purposes. Moderate to high single inter-observer reliability was found. For future research with SymNose reliable outcomes can be achieved by using the average outcomes of single tracings of two observers. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Fast and accurate quantitative organic acid analysis with LC-QTOF/MS facilitates screening of patients for inborn errors of metabolism.

    Science.gov (United States)

    Körver-Keularts, Irene M L W; Wang, Ping; Waterval, Huub W A H; Kluijtmans, Leo A J; Wevers, Ron A; Langhans, Claus-Dieter; Scott, Camilla; Habets, Daphna D J; Bierau, Jörgen

    2018-02-12

    Since organic acid analysis in urine with gaschromatography-mass spectrometry (GC-MS) is a time-consuming technique, we developed a new liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF/MS) method to replace the classical analysis for diagnosis of inborn errors of metabolism (IEM). Sample preparation is simple and experimental time short. Targeted mass extraction and automatic calculation of z-scores generated profiles characteristic for the IEMs in our panel consisting of 71 biomarkers for defects in amino acids, neurotransmitters, fatty acids, purine, and pyrimidine metabolism as well as other disorders. In addition, four medication-related metabolites were included in the panel. The method was validated to meet Dutch NEN-EN-ISO 15189 standards. Cross validation of 24 organic acids from 28 urine samples of the ERNDIM scheme showed superiority of the UPLC-QTOF/MS method over the GC-MS method. We applied our method to 99 patient urine samples with 32 different IEMs, and 88 control samples. All IEMs were unambiguously established/diagnosed using this new QTOF method by evaluation of the panel of 71 biomarkers. In conclusion, we present a LC-QTOF/MS method for fast and accurate quantitative organic acid analysis which facilitates screening of patients for IEMs. Extension of the panel of metabolites is easy which makes this application a promising technique in metabolic diagnostics/laboratories.

  9. Greater Calcium Intake is Associated with Better Bone Health Measured by Quantitative Ultrasound of the Phalanges in Pediatric Patients Treated with Anticonvulsant Drugs

    Directory of Open Access Journals (Sweden)

    Vicente Vera

    2015-12-01

    Full Text Available We aimed to investigate and compare the effects of chronic antiepileptic therapy on bone health in pediatric patients using quantitative ultrasound of the phalanges (QUS and controlling for potential confounding factors, particularly nutrient intake. The amplitude-dependent speed of sound (Ad-SoS was measured in 33 epileptic children and 32 healthy children aged 6.5 ± 3.1 and 6.3 ± 1.1 (mean ± SD years, respectively. There were no significant differences in the demographics such as age, weight and height between epileptic children and the control group children. None of the children in the epileptic or the treatment group were found to have a vitamin D deficiency. There were no significant differences in laboratory tests between groups. Lower QUS figures were found in the epileptic children (p = 0.001. After further adjustment for potential confounders such age, height, weight, calcium intake, vitamin D intake, physical activity and sex, the differences remained significant (p < 0.001. After further classification of the participants based on the tertile of calcium intake, no significant differences were found between patients and healthy controls in the greatest tertile of calcium intake (p = 0.217. We conclude that anticonvulsant therapy using valproate may lead to low bone mass in children and that an adequate intake of calcium might counteract such deleterious effects.

  10. Volume perfusion CT (VPCT) for the differential diagnosis of patients with suspected cerebral vasospasm: Qualitative and quantitative analysis of 3D parameter maps

    International Nuclear Information System (INIS)

    Dolatowski, K.; Malinova, V.; Frölich, A.M.J.; Schramm, R.; Haberland, U.; Klotz, E.; Mielke, D.; Knauth, M.; Schramm, P.

    2014-01-01

    Object: Cerebral vasospasm (CV) following subarachnoid hemorrhage (SAH) implies high risk for secondary ischemia. It requires early diagnosis to start treatment on time. We aimed to assess the utility of “whole brain” VPCT for detecting localization and characteristics of arterial vasospasm. Methods: 23 patients received a non-enhanced CT, VPCT and CTA of the brain. The distribution of ischemic lesions was analyzed on 3D-perfusion-parameter-maps of CBF, CBV, MTT, TTS, TTP, and TTD. CT-angiographic axial and coronal maximum-intensity-projections were reconstructed to determine arterial vasospasm. CT-data was compared to DSA, if performed additionally. Volume-of-interest placement was used to obtain quantitative mean VPCT values. Results: 82% patients (n = 19) had focal cerebral hypoperfusion. 100% sensitivity and 100% specificity was found for TTS (median 1.9 s), MTT (median 5.9 s) and TTD (median 7.6 s). CBV showed no significant differences. In 78% (n = 18) focal vessel aberrations could be detected either on CTA or DSA or on both. Conclusion: VPCT is a non-invasive method with the ability to detect focal perfusion deficits almost in the whole brain. While DSA remains to be the gold standard for detection of CV, VPCT has the potential to improve noninvasive diagnosis and treatment decisions

  11. Detection of Shigella spp. nucleic acids in the synovial tissue of Tunisian rheumatoid arthritis patients and other forms of arthritis by quantitative real-time polymerase chain reaction.

    Science.gov (United States)

    Siala, Mariam; Rihl, Markus; Sellami, Hanen; Znazen, Abir; Sassi, Nadia; Laadhar, Lilia; Gdoura, Radhouane; Belghuith, Imen; Mrabet, Dalila; Baklouti, Sofien; Sellami, Slaheddine; Sibilia, Jean; Fourati, Hela; Hammami, Adnene; Cheour, Ilhem

    2018-02-05

    Enterobacterial components in the joints of patients are believed to contribute to a perpetuating inflammation leading to a reactive arthritis (ReA), a condition in which microbial agents cannot be recovered from the joint. At present, it is unclear whether nucleic acids from Shigella spp. are playing a pathogenic role in causing not only ReA but also other forms of arthritis. Quantitative real-time polymerase chain reaction assay (qPCR) is the method of choice for the identification of bacteria within the synovium. The aim of our study was to detect the presence of Shigella spp. nucleic acids in the synovial tissue (ST) of Tunisian arthritis patients. We investigated 57 ST samples from rheumatoid arthritis (RA) n = 38, undifferentiated oligoarthritis (UOA) n = 12, and spondyloarthritis (SpA) n = 7 patients; 5 ST samples from healthy individuals were used as controls. Shigella spp. DNA and mRNA transcripts encoding the virulence gene A (VirA) were examined using an optimized qPCR with newly designed primers and probes. Using qPCR, Shigella spp. DNA was found in 37/57 (65%) ST samples (24/38, i.e., 63.2% of RA, 8/12, i.e., 67% of UOA, and 5/7, i.e., 71.4% of SpA patients). Paired DNA and mRNA were extracted from 39 ST samples, whose VirA cDNA was found in 29/39 (74.4%) patients. qPCR did not yield any nucleic acids in the five healthy control ST samples. The qPCR assay was sensitive and showed a good intra- and inter-run reproducibility. These preliminary findings generated by an optimized, highly sensitive PCR assay underline a potential role of past gastrointestinal infections. In Tunisian patients, a bacterial etiology involving Shigella spp. in the manifestation of arthritic disorders including RA might be more common than expected.

  12. The quantitative Morse theorem

    OpenAIRE

    Loi, Ta Le; Phien, Phan

    2013-01-01

    In this paper, we give a proof of the quantitative Morse theorem stated by {Y. Yomdin} in \\cite{Y1}. The proof is based on the quantitative Sard theorem, the quantitative inverse function theorem and the quantitative Morse lemma.

  13. Comparison of quantitative regional ventilation-weighted fourier decomposition MRI with dynamic fluorinated gas washout MRI and lung function testing in COPD patients.

    Science.gov (United States)

    Kaireit, Till F; Gutberlet, Marcel; Voskrebenzev, Andreas; Freise, Julia; Welte, Tobias; Hohlfeld, Jens M; Wacker, Frank; Vogel-Claussen, Jens

    2017-11-21

    Ventilation-weighted Fourier decomposition-MRI (FD-MRI) has matured as a reliable technique for quantitative measures of regional lung ventilation in recent years, but has yet not been validated in COPD patients. To compare regional fractional lung ventilation obtained by ventilation-weighted FD-MRI with dynamic fluorinated gas washout MRI ( 19 F-MRI) and lung function test parameters. Prospective study. Twenty-seven patients with chronic obstructive pulmonary disease (COPD, median age 61 [54-67] years) were included. For FD-MRI and for 19 F-MRI a spoiled gradient echo sequence was used at 1.5T. FD-MRI coronal slices were acquired in free breathing. Dynamic 19 F-MRI was performed after inhalation of 25-30 L of a mixture of 79% fluorinated gas (C 3 F 8 ) and 21% oxygen via a closed face mask tubing using a dedicated coil tuned to 59.9 MHz. 19 F washout times in numbers of breaths ( 19 F-n breaths ) as well as fractional ventilation maps for both methods (FD-FV, 19 F-FV) were calculated. Slices were matched using a landmark driven algorithm, and only corresponding slices with an overlap of >90% were coregistered for evaluation. The obtained parameters were correlated with each other using Spearman's correlation coefficient (r). FD-FV strongly correlated with 19 F-n breaths on a global (r = -0.72, P Fourier decomposition-MRI is a promising noninvasive, radiation-free tool for quantification of regional ventilation in COPD patients. 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017. © 2017 International Society for Magnetic Resonance in Medicine.

  14. A Morphological and Quantitative Analysis of Lung CT Scan in Patients With Acute Respiratory Distress Syndrome and in Cardiogenic Pulmonary Edema.

    Science.gov (United States)

    Vergani, Giordano; Cressoni, Massimo; Crimella, Francesco; L'Acqua, Camilla; Sisillo, Erminio; Gurgitano, Martina; Liguori, Alessandro; Annoni, Andrea; Carrafiello, Gianpaolo; Chiumello, Davide

    2017-01-01

    The acute respiratory distress syndrome (ARDS) and cardiogenic pulmonary edema (CPE) are both characterized by an increase in lung edema that can be measured by computed tomography (CT). The aim of this study was to compare possible differences between patients with ARDS and CPE in the morphologic pattern, the aeration, and the amount and distribution of edema within the lung. Lung CT was performed at a mean positive end-expiratory pressure level of 5 cm H 2 O in both groups. The morphological evaluation was performed by two radiologists, while the quantitative evaluation was performed by a dedicated software. A total of 60 patients with ARDS (20 mild, 20 moderate, 20 severe) and 20 patients with CPE were enrolled. The ground-glass attenuation regions were similarly present among the groups, 8 (40%), 8 (40%), 14 (70%), and 10 (50%), while the airspace consolidations were significantly more present in ARDS. The lung gas volume was significantly lower in severe ARDS compared to CPE (830 [462] vs 1120 [832] mL). Moving from the nondependent to the dependent lung regions, the not inflated lung tissue significantly increased, while the well inflated tissue decreased (ρ = 0.96-1.00, P edema was significantly higher, compared to CPE (757 [740] vs 532 [637] g). Both ARDS and CPE are characterized by a similar presence of ground-glass attenuation and different airspace consolidation regions. Acute respiratory distress syndrome has a higher amount of not inflated tissue and lower amount of well inflated tissue. However, the overall regional distribution is similar within the lung.

  15. Airway bacteria measured by quantitative polymerase chain reaction and culture in patients with stable COPD: relationship with neutrophilic airway inflammation, exacerbation frequency, and lung function

    Science.gov (United States)

    Bafadhel, Mona; Haldar, Koirobi; Barker, Bethan; Patel, Hemu; Mistry, Vijay; Barer, Michael R; Pavord, Ian D; Brightling, Christopher E

    2015-01-01

    Background Potentially pathogenic microorganisms can be detected by quantitative real-time polymerase chain reaction (qPCR) in sputum from patients with COPD, although how this technique relates to culture and clinical measures of disease is unclear. We used cross-sectional and longitudinal data to test the hypotheses that qPCR is a more sensitive measure of bacterial presence and is associated with neutrophilic airway inflammation and adverse clinical outcomes. Methods Sputum was collected from 174 stable COPD subjects longitudinally over 12 months. Microbial sampling using culture and qPCR was performed. Spirometry and sputum measures of airway inflammation were assessed. Findings Sputum was qPCR-positive (>106 copies/mL) in 77/152 samples (Haemophilus influenzae [n=52], Moraxella catarrhalis [n=24], Streptococcus pneumoniae [n=19], and Staphylococcus aureus [n=7]). Sputum was culture-positive in 50/174 samples, with 49 out of 50 culture-positive samples having pathogen-specific qPCR bacterial loads >106 copies/mL. Samples that had qPCR copy numbers >106/mL, whether culture-positive or not, had increased sputum neutrophil counts. H. influenzae qPCR copy numbers correlated with sputum neutrophil counts (r=0.37, P106/mL three or more times in 19 patients, eight of whom were repeatedly sputum culture-positive. Per