scholarly journals Non-Invasive Detection of Anastomotic Leakage Following Esophageal and Pancreatic Surgery by Urinary Analysis

2018 ◽  
Vol 36 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Victor D. Plat ◽  
Nora van Gaal ◽  
James A. Covington ◽  
Matthew Neal ◽  
Tim G.J. de Meij ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Area Under The Curve ◽  
Pancreatic Head ◽  
Postoperative Mortality ◽  
Immunological Response ◽  
International Study ◽  
Study Groups ◽  
Delay In Diagnosis ◽  
Non Invasive ◽  
Urinary Analysis

Background: Esophagectomy or pancreaticoduodenectomy is the standard surgical approach for patients with tumors of the esophagus or pancreatic head. Postoperative mortality is strongly correlated with the occurrence of anastomotic leakage (AL). Delay in diagnosis leads to delay in treatment, which ratifies the need for development of novel and accurate non-invasive diagnostic tests for detection of AL. Urinary volatile organic compounds (VOCs) reflect the metabolic status of an individual, which is associated with a systemic immunological response. The aim of this study was to determine the diagnostic accuracy of urinary VOCs to detect AL after esophagectomy or pancreaticoduodenectomy. Methods: In the present study, urinary VOCs of 63 patients after esophagectomy (n = 31) or pancreaticoduodenectomy (n = 32) were analyzed by means of field asymmetric ion mobility spectrometry. AL was defined according to international study groups. Results: AL was observed in 15 patients (24%). Urinary VOCs of patients with AL after pancreaticoduodenectomy could be distinguished from uncomplicated controls, area under the curve 0.85 (95% CI 0.76–0.93), sensitivity 76%, and specificity 77%. However, this was not observed following esophagectomy, area under the curve 0.51 (95% CI 0.37–0.65). Conclusion: In our study population AL following pancreaticoduodenectomy could be discriminated from uncomplicated controls by means of urinary VOC analysis, NTC03203434.

scholarly journals Sphingolipid Analysis Indicate Lactosylceramide as a Potential Biomarker of Inflammatory Bowel Disease in Children

Biomolecules ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 1083
Author(s):  
Aleksandra Filimoniuk ◽  
Agnieszka Blachnio-Zabielska ◽  
Monika Imierska ◽  
Dariusz Marek Lebensztejn ◽  
Urszula Daniluk
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
High Performance ◽  
Area Under The Curve ◽  
Study Groups ◽  
Diagnostic Value ◽  
Serum Samples ◽  
Specificity And Sensitivity ◽  
Potential Biomarker ◽  
Inflammatory Bowel

An altered ceramide composition in patients with inflammatory bowel disease (IBD) has been reported recently. The aim of this study was to evaluate the concentrations of sphingolipids in the serum of treatment-naive children with newly diagnosed IBD and to determine the diagnostic value of the tested lipids in pediatric IBD. The concentrations of sphingolipids in serum samples were evaluated using a quantitative method, an ultra-high-performance liquid chromatography-tandem mass spectrometry in children with Crohn’s disease (CD) (n=34), ulcerative colitis (UC) (n = 39), and controls (Ctr) (n = 24). Among the study groups, the most significant differences in concentrations were noted for C16:0-LacCer, especially in children with CD compared to Ctr or even to UC. Additionally, the relevant increase in C20:0-Cer and C18:1-Cer concentrations were detected in both IBD groups compared to Ctr. The enhanced C24:0-Cer level was observed only in UC, while C18:0-Cer only in the CD group. The highest area under the curve (AUC), specificity, and sensitivity were determined for C16:0-LacCer in CD diagnosis. Our results suggest that the serum LacC16-Cer may be a potential biomarker that distinguishes children with IBD from healthy controls and differentiates IBD subtypes. In addition, C20:0-Cer and C18:0-Cer levels also seem to be closely connected with IBD.

scholarly journals Difference in surgical outcomes of rectal cancer by study design: meta-analyses of randomized clinical trials, case-matched studies, and cohort studies

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
N Hoshino ◽  
T Sakamoto ◽  
K Hida ◽  
Y Takahashi ◽  
H Okada ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Robotic Surgery ◽  
Cohort Studies ◽  
Anastomotic Leakage ◽  
Study Design ◽  
Randomized Clinical Trials ◽  
Postoperative Mortality ◽  
Resection Margins ◽  
Meta Analyses

Abstract Background RCTs are considered the standard in surgical research, whereas case-matched studies and propensity score matching studies are conducted as an alternative option. Both study designs have been used to investigate the potential superiority of robotic surgery over laparoscopic surgery for rectal cancer. However, no conclusion has been reached regarding whether there are differences in findings according to study design. This study aimed to examine similarities and differences in findings relating to robotic surgery for rectal cancer by study design. Methods A comprehensive literature search was conducted using PubMed, Scopus, and Cochrane CENTRAL to identify RCTs, case-matched studies, and cohort studies that compared robotic versus laparoscopic surgery for rectal cancer. Primary outcomes were incidence of postoperative overall complications, incidence of anastomotic leakage, and postoperative mortality. Meta-analyses were performed for each study design using a random-effects model. Results Fifty-nine articles were identified and reviewed. No differences were observed in incidence of anastomotic leakage, mortality, rate of positive circumferential resection margins, conversion rate, and duration of operation by study design. With respect to the incidence of postoperative overall complications and duration of hospital stay, the superiority of robotic surgery was most evident in cohort studies (risk ratio (RR) 0.83, 95 per cent c.i. 0.74 to 0.92, P < 0.001; mean difference (MD) –1.11 (95 per cent c.i. –1.86 to –0.36) days, P = 0.004; respectively), and least evident in RCTs (RR 1.12, 0.91 to 1.38, P = 0.27; MD –0.28 (–1.44 to 0.88) days, P = 0.64; respectively). Conclusion Results of case-matched studies were often similar to those of RCTs in terms of outcomes of robotic surgery for rectal cancer. However, case-matched studies occasionally overestimated the effects of interventions compared with RCTs.

scholarly journals A [68Ga]Ga-DOTANOC PET/CT Radiomic Model for Non-Invasive Prediction of Tumour Grade in Pancreatic Neuroendocrine Tumours

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 870
Author(s):  
Alessandro Bevilacqua ◽  
Diletta Calabrò ◽  
Silvia Malavasi ◽  
Claudio Ricci ◽  
Riccardo Casadei ◽  
...  
Keyword(s):  
Neuroendocrine Tumour ◽  
Area Under The Curve ◽  
Tumour Volume ◽  
Assessment Method ◽  
Second Order ◽  
Tumour Grade ◽  
Non Invasive ◽  
Pet Ct ◽  
Median Test ◽  
Fdg Pet Ct

Predicting grade 1 (G1) and 2 (G2) primary pancreatic neuroendocrine tumour (panNET) is crucial to foresee panNET clinical behaviour. Fifty-one patients with G1-G2 primary panNET demonstrated by pre-surgical [68Ga]Ga-DOTANOC PET/CT and diagnostic conventional imaging were grouped according to the tumour grade assessment method: histology on the whole excised primary lesion (HS) or biopsy (BS). First-order and second-order radiomic features (RFs) were computed from SUV maps for the whole tumour volume on HS. The RFs showing the lowest p-values and the highest area under the curve (AUC) were selected. Three radiomic models were assessed: A (trained on HS, validated on BS), B (trained on BS, validated on HS), and C (using the cross-validation on the whole dataset). The second-order normalized homogeneity and entropy was the most effective RFs couple predicting G2 and G1. The best performance was achieved by model A (test AUC = 0.90, sensitivity = 0.88, specificity = 0.89), followed by model C (median test AUC = 0.87, sensitivity = 0.83, specificity = 0.82). Model B performed worse. Using HS to train a radiomic model leads to the best prediction, although a “hybrid” (HS+BS) population performs better than biopsy-only. The non-invasive prediction of panNET grading may be especially useful in lesions not amenable to biopsy while [68Ga]Ga-DOTANOC heterogeneity might recommend FDG PET/CT.

scholarly journals Nanoparticles as Adjuvants and Nanodelivery Systems for mRNA-Based Vaccines

Pharmaceutics ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 45
Author(s):  
Iman M. Alfagih ◽  
Basmah Aldosari ◽  
Bushra AlQuadeib ◽  
Alanood Almurshedi ◽  
Mariyam M. Alfagih
Keyword(s):  
Messenger Rna ◽  
Immune Cell ◽  
Natural Infection ◽  
Immunological Response ◽  
Infection Process ◽  
Dual Function ◽  
Therapeutic Vaccines ◽  
Non Invasive ◽  
Recent Developments

Messenger RNA (mRNA)-based vaccines have shown promise against infectious diseases and several types of cancer in the last two decades. Their promise can be attributed to their safety profiles, high potency, and ability to be rapidly and affordably manufactured. Now, many RNA-based vaccines are being evaluated in clinical trials as prophylactic and therapeutic vaccines. However, until recently, their development has been limited by their instability and inefficient in vivo transfection. The nanodelivery system plays a dual function in RNA-based vaccination by acting as a carrier system and as an adjuvant. That is due to its similarity to microorganisms structurally and size-wise; the nanodelivery system can augment the response by the immune system via simulating the natural infection process. Nanodelivery systems allow non-invasive mucosal administration, targeted immune cell delivery, and controlled delivery, reducing the need for multiple administrations. They also allow co-encapsulating with immunostimulators to improve the overall adjuvant capacity. The aim of this review is to discuss the recent developments and applications of biodegradable nanodelivery systems that improve RNA-based vaccine delivery and enhance the immunological response against targeted diseases.

scholarly journals Prognostic Nomogram for Patients With Pancreatic Ductal Adenocarcinoma of Pancreatic Head After Pancreaticoduodenectomy

2021 ◽  
Vol 15 ◽  
pp. 117955492110241
Author(s):  
Hongkai Zhuang ◽  
Zixuan Zhou ◽  
Zuyi Ma ◽  
Shanzhou Huang ◽  
Yuanfeng Gong ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Perineural Invasion ◽  
Cox Regression ◽  
Area Under The Curve ◽  
Pancreatic Head ◽  
Ductal Adenocarcinoma ◽  
R0 Resection ◽  
Cox Regression Analysis ◽  
Ajcc Stage

Background: The prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) of pancreatic head remains poor, even after potentially curative R0 resection. The aim of this study was to develop an accurate model to predict patients’ prognosis for PDAC of pancreatic head following pancreaticoduodenectomy. Methods: We retrospectively reviewed 112 patients with PDAC of pancreatic head after pancreaticoduodenectomy in Guangdong Provincial People’s Hospital between 2014 and 2018. Results: Five prognostic factors were identified using univariate Cox regression analysis, including age, histologic grade, American Joint Committee on Cancer (AJCC) Stage 8th, total bilirubin (TBIL), CA19-9. Using all subset analysis and multivariate Cox regression analysis, we developed a nomogram consisted of age, AJCC Stage 8th, perineural invasion, TBIL, and CA19-9, which had higher C-indexes for OS (0.73) and RFS (0.69) compared with AJCC Stage 8th alone (OS: 0.66; RFS: 0.67). The area under the curve (AUC) values of the receiver operating characteristic (ROC) curve for the nomogram for OS and RFS were significantly higher than other single parameter, which are AJCC Stage 8th, age, perineural invasion, TBIL, and CA19-9. Importantly, our nomogram displayed higher C-index for OS than previous reported models, indicating a better predictive value of our model. Conclusions: A simple and practical nomogram for patient prognosis in PDAC of pancreatic head following pancreaticoduodenectomy was established, which shows satisfactory predictive efficacy and deserves further evaluation in the future.

scholarly journals The Effect of an Encapsulated Nutrient Mixture on Food Intake and Satiety: A Double-Blind Randomized Cross-Over Proof of Concept Study

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1787 ◽  
Author(s):  
Annick Alleleyn ◽  
Mark van Avesaat ◽  
Dina Ripken ◽  
Sinéad Bleiel ◽  
Daniel Keszthelyi ◽  
...  
Keyword(s):  
Small Intestine ◽  
Food Intake ◽  
Area Under The Curve ◽  
Double Blind ◽  
Distal Small Intestine ◽  
Active Product ◽  
Non Invasive ◽  
Control Product ◽  
Scale Scores ◽  
And Control

Activation of the intestinal brake by infusing nutrients into the distal small intestine with catheters inhibits food intake and enhances satiety. Encapsulation of macronutrients, which protects against digestion in the proximal gastrointestinal tract, can be a non-invasive alternative to activate this brake. In this study, we investigate the effect of oral ingestion of an encapsulated casein and sucrose mixture (active) targeting the distal small intestine versus a control product designed to be released in the stomach on food intake, satiety, and plasma glucose concentrations. Fifty-nine volunteers received the active and control product on two separate test days. Food intake was determined during an ad libitum meal 90 min after ingestion of the test product. Visual analogue scale scores for satiety and blood samples for glucose analysis were collected at regular intervals. Ingestion of the active product decreased food intake compared to the control product (655 kcal compared with 699 kcal, respectively, p < 0.05). The area under the curve (AUC) for hunger was decreased (p < 0.05) and AUC for satiety was increased (p < 0.01) after ingestion of the active product compared to the control product. Ingestion of an encapsulated protein-carbohydrate mixture resulted in inhibition of food intake compared to a non-encapsulated control product.

Validation of the International Study Group of Rectal Cancer definition and severity grading of anastomotic leakage

Surgery ◽  
2013 ◽  
Vol 153 (6) ◽  
pp. 753-761 ◽  
Author(s):  
Yakup Kulu ◽  
Alexis Ulrich ◽  
Thomas Bruckner ◽  
Pietro Contin ◽  
Thilo Welsch ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
International Study ◽  
Study Group ◽  
International Study Group ◽  
Severity Grading

scholarly journals Faecal Scent as a Novel Non-Invasive Biomarker to Discriminate between Coeliac Disease and Refractory Coeliac Disease: A Proof of Principle Study

Biosensors ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 69 ◽  
Author(s):  
Maxine D. Rouvroye ◽  
Alfian Wicaksono ◽  
Sofie Bosch ◽  
Edo Savelkoul ◽  
James A. Covington ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Ion Mobility ◽  
Clinical Symptoms ◽  
Area Under The Curve ◽  
Gluten Free ◽  
Future Studies ◽  
Non Invasive ◽  
Significant Difference ◽  
Volatile Organic ◽  
Refractory Coeliac Disease

Currently, the gold standard for diagnosis of coeliac disease (CD) is based on serology and gastroduodenoscopy with histology of duodenal mucosal biopsies. The aim of this study was to evaluate the potential of faecal volatile organic compounds (VOCs) analysis as a novel, non-invasive tool to discriminate between CD in remission in patients on a gluten-free diet (GFD), refractory coeliac disease (RCD) and controls without CD. Patients with an established diagnosis of CD on a GFD, RCD and healthy controls (HC) were instructed to collect a faecal sample. All subjects completed questionnaires on clinical symptoms, lifestyle and dietary information. Faecal VOCs were measured using gas chromatography-ion mobility spectrometry. A total of 13 CD, 7 RCD and 10 HC were included. A significant difference in VOC profiles between CD and RCD patients (area under the curve (AUC) ± 95% CI: 0.91 (0.79–1) p = 0.000) and between CD and HC (AUC ± 95% CI: 0.71 (0.51–0.91) p = 0.0254) was observed. We found no significant differences between faecal VOC patterns of HC and RCD. Based on faecal VOCs, CD could be discriminated from RCD and HC. This implies that faecal VOC analysis may hold potential as a novel non-invasive biomarker for RCD. Future studies should encompass a larger cohort to further investigate and validate this prior to application in clinical practice.

Real-time monitoring hypoxia at high altitudes using electrical bioimpedance technique: an animal experiment

2020 ◽  
Author(s):  
Lin Yang ◽  
Meng Dai ◽  
Qinglin Cao ◽  
Shuai Ding ◽  
Zhanqi Zhao ◽  
...  
Keyword(s):  
Real Time ◽  
Measurement Data ◽  
Area Under The Curve ◽  
Hypoxic Condition ◽  
Control Group ◽  
Characteristic Analysis ◽  
Non Invasive ◽  
Electrical Bioimpedance ◽  
High Concordance ◽  
Sensitivity Specificity

Hypoxia poses a serious threat to pilots. The aim of the study was to examine the efficacy of electrical bioimpedance (EBI) in detecting the onset of hypoxia in real time in a rabbit hypoxia model. Thirty-two New Zealand rabbits were divided equally into four groups (control group and 3 hypoxia groups, i.e. mild, moderate and severe). Hypoxia was induced by simulating various altitudes in the hypobaric oxygen chamber (3000 m, 5000 m and 8000 m). Both cerebral impedance and blood oxygen (SaO2) were monitored continuously. Results showed that the cerebral impedance increased immediately during the period of increasing altitude and decreased quickly to the initial baseline at the phase of descending altitude. Moreover, the change of cerebral impedance in mild hypoxia group (3000 m) is significantly smaller than those in the other two groups (5000 m and 8000 m, P<0.05). The changes of cerebral impedance and SaO2 were significantly correlated based on the total of measurement data (R2=0.628, P<0.001). Further, the agreement analysis performed with Bland-Altman and standardized residual plots exhibited high concordance between cerebral impedance and SaO2. Receiver operator characteristic analysis manifested that the sensitivity, specificity and area under the curve using cerebral impedance for changes of SaO2 >10% were 0.735, 0.826 and 0.845, respectively. These findings demonstrated that EBI could sensitively and accurately monitor changes of cerebral impedance induced by hypoxia, which might provide a potential tool for the real-time and non-invasive monitoring of hypoxic condition of pilots in flight for early identification of hypoxia.

scholarly journals Circulating Coding and Long Non-Coding RNAs as Potential Biomarkers of Idiopathic Pulmonary Fibrosis

2020 ◽  
Vol 21 (22) ◽  
pp. 8812
Author(s):  
Stefania Di Mauro ◽  
Alessandra Scamporrino ◽  
Mary Fruciano ◽  
Agnese Filippello ◽  
Evelina Fagone ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Area Under The Curve ◽  
P Value ◽  
Patient Identification ◽  
Clinical Issue ◽  
Rna Molecules ◽  
Non Invasive ◽  
Non Coding Rnas ◽  
Whole Transcriptome Analysis

Background: Idiopathic Pulmonary Fibrosis (IPF) is a chronic degenerative disease with a median survival of 2–5 years after diagnosis. Therefore, IPF patient identification represents an important and challenging clinical issue. Current research is still searching for novel reliable non-invasive biomarkers. Therefore, we explored the potential use of long non-coding RNAs (lncRNAs) and mRNAs as biomarkers for IPF. Methods: We first performed a whole transcriptome analysis using microarray (n = 14: 7 Control, 7 IPF), followed by the validation of selected transcripts through qPCRs in an independent cohort of 95 subjects (n = 95: 45 Control, 50 IPF). Diagnostic performance and transcript correlation with functional/clinical data were also analyzed. Results: 1059 differentially expressed transcripts were identified. We confirmed the downregulation of FOXF1 adjacent non-coding developmental regulatory RNA (FENDRR) lncRNA, hsa_circ_0001924 circularRNA, utrophin (UTRN) and Y-box binding protein 3 (YBX3) mRNAs. The two analyzed non-coding RNAs correlated with Forced Vital Capacity (FVC)% and Diffusing Capacity of the Lung for carbon monoxide (DLCO)% functional data, while coding RNAs correlated with smock exposure. All analyzed transcripts showed excellent performance in IPF identification with Area Under the Curve values above 0.87; the most outstanding one was YBX3: AUROC 0.944, CI 95% = 0.895–0.992, sensitivity = 90%, specificity = 88.9%, p-value = 1.02 × 10−13. Conclusions: This study has identified specific transcript signatures in IPF suggesting that validated transcripts and microarray data could be useful for the potential future identification of RNA molecules as non-invasive biomarkers for IPF.

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