scholarly journals Prognostic value of complementary biomarkers of neurodegeneration in a mixed memory clinic cohort

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9498
Author(s):  
Mathias Holsey Gramkow ◽  
Le Gjerum ◽  
Juha Koikkalainen ◽  
Jyrki Lötjönen ◽  
Ian Law ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Neurodegenerative Disease ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Primary Objective ◽  
University Hospital ◽  
Memory Clinic ◽  
Increased Risk ◽  
Risk Of Progression

Background Biomarkers of neurodegeneration, e.g. MRI brain atrophy and [18F]FDG-PET hypometabolism, are often evaluated in patients suspected of neurodegenerative disease. Objective Our primary objective was to investigate prognostic properties of atrophy and hypometabolism. Methods From March 2015-June 2016, 149 patients referred to a university hospital memory clinic were included. The primary outcome was progression/stable disease course as assessed by a clinician at 12 months follow-up. Intracohort defined z-scores of baseline MRI automatic quantified volume and [18F]FDG-PET standardized uptake value ratios were calculated for all unilaterally defined brain lobes and dichotomized as pronounced atrophy (+A)/ pronounced hypometabolism (+H) at z-score <0. A logistic regression model with progression status as the outcome was carried out with number of lobes with the patterns +A/-H, -A/+H, +A/+H respectively as predictors. The model was mutually adjusted along with adjustment for age and sex. A sensitivity analysis with a z-score dichotomization at −0.1 and −0.5 and dichotomization regarding number of lobes affected at one and three lobes was done. Results Median follow-up time was 420 days [IQR: 387-461 days] and 50 patients progressed. Patients with two or more lobes affected by the pattern +A/+H compared to patients with 0–1 lobes affected had a statistically significant increased risk of progression (odds ratio, 95 % confidence interval: 4.33, 1.90–9.86) in a multivariable model. The model was partially robust to the applied sensitivity analysis. Conclusion Combined atrophy and hypometabolism as assessed by MRI and [18F]FDG-PET in patients under suspicion of neurodegenerative disease predicts progression over 1 year.

scholarly journals Predictive value of suvmax changes between two sequential post-therapeutic FDG-pet in head and neck squamous cell carcinomas

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Thomas M. Stadler ◽  
Martin W. Hüllner ◽  
Martina A. Broglie ◽  
Grégoire B. Morand
Keyword(s):  
Head And Neck ◽  
Squamous Cell ◽  
Metabolic Activity ◽  
Fdg Pet ◽  
Tumor Recurrence ◽  
Standardized Uptake Value ◽  
University Hospital ◽  
Position Emission Tomography ◽  
The Impact

Abstract 18-flurodesoxyglucose position emission tomography (FDG-PET) with computed tomography (CT) or magnetic resonance imaging (MRI) is a broadly accepted tool for pretherapeutic staging and post-therapeutic assessment of response. The prognostic value of sequential post-therapeutic FDG-PETs and the impact of change in metabolic activity has been scarcely reported so far. We hypothesized that an increase in metabolic activity (as measured by maximum standardized uptake value, SUVmax) would be predictive for recurrence. We retrospectively assessed all oral, oropharyngeal, laryngeal, and hypopharyngeal squamous cell carcinoma patients treated at the Department of Otorhinolaryngology—Head and Neck Surgery, University Hospital Zurich between April 1st, 2010 and September 30th, 2018 (N = 337). After a negative post-treatment FDG-PET at 3 months, we measured the SUVmax of the local tumor area and the regional lymph nodes on follow-up FDG-PET at 9 months. We then correlated SUVmax difference between 9 and 3 months with tumor recurrence using Kaplan Meier analysis. During follow-up, 68 patients (20.2%) had local recurrence and 53 had regional recurrence (15.7%) at a median time of 9.0 (IQR 4.25–14) and 7.0 (IQR 5.25–23) months, respectively. An increase in local and/or regional SUVmax from the 3 months to the 9 months post-therapeutic FDG-PET resulted in a poorer recurrence-free survival (Log rank, P = 0.001, for both). An increase in local SUVmax between 3 and 9 months was associated with a hazard ratio of 4.17 for recurrence (95%CI 1.89–9.2, P = 0.0003). In conclusion, an increase in metabolic activity/SUVmax between two post-therapeutic FDG-PETs requires a histological examination as it is associated with tumor recurrence.

scholarly journals Usefulness of E7 mRNA in HPV16-positive women to predict the risk of progression to HSIL/CIN2+

2021 ◽  
Author(s):  
Cristina Marti ◽  
Lorena Marimon ◽  
Ariel Glickman ◽  
Carla Henere ◽  
Adela Saco ◽  
...  
Keyword(s):  
Mrna Expression ◽  
Pap Smear ◽  
Histological Diagnosis ◽  
University Hospital ◽  
Low Grade ◽  
Hpv Testing ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Hpv16 Infection

Objective: To evaluate whether E7 mRNA can predict the risk of progression in women with HPV16 infection. Design: prospective observational study Setting: Tertiary university hospital Population: A cohort of 139 women referred to colposcopy for an abnormal screening result fulfilling the following inclusion criteria: 1) a positive test result confirming HPV16 infection; 2) a biopsy sample with a histological diagnosis of absence of lesion or low-grade SIL/CIN grade1 (LSIL/CIN1); 3) no previous HPV vaccination; 4) no pregnancy; and 5) no previous cervical treatments; and 6) no immunosuppression. Methods: At the first visit all women underwent a cervical sample for liquid-based cytology, HPV testing and genotyping, and HPV16 E7 mRNA analysis and a colposcopy with at least one colposcopy-guided biopsy. Follow-up visits were scheduled every six months. In each control a liquid-based Pap smear, HPV testing, as well as a colposcopy examination with biopsy if necessary were performed. Main outocome measures: Histological diagnosis of HSIL/CIN2+ at any time during follow-up Results: E7 mRNA expression was positive in 55/127 (43.3%) women included in the study and seven (12.7%) progressed to HSIL/CIN2+. In contrast, only 1/72 (1.4%) women with no HPV16 E7 mRNA expression progressed (p=0.027). HPV16 E7 mRNA expression was associated with a 10-fold increased risk of progression (HR 10.0; 95%CI 1.2-81.4). Conclusions: HPV16 E7 mRNA could be useful for risk stratification of women with HPV16 infection in whom a HSIL/CIN2+ has been ruled out.

scholarly journals Usefulness of E7 mRNA in HPV16-Positive Women to Predict the Risk of Progression to HSIL/CIN2+

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1634
Author(s):  
Cristina Martí ◽  
Lorena Marimón ◽  
Ariel Glickman ◽  
Carla Henere ◽  
Adela Saco ◽  
...  
Keyword(s):  
Mrna Expression ◽  
Pap Smear ◽  
Histological Diagnosis ◽  
University Hospital ◽  
Low Grade ◽  
Hpv Testing ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Hpv16 Infection

Objective: To evaluate whether E7 mRNA can predict the risk of progression in women with HPV16 infection. Design: A prospective observational study. Setting: A tertiary university hospital. Population: A cohort of 139 women referred to colposcopy for an abnormal screening result fulfilling the following inclusion criteria: (1) a positive test result confirming HPV16 infection; (2) a biopsy sample with a histological diagnosis of an absence of lesion or low-grade SIL/CIN grade1 (LSIL/CIN1); (3) no previous HPV vaccination; (4) no pregnancy; and (5) no previous cervical treatments; and (6) no immunosuppression. Methods: At the first visit, all women underwent a cervical sample for liquid-based cytology, HPV testing and genotyping, and HPV16 E7 mRNA analysis and a colposcopy with at least one colposcopy-guided biopsy. Follow-up visits were scheduled every six months. In each control, a liquid-based Pap smear, HPV testing, as well as a colposcopy examination with biopsy if necessary were performed. Main outcome measures: Histological diagnosis of HSIL/CIN2+ at any time during follow-up. Results: E7 mRNA expression was positive in 55/127 (43.3%) women included in the study and seven (12.7%) progressed to HSIL/CIN2+. In contrast, only 1/72 (1.4%) women with no HPV16 E7 mRNA expression progressed (p = 0.027). HPV16 E7 mRNA expression was associated with a 10-fold increased risk of progression (HR 10.0; 95% CI 1.2–81.4). Conclusions: HPV16 E7 mRNA could be useful for risk stratification of women with HPV16 infection in whom a HSIL/CIN2+ has been ruled out. Funding: Instituto de Salud Carlos III (ICSIII)-Fondo de Investigación Sanitaria and ERDF ‘One Way to Europe’ (PI17/00772).

scholarly journals Serum BCMA levels predict outcomes in MGUS and smoldering myeloma patients

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
A. Visram ◽  
C. Soof ◽  
S. V. Rajkumar ◽  
S. K. Kumar ◽  
S. Bujarski ◽  
...  
Keyword(s):  
Monoclonal Gammopathy ◽  
Serum Samples ◽  
Risk Models ◽  
Independent Validation ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Paired Serum ◽  
Smoldering Myeloma ◽  
Undetermined Significance

AbstractSoluble BCMA (sBCMA) levels are elevated in monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). However, the association between sBCMA levels and prognosis in MGUS and SMM has not been studied. We retrospectively analyzed sBCMA levels in stored samples from 99 MGUS and 184 SMM patients. Baseline sBCMA levels were significantly higher in MGUS and SMM patients progressing to MM during clinical follow up. When stratified according to the median baseline sBCMA level for each cohort, higher levels were associated with a shorter PFS for MGUS (HR 3.44 comparing sBCMA ≥77 vs <77 ng/mL [95% CI 2.07–5.73, p < 0.001] and SMM (HR 2.0 comparing sBCMA ≥128 vs <128 ng/mL, 95% 1.45–2.76, p < 0.001) patients. The effect of sBCMA on PFS was similar even after adjusting for the baseline MGUS or SMM risk stratification. We evaluated paired serum samples and found that sBCMA increased significantly in MGUS and SMM patients who eventually progressed to MM, whereas among MGUS non-progressors the sBCMA level remained stable. While our results require independent validation, they suggest that sBCMA may be a useful biomarker to identify MGUS and SMM patients at increased risk of progression to MM independent of the established risk models.

Management of Unruptured Intracranial Aneurysm in Japan

1998 ◽  
Vol 18 (4) ◽  
pp. 357-364 ◽  
Author(s):  
Noriaki Aoki ◽  
Takao Kitahara ◽  
Tsuguya Fukui ◽  
J. Robert Beck ◽  
Kazui Soma ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Sensitivity Analysis ◽  
Glasgow Outcome Scale ◽  
Intracranial Aneurysms ◽  
University Hospital ◽  
Health Providers ◽  
Unruptured Intracranial Aneurysm ◽  
Unruptured Intracranial Aneurysms ◽  
Quality Adjusted Life

The purpose of this study was to analyze the management of individual patients with unruptured intracranial aneurysms (UN-ANs) using a decision-analytic approach. Tran sition probabilities among Glasgow Outcome Scale (GOS) categories were estimated from the published literature and data from patients who had been treated at Kitasato University Hospital. Utilities were obtained from 140 health providers based principally on the GOS. Baseline analysis for a healthy 40-year-old man with an anterior UN-AN less than 10 mm in diameter showed that the quality-adjusted life expectancies for preventive operation and follow-up were 15.34 and 14.66 years, respectively. For a follow-up strategy to be preferred, the annual rupture rate had to be as low as 0.9%. These results were sustained through extensive sensitivity analysis. The results sup port preventive operation for UN-ANs, and identify problems that can be clarified with a well-designed stratified clinical trial. Key words: decision analysis; Markov model; unruptured intracranial aneurysms; Glasgow Outcome Scale; utility; preventive oper ations. (Med Decis Making 1998;18:357-364)

Recurrence of First Afebrile Unprovoked Seizure and Parental Consanguinity: A Hospital-Based Study

2020 ◽  
Vol 35 (10) ◽  
pp. 643-648
Author(s):  
Miral A. Al Momani ◽  
Basima Almomani ◽  
Salar Bani Hani ◽  
Andrew Lux
Keyword(s):  
University Hospital ◽  
Unprovoked Seizure ◽  
Recurrent Attack ◽  
Parental Consanguinity ◽  
Pediatric Clinic ◽  
Increased Risk ◽  
High Incidence ◽  
History Of

Purpose: The aim of the current study was to determine the incidence, clinical characteristics, and risk factors associated with the recurrence of first unprovoked seizure in children. Methods: A retrospective, observational study was conducted at King Abdullah University Hospital in Jordan. Children aged from 1 month to 16 years old who attended the hospital between January 2013 to December 2017 were evaluated on the basis of medical records, from the first visit and for a 1-year follow-up period. Results: During the study period, a total of 290 cases with first unprovoked seizure were included. The incidence of first unprovoked seizure was 441 cases per 100 000 patient visits to the pediatric clinic. More than half of the cases developed a second attack (55.3%). Children with parental consanguinity were almost 3 times more likely to develop a second attack of seizure compared to those without parental consanguinity (odds ratio [OR] = 2.785, 95% confidence interval [CI] = 1.216-6.378, P = .015) and patients who had a history of focal type of seizure were almost twice as likely to develop seizure recurrence (OR = 1.798, 95% CI = 1.013-3.193, P = .045). Conclusions: The current results showed a high incidence of first unprovoked seizure among children in Jordan. Parental consanguinity and focal seizure were associated with the increased risk of recurrent attack. This finding highlights the need for public education regarding the outcomes of parental consanguinity to improve the patient’s quality of life.

scholarly journals Trichoepithelioma Arising in an Ovarian Mature Cystic Teratoma

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Takashi Suzuki ◽  
Satoru Nakayama ◽  
Haruka Muto ◽  
Shinichi Shimizu ◽  
Yoshiro Otsuki ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Cystic Teratoma ◽  
Standardized Uptake Value ◽  
Japanese Woman ◽  
Mature Cystic Teratoma ◽  
Outer Root Sheath ◽  
Epithelial Tumor ◽  
Positron Emission ◽  
Old Japanese

Here, we report an extremely rare case of trichoepithelioma (TE)—a benign epithelial tumor originating from the outer root sheath of a hair follicle—arising in an ovarian mature cystic teratoma (MCT) with fluorodeoxyglucose-positron emission tomography (FDG-PET) findings. A 48-year-old Japanese woman presented to our hospital for her annual follow-up of adenomyosis. Ultrasonography and magnetic resonance imaging revealed a left ovarian tumor with irregular-shaped septum, which was suspicious of malignancy. However, tumor marker levels were within normal range. On FDG-PET, the maximum standardized uptake value (SUVmax) of the tumor was 2.9. Laparotomy with left salpingooophorectomy was performed. Pathologic examination revealed the probability of TE, rather than basal cell carcinoma (BCC), arising in an ovarian MCT. After five years of follow-up, the patient had no sign of recurrence. The FDG-PET SUVmax was low in TE, as with other benign tumor. However, future investigation is needed to evaluate the findings of FDG-PET imaging in TE cases.

Prognostic implication of the maximum standardized uptake value (mSUV) on 18F FDG-PET in patients with metastatic hepatocellular carcinoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15531-e15531
Author(s):  
D. Shin ◽  
S. Han ◽  
D. Oh ◽  
S. Im ◽  
T. Kim ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Fdg Pet ◽  
Univariate Analysis ◽  
Standardized Uptake Value ◽  
Palliative Radiotherapy ◽  
Palliative Surgery ◽  
University Hospital ◽  
Prognostic Impact ◽  
Metastatic Setting ◽  
Anticancer Treatment

e15531 Background: The role of 18F-fluorodeoxyglucose-positron emission tomography (18F FDG- PET) in hepatocelluar carcinoma (HCC) has not been firmly established. We conduct this study to investigate the value of mSUV on 18F FDG-PET as a prognostic factor in HCC, especially in metastatic setting. Methods: We consecutively enrolled HCC patients with extrahepatic metastatic lesions, who have been evaluated with 18F FDG-PET before palliative anticancer treatment, between January 2000 and June 2008 at the Seoul National University Hospital. We retrospectively analyzed the clinical outcome and the value of mSUV as a prognostic factor. Results: A total of 57 patients (male, 86.0%) were enrolled. Median age was 57 years (range, 36–78). Hepatitis B was the predominant cause of HCC (82.5%), followed by non-viral hepatitis (14.0%) and hepatitis C (3.5%). Most patients (94.7%) were Child-Pugh A and 3 patients (5.3%) were Child-Pugh B. The most commonly involved site was lung (47%), bone (26%), and LN (33%). Median serum AFP level was 68ng/ml (range, 2–48000) and the median mSUV was 4.1 (range, 0.5–57.0). Forty patients (70.2%) received systemic chemotherapy, 14 patients (24.6%) received palliative radiotherapy, 23 patients (40.4%) received palliative surgery, and 7 patients (12.3%) received TACE. In univariate analysis of overall survival (OS), patients with mSUV over 4.0, AFP over 400ng/ml, and presence of intrahepatic viable lesion, and no palliative surgery showed significantly shorter OS (p=0.007, p=0.006, p<0.001, p=0.02, respectively). In multivariate analysis of OS, mSUV over 4.0, AFP over 400ng/ml, and presence of intrahepatic viable lesion were independent prognostic factors (p=0.01, p=0.01, p<0.001, respectively). In patients with mSUV > VS <4.0 or AFP > VS <400ng/ml, there was no difference of palliative anticancer treatment pattern. When combined mSUV with AFP, the OS of patients with mSUV >4.0 and AFP>400ng/ml VS mSUV <4.0 or AFP<400ng/ml VS mSUV <4.0 and AFP<400ng/ml was 11.0 months vs 16.0 months vs 35.7 months, respectively (p=0.006). Conclusions: The mSUV on 18F FDG-PET is a prognostic factor for OS in patients with metastatic HCC. The combined analysis of mSUV with AFP can have a more potent prognostic impact. No significant financial relationships to disclose.

scholarly journals Increased risk of Graves´ophthalmopathy in patients with increasing TRAb after radioiodine treatment and the impact of CTLA4 on TRAb titres

Endocrine ◽  
2021 ◽  
Author(s):  
Bushra Shahida ◽  
Kleoniki Tsoumani ◽  
Tereza Planck ◽  
Vijayachitra Modhukur ◽  
Pernilla Asp ◽  
...  
Keyword(s):  
Previous Treatment ◽  
University Hospital ◽  
Risk Genes ◽  
Graves Ophthalmopathy ◽  
Increased Risk ◽  
Orbital Tissue ◽  
The Impact ◽  
The Relationship ◽  
Hospital Clinic

Abstract Introduction Treatment of Graves´ disease (GD) with radioiodine increases the risk of developing Graves´ ophthalmopathy (GO), and the link between thyroid and orbital tissue may be the presence of TSH-receptors. Radioiodine increases the titers of TRAb and the aim was to investigate the relationship between GO and TRAb titers after treatment with radioiodine and to define the impact of risk genes. Methods GD patients without ophthalmopathy or previous treatment with radioiodine were prospectively included at treatment with radioiodine for hyperthyroidism. A follow-up was performed 1 year later for the registration of GO development. The study was performed at a University Hospital Clinic; a referral center of all patients treated with radioiodine in the south of Sweden. The main outcome measures were the development of TRAb, anti-TPO, and anti-TG after 3 months and GO after 12 months and relationship to the genetic background (HLA, CTLA-4, and CYR61). Results Three months of radioiodine TRAb titers increased in two thirds of patients (p < 0.0005) but not in the other third. Anti-TPO titers were associated with TRAb (R = 0.362, p < 0.0001) but not anti-TG. At follow-up 1 year later (n = 204) 32 patients developed GO with a proportion of 70% in the group increasing in TRAb titers and 30% in the group with unchanged or lower TRAb titers (p-value < 0.0005). Patients with GO had higher titers of TRAb than patients without GO. CTLA-4 (rs231775 SNP) was significantly (p < 0.005) associated with TRAb titers above the median three months after radioiodine. Conclusions The increase in TRAb titers after treatment with radioiodine is associated with GO and a genetic variation in CTLA-4 is associated with higher titers of TRAb.

scholarly journals Increased Risk of Graves´ophthalmopathy in Patients With Increasing TRAb After Radioiodine Treatment and the Impact of CTLA4 on TRAb Titres

2021 ◽  
Author(s):  
Bushra Shahida ◽  
Kleoniki Tsoumani ◽  
Tereza Planck ◽  
Vijayachitra Modhukur ◽  
Pernilla Asp ◽  
...  
Keyword(s):  
Previous Treatment ◽  
University Hospital ◽  
P Value ◽  
Graves Ophthalmopathy ◽  
Increased Risk ◽  
Orbital Tissue ◽  
One Year ◽  
The Impact ◽  
The Relationship

Abstract Introduction. Treatment of Graves´ disease (GD) with radioiodine increases the risk of developing Graves´ ophthalmopathy (GO) but the link between thyroid and orbital tissue remains undefined.The aim was to investigate the relationship between GO and TRAb after treatment with radioiodine and to define the impact of risk genes.Methods. GD patients without ophthalmopathy or previous treatment with radioiodine were prospectively included at treatment with radioiodine for hyperthyroidism. A follow-up was performed one year later for registration of GO development. The study was performed at a University Hospital Clinic; referral center of all patients treated with radioiodine in the south of Sweden. The main outcome measures were development of TRAb, anti-TPO, anti-TG after three months and GO after 12 months and relationship to the genetic background (HLA, CTLA-4, CYR61).Results. Three months of radioiodine TRAb increased in two thirds of patients (p<0.0005) but not in the other third. Anti-TPO was associated with TRAb (R=0.362, p <0.0001) but not anti-TG. At follow-up one year later (n=204) 32 patients developed GO with a proportion of 70% in the group increasing in TRAb and 30 % in the group with unchanged or lower TRAb (p-value <0.0005). Patients with GO had higher levels of TRAb than patients without GO. CTLA-4 (rs231775 SNP) was significantly (p<0.005) associated with TRAb levels above the median three months after radioiodine.Conclusions. The increase in TRAb after treatment with radioiodine is associated with GO and a genetic variation in CTLA-4 is associated with higher levels of TRAb.

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