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Daubney ER, D'Urso S, Cuellar-Partida G, Rajbhandari D, Peach E, de Guzman E, McArthur C, Rhodes A, Meyer J, Finfer S, Myburgh J, Cohen J, Schirra HJ, Venkatesh B, Evans DM. A Genome-Wide Association Study of Serum Metabolite Profiles in Septic Shock Patients. Crit Care Explor 2024; 6:e1030. [PMID: 38239409 PMCID: PMC10796137 DOI: 10.1097/cce.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVES We sought to assess whether genetic associations with metabolite concentrations in septic shock patients could be used to identify pathways of potential importance for understanding sepsis pathophysiology. DESIGN Retrospective multicenter cohort studies of septic shock patients. SETTING All participants who were admitted to 27 participating hospital sites in three countries (Australia, New Zealand, and the United Kingdom) were eligible for inclusion. PATIENTS Adult, critically ill, mechanically ventilated patients with septic shock (n = 230) who were a subset of the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock trial (ClinicalTrials.gov number: NCT01448109). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A genome-wide association study was conducted for a range of serum metabolite levels for participants. Genome-wide significant associations (p ≤ 5 × 10-8) were found for the two major ketone bodies (3-hydroxybutyrate [rs2456680] and acetoacetate [rs2213037] and creatinine (rs6851961). One of these single-nucleotide polymorphisms (SNPs) (rs2213037) was located in the alcohol dehydrogenase cluster of genes, which code for enzymes related to the metabolism of acetoacetate and, therefore, presents a plausible association for this metabolite. None of the three SNPs showed strong associations with risk of sepsis, 28- or 90-day mortality, or Acute Physiology and Chronic Health Evaluation score (a measure of sepsis severity). CONCLUSIONS We suggest that the genetic associations with metabolites may reflect a starvation response rather than processes involved in sepsis pathophysiology. However, our results require further investigation and replication in both healthy and diseased cohorts including those of different ancestry.
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Affiliation(s)
- Emily R Daubney
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
- Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Shannon D'Urso
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | | | | | - Elizabeth Peach
- Frazer Institute, University of Queensland, Brisbane, QLD, Australia
| | - Erika de Guzman
- Australian Translational Genomics Centre, Queensland University of Technology, Brisbane, QLD, Australia
| | - Colin McArthur
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Andrew Rhodes
- Department of Adult Critical Care, St George's University Hospitals NHS Foundation Trust and St George's University of London, London, United Kingdom
| | - Jason Meyer
- The George Institute for Global Health, Sydney, NSW, Australia
- Intensive Care Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Simon Finfer
- The George Institute for Global Health, Sydney, NSW, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - John Myburgh
- The George Institute for Global Health, Sydney, NSW, Australia
- St George Hospital, Sydney, NSW, Australia
| | - Jeremy Cohen
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Intensive Care Unit, The Wesley Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Horst Joachim Schirra
- Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
- Griffith School of Environment and Science-Chemical Sciences, Griffith University, Brisbane, QLD, Australia
- Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD, Australia
| | - Balasubramanian Venkatesh
- The George Institute for Global Health, Sydney, NSW, Australia
- Intensive Care Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Intensive Care Unit, The Wesley Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Faculty of Health, University of New South Wales, Sydney, NSW, Australia
| | - David M Evans
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
- Frazer Institute, University of Queensland, Brisbane, QLD, Australia
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
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Brito Nunes C, Huang P, Wang G, Lundberg M, D'Urso S, Wootton RE, Borges MC, Lawlor DA, Warrington NM, Evans DM, Hwang LD, Moen GH. Mendelian randomization study of maternal coffee consumption and its influence on birthweight, stillbirth, miscarriage, gestational age and pre-term birth. Int J Epidemiol 2023; 52:165-177. [PMID: 35679582 PMCID: PMC9908064 DOI: 10.1093/ije/dyac121] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Coffee consumption has been associated with several adverse pregnancy outcomes, although data from randomized-controlled trials are lacking. We investigate whether there is a causal relationship between coffee consumption and miscarriage, stillbirth, birthweight, gestational age and pre-term birth using Mendelian randomization (MR). METHODS A two-sample MR study was performed using summary results data from a genome-wide association meta-analysis of coffee consumption (N = 91 462) from the Coffee and Caffeine Genetics Consortium. Outcomes included self-reported miscarriage (N = 49 996 cases and 174 109 controls from a large meta-analysis); the number of stillbirths [N = 60 453 from UK Biobank (UKBB)]; gestational age and pre-term birth (N = 43 568 from the 23andMe, Inc cohort) and birthweight (N = 297 356 reporting own birthweight and N = 210 248 reporting offspring's birthweight from UKBB and the Early Growth Genetics Consortium). Additionally, a one-sample genetic risk score (GRS) analysis of coffee consumption in UKBB women (N up to 194 196) and the Avon Longitudinal Study of Parents and Children (N up to 6845 mothers and 4510 children) and its relationship with offspring outcomes was performed. RESULTS Both the two-sample MR and one-sample GRS analyses showed no change in risk of sporadic miscarriages, stillbirths, pre-term birth or effect on gestational age connected to coffee consumption. Although both analyses showed an association between increased coffee consumption and higher birthweight, the magnitude of the effect was inconsistent. CONCLUSION Our results suggest that coffee consumption during pregnancy might not itself contribute to adverse outcomes such as stillbirth, sporadic miscarriages and pre-term birth or lower gestational age or birthweight of the offspring.
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Affiliation(s)
- Caroline Brito Nunes
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Peiyuan Huang
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Geng Wang
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - Mischa Lundberg
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - Shannon D'Urso
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Robyn E Wootton
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Maria Carolina Borges
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicole M Warrington
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia.,Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia.,Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - David M Evans
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.,The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia.,Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Liang-Dar Hwang
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia.,Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Gunn-Helen Moen
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia.,Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia.,Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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D'Urso S, Arumugam P, Weider T, Hwang LD, Bond TA, Kemp JP, Warrington NM, Evans DM, O'Mara TA, Moen GH. Mendelian randomization analysis of factors related to ovulation and reproductive function and endometrial cancer risk. BMC Med 2022; 20:419. [PMID: 36320039 PMCID: PMC9623961 DOI: 10.1186/s12916-022-02585-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Observational epidemiological studies suggest a link between several factors related to ovulation and reproductive function and endometrial cancer (EC) risk; however, it is not clear whether these relationships are causal, and whether the risk factors act independently of each other. The aim of this study was to investigate putative causal relationships between the number of live births, age at last live birth, and years ovulating and EC risk. METHODS: We conducted a series of observational analyses to investigate various risk factors and EC risk in the UK Biobank (UKBB). Additionally, multivariate analysis was performed to elucidate the relationship between the number of live births, age at last live birth, and years ovulating and other related factors such as age at natural menopause, age at menarche, and body mass index (BMI). Secondly, we used Mendelian randomization (MR) to assess if these observed relationships were causal. Genome-wide significant single nucleotide polymorphisms (SNPs) were extracted from previous studies of woman's number of live births, age at menopause and menarche, and BMI. We conducted a genome-wide association analysis using the UKBB to identify SNPs associated with years ovulating, years using the contraceptive pill, and age at last live birth. RESULTS We found evidence for a causal effect of the number of live births (inverse variance weighted (IVW) odds ratio (OR): 0.537, p = 0.006), the number of years ovulating (IVW OR: 1.051, p = 0.014), in addition to the known risk factors BMI, age at menarche, and age at menopause on EC risk in the univariate MR analyses. Due to the close relationships between these factors, we followed up with multivariable MR (MVMR) analysis. Results from the MVMR analysis showed that number of live births had a causal effect on EC risk (OR: 0.783, p = 0.036) independent of BMI, age at menarche and age at menopause. CONCLUSIONS MVMR analysis showed that the number of live births causally reduced the risk of EC.
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Affiliation(s)
- Shannon D'Urso
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Pooja Arumugam
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Therese Weider
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Liang-Dar Hwang
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Tom A Bond
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
- Bristol Medical School, Population Health Science, University of Bristol, Bristol, UK
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - John P Kemp
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Nicole M Warrington
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - David M Evans
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Tracy A O'Mara
- Cancer Research Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gunn-Helen Moen
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia.
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
- The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.
- Bristol Medical School, Population Health Science, University of Bristol, Bristol, UK.
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
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Orlacchio A, Schillaci O, Fusco N, Broccoli P, Maurici M, Yamgoue M, Danieli R, D'Urso S, Simonetti G. Role of PET/CT in the detection of liver metastases from colorectal cancer. Radiol Med 2009; 114:571-85. [PMID: 19444590 DOI: 10.1007/s11547-009-0393-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 07/08/2008] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to compare the diagnostic accuracy of 2-[fluorine-18] fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) and computed tomography (CT) with PET/CT in the detection of liver metastases during tumour staging in patients suffering from colorectal carcinoma for the purposes of correct surgical planning and follow-up. MATERIALS AND METHODS A total of 467 patients underwent a PET/CT scan using an iodinated contrast medium. We compared images obtained by the single PET scan, the single CT scan and by the fusion of the two procedures (PET/CT). The final diagnosis was obtained by histological examination and/or by the follow-up of all patients, including those who did not undergo surgery or biopsy. RESULTS The PET scan had 94.05% sensitivity, 91.60% specificity and 93.36% accuracy; the CT scan had 91.07% sensitivity, 95.42% specificity and 92.29% accuracy. The combined procedures (PET/CT) had the following values: sensitivity 97.92%, specificity 97.71% and accuracy 97.86%. CONCLUSIONS This study indicates that PET/CT is very useful in staging and restaging patients suffering from colorectal cancer. It was particularly useful when recurrences could not be visualised either clinically or by imaging despite increasing tumour markers, as it guaranteed an earlier diagnosis. PET/CT not only provides high diagnostic performance in terms of sensitivity and specificity, enabling modification of patient treatment, but it is also a unique, high-profile procedure that can produce cost savings.
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Affiliation(s)
- A Orlacchio
- Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Policlinico Universitario Tor Vergata, Viale Oxford 81, 00133, Roma, Italy.
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Bovera F, D'Urso S, Calabrò S, Tudisco R, Di Meo C, Nizza A. Use of faeces as an alternative inoculum to caecal content to study in vitro feed digestibility in domesticated ostriches (Struthio camelus var. domesticus). Br Poult Sci 2007; 48:354-62. [PMID: 17578699 DOI: 10.1080/00071660701341989] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
1. In order to find an alternative source of inoculum to caecal content for studying the in vitro feed digestibility in domesticated ostriches (Struthio camelus var. domesticus), caecal content and faeces of 4 male birds were used as inocula for an in vitro gas production trial. 2. About 1 g of each of 5 substrates (maize silage, CS; alfalfa hay, AH; barley, BG; soybean meal, SM; beet pulp, BP) was weighed, in quadruplicate per inoculum, in 120 ml flasks; 75 ml of anaerobic medium and 4 ml of reducing solution were added and flasks were kept at 39 degrees C. Caecal content and faeces were diluted respectively 1 : 2 (CI) and 1 : 4 (FI) with an anaerobic medium and were injected into the respective flasks (10 ml). 3. Gas production was recorded 22 times up to 120 h of incubation and fermentation characteristics (for instance, degraded organic matter, OMd; potential gas production, A; maximum fermentation rate, Rmax; time at which it is reached, Tmax; pH; volatile fatty acid, VFA; ammonia) were studied for each inoculum and substrate. 4. CI and FI showed significant differences in Tmax (16.37 vs 18.47 h, respectively), propionic (16.47 vs 12.07 mmoles/l) and butyric acid (6.50 vs 7.98 mmoles/l) and ammonia concentration (17.18 vs 19.95 mmoles/l). The substrates, according to their chemical composition, showed different fermentation characteristics. However, the regression equations able to estimate some fermentation characteristics of the caecum from those of faeces were statistically significant and showed R2-values ranging from 0.87 to 0.99. 5. The differences in fermentation pathways of the two inocula did not appear to influence the rate and extent of OM digestion. Faecal fermentation predicted rates and extent of OM digestion by caecal fermentation in ostriches; consequently, the faeces could be considered as an alternative to caecal content to study feed digestibility in the species, although there is a need to undertake further research.
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Affiliation(s)
- F Bovera
- Faculty of Veterinary Medicine, Dipartimento di Scienze Zootecniche e Ispezione degli Alimenti, University of Naples Federico II, Naples, Italy.
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Bovera F, Cutrignelli MI, Calabrò S, Piccolo G, Tudisco R, D'Urso S, Infascelli F. Use of two different dietary energy and protein contents to define nutritive requirements of lactating buffalo cows. J Anim Physiol Anim Nutr (Berl) 2007; 91:181-6. [PMID: 17516938 DOI: 10.1111/j.1439-0396.2007.00690.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Two total mixed rations, differing in energy and protein concentrations (diet A: 6.1 MJ/kg DM of NE(l), 112.5 g/kg DM of metabolizable protein, MP, and 101.7 g of protein digestible at the intestinal level, PDI, vs. diet B: 6.4 MJ, 95.1 g of MP, 78.9 g of PDI) were administered ad libitum for 1 year to two groups of 12 buffaloes in which the partial monthly turnover of animals allowed the lactation stage to be maintained close to 160 days. The diets were formulated to obtain, with a daily intake of about 15.5 kg of DM, a balanced energy supply but an excess of protein (diet A); the opposite occurred with diet B. The average dry matter intake recorded during the trial was 14.5 kg for diet A and 15.0 kg for diet B. Milk production was similar for both groups (7.94 kg vs. 7.95 kg). The diet with a higher protein concentration brought about a significant increase in protein, casein and non-protein nitrogen contents in the milk. A significant increase in milk fat percentage was observed when the animals were fed the diet with a higher energy concentration. The serum urea concentration (8.62 mm/l) of buffaloes fed diet A was outside the physiological range for lactating buffaloes. The energy and protein conversion efficiencies for milk production were more favourable when their supplies were balanced: 3.58 MJ of NE(l)/kg of FPCM for diet A; 2.50 g of MP or 2.07 g of PDI/g of protein milk for diet B. Moreover, when the requirements were satisfied, greater energy or protein supplies failed to induce significant changes in milk yield and quality. Finally, regarding the great differences between estimated MP requirements and those recorded during the trial, the authors suggest that the equations used in the CPM-Dairy software, formulated for dairy cows, are not applicable in buffaloes.
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Affiliation(s)
- F Bovera
- Dipartimento di Scienze Zootecniche e Ispezione degli Alimenti, University of Naples Federico II, Naples, Italy.
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Tudisco R, Cutrignelli MI, Bovera F, Calabrò S, Piccolo G, D'Urso S, Infascelli F. Influence of the Concentrate Pellet Process on the Fate of Feed Plant DNA in the Rabbit. Vet Res Commun 2007; 31 Suppl 1:409-12. [PMID: 17682926 DOI: 10.1007/s11259-0068-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R Tudisco
- Department of Zootechnic Science and Food Inspection, Faculty of Veterinary Medicine, University of Naples Federico II, Naples, Italy.
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Orlacchio A, Schillaci O, Antonelli L, D'Urso S, Sergiacomi G, Nicolì P, Simonetti G. Solitary pulmonary nodules: morphological and metabolic characterisation by FDG-PET-MDCT. Radiol Med 2007; 112:157-73. [PMID: 17361379 DOI: 10.1007/s11547-007-0132-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2006] [Accepted: 06/16/2006] [Indexed: 11/27/2022]
Abstract
PURPOSE This study was done to analyse the additional morphological and functional information provided by the integration of [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography ([18F]-FDG-PET) with contrast-enhanced multidetector computed tomography (MDCT) in the characterisation of indeterminate solitary pulmonary nodules (SPNs). MATERIALS AND METHODS Fifty-six SPNs, previously classified as indeterminate, were evaluated using a Discovery ST16 PET/CT system (GE Medical Systems) with nonionic iodinated contrast material and [18F]-FDG as a positron emitter. Images were evaluated on a dedicated workstation. Semiquantitative parameters of [18F]-FDG uptake and morphological, volumetric and densitometric parameters before and after contrast administration were analysed. Results were correlated with the histological and follow-up findings. RESULTS Twenty-six SPNs were malignant and 30 were benign. Malignant lesions at both PET/CT and histology had a mean diameter of 1.8+/-1.2 cm, a volume doubling time (DT) of 222 days, a mean standardized uptake value (SUV) of 4.7 versus 1.08 in benign lesions and a mean postcontrast enhancement of 44.8 HU as opposed to 4.8 HU in benign nodules. Malignant lesions had a significantly shorter doubling time and significantly greater postcontrast enhancement compared with benign nodules. Based on the SUV and using a cut-off value of >2.5, PET/CT had a sensitivity of 76.9%, specificity of 100%, diagnostic accuracy of 89.2%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 83.3%. Based on doubling time (cut off<400 days), it had a sensitivity of 76.9%, specificity of 93.3%, accuracy of 85.7%, PPV of 90.9% and NPV of 82.3%. Based on postcontrast enhancement (cut off>15 HU), it had a sensitivity of 92.3%, specificity of 100%, accuracy of 96.4%, PPV of 100% and NPV of 93.7%. CONCLUSION PET/CT allows accurate analysis of anatomical/morphological and metabolic/functional correlations of SPN, providing useful data for identifying and locating the disease, for differentiating between malignant and benign nodules and for establishing the aggressiveness and degree of vascularity of pulmonary lesions. Therefore, partly in view of the considerable reduction in time and cost of the single examinations, we believe that PET/CT will gain an increasingly dominant role in the diagnostic and therapeutic approach to lung cancer, especially in the preclinical phase.
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Affiliation(s)
- A Orlacchio
- Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, Policlinico Universitario Tor Vergata, Viale Oxford 81, I-00133, Roma, Italy.
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Del Curto MD, Chicco D, D'Antonio M, Ciolli V, Dannan H, D'Urso S, Neuteboom B, Pompili S, Schiesaro S, Esposito P. Lipid microparticles as sustained release system for a GnRH antagonist (Antide). J Control Release 2003; 89:297-310. [PMID: 12711452 DOI: 10.1016/s0168-3659(03)00120-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Lipid microparticles (LMs) as a sustained release system for a gonadotropin release hormone (GnRH) antagonist (Antide) were prepared and evaluated. Antide loaded microparticles (Antide-LMs) were obtained by a cryogenic micronization process starting from two different monoglycerides (glyceryl monobehenate and glyceryl monostearate) and using two different incorporation methods (co-melting and solvent evaporation). Antide-LMs, 2% (w/w) loading, were characterized for drug incorporation by RP-HPLC, particle size by laser diffractometry and surface morphology by scanning electron microscopy. In vitro peptide release and in vitro biological activity were also studied. Serum Antide and testosterone levels, as pharmacodynamic marker, were assessed following subcutaneous administration in rats. Antide-LMs showed a mean diameter of approximately 30 micro m and variable Antide release depending on lipid matrix and incorporation method. In vivo experiments demonstrated that detectable Antide plasma levels were present, in the case of Antide-LMs based on Compritol E ATO obtained by co-melting procedure, for at least 30 days after dosing. Testosterone levels were consistent with prolonged pharmacokinetic profiles. In vitro release of Antide from LMs correlated well with the in vivo release. In conclusion, LMs can sustain the release of Antide for at least 1 month. The levels of the initial 'burst' and the extent of the pharmacodynamic effect can be influenced by the lipid characteristics and by process conditions.
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Affiliation(s)
- M D Del Curto
- Industria Farmaceutica Serono, Drug Delivery Systems, BioIndustry Park, via Ribes 5, I-10010 Colleretto Giacosa, Turin, Italy.
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Dong SX, Ping ZZ, Xiao WZ, Shu CC, Bartoli A, Gatti G, D'Urso S, Perucca E. Effect of active and passive cigarette smoking on CYP1A2-mediated phenacetin disposition in Chinese subjects. Ther Drug Monit 1998; 20:371-5. [PMID: 9712458 DOI: 10.1097/00007691-199808000-00002] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The effect of active and passive cigarette smoking on CYP1A2-mediated phenacetin disposition was evaluated in a controlled study of 36 healthy Chinese subjects. Each subject was administered a single oral dose of phenacetin (900 mg), and frequent blood samples were taken for up to 12 hours for simultaneous high-pressure liquid chromatography determinations of plasma concentrations of phenacetin and metabolically derived paracetamol. Compared with values observed in controls not exposed to cigarette smoking, subjects who smoked 7 to 40 (median, 20) cigarettes per day exhibited a 2.5-fold higher phenacetin apparent oral clearance (7.2, 4.3-12.0 L x h(-1) x kg(-1) vs 2.9, 1.8-4.6 L x h(-1) x kg(-1) [geometric means, 95% confidence intervals]; n = 12, p < 0.05). In subjects exposed to passive smoking, phenacetin's apparent oral clearance (3.6, 2.0-46.6 L x h(-1) x kg(-1), n = 12) was intermediate between the values observed in the two other groups. Plasma paracetamol levels were moderately lower in active smokers than in passive smokers and controls. These results demonstrated that, in contrast to results found in previous studies, Chinese subjects were fully susceptible to the inducing effect of cigarette smoke on CYP1A2 activity.
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Affiliation(s)
- S X Dong
- Institute of Clinical Pharmacology, Great Chinese Wall Hospital, Beijing, People's Republic of China
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Robinson D, Herman M, D'Urso S. Survey of coronary care facilities in 50 Massachusetts hospitals. Public Health Rep (1896) 1970; 85:123-9. [PMID: 4983902 PMCID: PMC2031655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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