scholarly journals Chromogranin A in the Laboratory Diagnosis of Pheochromocytoma and Paraganglioma

Cancers ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 586 ◽  
Author(s):  
Bílek ◽  
Vlček ◽  
Šafařík ◽  
Michalský ◽  
Novák ◽  
...  
Keyword(s):  
Chromogranin A ◽  
Clinical Performance ◽  
Laboratory Diagnosis ◽  
Control Group ◽  
Neuroendocrine Neoplasms ◽  
Blood Samples ◽  
Clinical Sensitivity ◽  
Adrenergic Activity ◽  
One Year ◽  
Clinical Conditions

This work discusses the clinical performance of chromogranin A (CGA), a commonly measured marker in neuroendocrine neoplasms, for the diagnosis of pheochromocytoma/ paraganglioma (PPGL). Plasma CGA (cut-off value 150 µg/L) was determined by an immunoradiometric assay. Free metanephrine (cut-off value 100 ng/L) and normetanephrine (cut-off value 170 ng/L) were determined by radioimmunoassay. Blood samples were collected from PPGL patients preoperatively, one week, six months, one year and two years after adrenal gland surgery. The control patients not diagnosed with PPGL suffered from adrenal problems or from MEN2 and thyroid carcinoma. The clinical sensitivity in the PPGL group of patients (n = 71) based on CGA is 90% and is below the clinical sensitivity determined by metanephrines (97%). The clinical specificity based on all plasma CGA values after surgery (n = 98) is 99% and is the same for metanephrines assays. The clinical specificity of CGA in the control group (n = 85) was 92% or 99% using metanephrines tests. We can conclude that plasma CGA can serve as an appropriate complement to metanephrines assays in laboratory diagnosis of PPGL patients. CGA is elevated in PPGLs, as well as in other neuroendocrine or non-neuroendocrine neoplasia and under clinical conditions increasing adrenergic activity.

scholarly journals Radioimmunoassay of Chromogranin A and Free Metanephrines in Diagnosis of Pheochromocytoma

2017 ◽  
pp. S397-S408 ◽  
Author(s):  
R. BÍLEK ◽  
T. ZELINKA ◽  
P. VLČEK ◽  
J. DUŠKOVÁ ◽  
D. MICHALSKÝ ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Chromogranin A ◽  
Multiple Endocrine Neoplasia ◽  
Clinical Performance ◽  
Blood Samples ◽  
Tumor Mass ◽  
Clinical Sensitivity ◽  
Comparative Group ◽  
Edta Plasma ◽  
One Year

This work discusses the clinical performance of chromogranin A, free metanephrine and normetanephrine determination in plasma using a radioimmunoanalytical methods for the diagnosis of pheochromocytoma and paraganglioma. Blood samples were collected from 55 patients (46 pheochromocytomas, 9 paragangliomas). A sampling of biological materials was performed preoperatively and about one week, six months and one year after adrenal gland surgery. The comparative group without a diagnosis of pheochromocytoma/paraganglioma consisted of 36 pheochromocytoma/paraganglioma patients more than 4 months after adrenal gland surgery, and of 87 patients, 16 of them with multiple endocrine neoplasia, 9 with medullary and 5 with parafolicullar carcinoma of the thyroid gland. The rest were patients with various adrenal gland disorders. Chromogranin A, metanephrine and normetanephrine were determined in the EDTA-plasma using a radioimmunoassay kits Cisbio Bioassays, France and IBL International GmbH, Germany. Clinical sensitivity was 96 % for the combination of metanephrine and normetanephrine, and 93 % for chromogranin A. Clinical specificity was 100 % for the combination metanephrine and normetanephrine, and 96 % for chromogranin A. Falsely elevated levels of chromogranin A were observed in 1 patient with chronic renal insufficiency and 9 analyses were influenced by the administration of proton pump inhibitors. These results were excluded of CGA specificity. Both the combination of plasma free metanephrine, normetanephrine and chromogranin A as determined by radioimmunoassays, which are simple without the necessity of special laboratory material, are effective markers of pheochromocytoma or paraganglioma. Chromogranin A exerts association to malignity and all markers are associated with tumor mass.

scholarly journals Deconjugated Urinary Metanephrine, Normetanephrine and 3-Methoxytyramine in Laboratory Diagnosis of Pheochromocytoma and Paraganglioma

2015 ◽  
pp. S313-S322 ◽  
Author(s):  
R. BÍLEK ◽  
T. ZELINKA ◽  
P. VLČEK ◽  
J. DUŠKOVÁ ◽  
D. MICHALSKÝ ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Clinical Performance ◽  
Chromatographic Determination ◽  
Laboratory Diagnosis ◽  
Control Group ◽  
Clinical Sensitivity ◽  
One Year ◽  
Plasma Free Metanephrines ◽  
Urinary Metanephrines

This work discusses the clinical performance of deconjugated metanephrine (MN), normetanephrine (NMN) and 3-methoxytyramine (3MT) determined in the basal first morning urine using a chromatographic method with electrochemical detection for the clinical diagnosis of pheochromocytoma (PHEO) and paraganglioma (PGL). Urine samples were collected from 44 patients (36 with PHEO, 8 with PGL) aged 54+/-17 (20-78) years (22 females, 22 males). A sampling of biological materials was performed preoperatively and about one week, six months and one year after adrenal gland surgery. The control group consisted of 34 PHEO/PGL patients more than 4 months after adrenal gland surgery. All subjects in the control group were without a diagnosis of PHEO or PGL. Clinical sensitivity was 55 % for MN, 64 % for NMN, 80 % for combination of both MN and NMN, and only 23 % for 3TM. Clinical specificity calculated from the control group was 93 % for MN, 95 % for NMN, 95 % for the combination MN and NMN, and 97 % for 3TM. Cut-off values for deconjugated metanephrines in the basal urine were 310 (MN), 690 (NMN) and 250 μg/l (3MT). Chromatographic determination of deconjugated urinary metanephrines, which is simple without the necessity of special laboratory material, can serve for the screening of PHEO or PGL patients. Urine NMN and 3MT exerts an association to malignity, and all markers are associated with tumor mass. However, the principal laboratory diagnosis of PHEO or PGL must be based on plasma-free metanephrines and plasma chromogranin A with better performance in the laboratory diagnosis of PHEO or PGL.

scholarly journals One-year clinical evaluation of IPS Empress CAD versus polished Celtra Duo ceramic Laminate veneers (randomized controlled clinical trial)

2021 ◽  
Vol 24 (3) ◽  
pp. 13p
Author(s):  
Hayat Elbanna ◽  
Mohammed Labib Zamzam ◽  
Jylan Fouad El-Guindy ◽  
Ahmed Soliman Idris
Keyword(s):  
Survival Rate ◽  
Fracture Resistance ◽  
Clinical Performance ◽  
Control Group ◽  
Marginal Adaptation ◽  
Anterior Teeth ◽  
Significant Difference ◽  
One Year ◽  
Laminate Veneers

Objective: To evaluate fracture resistance and survival rate of IPS Empress CAD versus Polished Celtra Duo ceramic laminate veneers. Material and Methods: Thirty-six ceramic laminate veneers were fabricated for maxillary anterior teeth. The patients were divided into two groups according to the material Group 1(control group) fabricated from IPS Empress CAD laminate veneers and group 2(intervention group) fabricated from Polished Celtra Duo laminate veneers. Standardized the same preparation with butt joint design and chamfer finish line located supra gingival were performed for all the teeth. The fabrication of the veneers was performed using Cad\Cam (Ceramill motion) machine, with software (Exocad). The veneers surfaces were treated and silanated according to the manufacture instruction of each ceramic and enamel surfaces were etched where total etch adhesive protocol was obeyed using BISCO. Follow up sessions were done every two months up to one year for each patient using dental probe and operator vision to evaluate the fracture, survival rate, marginal adaptation, sensitivity and caries. according to USPHS criteria (United States Public Health Service). This was performed by an experienced, blinded investigator. Results: Fracture resistance, marginal adaptation, retention, caries and sensitivity were evaluated according to the criteria of USPHS and we found there is no significant difference as both groups scaled zero score. Conclusion: Both IPS Empress Cad and Polished Celtra Duo laminate veneers revealed successful clinical performance in terms of fracture resistance, marginal adaptation, retention, and sensitivity after one year follow up period.   Keywords Ceramic laminate veneers; IPS Empress CAD; Celtra DUO; Clinical performance.

scholarly journals Prognostic value of chromogranin A in patients with GET/NEN in the pancreas and the small intestine

2018 ◽  
Vol 7 (6) ◽  
pp. 803-810 ◽  
Author(s):  
Małgorzata Fuksiewicz ◽  
Maria Kowalska ◽  
Agnieszka Kolasińska-Ćwikła ◽  
Jarosław B Ćwikła ◽  
Łukasz Sawicki ◽  
...  
Keyword(s):  
Small Intestine ◽  
Chromogranin A ◽  
Progression Free Survival ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Control Group ◽  
Neuroendocrine Neoplasms ◽  
Free Survival ◽  
Node Involvement ◽  
Predictive Indicator

The aim of this study was to evaluate the clinical usefulness of the chromogranin A (CgA) determination in patients with neuroendocrine neoplasms (NENs) of the digestive system and to analyse the association between concentration of the marker and progression-free survival (PFS) and overall survival (OS). Serum concentrations of CgA were determined before the treatment in 131 patients with NENs, including patients with tumours located in the pancreas, the small intestine, caecum, appendix and in the colon. No significant associations were identified in CgA concentrations between the control group and patients with NENs in appendix and colon. In patients with NENs of the pancreas and NENs of the small intestine and caecum, increased CgA levels were associated with lymph node involvement, distant metastases and a baseline liver involvement. Analyses revealed significantly higher CgA concentrations in patients with active disease compared to those without symptoms of NEN. In patients with NENs of the pancreas, CgA concentration was correlated with tumour grade and Ki67. Significantly higher CgA levels were also found in patients who died compared to those who lived. Analyses of PFS and OS revealed that CgA concentration was not a prognostic factor in patients with NENs of the pancreas. In patients with NENs of the small intestine and caecum, increased CgA concentrations are independent, poor prognostic factors for both PFS and OS. In conclusion, in patients with NENs in pancreas, CgA levels are associated with disease progression, while in patients with NENs in small intestine and caecum, its concentration is a predictive indicator for PFS and OS.

Screening for haemorrhagic disorders in paediatric patients by means of a questionnaire

2009 ◽  
Vol 29 (S 01) ◽  
pp. S87-S89 ◽  
Author(s):  
I. Music ◽  
M. Novak ◽  
B. Acham-Roschitz ◽  
W. Muntean
Keyword(s):  
Predictive Value ◽  
Laboratory Diagnosis ◽  
Von Willebrand Disease ◽  
Control Group ◽  
Older Children ◽  
Mild Disease ◽  
History Of ◽  
Von Willebrand ◽  
Specific Symptoms ◽  
Infants And Young Children

SummaryAim: In children, screening for haemorrhagic disorders is further complicated by the fact that infants and young children with mild disease in many cases most likely will not have a significant history of easy bruising or bleeding making the efficacy of a questionnaire even more questionable. Patients, methods: We compared the questionnaires of a group of 88 children in whom a haemorrhagic disorder was ruled out by rigorous laboratory investigation to a group of 38 children with mild von Willebrand disease (VWD). Questionnaires about child, mother and father were obtained prior to the laboratory diagnosis on the occasion of routine preoperative screening. Results: 23/38 children with mild VWD showed at least one positive question in the questionnaire, while 21/88 without laboratory signs showed at least one positive question. There was a trend to more specific symptoms in older children. Three or more positive questions were found only in VWD patients, but only in a few of the control group. The question about menstrual bleeding in mothers did not differ significantly. Sensitivity of the questionnaire for a hemostatic disorder was 0.60, while specifity was 0.76. The negative predictive value was 0.82, but the positive predictive value was only 0.52. Conclusions: Our small study shows, that a questionnaire yields good results to exclude a haemostatic disorder, but is not a sensitive tool to identify such a disorder.

Levels of Prothrombin Fragment F1+2 in Patients with Hyperhomocysteinemia and a History of Venous Thromboembolism

1997 ◽  
Vol 78 (05) ◽  
pp. 1327-1331 ◽  
Author(s):  
Paul A Kyrle ◽  
Andreas Stümpflen ◽  
Mirko Hirschl ◽  
Christine Bialonczyk ◽  
Kurt Herkner ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Thrombin Generation ◽  
Oral Anticoagulant Therapy ◽  
Oral Anticoagulants ◽  
Control Group ◽  
Prothrombin Fragment ◽  
Hemostatic System ◽  
Significant Difference ◽  
System Activation ◽  
One Year

SummaryIncreased thrombin generation occurs in many individuals with inherited defects in the antithrombin or protein C anticoagulant pathways and is also seen in patients with thrombosis without a defined clotting abnormality. Hyperhomocysteinemia (H-HC) is an important risk factor of venous thromboembolism (VTE). We prospectively followed 48 patients with H-HC (median age 62 years, range 26-83; 18 males) and 183 patients (median age 50 years, range 18-85; 83 males) without H-HC for a period of up to one year. Prothrombin fragment Fl+2 (Fl+2) was determined in the patient’s plasma as a measure of thrombin generation during and at several time points after discontinuation of secondary thromboprophylaxis with oral anticoagulants. While on anticoagulants, patients with H-HC had significantly higher Fl+2 levels than patients without H-HC (mean 0.52 ± 0.49 nmol/1, median 0.4, range 0.2-2.8, versus 0.36 ± 0.2 nmol/1, median 0.3, range 0.1-2.1; p = 0.02). Three weeks and 3,6,9 and 12 months after discontinuation of oral anticoagulants, up to 20% of the patients with H-HC and 5 to 6% without H-HC had higher Fl+2 levels than a corresponding age- and sex-matched control group. 16% of the patients with H-HC and 4% of the patients without H-HC had either Fl+2 levels above the upper limit of normal controls at least at 2 occasions or (an) elevated Fl+2 level(s) followed by recurrent VTE. No statistical significant difference in the Fl+2 levels was seen between patients with and without H-HC. We conclude that a permanent hemostatic system activation is detectable in a proportion of patients with H-HC after discontinuation of oral anticoagulant therapy following VTE. Furthermore, secondary thromboprophylaxis with conventional doses of oral anticoagulants may not be sufficient to suppress hemostatic system activation in patients with H-HC.

RELATED FACTORS TO RELAPSE IN DEPRESSED PATIENTS AFTER COGNITIVE BEHAVIOURAL THERAPY DURING ONE YEAR PROSPECTIVE FOLLOW-UP

2011 ◽  
pp. 13-19
Author(s):  
Nhu Minh Hang Tran ◽  
Huu Cat Nguyen ◽  
Dang Doanh Nguyen ◽  
Van Luong Ngo ◽  
Vu Hoang Nguyen ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Relapse Rate ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Related Factors ◽  
Depressed Patients ◽  
One Year

Objectives: To determine factors impact on the relapse in depressed patients treated with Cognitive Behavioral Therapy (CBT) during one year follow-up. Materials and Methods: 80 depressed patients divided into two groups, group 1: included 40 patients treated with CBT; group 2: 40 patients on amitriptyline. Non-randomized controlled clinical trial, opened, longiditual and prospective research. Results and Conclusions: relapse rate after CBT during 1 year follow-up is 10% (compared to 25% in control group), related factors to relapse rate in depression after CBT are age and education. Shared predictors between 2 groups are severity and recurrence of depression. Key words: Depression, relapse, Cognitive Behavioral Therapy (CBT)

The Role of Chess in the Intellectual Development of Childrens from Primary School

2019 ◽  
pp. 58-62
Author(s):  
Vlad Stegariu ◽  
Simona Andreea Popușoi ◽  
Beatrice Abălașei ◽  
Nicolae Lucian Voinea ◽  
Ioan Stelescu ◽  
...  
Keyword(s):  
Cognitive Development ◽  
Primary School ◽  
Intellectual Development ◽  
Resources Allocation ◽  
Control Group ◽  
Cognitive Resources ◽  
One Year ◽  
Better Than ◽  
Chess Playing

Chess playing has a significant role in participants’ resources allocation, both at a psychological level, but mostly concerning the cognitive resources. The aim of the present study was to examine the effect of chess playing on the intellectual development of primary-class students. 67 children were tested using the Raven Standard Progressive Matrices and were distributed in three different groups according to their experience with chess, namely: the control group (formed by students with no experience with chess playing), the beginners group (students with less than one year in chess playing training) and the advanced group (children with more than two years experience with chess). Results indicated that chess playing had a significant effect on the SPM performance, indicating that those in the advanced group performed significantly better than those in the control or in the beginners group. Conclusions of this study tap into the benefits of playing chess with a focus on the children’s’ cognitive development.

scholarly journals Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan

2021 ◽  
Vol 11 (6) ◽  
pp. 478
Author(s):  
Ching Chang ◽  
Chien-Hao Huang ◽  
Hsiao-Jung Tseng ◽  
Fang-Chen Yang ◽  
Rong-Nan Chien
Keyword(s):  
Hepatic Encephalopathy ◽  
Real World ◽  
Ammonia Level ◽  
Decompensated Cirrhosis ◽  
Control Group ◽  
Multivariable Logistic Regression Model ◽  
Before And After ◽  
One Year ◽  
The One ◽  
Serum Ammonia

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Therefore, the aim of this study is to evaluate the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission in Taiwan. Methods: We conducted a real-world single-center retrospective cohort study to compare the long-term efficacy of rifaximin add-on to lactulose (group R + L) versus lactulose alone (group L, control group). Furthermore, the treatment efficacy before and after rifaximin add-on to lactulose was also analyzed. The primary endpoint of our study was time to first HE recurrence (Conn score ≥ 2). All patients were followed up every three months until death, and censored at one year if still alive. Results and Conclusions: 12 patients were enrolled in group R + L. Another 31 patients were stratified into group L. Sex, comorbidity, ammonia level, and ascites grade were matched while age, HE grade, and model for end-stage liver disease (MELD) score were adjusted in the multivariable logistic regression model. Compared with group L, significant improvement in the maintenance of HE remission and decreased episodes and days of HE-related hospitalizations were demonstrated in group R + L. The serum ammonia levels were significantly lower at the 3rd and 6th month in group 1. Concerning changes before and after rifaximin add-on in group R + L, mini-mental status examination (MMSE), episodes of hospitalization, and variceal bleeding also improved at 6 and 12 months. Days of hospitalization, serum ammonia levels also improved at 6th month. Except for concern over price, no patients discontinued rifaximin due to adverse events or complications. The above results provide evidence for the one-year use of rifaximin add-on to lactulose in reducing HE recurrence and HE-related hospitalization for patients with decompensated cirrhosis.

scholarly journals One-Year Clinical Evaluation of the Bonding Effectiveness of a One-Step, Self-Etch Adhesive in Noncarious Cervical Lesion Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Babacar Faye ◽  
Mouhamed Sarr ◽  
Khaly Bane ◽  
Adjaratou Wakha Aidara ◽  
Seydina Ousmane Niang ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Retention Rate ◽  
Recall Rate ◽  
Acid Etching ◽  
Significant Difference ◽  
Usphs Criteria ◽  
One Step ◽  
One Year ◽  
The One ◽  
Self Etch

This study evaluated the one-year clinical performance of a one-step, self-etch adhesive (Optibond All-in-One, Kerr, CA, USA) combined with a composite (Herculite XRV Ultra, Kerr Hawe, CA, USA) to restore NCCLs with or without prior acid etching. Restorations performed by the same practitioner were evaluated at baseline and after 3, 6, and 12 months using modified USPHS criteria. At 6 months, the recall rate was 100%. The retention rate was 84.2% for restorations with prior acid etching, but statistically significant differences were observed between baseline and 6 months. Without acid etching, the retention rate was 77%, and no statistically significant difference was noted between 3 and 6 months. Marginal integrity (93.7% with and 87.7% without acid etching) and discoloration (95.3% with and 92.9% without acid etching) were scored as Alpha or Bravo, with better results after acid etching. After one year, the recall rate was 58.06%. Loss of pulp vitality, postoperative sensitivity, or secondary caries were not observed. After one year retention rate was of 90.6% and 76.9% with and without acid conditioning. Optibond All-in-One performs at a satisfactory clinical performance level for restoration of NCCLs after 12 months especially after acid etching.

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