scholarly journals Usefulness of Ki-67, Mitoses, and Tumor Size for Predicting Metastasis in Carcinoid Tumors of the Lung: A Study of 48 Cases at a Tertiary Care Centre in Canada

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
M. G. Joseph ◽  
A. Shibani ◽  
N. Panjwani ◽  
A. Arab ◽  
J. Shepherd ◽  
...  
Keyword(s):  
Tumor Size ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Carcinoid Tumors ◽  
Computer Assisted ◽  
Tertiary Care Centre ◽  
Ki 67 ◽  
Computer Assisted Image ◽  
The Mean

Background. Evaluation of Ki-67 index in lung carcinoid tumors (LCTs) has been of interest in order to identify high risk subsets. Our objectives are (1) to evaluate the usefulness of Ki-67 index, mitoses, and tumor size in predicting metastasis and (2) to compare the Manual Conventional Method (MCM) and the Computer Assisted Image Analysis Method (CIAM) for Ki-67 calculation. Methods. We studied 48 patients with LCTs from two academic centres in Canada. For Ki-67 calculation, digital images of 5000 cells were counted using an image processing software and 2000 cells by MCM. Mitoses/10 HPF was counted. Results. We had 37 typical carcinoids (TCs) and 11 atypical carcinoids (ACs). 7/48 patients developed metastasis. There was a positive relationship between metastasis and carcinoid type (P=0.039) and metastasis and mitoses (≥2) (P=0.017). Although not statistically significant, the mean Ki-67 index for ACs was higher than for TCs (0.95% versus 0.72%, CIAM, P=0.299). Similarly, although not statistically significant, the mean Ki-67 index for metastatic group (MG) was higher than for nonmetastatic group (NMG) (1.01% versus 0.71% by CIAM, P=0.281). However when Ki-67 index data was categorized at various levels, there is suggestion of a useful cutoff (≥0.50%) to predict metastasis (P=0.106, CIAM). A significantly higher proportion of patients with mitosis ≥2 and Ki-67 index ≥0.50% had metastasis (P=0.033) compared to other patients. Similarly patients with tumor size ≥3 cm and Ki-67 ≥0.50% had a greater percentage of metastases than others (P=0.039). Although there was a strong correlation between two (MCM versus CIAM) counting methods (r=0.929, P=0.001), overall the calculated Ki-67 index was slightly higher by MCM (range 0 to 6.4, mean 1.5) compared to CIAM (range 0 to 2.9, mean 0.75). Conclusion. This study confirms that mitoses ≥2 is a powerful predictor of metastasis in LCTs. Although this is a small sample size, there is suggestion that analysis of Ki-67 index along with mitoses and tumor size may be a useful adjunct for predicting metastasis in LCTs.

scholarly journals STUDY ON ELEVATED SERUM GAMMA-GLUTAMYL TRANSFERAGE (GGT) LEVEL TO EVALUATE ITS CLINICAL RELEVANCE IN PATIENTS FROM DIFFERENT INDIGENOUS COMMUNITIES IN A TERTIARY CARE CENTRE, RIMS RANCHI JHARKHAND INDIA

2020 ◽  
pp. 1-4
Author(s):  
Neelam Kumari ◽  
Chandra Bhushan Sharma ◽  
Rishi Tuhin Guria ◽  
Sanjay Kumar ◽  
Piyush Kumar ◽  
...  
Keyword(s):  
Life Style ◽  
Clinical Relevance ◽  
Dietary Habits ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Indigenous Communities ◽  
Small Sample ◽  
Tertiary Care Centre ◽  
Community Based

Very few studies have examined the interaction between various environmental and life style factors on elevated serum GGT concentration. Such studies especially in tribal dominated Jharkhand is further rare. Whereas the present study has been done to elucidate the interaction between overweight/obesity and alcohol intake on liver enzyme concentrations and results of instant study have been found to be very useful for better clinical practice. In the instant study, it has been found that higher Body Mass Index (BMI) of patients were associated with elevated Serum GGT level, which in turn associated with hypertension, incident diabetes, metabolic syndrome, cardiovascular disease etc., which increases the morbidity and mortality. Aims & Objectives- The aim of this study is to examine the association between various environmental and lifestyle factors on elevated serum GGT level in a community based indigenous population in Eastern part of India and its clinical relevance. Material and Methods The present study enrolled a total of 404 patients either through outdoor or indoor patients coming to Department of Medicine, RIMS, Ranchi, Jharkhand. Patients with serum GGT concentrations > 38 IU/L and aged 18 years or above from all different communities were included for the study. Additionally, we excluded patients with Serum GGT level ˂ 38 IU/L, yielding a final sample of 193 patients (75 women) for the present study. All patients provided written consent, and the study protocol was approved by the Institution Review Board of the Rajendra Institute of Medical Sciences, Ranchi, Jharkhand. Participants’ age, gender, religion followed by community, occupation with annual per capita income, BMI were recorded. Retrospectively participants’ dietary habits were also recorded. Strengths and Limitations The present study has several strengths including the community based sample of men and women, their religion, occupation, income which indirectly affect their life style like physical activity. However, there are several limitations that must be noted like small sample size, localized population of Eastern India, which limits the generalizability of our result to other ethnic groups.

Stillbirth Rate and Weight at Birth of Quintuplets in Japan

1989 ◽  
Vol 38 (1-2) ◽  
pp. 65-69 ◽  
Author(s):  
Yoko Imaizumi
Keyword(s):  
Sample Size ◽  
Birth Order ◽  
Gestational Age ◽  
Size Effects ◽  
Maternal Age ◽  
Small Sample Size ◽  
Small Sample ◽  
Stillbirth Rate ◽  
The Mean

AbstractNation-wide data in Japan on births and prenatal deaths of 16 sets of quintuplets during 1974-1985 were analysed. Among the 16 sets, 3 sets were liveborn, 8 were stillborn, and 5 were mixed, with a stillbirth rate of 0.64 (51/80). Effects of sex, maternal age and birth order on the stillbirth rate were not considered because of the small sample size. Effects of gestational age and birthweight on stillbirth rate were also examined. The mean weight of the 40 quintuplet individuals was 1,048 g.

scholarly journals Thyroid status and Treatment Response of Hypothyroid Infertile Women in Tertiary Care Center of Bangladesh

2017 ◽  
Vol 31 (2) ◽  
pp. 86-89
Author(s):  
Farzana Deeba ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Shakeela Ishrat ◽  
Nurjahan Begum ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Early Stage ◽  
Care Center ◽  
Tertiary Care ◽  
Target Population ◽  
Fertility Treatment ◽  
Tertiary Care Centre ◽  
Infertile Women ◽  
The Mean ◽  
Tsh Levels

Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of infertility was 4.5 ± 1.2 years. Ninety two (23%) patients were hypothyroid. Among them 66 (16.5%) were subclinical hypothyroid and 26 (6.5%) were frank hypothyroid. The mean TSH levels were 7.34 ± 2.13 ìIU/ml, and the mean PRL levels were 52.46 ± 11.17 ng/ml. Out of 92 infertile women diagnosed as hypothyroidism 75 (81.52%) women conceived after treatment with drugs for hypothyroidism (dose depending upon severity of hypothyroidism, i.e. TSH levels). More than 90% women had regular ovulation for consecutive three cycles after initiation of treatment.Conclusion: The normal TSH levels are the pre-requisite for fertilization. The decision to initiate thyroid replacement therapy in both clinical and subclinical hypothyroidism at early stage is justified in infertile women.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 86-89

scholarly journals Clinical and dermoscopic patterns of childhood alopecia areata in a tertiary care centre in North India

2021 ◽  
Vol 7 (6) ◽  
pp. 811
Author(s):  
Pooja Bains ◽  
Simplepreet Kaur
Keyword(s):  
Alopecia Areata ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Care Hospital ◽  
Common Site ◽  
Tertiary Care Centre ◽  
Exclamation Mark ◽  
Epidemiologic Profile ◽  
The Mean

<p class="abstract"><strong>Background:</strong> To describe the clinico epidemiologic profile and dermoscopic findings in children with alopecia areata (AA) and correlate the dermoscopic findings with stage and severity.</p><p class="abstract"><strong>Methods:</strong> The present study was performed over a period of six months, from July 2020 to December 2020 in a tertiary care hospital where 50 clinically diagnosed children ≤15 years with AA were enrolled. A thorough clinical examination followed by dermoscopy was performed. The results were tabulated and then analyzed statistically.</p><p class="abstract"><strong>Results: </strong>The mean age of presentation was 9.74 years. The most common site involved was scalp and the most common dermoscopic findings were yellow dots (25/50, 50%), short vellus hair (22/50, 44%), black dots (21/50, 42%), exclamation mark hair (15/50, 30%) and broken hair (11/50, 22%).</p><p class="abstract"><strong>Conclusions:</strong> No significant associations was found between dermoscopic findings and severity or stage of childhood alopecia areata. There was a significant correlation of alopecia areata severity with nail findings in children with alopecia areata.</p>

The use of frequency distributions in an attempt to detect host mortality induced by infections of diplostomatid metacercariae

Parasitology ◽  
1984 ◽  
Vol 89 (2) ◽  
pp. 209-220 ◽  
Author(s):  
C. R. Kennedy
Keyword(s):  
Small Sample Size ◽  
Parasite Burden ◽  
Fish Host ◽  
Small Sample ◽  
Host Age ◽  
Parasite Abundance ◽  
Frequency Distributions ◽  
Host Mortality ◽  
The Mean ◽  
Over Dispersion

SummaryFollowing recent suggestions that a peaked host age–parasite abundance curve, concomitant with a decline in the degree of dispersion of parasites in the older age classes of hosts, can provide evidence of parasite-induced host mortality, the changes in mean abundance and over-dispersion of metacercarial stages of Diplostomum spathaceum, D. gasterostei, Tylodelphys clavata and T. podicipina in relation to fish age were studied in a field locality. The mean parasite burden of D. spathaceum, D. gasterostei and T. clavata increased with host age and the maximum mean burden was found in the oldest hosts. The variance to mean ratio also increased in D. gasterostei, but decreased in the oldest hosts in D. spathaceum and T. clavata. It is concluded that this decrease could be due to parasite-induced host mortality but could equally be due to death of parasites within the host or to changes in infection rate or could be a reflection of the small sample size of the oldest fish. The mean burden of T. podicipina declined gradually with host age, but the variance to mean ratio remained constant and it is concluded that this could be explained by death of the parasites within the host. None of these data or data from other localities provided clear and unambiguous evidence of host mortality induced by heavy infections of any of the four species, although they are consistent with such mortality and do not refute such a possibility. It is concluded that it may be just as difficult to detect and unequivocally demonstrate parasite-induced host mortality in metacercarial digenean–fish host systems as in any other parasite–host systems.

Magnitude of thyroid dysfunction among antenatal women attending tertiary care centre

2019 ◽  
Vol 8 (11) ◽  
pp. 4371
Author(s):  
Deepa Shanmugham ◽  
Deepak Kannan Saravanan ◽  
Priyanka Shah
Keyword(s):  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
First Trimester ◽  
Endocrine Disorders ◽  
Tertiary Care Centre ◽  
Free T4 ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Mean

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.

scholarly journals Mitochondrial DNA Content Varies with Pathological Characteristics of Breast Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Ren-Kui Bai ◽  
Julia Chang ◽  
Kun-Tu Yeh ◽  
Mary Ann Lou ◽  
Jyh-Feng Lu ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Tumor Size ◽  
Small Sample Size ◽  
Small Sample ◽  
Coding Region ◽  
Normal Tissues ◽  
Pathological Characteristics ◽  
Loop Region ◽  
Tumor Tissues ◽  
Grade Ii

Changes in mitochondrial DNA (mtDNA) content in cancers have been reported with controversial results, probably due to small sample size and variable pathological conditions. In this study, mtDNA content in 302 breast tumor/surrounding normal tissue pairs were evaluated and correlated with the clinico-pathological characteristics of tumors. Overall, mtDNA content in tumor tissues is significantly lower than that in the surrounding normal tissues,P<0.00001. MtDNA content in tumor tissues decreased with increasing tumor size. However, when the tumor is very large (>50 cm3), mtDNA content started to increase. Similarly, mtDNA content decreased from grades 0 and I to grade II tumors, but increased from grade II to grade III tumors. Tumors with somatic mtDNA alterations in coding region have significantly higher mtDNA content than tumors without somatic mtDNA alterations (P<0.001). Tumors with somatic mtDNA alterations in the D-Loop region have significantly lower mtDNA content (P<0.001). Patients with both low and high mtDNA content in tumor tissue have significantly higher hazard of death than patients with median levels of mtDNA content. mtDNA content in tumor tissues change with tumor size, grade, and ER/PR status; significant deviation from the median level of mtDNA content is associated with poor survival.

scholarly journals The Impact of Improved Thermistor Calibration on the Expendable Bathythermograph Profile Data

2017 ◽  
Vol 34 (9) ◽  
pp. 1947-1961 ◽  
Author(s):  
Marlos Goes ◽  
Elizabeth Babcock ◽  
Francis Bringas ◽  
Peter Ortner ◽  
Gustavo Goni
Keyword(s):  
Small Sample Size ◽  
Heat Content ◽  
Small Sample ◽  
Profile Data ◽  
Expendable Bathythermograph ◽  
Different Types ◽  
Long Term Trends ◽  
The Mean ◽  
The Impact

AbstractExpendable bathythermograph (XBT) data provide one of the longest available records of upper-ocean temperature. However, temperature and depth biases in XBT data adversely affect estimates of long-term trends of ocean heat content and, to a lesser extent, estimates of volume and heat transport in the ocean. Several corrections have been proposed to overcome historical biases in XBT data, which rely on constantly monitoring these biases. This paper provides an analysis of data collected during three recent hydrographic cruises that utilized different types of probes, and examines methods to reduce temperature and depth biases by improving the thermistor calibration and reducing the mass variability of the XBT probes.The results obtained show that the use of individual thermistor calibration in XBT probes is the most effective calibration to decrease the thermal bias, improving the mean thermal bias to less than 0.02°C and its tolerance from 0.1° to 0.03°C. The temperature variance of probes with screened thermistors is significantly reduced by approximately 60% in comparison to standard probes. On the other hand, probes with a tighter weight tolerance did not show statistically significant reductions in the spread of depth biases, possibly because of the small sample size or the sensitivity of the depth accuracy to other causes affecting the analysis.

Vulnerability and agency work: from the workers’ perspectives

2015 ◽  
Vol 36 (6) ◽  
pp. 947-965 ◽  
Author(s):  
Robyn Cochrane ◽  
Tui McKeown
Keyword(s):  
Work Experience ◽  
Small Sample Size ◽  
Individual Characteristics ◽  
Small Sample ◽  
Computer Assisted ◽  
Apparent Contradiction ◽  
Content Type ◽  
Nonstandard Work ◽  
Template Analysis ◽  
Social Vulnerabilities

Purpose – The notion of worker vulnerability is often seen as synonymous with disadvantage in discussions of nonstandard work. The purpose of this paper is to separate and examine these two notions by considering economic, social and psychological perspectives and exploring the reality as experienced by agency workers. Design/methodology/approach – In total, 178 Australian clerical agency workers employed by eight agencies completed a mail questionnaire. Personalised responses were subjected to computer-assisted template analysis. Findings – Sample characteristics revealed a gendered and heterogeneous workforce. Findings showed evidence of economic, psychological and social vulnerabilities although favourable features were also reported. This apparent contradiction suggests linkages between the features of nonstandard work, worker preferences, individual characteristics and the experience of worker vulnerability. Research limitations/implications – The notion of varying degrees of worker vulnerability offers a new lens to investigate agency work. The relatively small sample size, focus on clerical work and features of the Australian context may limit generalisability. Practical implications – Findings demonstrate the nature and extent of agency worker vulnerability which allows us to offer policy interventions for governments, agencies and user organisations and insights for prospective agency workers. Originality/value – The widespread use of agency workers provides an imperative for frameworks to assess the nuances of the agency work experience. This study presents the reality of agency work as experienced by the workers and reveals the good and bad aspects of agency work.

Revision: review of non-elective hospitalisations of adults with CHD

2017 ◽  
Vol 27 (9) ◽  
pp. 1764-1770 ◽  
Author(s):  
Alexandra Soufi ◽  
Jack M. Colman ◽  
Qunyu Li ◽  
Erwin N. Oechslin ◽  
Adrienne H. Kovacs
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Quality Care ◽  
Tertiary Care ◽  
Interdisciplinary Approach ◽  
Resource Utilisation ◽  
Tertiary Care Centre ◽  
Single Centre Study ◽  
The Mean ◽  
Service Data

AbstractIntroductionThe adult CHD population is increasing and ageing and remains at high risk for morbidity and mortality. In a retrospective single-centre study, we conducted a comprehensive review of non-elective hospitalisations of adults with CHD and explored factors associated with length of stay.MethodsWe identified adults (⩾18 years) with CHD admitted during a 12-month period and managed by the adult CHD service. Data regarding demographics, cardiac history, hospital admission, resource utilisation, and length of stay were extracted.ResultsThere were 103 admissions of 91 patients (age 37±10 years; 52% female). Of 91 patients, 96% had moderate or complex defects. Of 103 admissions, 45% were through the emergency department. The most common reasons for admission were arrhythmia (37%) and heart failure (28%); 29% of admissions included a stay in the ICU. The mean number of consultations by other services was 2.0. Electrophysiology and anaesthesiology departments were most frequently consulted. After removing outliers, the mean length of stay was 7.9±7.4 days (median=5 days). The length of stay was longer for patients admitted for heart failure (12.2±10.3 days; p=0.001) and admitted directly to the ward (9.6±8.9 days; p=0.009).ConclusionsAmong non-electively hospitalised adults with CHD in a tertiary-care centre, management often entails an interdisciplinary approach, and the length of stay is longest for patients admitted with heart failure. The healthcare system must ensure optimal resources to maintain high-quality care for this expanding patient population.

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