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Ferrari L, Nicolaou S, Adams K. Implementation of a robotic surgical practice in inflammatory bowel disease. J Robot Surg 2024; 18:57. [PMID: 38281204 DOI: 10.1007/s11701-023-01750-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/02/2023] [Indexed: 01/30/2024]
Abstract
Robotics adoption has increased in colorectal surgery. While there are well-established advantages and standardised techniques for cancer patients, the use of robotic surgery in inflammatory bowel disease (IBD) has not been studied yet. To evaluate the feasibility and safety of robotic surgery for IBD patients. Prospectively data in IBD patients having robotic resection at Guy's and St Thomas' hospital. All resections performed by a single colorectal surgeon specialised in IBD, utilising DaVinci platform. July 2021 to January 2023, 59 robotic IBD cases performed, 14 ulcerative colitis (UC) and 45 Crohn's disease (CD). Average age; CD patients 35, UC 33 years. Average Body mass index (BMI); 23 for CD and 26.9 for UC patients. In total, we performed 31 ileo-caecal resections (ICR) with primary anastomosis (18 Kono-S anastomosis, 6 mechanical anastomosis and 7 ileo-colostomy), of those 4 had multivisceral resections (large bowel, bladder, ovary). Furthermore, 14 subtotal colectomy (1 emergency), 8 proctectomy, 3 panproctocolectomy and 3 ileoanal J pouch. 18 of the 45 patients (45.0%) with Crohn's disease had ongoing fistulating disease to other parts of the GI tract (small or large bowel). ICR were performed using different three ports position, depending on the anatomy established prior to surgery with magnetic resonance images (MRI). One patient had conversion to open due to anaesthetic problems and one patient required re-operation to refashion stoma. 98.0% cases completed robotically. Median Length of hospital stay (LOS) was 7 days for CD and 7 for UC cases, including LOS in patients on pre-operative parenteral nutrition. Robotic colorectal techniques can be safely used for patients with IBD, even with fistulating disease. Future research and collaborations are necessary to standardize technique within institutions.
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Affiliation(s)
- Linda Ferrari
- Pelvic Floor Unit, Mitchener Ward, St Thomas' Hospital, Guy's and St Thomas NHS Foundation Trust, Westminster Bridge Road, London, SE17EH, UK.
| | - Stella Nicolaou
- Pelvic Floor Unit, Mitchener Ward, St Thomas' Hospital, Guy's and St Thomas NHS Foundation Trust, Westminster Bridge Road, London, SE17EH, UK
| | - Katie Adams
- Pelvic Floor Unit, Mitchener Ward, St Thomas' Hospital, Guy's and St Thomas NHS Foundation Trust, Westminster Bridge Road, London, SE17EH, UK
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2
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Prina E, Tedeschi F, Salazzari D, Botte T, Ballarin M, Rabbi L, Imperadore G, Roccato S, Nicolaou S, Ruggeri M, Gomez F, Lasalvia A, Amaddeo F. Effect of COVID-19 pandemic on utilisation of community-based mental health care in North-East of Italy: A psychiatric case register study. Epidemiol Psychiatr Sci 2023; 32:e17. [PMID: 37039429 PMCID: PMC10130733 DOI: 10.1017/s2045796023000100] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
AIMS WHO declared that mental health care should be considered one essential health service to be maintained during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to describe the effect of lockdown and restrictions due to the COVID-19 pandemic in Italy on mental health services' utilisation, by considering psychiatric diagnoses and type of mental health contacts. METHODS The study was conducted in the Verona catchment area, located in the Veneto region (northeastern Italy). For each patient, mental health contacts were grouped into: (1) outpatient care, (2) social and supportive interventions, (3) rehabilitation interventions, (4) multi-professional assessments, (5) day care. A 'difference in differences' approach was used: difference in the number of contacts between 2019 and 2020 on the weeks of lockdown and intermediate restrictions was compared with the same difference in weeks of no or reduced restrictions, and such difference was interpreted as the effect of restrictions. Both a global regression on all contacts and separate regressions for each type of service were performed and Incidence Rate Ratios (IRRs) were calculated. RESULTS In 2020, a significant reduction in the number of patients who had mental health contacts was found, both overall and for most of the patients' characteristics considered (except for people aged 18-24 years for foreign-born population and for those with a diagnosis of schizophrenia. Moreover, in 2020 mental health contacts had a reduction of 57 096 (-33.9%) with respect to 2019; such difference remained significant across the various type of contacts considered, with rehabilitation interventions and day care showing the greatest reduction. Negative Binomial regressions displayed a statistically significant effect of lockdown, but not of intermediate restrictions, in terms of reduction in the number of contacts. The lockdown period was responsible of a 32.7% reduction (IRR 0.673; p-value <0.001) in the overall number of contacts. All type of mental health contacts showed a reduction ascribable to the lockdown, except social and supportive interventions. CONCLUSIONS Despite the access to community mental health care during the pandemic was overall reduced, the mental health system in the Verona catchment area was able to maintain support for more vulnerable and severely ill patients, by providing continuity of care and day-by-day support through social and supportive interventions.
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Affiliation(s)
- E Prina
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - F Tedeschi
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - D Salazzari
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - T Botte
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - M Ballarin
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - L Rabbi
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - G Imperadore
- Mental Health Department, Local Health District n. 9 of Verona, Verona, Italy
| | - S Roccato
- Mental Health Department, Local Health District n. 9 of Verona, Verona, Italy
| | - S Nicolaou
- Mental Health Department, Local Health District n. 9 of Verona, Verona, Italy
| | - M Ruggeri
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - F Gomez
- Mental Health Department, Local Health District n. 9 of Verona, Verona, Italy
| | - A Lasalvia
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
| | - F Amaddeo
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Verona, Italy
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3
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Nicolaou S, Goldberg SF, Michael KM, Berenson KR. Responses to validating versus reframing support strategies as a function of borderline personality features and interpersonal problems. Cogent Psychology 2023. [DOI: 10.1080/23311908.2022.2146280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Stella Nicolaou
- Department of Psychology, Gettysburg College, Gettysburg, PA, USA
- Department of Psychiatry and Mental Health, Hospital of Igualada, Consorci Sanitari de l’Anoia & Fundació Sanitària d’Igualada, Barcelona, Spain
- Department of Cognition, Development and Educational Psychology, Institute of Neurosciences (Ubneuro), University of Barcelona, Barcelona, Spain
| | | | - Kaley M. Michael
- Department of Psychology, Gettysburg College, Gettysburg, PA, USA
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Mendez I, Sintes A, Pascual JC, Puntí J, Lara A, Briones-Buixassa L, Nicolaou S, Schmidt C, Romero S, Fernández M, Carmona I Farrés C, Soler J, Santamarina-Perez P, Vega D. Borderline personality traits mediate the relationship between low perceived social support and non-suicidal self-injury in a clinical sample of adolescents. J Affect Disord 2022; 302:204-213. [PMID: 35038480 DOI: 10.1016/j.jad.2022.01.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a serious public health concern among adolescents, especially in clinical settings. Social support plays a critical role in the onset and maintenance of NSSI in adolescence. NSSI is closely associated with borderline personality disorder (BPD), yet no previous work has analyzed the mediating role of borderline traits in the relationship between perceived social support (PSS) and NSSI. This study aimed to address this gap. METHODS Participants were 228 adolescent patients (12 to 18 years old), who completed a clinical interview and self-report measures of BPD-traits, current psychological distress, emotion dysregulation and PSS. They were grouped based on the presence (vs. absence) of NSSI. Univariate and multivariate logistic regression analyses were used to identify risk factors of NSSI, and a mediation analysis was conducted to examine the intermediary role of borderline traits in the relationship between PSS and NSSI. RESULTS NSSI was highly prevalent in our sample (58%) and was associated with higher clinical severity. Low PSS predicted NSSI in univariate, but not multivariate regression. Mediation analyses showed that borderline traits fully accounted for the relationship between low PSS and NSSI, even when controlling for current psychological distress and gender. LIMITATIONS Cross-sectional design through self-report assessment. CONCLUSIONS Findings suggest that adolescents with low PSS are especially vulnerable for developing NSSI due to elevated BPD traits. In clinical settings, interventions aimed to reduce borderline symptoms may be a promising treatment option for adolescents with NSSI and low PSS.
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Affiliation(s)
- Iria Mendez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Sintes
- Servicio de salud mental infantojuvenil, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Juan Carlos Pascual
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquim Puntí
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Hospital de Dia de Adolescentes. Servicio de Salud Mental. Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain; Departamento de Psicología Clínica y de la Salud, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anaís Lara
- Servicio de Psiquiatría y Psicología, ALTHAIA, Xarxa Assistencial i Universitària de Manresa, Barcelona, Manresa, Spain
| | - Laia Briones-Buixassa
- Mental Health and Social Innovation Research Group and Centre for Health and Social Care Research, Universitat de Vic - Universitat Central de Catalunya, Catalonia, Spain
| | - Stella Nicolaou
- PhD Programme in Biomedicine, University of Barcelona, Spain; Psychiatry and Mental Health Department, Consorci Sanitari de l'Anoia & Fundació Sanitària d'Igualada, Hospital Universitari d'Igualada. Av. Catalunya 11, Barcelona, Igualada 08700, Spain
| | - Carlos Schmidt
- Psychiatry and Mental Health Department, Consorci Sanitari de l'Anoia & Fundació Sanitària d'Igualada, Hospital Universitari d'Igualada. Av. Catalunya 11, Barcelona, Igualada 08700, Spain
| | - Soledad Romero
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marta Fernández
- Servicio de salud mental infantojuvenil, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Cristina Carmona I Farrés
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquim Soler
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Santamarina-Perez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Vega
- Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Psychiatry and Mental Health Department, Consorci Sanitari de l'Anoia & Fundació Sanitària d'Igualada, Hospital Universitari d'Igualada. Av. Catalunya 11, Barcelona, Igualada 08700, Spain.
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Neocleous V, Fanis P, Toumba M, Gorka B, Kousiappa I, Tanteles GA, Iasonides M, Nicolaides NC, Christou YP, Michailidou K, Nicolaou S, Papacostas SS, Christoforidis A, Kyriakou A, Vlachakis D, Skordis N, Phylactou LA. Pathogenic and Low-Frequency Variants in Children With Central Precocious Puberty. Front Endocrinol (Lausanne) 2021; 12:745048. [PMID: 34630334 PMCID: PMC8498594 DOI: 10.3389/fendo.2021.745048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/03/2021] [Indexed: 12/18/2022] Open
Abstract
Background Central precocious puberty (CPP) due to premature activation of GnRH secretion results in early epiphyseal fusion and to a significant compromise in the achieved final adult height. Currently, few genetic determinants of children with CPP have been described. In this translational study, rare sequence variants in MKRN3, DLK1, KISS1, and KISS1R genes were investigated in patients with CPP. Methods Fifty-four index girls and two index boys with CPP were first tested by Sanger sequencing for the MKRN3 gene. All children found negative (n = 44) for the MKRN3 gene were further investigated by whole exome sequencing (WES). In the latter analysis, the status of variants in genes known to be related with pubertal timing was compared with an in-house Cypriot control cohort (n = 43). The identified rare variants were initially examined by in silico computational algorithms and confirmed by Sanger sequencing. Additionally, a genetic network for the MKRN3 gene, mimicking a holistic regulatory depiction of the crosstalk between MKRN3 and other genes was designed. Results Three previously described pathogenic MKRN3 variants located in the coding region of the gene were identified in 12 index girls with CPP. The most prevalent pathogenic MKRN3 variant p.Gly312Asp was exclusively found among the Cypriot CPP cohort, indicating a founder effect phenomenon. Seven other CPP girls harbored rare likely pathogenic upstream variants in the MKRN3. Among the 44 CPP patients submitted to WES, nine rare DLK1 variants were identified in 11 girls, two rare KISS1 variants in six girls, and two rare MAGEL2 variants in five girls. Interestingly, the frequent variant rs10407968 (p.Gly8Ter) of the KISS1R gene appeared to be less frequent in the cohort of patients with CPP. Conclusion The results of the present study confirm the importance of the MKRN3-imprinted gene in genetics of CPP and its key role in pubertal timing. Overall, the results of the present study have emphasized the importance of an approach that aligns genetics and clinical aspects, which is necessary for the management and treatment of CPP.
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Affiliation(s)
- Vassos Neocleous
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Pavlos Fanis
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Meropi Toumba
- Child Endocrine Care, Department of Pediatrics, Aretaeio Hospital, Nicosia, Cyprus
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Barbara Gorka
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Ioanna Kousiappa
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
- Department of Neurobiology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - George A Tanteles
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
- Department of Clinical Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Michalis Iasonides
- Department of Pediatrics, Iliaktida Paediatric & Adolescent Medical Centre, Limassol, Cyprus
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Nicolas C Nicolaides
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Yiolanda P Christou
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
- Department of Neurobiology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Kyriaki Michailidou
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
- Biostatistics Unit, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Stella Nicolaou
- Division of Pediatric Endocrinology, Archbishop Makarios III Hospital, Nicosia, Cyprus
| | - Savvas S Papacostas
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
- Department of Neurobiology, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- University of Nicosia Medical School, Nicosia, Cyprus
- Centre for Neuroscience and Integrative Brain Research (CENIBRE), University of Nicosia, Nicosia, Cyprus
| | - Athanasios Christoforidis
- First Pediatric Department, School of Medicine, Faculty of Medical Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Kyriakou
- Division of Pediatric Endocrinology, Archbishop Makarios III Hospital, Nicosia, Cyprus
- Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
- Lab of Molecular Endocrinology, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Department of Informatics, Faculty of Natural and Mathematical Sciences, King's College London, London, United Kingdom
| | - Nicos Skordis
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- St George's, University of London Medical School, University of Nicosia, Nicosia, Cyprus
- Division of Pediatric Endocrinology, Paedi Center for specialized Pediatrics, Nicosia, Cyprus
| | - Leonidas A Phylactou
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
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6
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Berenson KR, Van De Weert SM, Nicolaou S, Campoverde C, Rafaeli E, Downey G. Reward and Punishment Sensitivity in Borderline and Avoidant Personality Disorders. J Pers Disord 2021; 35:573-588. [PMID: 32163026 DOI: 10.1521/pedi_2020_34_475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors compared self-reported and behavioral responses to reward and punishment in individuals diagnosed with borderline personality disorder (BPD) or avoidant personality disorder (APD) relative to a healthy comparison (HC) group. As predicted, self-reported sensitivity to reward was significantly higher in the BPD group than in the APD and HC groups. Also as predicted, self-reported sensitivity to punishment was significantly elevated in both disordered groups but significantly higher in APD than in BPD. These hypothesized patterns were also evident in responses to behavioral tasks: Participants with BPD made more errors of commission and fewer errors of omission than HC participants on a passive avoidance learning task, and participants with APD showed greater reactivity to losses than other participants on a probabilistic reversal learning task. Results help characterize differences between these two disorders.
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Affiliation(s)
- Kathy R Berenson
- Department of Psychology, Gettysburg College, Gettsyburg, Pennsylvania
| | | | | | - Cindy Campoverde
- Department of Psychology, Gettysburg College, Gettsyburg, Pennsylvania
| | - Eshkol Rafaeli
- Department of Psychology, Barnard College, New York, New York, and Department of Psychology, Bar-Ilan University, Israel
| | - Geraldine Downey
- Department of Psychology, Columbia University, New York, New York
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7
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Abstract
Although acute ischemic stroke remains one of the most common causes of death and disability worldwide, it is a potentially treatable condition if appropriately managed in a timely manner. The goals of acute stroke imaging include establishing a diagnosis as fast as possible with (1) accurate infarct quantification, (2) intracranial and cervical vasculature assessment, and (3) brain perfusion analysis for detection of infarct core and potentially salvageable penumbra allowing optimal patient selection for appropriate therapy. Given the extensive number of images generated from acute stroke imaging studies and as "time is brain," this article aims to highlight a logical approach for the radiologist in acute stroke computed tomography imaging in order to accurately interpret and communicate results in a timely manner.
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Affiliation(s)
- D Byrne
- Division of Neuroradiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
| | - J P Walsh
- University of British Columbia, Vancouver, British Columbia, Canada.,Division of Emergency Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - G Sugrue
- University of British Columbia, Vancouver, British Columbia, Canada.,Division of Emergency Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - S Nicolaou
- University of British Columbia, Vancouver, British Columbia, Canada.,Division of Emergency Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - A Rohr
- Division of Neuroradiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
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8
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Neocleous V, Fanis P, Toumba M, Stylianou C, Picolos M, Andreou E, Kyriakou A, Iasonides M, Nicolaou S, Kyriakides TC, Tanteles GA, Skordis N, Phylactou LA. The Spectrum of Genetic Defects in Congenital Adrenal Hyperplasia in the Population of Cyprus: A Retrospective Analysis. Horm Metab Res 2019; 51:586-594. [PMID: 31505704 DOI: 10.1055/a-0957-3297] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) is caused by mutations in the CYP21A2 gene. The study refers to CAH patients of Greek-Cypriot ancestry between years 2007 and 2018. One hundred and twenty patients with various degrees of CAH were categorized and genotyped. The patients were categorized in 4 mutation groups based on their clinical and biochemical findings. The majority of patients (85.0%) belonged to the non-classic (NC)-CAH form and the disorder was more often diagnosed in females (71.7%). The most severe classic salt-wasting (SW) form was identified in 11 neonates (9.2%). Seven (5.8%) children were also identified with the simple virilizing (SV) form and a median presentation age of 5 years [interquartile range (IQR) 3.2-6.5]. In the 240 nonrelated alleles, the most frequent mutation was p.Val281Leu (60.0%) followed by c.655 A/C>G (IVS2-13A/C>G) (8.8%), p.Pro453Ser (5.8%), DelEx1-3 (4.6%), p.Val304Met (4.6%), and p.Gln318stop (4.2%). Other less frequent mutations including rare deletions were also identified. Following our recent report that the true carrier frequency of CYP21A2 in Greek-Cypriots is 1:10, this study reports that the CAH prevalence is predicted around 1.7 cases per 10 000 people. Therefore, the up-to-date 120 CAH patients identified by our group make only the 6.9% of the ones estimated (approximately 1750) to exist in the Greek Cypriot population. The compiled data from a coherent population such as the Greek-Cypriot could be valuable for the antenatal diagnosis, management and genetic counselling of the existing and prospect families with CAH.
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Affiliation(s)
- Vassos Neocleous
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Pavlos Fanis
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Meropi Toumba
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Pediatric Endocrine Clinic, IASIS Hospital, Paphos, Cyprus
| | | | | | - Elena Andreou
- Dasoupolis Endocrinology Center, Andrea Dimitriou Street Dasoupolis, Nicosia, Cyprus
| | - Andreas Kyriakou
- Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK
| | | | - Stella Nicolaou
- Division of Pediatric Endocrinology, Makarios III Hospital, Nicosia, Cyprus
| | - Tassos C Kyriakides
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - George A Tanteles
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
- Department of Clinical Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Nicos Skordis
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Division of Pediatric Endocrinology, Paedi Center for Specialized Pediatrics, Nicosia, Cyprus
- St George's, University of London Medical School at the University of Nicosia, Nicosia, Cyprus
| | - Leonidas A Phylactou
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
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9
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Fanis P, Skordis N, Frangos S, Christopoulos G, Spanou-Aristidou E, Andreou E, Manoli P, Mavrommatis M, Nicolaou S, Kleanthous M, Cariolou MA, Christophidou-Anastasiadou V, Tanteles GA, Phylactou LA, Neocleous V. Multiple endocrine neoplasia 2 in Cyprus: evidence for a founder effect. J Endocrinol Invest 2018; 41:1149-1157. [PMID: 29396759 PMCID: PMC6182349 DOI: 10.1007/s40618-018-0841-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 12/11/2017] [Accepted: 01/22/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Multiple endocrine neoplasia type 2 (MEN2) affects patients with RET proto-oncogene mutations. This cohort study refers to patients who were diagnosed with familial medullary thyroid carcinoma (MTC) and underwent RET genetic testing in Cyprus between years 2002 and 2017. METHODS AND PATIENTS Forty patients underwent RET testing by Sanger sequencing of exons 10-11 and 13-16. Genotyping with STR genetic markers flanking the RET gene along with Y-chromosome genotyping and haplogroup assignment was also performed. RESULTS RET mutations were identified in 40 patients from 11 apparently unrelated Cypriot families and two non-familial sporadic cases. Nine probands (69.2%) were heterozygous for p.Cys618Arg, one (7.7%) for p.Cys634Phe, one (7.7%) for the somatic delE632-L633 and two (15.4%) for p.Met918Thr mutations. The mean age at MTC diagnosis of patients carrying p.Cys618Arg was 36.8 ± 14.2 years. The age of pheo diagnosis ranged from 26 to 43 years and appeared simultaneously with MTC in 5/36 (13.9%) cases. The high frequency of the p.Cys618Arg mutation suggested a possible ancestral mutational event. Haplotype analysis was performed in families with and without p.Cys618Arg. Six microsatellite markers covering the RET gene and neighboring regions identified one core haplotype associated with all patients carrying p.Cys618Arg mutation. CONCLUSIONS The mutation p.Cys618Arg is by far the most prevalent mutation in Cyprus followed by other reported mutations of variable clinical significance. The provided molecular evidence speculates p.Cys618Arg mutation as an ancestral mutation that has spread in Cyprus due to a possible founder effect.
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Affiliation(s)
- P Fanis
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683, Nicosia, Cyprus
| | - N Skordis
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683, Nicosia, Cyprus
- Division of Pediatric Endocrinology, Paedi Center for Specialized Pediatrics, Nicosia, Cyprus
- St George's, University of London Medical School at the University of Nicosia, Nicosia, Cyprus
| | - S Frangos
- Nuclear Medicine Department, Bank of Cyprus Oncology Center, Nicosia, Cyprus
| | - G Christopoulos
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - E Spanou-Aristidou
- Department of Clinical Genetics, The Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683, Nicosia, Cyprus
| | - E Andreou
- Dasoupolis Endocrinology Center, Andrea Dimitriou Street Dasoupolis, Nicosia, Cyprus
| | - P Manoli
- Department of Cardiovascular Genetics and the Laboratory of Forensic Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - M Mavrommatis
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - S Nicolaou
- Division of Pediatric Endocrinology, Makarios III Hospital, Nicosia, Cyprus
| | - M Kleanthous
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - M A Cariolou
- Department of Cardiovascular Genetics and the Laboratory of Forensic Genetics, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - V Christophidou-Anastasiadou
- Department of Clinical Genetics, The Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683, Nicosia, Cyprus
- Department of Clinical Genetics, Makarios III Hospital, Nicosia, Cyprus
| | - G A Tanteles
- Department of Clinical Genetics, The Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683, Nicosia, Cyprus
| | - L A Phylactou
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683, Nicosia, Cyprus.
- Cyprus School of Molecular Medicine, Nicosia, Cyprus.
| | - V Neocleous
- Department of Molecular Genetics, Function and Therapy, The Cyprus Institute of Neurology and Genetics, P.O. Box 23462, 1683, Nicosia, Cyprus.
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Ahmadi M, Khurshid K, Sanelli PC, Jalal S, Chahal T, Norbash A, Nicolaou S, Castillo M, Khosa F. Influences for Gender Disparity in Academic Neuroradiology. AJNR Am J Neuroradiol 2017; 39:18-23. [PMID: 29191872 DOI: 10.3174/ajnr.a5443] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 08/08/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There has been extensive interest in promoting gender equality within radiology, a predominately male field. In this study, our aim was to quantify gender representation in neuroradiology faculty rankings and determine any related factors that may contribute to any such disparity. MATERIALS AND METHODS We evaluated the academic and administrative faculty members of neuroradiology divisions for all on-line listed programs in the US and Canada. After excluding programs that did not fulfill our selection criteria, we generated a short list of 85 US and 8 Canadian programs. We found 465 faculty members who met the inclusion criteria for our study. We used Elsevier's SCOPUS for gathering the data pertaining to the publications, H-index, citations, and tenure of the productivity of each faculty member. RESULTS Gender disparity was insignificant when analyzing academic ranks. There are more men working in neuroimaging relative to women (χ2 = 0.46; P = .79). However, gender disparity was highly significant for leadership positions in neuroradiology (χ2 = 6.76; P = .009). The median H-index was higher among male faculty members (17.5) versus female faculty members (9). Female faculty members have odds of 0.84 compared with male faculty members of having a higher H-index, adjusting for publications, citations, academic ranks, leadership ranks, and interaction between gender and publications and gender and citations (9). CONCLUSIONS Neuroradiology faculty members follow the same male predominance seen in many other specialties of medicine. In this study, issues such as mentoring, role models, opportunities to engage in leadership/research activities, funding opportunities, and mindfulness regarding research productivity are explored.
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Affiliation(s)
- M Ahmadi
- From the Department of Emergency & Trauma Radiology (M.A., K.K., S.J., S.N., F.K.), Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - K Khurshid
- From the Department of Emergency & Trauma Radiology (M.A., K.K., S.J., S.N., F.K.), Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - P C Sanelli
- Department of Radiology (P.C.S.), Northwell Health, Manhasset, New York
| | - S Jalal
- From the Department of Emergency & Trauma Radiology (M.A., K.K., S.J., S.N., F.K.), Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - T Chahal
- Faculty of Medicine (T.C.), University of British Columbia, Vancouver, British Columbia, Canada
| | - A Norbash
- Department of Radiology (A.N.) University of California, San Diego, San Diego, California
| | - S Nicolaou
- From the Department of Emergency & Trauma Radiology (M.A., K.K., S.J., S.N., F.K.), Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - M Castillo
- Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - F Khosa
- From the Department of Emergency & Trauma Radiology (M.A., K.K., S.J., S.N., F.K.), Vancouver General Hospital, Vancouver, British Columbia, Canada
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Neocleous V, Shammas C, Phelan MM, Nicolaou S, Phylactou LA, Skordis N. In silico analysis of a novel MKRN3 missense mutation in familial central precocious puberty. Clin Endocrinol (Oxf) 2016; 84:80-4. [PMID: 26173472 DOI: 10.1111/cen.12854] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 06/10/2015] [Accepted: 07/09/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The onset of puberty is influenced by the interplay of stimulating and restraining factors, many of which have a genetic origin. Premature activation of the GnRH secretion in central precocious puberty (CPP) may arise either from gain-of-function mutations of the KISS1 and KISS1R genes or from loss-of-function manner mutations of the MKRN3 gene leading to MKRN3 deficiency. OBJECTIVE To explore the genetic causes responsible for CPP and the potential role of the RING finger protein 3 (MKRN3) gene. DESIGN AND PATIENTS We investigated potential sequence variations in the intronless MKRN3 gene by Sanger sequencing of the entire 507 amino acid coding region of exon 1 in a family with two affected girls presented with CPP at the age of 6 and 5·7 years, respectively. RESULTS A novel heterozygous g.Gly312Asp missense mutation in the MKRN3 gene was identified in these siblings. The imprinted MKRN3 missense mutation was also identified as expected in the unaffected father and followed as expected an imprinted mode of inheritance. In silico analysis of the altered missense variant using the computational algorithms Polyphen2, SIFT and Mutation Taster predicted a damage and pathogenic alteration causing CPP. The pathogenicity of the alteration at the protein level via an in silico structural model is also explored. CONCLUSION A novel mutation in the MKRN3 gene in two sisters with CPP was identified, supporting the fundamental role of this gene in the suppression of the hypothalamic GnRH neurons.
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Affiliation(s)
- Vassos Neocleous
- Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Christos Shammas
- Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Marie M Phelan
- NMR Centre for Structural Biology, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - Stella Nicolaou
- Division of Pediatric Endocrinology, Makarios III Hospital, Nicosia, Cyprus
| | - Leonidas A Phylactou
- Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
| | - Nicos Skordis
- Department of Molecular Genetics, Function & Therapy, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus
- Division of Pediatric Endocrinology, Paedi Center for specialized Pediatrics, Nicosia, Cyprus
- St George's University of London Medical School at the University of Nicosia, Nicosia, Cyprus
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Saw J, DeJong P, Lempereur M, Gin K, Jue J, Mayo J, Nicolaou S. CARDIAC CT ANGIOGRAPHY IS A USEFUL NON-INVASIVE SURVEILLANCE IMAGING TEST AFTER PERCUTANEOUS LEFT ATRIAL APPENDAGE CLOSURE. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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13
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McLaughlin PD, Liang T, Homiedan M, Louis LJ, O'Connell TW, Krzymyk K, Nicolaou S, Mayo JR. High pitch, low voltage dual source CT pulmonary angiography: assessment of image quality and diagnostic acceptability with hybrid iterative reconstruction. Emerg Radiol 2014; 22:117-23. [PMID: 24993583 DOI: 10.1007/s10140-014-1230-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/23/2014] [Indexed: 12/20/2022]
Abstract
Increased use of CT Pulmonary angiography in suspected pulmonary embolism (PE) has driven research to minimize radiation dose while maintaining image quality and diagnostic accuracy. Following institutional review board approval, we performed a retrospective comparison study in patients with suspected PE. Patients were scanned using an ultra high pitch dual source technique (pitch = 2.6) using 120 kV (SVCTPA) (n = 54) or 100 kV (RV-CTPA) (n = 52). SV-CTPA images were reconstructed using filtered back projection (SV-wFBP) and RV-CTPA images were reconstructed using both FBP (RV-wFBP) and Iterative Reconstruction (RV-IR). Comparison of radiation dose, diagnostic ability, subjective image noise, quality, and sharpness, diagnostic agreement, signal to noise (SNR) and contrast to noise ratios (CNR) were performed. Mean effective dose was 2.56 ± 0.19 mSv for the RV protocol compared to 5.36 ± 0.60 mSv for the SV. The RV-CTPA protocol resulted in a mean DLP reduction of 52 % and mean CTDI reduction of 51 %. Pulmonary artery SNR and CNR were significantly higher on RV-IR images than SV-wFBP (p = 0.007, p = 0.003). Mean subjective image noise, quality and sharpness scores did not differ significantly between the SV-wFBP and RVIR images (p > 0.05). Subjective quality scores were significantly better for the RV-IR group compared to the RV-wFBP group (p < 0.001). Agreement between readers for presence or absence of pulmonary emboli on RV-IR images was almost perfect (κ = 0.891, p < 0.001). Iterative reconstruction complements ultra high pitch dual source CTPA examinations acquired using a reduced voltage resulting in higher mean pulmonary artery SNR and CNR when compared to both RV-wFBP and SV-CTPA.
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Affiliation(s)
- Patrick D McLaughlin
- Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada, V5Z 1M9,
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Cibere J, Kopec J, Wong H, Singer J, Esdaile J, Nicolaou S, Guermazi A. THU0224 Knee Effusion is A Risk Factor for Prevalence and Progression of Bone Marrow Lesions: A Population-Based Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Crema MD, Cibere J, Sayre EC, Roemer FW, Wong H, Thorne A, Singer J, Esdaile JM, Marra MD, Kopec JA, Nicolaou S, Guermazi A. The relationship between subchondral sclerosis detected with MRI and cartilage loss in a cohort of subjects with knee pain: the knee osteoarthritis progression (KOAP) study. Osteoarthritis Cartilage 2014; 22:540-6. [PMID: 24508776 DOI: 10.1016/j.joca.2014.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 12/27/2013] [Accepted: 01/25/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the association between subchondral sclerosis detected at baseline with MRI and cartilage loss over time in the same region of the knee in a cohort of subjects with knee pain. METHODS 163 subjects with knee pain participated in a longitudinal study to assess knee osteoarthritis progression (KOAP). Subjects received baseline knee radiographs as well as baseline and 3-year follow-up MRI examinations. Baseline subchondral sclerosis and bone marrow lesions (BMLs) were scored semiquantitatively on MRI in each region from 0 to 3. Cartilage morphology at baseline and follow-up was scored semiquantitatively from 0 to 4. The association between baseline subchondral sclerosis and cartilage loss in the same region of the knee was evaluated using logistic regression, adjusting the results for age, gender, body mass index, and the presence of concomitant BMLs. RESULTS The prevalence of subchondral sclerosis detected by MRI in the regions of the knee varied between 1.6% (trochlea) and 17% (medial tibia). The occurrence of cartilage loss over time in regions varied between 6% (lateral tibia) and 13.1% (medial femur). The prevalence of radiographically-detected subchondral sclerosis in compartments varied from 2.9% (patellofemoral) to 14.2% (medial tibiofemoral). In logistic regression models, there were no significant associations between baseline subchondral sclerosis detected by MRI and cartilage loss in the same region of the knee. CONCLUSION Baseline subchondral sclerosis as detected by MRI did not increase the risk of cartilage loss over time.
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Affiliation(s)
- M D Crema
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Hospital do Coração (HCor) and Teleimagem, Sao Paulo, Brazil.
| | - J Cibere
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Arthritis Research Centre of Canada, Richmond, BC, Canada
| | - E C Sayre
- Arthritis Research Centre of Canada, Richmond, BC, Canada
| | - F W Roemer
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen, Erlangen, Germany
| | - H Wong
- Arthritis Research Centre of Canada, Richmond, BC, Canada; School of Population of Public Health, University of British Columbia, Vancouver, BC, Canada
| | - A Thorne
- School of Population of Public Health, University of British Columbia, Vancouver, BC, Canada
| | - J Singer
- School of Population of Public Health, University of British Columbia, Vancouver, BC, Canada
| | - J M Esdaile
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M D Marra
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA
| | - J A Kopec
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - S Nicolaou
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Guermazi
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA
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Hemmati I, Sayre EC, Guermazi A, Nicolaou S, Kopec JA, Thorne A, Singer J, Cibere J. SAT0331 Comparison of Anatomic Knee Alignment on Physical Examination and Radiographs. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Crema MD, Guermazi A, Sayre EC, Roemer FW, Wong H, Thorne A, Singer J, Esdaile JM, Marra MD, Kopec JA, Nicolaou S, Cibere J. The association of magnetic resonance imaging (MRI)-detected structural pathology of the knee with crepitus in a population-based cohort with knee pain: the MoDEKO study. Osteoarthritis Cartilage 2011; 19:1429-32. [PMID: 21945851 DOI: 10.1016/j.joca.2011.09.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 08/19/2011] [Accepted: 09/03/2011] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is the most common arthropathy of the knee joint(1). Symptoms reported by patients and signs noted during physical examination guide clinicians in identifying subjects with knee OA(2-4). Pain is one of the most important symptoms reported by subjects with knee OA(2,3). Although very common, pain is a non-specific symptom, related to pathology in several structures within the knee joint, and includes synovitis(5), subchondral bone marrow lesions(6), and joint effusion(7). Further, pain is a subjective symptom that cannot be directly measured or assessed during physical examination. Crepitus or crepitation in association with arthritis is defined as a crackling or grinding sound on joint movement with a sensation in the joint. Crepitus may occur with or without pain and is a common finding during physical examination in subjects with knee OA(2-4,8,9). It is not known whether crepitus is related to pathology in various structures within the knee. The aim of our study was to determine the cross-sectional associations of structural pathologies within the knee with crepitus in a population-based cohort with knee pain, using magnetic resonance imaging (MRI). Subjects with knee pain were recruited as a random population sample, with crepitus assessed in each compartment of the knee using a validated and standardized approach during physical examination(10). MRI of the knee was performed to assess cartilage morphology, meniscal morphology, osteophytes, cruciate ligaments, and collateral ligaments. For both compartment-specific and whole-knee analyses, a multiple logistic regression analysis was performed to assess the associations of MRI-detected structural pathology with crepitus, adjusting for potential confounders. Variables were selected by backwards elimination within each compartment and in the overall knee models, and only statistically significant variables remained in the "selected" models; remaining variables in these models are adjusted for each other. An increased risk for compartment-specific crepitus was associated with osteophytes at the patellofemoral (PF) and lateral tibiofemoral (LTF) joints. Crepitus was associated with osteophytes and medial collateral ligament (MCL) pathology at the medial tibiofemoral (MTF) compartment, but cartilage damage was negatively associated with crepitus at this compartment. In the selected whole-knee model, only meniscal tears were associated with an increased risk for general crepitus. Thus, it seems that crepitus may be associated with pathology in several internal structures.
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Affiliation(s)
- M D Crema
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, Third Floor, Boston, MA 02118, USA.
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Poulter R, Fung A, Mayo J, Nicolaou S. 011 Comparison of raw hounsfield unit attenuation ratio to dual energy iodine concentration for the evaluation of the hemodynamic significance of coronary stenoses. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Cibere J, Sayre EC, Guermazi A, Nicolaou S, Kopec JA, Esdaile JM, Thorne A, Singer J, Wong H. Natural history of cartilage damage and osteoarthritis progression on magnetic resonance imaging in a population-based cohort with knee pain. Osteoarthritis Cartilage 2011; 19:683-8. [PMID: 21329760 DOI: 10.1016/j.joca.2011.02.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 02/07/2011] [Accepted: 02/09/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To determine the natural history of cartilage damage and of osteoarthritis (OA) progression using magnetic resonance imaging (MRI); to evaluate whether OA progression varies by stage of disease. METHODS A population-based cohort with knee pain was assessed clinically, with X-ray (Kellgren-Lawrence [KL] grading) and MRI. Cartilage was graded 0-3 on six joint surfaces. Frequency of cartilage damage change was determined for each joint site. Progression of OA was defined as a worsening of MRI cartilage damage by ≥1 grade in at least two joint sites or ≥2 grades in at least one joint site. The association of KL grade with OA progression was evaluated using parametric lifetime regression analysis. RESULTS 163 subjects were assessed at baseline and follow-up (mean 3.2 years). KL grade ≥2 was present in 39.4% at baseline. An increase in cartilage damage by ≥1 grade was seen in 8.0-14.1% of subjects at different joint sites. OA progression on MRI was present in 15.5%. Baseline KL grade was a significant predictor of OA progression with hazard ratio (HR) of 6.5 (95% confidence interval [CI] 1.4-30.7), 6.1 (95% CI 1.3-28.9), and 9.2 (95% CI 1.9-44.9) for KL grades 1, 2 and ≥3, respectively. CONCLUSION A low OA progression rate was seen over 3 years in this population-based symptomatic cohort. Radiographic severity, including KL grade 1, was a significant predictor of OA progression. Future interventions aimed at reducing progression will need to target not only radiographic OA, but also those with early abnormalities suggestive of pre-radiographic OA.
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Affiliation(s)
- J Cibere
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Arthritis Research Centre of Canada, Vancouver, BC, Canada.
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Choi HK, Al-Arfaj AM, Eftekhari A, Munk PL, Shojania K, Reid G, Nicolaou S. Dual energy computed tomography in tophaceous gout. Ann Rheum Dis 2008; 68:1609-12. [DOI: 10.1136/ard.2008.099713] [Citation(s) in RCA: 252] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bodi I, D'Souza K, Rubio M, Nicolaou S, Fuller G, Conforti L, Molkentin J, Schwartz A. Calcineurin Aβ null partially rescues impaired cardiac function in targeted overexpression of L-LVDCC α1C. J Mol Cell Cardiol 2007. [DOI: 10.1016/j.yjmcc.2007.03.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fegou E, Jelastopulu E, Nicolaou S, Sevdali M, Anagnostou S, Kanavaki S, Dimitracopoulos G, Spiliopoulou I. Comparison of the manual Mycobacteria Growth Indicator tube and the Etest with the method of proportion for susceptibility testing of Mycobacterium tuberculosis. Chemotherapy 2006; 52:174-7. [PMID: 16675901 DOI: 10.1159/000093035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 03/11/2005] [Accepted: 09/06/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Clinical microbiology laboratories should provide reliable results on susceptibility testing of Mycobacterium tuberculosis to different agents. METHODS The manual Mycobacteria Growth Indicator Tube (MGIT) and Etest were compared to the method of proportion (MOP) for susceptibility testing of 88 clinical isolates of M. tuberculosis against isoniazid (INH), rifampin (RIF), streptomycin (STR) and ethambutol (EMB). Isolates were recovered from different patients and were identified at species level by PCR and hybridization. RESULTS Resistance to INH was detected in 20.5, 29.5 and 12.5% of the isolates, followed by STR resistance (19.3, 26.1 and 1.1%), RIF (9.1, 4.5 and 5.7%) and EMB (2.3, 11.4 and 2.3%) by the MOP, MGIT and Etest, respectively. Sensitivity of the manual MGIT ranged from 37.5% for RIF resistance to 100% for EMB, while Etest sensitivity ranged from 5.9% for STR to 62.5% for RIF. CONCLUSIONS MOP remains the method of choice, with the manual MGIT showing superior sensitivity at detecting resistance to INH, STR and EMB compared to the Etest.
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Affiliation(s)
- E Fegou
- Department of Microbiology, University of Patras, School of Medicine, Patras, Greece
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Nicolaou S, Szigligeti P, Duncan H, Neumeier L, Molleran Lee S, Kant S, Filipovich A, Conforti L. F.51. Altered Dynamics of Kv1.3 Channel Compartmentalization in the Immunological Synapse in Systemic Lupus Erythematosus. Clin Immunol 2006. [DOI: 10.1016/j.clim.2006.04.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, Hameed SM, Brown R, Simons R, Dulchavsky SA, Hamiilton DR, Nicolaou S. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). ACTA ACUST UNITED AC 2004; 57:288-95. [PMID: 15345974 DOI: 10.1097/01.ta.0000133565.88871.e4] [Citation(s) in RCA: 378] [Impact Index Per Article: 18.9] [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: 12/13/2022]
Abstract
BACKGROUND Thoracic ultrasound (EFAST) has shown promise in inferring the presence of post-traumatic pneumothoraces (PTXs) and may have a particular value in identifying occult pneumothoraces (OPTXs) missed by the AP supine chest radiograph (CXR). However, the diagnostic utility of hand-held US has not been previously evaluated in this role. METHODS Thoracic US examinations were performed during the initial resuscitation of injured patients at a provincial trauma referral center. A high frequency linear transducer and a 2.4 kg US attached to a video-recorder were used. Real-time EFAST examinations for PTXs were blindly compared with the subsequent results of CXRs, a composite standard (CXR, chest and abdominal CT scans, clinical course, and invasive interventions), and a CT gold standard (CT only). Charts were reviewed for in-hospital outcomes and follow-up. RESULTS There were 225 eligible patients (207 blunt, 18 penetrating); 17 were excluded from the US examination because of battery failure or a lost probe. Sixty-five (65) PTXs were detected in 52 patients (22% of patients), 41 (63%) being occult to CXR in 33 patients (14.2% whole population, 24.6% of those with a CT). The US and CXR agreed in 186 (89.4%) of patients, EFAST was better in 16 (7.7%), and CXR better in 6 (2.9%). Compared with the composite standard, the sensitivity of EFAST was 58.9% with a likelihood ratio of a positive test (LR+) of 69.7 and a specificity of 99.1%. Comparing EFAST directly to CXR, by looking at each of 266 lung fields with the benefit of the CT gold standard, the EFAST showed higher sensitivity over CXR (48.8% versus 20.9%). Both exams had a very high specificity (99.6% and 98.7%), and very predictive LR+ (46.7 and 36.3). CONCLUSION EFAST has comparable specificity to CXR but is more sensitive for the detection of OPTXs after trauma. Positive EFAST findings should be addressed either clinically or with CT depending on hemodynamic stability. CT should be used if detection of all PTXs is desired.
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Affiliation(s)
- A W Kirkpatrick
- Department of Critical Care Medicine, Foothills Medical Centre, Calgary, Alberta, Canada.
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Abstract
The article discusses traumatic, insufficiency and pathological sacral fractures. Special attention is paid to the biomechanics and subsequent classification of traumatic sacral fractures.
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Affiliation(s)
- J H White
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, Canada
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26
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Kontos F, Petinaki E, Nicolaou S, Gitti Z, Anagnostou S, Maniati M, Costopoulos C, Tselentis I, Maniatis AN. Multicenter evaluation of the fully automated bactec MGIT 960 system and three molecular methods for the isolation and the identification of mycobacteria from clinical specimens. Diagn Microbiol Infect Dis 2003; 46:299-301. [PMID: 12944024 DOI: 10.1016/s0732-8893(03)00078-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 11/15/2022]
Abstract
A combination of Bactec MGIT 960 system, a PCR-based assay and a PCR-Restriction Analysis procedure (PRA) was assessed for the detection and identification of mycobacteria from clinical samples. The MGIT recovered 243 from 266 mycobacterial isolates. The PCR-based assay correctly identified all (234) Mycobacterium tuberculosis isolates, while 35 nontuberculous mycobacterial isolates were identified by PRA.
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Affiliation(s)
- F Kontos
- Department of Microbiology, Medical School, University Hospital of Larissa, Papakyriazi 22, Larissa, Greece
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27
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Gee R, Munk PL, Keogh C, Nicolaou S, Masri B, Marchinkow LO, Ellis J, Chan LP. Radiography of the PROSTALAC (prosthesis with antibiotic-loaded acrylic cement) orthopedic implant. AJR Am J Roentgenol 2003; 180:1701-6. [PMID: 12760947 DOI: 10.2214/ajr.180.6.1801701] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- R Gee
- Department of Radiology, Vancouver General Hospital and University of British Columbia, 899 W. 12th Ave., Canada
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28
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Kirkpatrick AW, Nicolaou S, Campbell MR, Sargsyan AE, Dulchavsky SA, Melton S, Beck G, Dawson DL, Billica RD, Johnston SL, Hamilton DR. Percutaneous aspiration of fluid for management of peritonitis in space. Aviat Space Environ Med 2002; 73:925-30. [PMID: 12234046] [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] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND As a medical emergency that can affect even well-screened, healthy individuals, peritonitis developing during a long-duration space exploration mission may dictate deviation from traditional clinical practice due to the absence of otherwise indicated surgical capabilities. Medical management can treat many intra-abdominal processes, but treatment failures are inevitable. In these circumstances, percutaneous aspiration under sonographic guidance could provide a "rescue" strategy. HYPOTHESIS Sonographically guided percutaneous aspiration of intra-peritoneal fluid can be performed in microgravity. METHODS Investigations were conducted in the microgravity environment of NASA's KC-135 research aircraft (0 G). The subjects were anesthetized female Yorkshire pigs weighing 50 kg. The procedures were rehearsed in a terrestrial animal lab (1 G). Colored saline (500 mL) was introduced through an intra-peritoneal catheter during flight. A high-definition ultrasound system (HDI-5000, ATL, Bothell, WA) was used to guide a 16-gauge needle into the peritoneal cavity to aspirate fluid. RESULTS Intra-peritoneal fluid collections were easily identified, distinct from surrounding viscera, and on occasion became more obvious during weightless conditions. Subjectively, with adequate restraint of the subject and operators, the procedure was no more demanding than during the 1-G rehearsals. CONCLUSIONS Sonographically guided percutaneous aspiration of intra-peritoneal fluid collections is feasible in weightlessness. Treatment of intra-abdominal inflammatory conditions in spaceflight might rely on pharmacological options, backed by sonographically guided percutaneous aspiration for the "rescue" of treatment failures. While this risk mitigation strategy cannot guarantee success, it may be the most practical option given severe resource limitations.
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29
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Abstract
Von Hippel-Lindau disease is a progressive autosomal dominant disorder with multi-organ involvement. A variety of benign and malignant disease processes lie within the spectrum of disease processes associated with this condition. Early detection and treatment of complications is paramount in the management of these patients. The purpose of this pictorial review is to depict the various radiological manifestations that are commonly seen in this disease.
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Affiliation(s)
- W C Torreggiani
- Department of Radiology, Vancouver General Hospital, Vancouver, Canada
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30
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Abstract
Baker's (Popliteal) cysts are frequently encountered on cross-sectional imaging of the knee. These consist of enlarged gastrocnemius semimembranosus bursa which typically communicate with the knee. They may be imaged with a variety of techniques including arthopgraphy, CT, ultrasound and MRI, with the latter two being more commonly used. Examples of bursa imaged with all of the above techniques are demonstrated in the essay, as well as variance of normal appearance and pathological entities including ruptured bursa, abnormally positioned bursa, osteochondromatosis, septic complications of the bursa and pigmented villonodular synovitis.
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Affiliation(s)
- W C Torreggiani
- The Department of Radiology, Vancouver General Hospital and the University of British Columbia, Vancouver, Canada
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31
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Kirkpatrick AW, Brown DR, Crickmer S, Mohr BP, Hamilton DR, Cunningham J, Walden PD, Nicolaou S. Hand-held portable sonography for the on-mountain exclusion of a pneumothorax. Wilderness Environ Med 2002; 12:270-2. [PMID: 11769924 DOI: 10.1580/1080-6032(2001)012[0270:hhpsft]2.0.co;2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A W Kirkpatrick
- Section of Trauma Services, Vancouver Hospital and Health Sciences Center, British Columbia, Canada.
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32
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Torreggiani WC, Munk PL, Al-Ismail K, O'Connell JX, Nicolaou S, Lee MJ, Masri BA. MR imaging features of bizarre parosteal osteochondromatous proliferation of bone (Nora's lesion). Eur J Radiol 2001; 40:224-31. [PMID: 11731211 DOI: 10.1016/s0720-048x(01)00362-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [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: 12/21/2022]
Abstract
The purpose of this study was to review the imaging findings of three patients with bizarre parosteal osteochrondromatous proliferation of bone (BPOP). The plain radiographs and MRI images of three patients with BPOP were obtained and retrospectively reviewed. In two cases, BPOP involved the feet. In one case BPOP involved the hand. In all three cases, plain radiographs showed a well-defined calcium containing mass adjacent to the cortical surface of the adjacent bone. The underlying bone appeared normal in all cases. On MRI, the lesion was of low signal intensity on T1 weighted sequences in all cases. On FSE T2 weighted and STIR sequences, the lesion was of high signal in all cases. The cortex, medullary cavity and adjacent soft tissues appeared normal in all cases. While BPOP is rare and often confused with a variety of both benign and malignant lesions, there are specific radiological findings that may help to distinguish BPOP from many of its mimickers.
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Affiliation(s)
- W C Torreggiani
- Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9
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33
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Kirkpatrick AW, Simons RK, Brown DR, Ng AK, Nicolaou S. Digital hand-held sonography utilised for the focused assessment with sonography for trauma: a pilot study. Ann Acad Med Singap 2001; 30:577-81. [PMID: 11817283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To evaluate the accuracy of the focused assessment with sonography for trauma (FAST) exam performed with a digital hand-held ultrasound machine in the emergency evaluation and resuscitation of trauma victims. INTRODUCTION The FAST exam is a valuable screening tool in the evaluation of abdominal trauma. New digital ultrasound units have recently become available which can be hand-carried by clinicians responding to the earliest phases of trauma care. MATERIALS AND METHODS Forty-seven victims of blunt trauma and 3 victims of penetrating trauma underwent FAST examinations performed by an attending trauma surgeon. Scans were performed with a Sonosite 180, 2.4-kg machine utilising a 5-2 MHz curved array transducer. The results of the hand-held FAST were compared with formal sonographic examinations performed by radiology department personnel, computed tomographic (CT) studies, operative findings and ultimate hospital course. RESULTS In victims of blunt trauma, 7 of 8 true fluid collections were detected, and 38 out of 39 cases without the presence of fluid were correctly excluded. There was 1 false positive and 1 false negative determination, resulting in a sensitivity of 86%, specificity of 97%, positive predictive value of 88%, and a negative predictive value of 97%. The overall accuracy was 96% for victims of blunt trauma. The technique expediently detected intra-peritoneal bleeding in 2 victims of lateral penetrating abdominal trauma. Utilised as the initial component of a diagnostic protocol, no inappropriate management strategies were suggested. CONCLUSIONS Digital hand-held sonography by clinicians can accurately allow the early performance of FAST exams. This exam may accurately and safely extend the physical senses of the examining physician.
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Affiliation(s)
- A W Kirkpatrick
- Trauma Services, Vancouver Hospital & Health Sciences Centre, 3rd Floor, 855 West 10th Avenue, Vancouver, British Columbia V5Z 1L7, Canada.
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34
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Roche CJ, Lee WK, Duddalwar VA, Nicolaou S, Munk PL, Morris DC. Intrahepatic pseudoaneurysm complicating transjugular biopsy of the liver. AJR Am J Roentgenol 2001; 177:819-21. [PMID: 11566679 DOI: 10.2214/ajr.177.4.1770819] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- C J Roche
- Department of Radiology, Vancouver General Hospital, 855 W. 12th Ave., Vancouver, B.C. V5Z 1M9, Canada
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35
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Affiliation(s)
- W C Torreggiani
- Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
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36
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Abstract
Fractures of the thoracic and lumber spine are well recognized following an epileptic seizure. Fractures of the cervical spine are not. The rare occurrence of a displaced odontoid fracture type 2, secondary to a grand mal seizure is presented. To our knowledge, this association has not been described previously in the English literature.
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Affiliation(s)
- W C Torreggiani
- Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, V5Z 1V7, British Columbia, Canada.
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37
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Abstract
Skin tumours are usually divided into melanoma and non-melanoma types. Malignancies of the adnexal structures, of which sweat gland tumours are an example, are characterized under the non-melanoma types. Sweat gland malignancies are rare tumours that are usually associated with a poor prognosis. Given the rarity of these tumours, MRI findings of such tumours have not been described previously in the literature. We present a case report of an unusual malignant tumour of sweat gland origin known as a malignant chondroid syringoma of the skin with described MRI features. The MRI features are non-specific depicting intermediate signal intensity, changes on the proton density sequence and increased signal on the T2 and STIR-weighted sequences. Although these imaging features are characteristic of most soft tissue masses MRI can, in most cases, accurately depict the anatomic extent and identify tissue of origin, depth of invasion and relation to adjacent structures, such as muscles and bones. Thus high-resolution MRI of the skin in the future can be extremely helpful in characterizing and staging dermal neoplasms.
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Affiliation(s)
- S Nicolaou
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
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38
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Kirkpatrick AW, Ng AK, Dulchavsky SA, Lyburn I, Harris A, Torregianni W, Simons RK, Nicolaou S. Sonographic diagnosis of a pneumothorax inapparent on plain radiography: confirmation by computed tomography. J Trauma 2001; 50:750-2. [PMID: 11303179 DOI: 10.1097/00005373-200104000-00029] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- A W Kirkpatrick
- Trauma Services, Vancouver Hospital & Health Sciences Centre, Vancouver, British Columbia, Canada
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39
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Sargsyan AE, Hamilton DR, Nicolaou S, Kirkpatrick AW, Campbell MR, Billica RD, Dawson D, Williams DR, Melton SL, Beck G, Forkheim K, Dulchavsky SA. Ultrasound evaluation of the magnitude of pneumothorax: a new concept. Am Surg 2001; 67:232-5; discussion 235-6. [PMID: 11270880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Pneumothorax is commonly seen in trauma patients; the diagnosis is confirmed by radiography. The use of ultrasound where radiographic capabilities are absent, is being investigated by the National Aeronautics and Space Administration. We investigated the ability of ultrasound to assess the magnitude of pneumothorax in a porcine model. Sonography was performed on anesthetized pigs in both ground-based laboratory (n = 5) and microgravity conditions (0 x g) aboard the KC-135 aircraft during parabolic flight (n = 4). Aliquots of air (50-100 cm3) were introduced into the chest to simulate pneumothorax. Results were videorecorded and digitized for later interpretation. Several distinct sonographic patterns of partial lung sliding were noted including the combination of a sliding zone with a still zone and a "segmented" sliding zone. These "partial lung sliding" patterns exclude massive pneumothorax manifested by a complete separation of the lung from the parietal pleura. In 0 x g, the sonographic picture is more diverse; one x g differences between posterior and anterior aspects are diminished. Modest pneumothorax can be inferred by the ultrasound sign of "partial lung sliding." This finding, which increases the negative predictive value of thoracic ultrasound, may be attributed to intermittent pleural contact, small air spaces, or alterations in pleural lubricant. Further studies of these phenomena are warranted.
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40
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Torreggiani WC, Munk PL, Nicolaou S, Lee MJ. Musculoskeletal case 14. Presentation. Multiple enchondromatosis. Can J Surg 2001; 44:14, 63-4. [PMID: 11220792 PMCID: PMC3695176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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41
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Ruggeri M, Lasalvia A, Nicolaou S, Tansella M. [The Italian version of the Camberwell assessment of need (CAN), an interview for the identification of needs of care]. Epidemiol Psichiatr Soc 1999; 8:135-67. [PMID: 10617372 DOI: 10.1017/s1121189x00007648] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M Ruggeri
- Dipartimento di Medicina e Sanità Publica, Università di Verona. mrugborgoroma.unvir.it
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42
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Abstract
All clinical records of schizophrenic patients included in the period 1979-1995 in the South Verona Psychiatric Case Register were reviewed and diagnoses operationally defined according to ICD-10 criteria using OPCRIT 3.1. Among the 335 scrutinized, 205 patients met the ICD-10 criteria for paranoid or undifferentiated schizophrenia. No seasonality of birth was found in these patients using a log-linear equiprobability model. The incidence and seasonality of birth were then analysed on the subsample of 106 patients born in 1947-1974 for whom corresponding data for the Verona general population were available. Schizophrenic males displayed a significant excess of birth in November-January with respect to the Verona population (chi 2 = 10.93, p = 0.012). The time series of the incidence of schizophrenia by cohort of birth 1947-1974 had a linearly decreasing trend, steeper in males than in females. The significant increase in age at first ever psychiatric contact, observed in both males and females throughout the period considered, cannot completely account for the gender-specific decline of birth of schizophrenics.
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Affiliation(s)
- M Balestrieri
- Dipartimento di Patologia e Medicina S.C., Università di Udine, Italy
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43
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Affiliation(s)
- L Petrangeli
- Unità Operativa di Psichiatria, Azienda USSL 9, Grosseto Nord
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44
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Abstract
PURPOSE To correlate computed tomographic (CT) appearance of the thymus with results from histologic examination of thymic tissue and clinical outcome in patients with generalized myasthenia gravis who underwent thymectomy. MATERIALS AND METHODS Forty-five patients with myasthenia gravis underwent CT of the thorax and thymectomy. Findings at clinical follow-up were available in all patients. RESULTS Twenty-six patients had normal CT findings, seven had a diffusely enlarged thymus, and 12 had a focal mass. The results of histologic examination showed that 16 of 26 patients with normal CT findings had normal thymic tissue and 10 had lymphoid follicular hyperplasia; all seven patients with an enlarged thymus had lymphoid hyperplasia. Five of 12 patients with a focal mass at CT had lymphoid hyperplasia, and seven had thymoma. Clinical improvement following thymectomy was observed in 27 (93%) of 29 patients with lymphoid hyperplasia or thymoma and 11 (69%) of 16 patients with normal histologic examination (P < .03, chi(2) test). CONCLUSION The presence of an enlarged thymus or a focal mass in patients with myasthenia gravis indicates lymphoid hyperplasia or thymoma. However, CT is of limited value in distinguishing lymphoid follicular hyperplasia from a normal thymus or thymoma and in predicting clinical outcome.
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Affiliation(s)
- S Nicolaou
- Department of Radiology, University of British Columbia, Vancouver, Canada
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45
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Affiliation(s)
- S Nicolaou
- Department of Radiology, University of British Columbia, Vancouver, Canada
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46
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Nicolaou S, Badanoiu A, Gavrilescu M, Reiter L, Hontaru M. [Some remarks of a biopathologic nature on 50 cases of hereditary skin diseases]. G Ital Dermatol Minerva Dermatol 1970; 45:191-3. [PMID: 5468559] [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: 01/15/2023]
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