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Kazui S, Takenaka S, Nagai T, Kato Y, Komoriyama H, Kobayashi Y, Takahashi A, Kamiya K, Sato T, Tada A, Yasui Y, Nakai M, Sato T, Tsujino I, Konno S, Anzai T. Association of longitudinal cardiac troponin trajectory with adverse events in patients with cardiac sarcoidosis. Int J Cardiol 2023; 389:131268. [PMID: 37591415 DOI: 10.1016/j.ijcard.2023.131268] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Although high-sensitivity cardiac troponins may be sensitive and easily repeatable markers of disease activity in patients with cardiac sarcoidosis (CS), the association between longitudinal cardiac troponin trajectory and adverse events remains unclear. This study aimed to clarify whether longitudinal cardiac troponin levels were associated with adverse events in patients with CS. METHODS We examined 63 consecutive CS-initiated prednisolone (PSL) patients with available longitudinal high-sensitivity cardiac troponin T (cTnT) data between December 2013 and March 2023. The area under the cTnT trajectory, which reflected cumulative cTnT release, was calculated to assess the association between longitudinal cTnT levels and adverse events. Patients were divided into two groups according to the median area under the cTnT trajectory per month. The primary outcome was a composite of sustained ventricular tachycardia or fibrillation, worsening heart failure, and sudden cardiac death (SCD). RESULTS In total, 463 cTnT measurements were collected over a median follow-up period of 30.4 (interquartile range [IQR] 15.6-34.2) months. The primary outcome was observed in 12 (19%) patients. A higher area under the cTnT trajectory was significantly associated with an increased incidence of the primary outcome (P = 0.027), while cTnT levels before and one month after initiation of PSL, and these changes were not related to adverse events (P = 0.179, 0.096, and 0.95, respectively). CONCLUSIONS Longitudinal cTnT trajectory following PSL initiation was associated with adverse cardiac events in patients with CS, suggesting that longitudinal measurement of cTnT would be useful for the early identification of high-risk patients.
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Affiliation(s)
- Sho Kazui
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Sakae Takenaka
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Yoshiya Kato
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Cardiovascular Medicine, Kushiro City General Hospital, Hokkaido, Japan
| | - Hirokazu Komoriyama
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Cardiovascular Medicine, Kushiro City General Hospital, Hokkaido, Japan
| | - Yuta Kobayashi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akinori Takahashi
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan; Department of Cardiovascular Medicine, Kushiro City General Hospital, Hokkaido, Japan
| | - Kiwamu Kamiya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takuma Sato
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Atsushi Tada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yutaro Yasui
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Michikazu Nakai
- Clinical Research Support Center, University of Miyazaki Hospital, Miyazaki, Japan
| | - Takahiro Sato
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ichizo Tsujino
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Liu J, Pan Y, Nelson MC, Gooden LK, Metsch LR, Rodriguez AE, Tross S, Del Rio C, Mandler RN, Feaster DJ. Strategies of Managing Repeated Measures: Using Synthetic Random Forest to Predict HIV Viral Suppression Status Among Hospitalized Persons with HIV. AIDS Behav 2023; 27:2915-2931. [PMID: 36739589 PMCID: PMC10403627 DOI: 10.1007/s10461-023-04015-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2023] [Indexed: 02/06/2023]
Abstract
The HIV/AIDS epidemic remains a major public health concern since the 1980s; untreated HIV infection has numerous consequences on quality of life. To optimize patients' health outcomes and to reduce HIV transmission, this study focused on vulnerable populations of people living with HIV (PLWH) and compared different predictive strategies for viral suppression using longitudinal or repeated measures. The four methods of predicting viral suppression are (1) including the repeated measures of each feature as predictors, (2) utilizing only the initial (baseline) value of the feature as predictor, (3) using the last observed value as the predictors and (4) using a growth curve estimated from the features to create individual-specific prediction of growth curves as features. This study suggested the individual-specific prediction of the growth curve performed the best in terms of lowest error rate on an independent set of test data.
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Affiliation(s)
- Jingxin Liu
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA.
- Soffer Clinical Research Ctr, 1120 NW 14th St, Room 1059, Miami, FL, 33136-2107, USA.
| | - Yue Pan
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA
| | - Mindy C Nelson
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA
| | - Lauren K Gooden
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | | | - Susan Tross
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
| | - Carlos Del Rio
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Raul N Mandler
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Daniel J Feaster
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA
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Mair MJ, Ilhan-Mutlu A, Pajenda S, Kiesel B, Wöhrer A, Widhalm G, Dieckmann K, Marosi C, Wagner L, Preusser M, Berghoff AS. Circulating PD-L1 levels change during bevacizumab-based treatment in recurrent glioma. Cancer Immunol Immunother 2021; 70:3643-3650. [PMID: 33956203 PMCID: PMC8571215 DOI: 10.1007/s00262-021-02951-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/26/2021] [Indexed: 01/09/2023]
Abstract
Purpose In primary brain tumors, the efficacy of immune-modulating therapies is still under investigation as inflammatory responses are restricted by tight immunoregulatory mechanisms in the central nervous system. Here, we measured soluble PD-L1 (sPD-L1) in the plasma of patients with recurrent glioblastoma (GBM) and recurrent WHO grade II–III glioma treated with bevacizumab-based salvage therapy. Methods Thirty patients with recurrent GBM and 10 patients with recurrent WHO grade II–III glioma were treated with bevacizumab-based salvage therapy at the Medical University of Vienna. Prior to each treatment cycle, EDTA plasma was drawn and sPD-L1 was measured applying a sandwich ELISA with a lower detection limit of 0.050 ng/ml. Leukocyte counts and C-reactive protein (CRP) levels were measured according to institutional practice. Results Median number of sPD-L1 measurements was 6 per patient (range: 2–24). At baseline, no significant difference in sPD-L1 concentrations was observed between WHO grade II–III glioma and GBM. Intra-patient variability of sPD-L1 concentrations was significantly higher in WHO grade II–III glioma than in GBM (p = 0.014) and tendentially higher in IDH-mutant than in IDH-wildtype glioma (p = 0.149) In WHO grade II–III glioma, sPD-L1 levels were significantly lower after one administration of bevacizumab than at baseline (median: 0.039 ng/ml vs. 0.4855 ng/ml, p = 0.036). In contrast, no significant change could be observed in patients with GBM. Conclusions Changes in systemic inflammation markers including sPD-L1 are observable in patients with recurrent glioma under bevacizumab-based treatment and differ between WHO grade II–III glioma and GBM. Supplementary Information The online version contains supplementary material available at 10.1007/s00262-021-02951-2.
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Affiliation(s)
- Maximilian J Mair
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Personalized Immunotherapy, Medical University of Vienna, Vienna, Austria
| | - Ayseguel Ilhan-Mutlu
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Sahra Pajenda
- Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Adelheid Wöhrer
- Department of Neurology, Division of Neuropathology and Neurochemistry, Medical University of Vienna, Vienna, Austria
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Karin Dieckmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Christine Marosi
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Ludwig Wagner
- Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Personalized Immunotherapy, Medical University of Vienna, Vienna, Austria
| | - Anna S Berghoff
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria. .,Christian Doppler Laboratory for Personalized Immunotherapy, Medical University of Vienna, Vienna, Austria.
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Li MY, Rawal S, Hinkle SN, Zhu YY, Tekola-Ayele F, Tsai MY, Liu SM, Zhang CL. Sex Hormone-binding Globulin, Cardiometabolic Biomarkers, and Gestational Diabetes: A Longitudinal Study and Meta-analysis. ACTA ACUST UNITED AC 2020; 2:2-9. [PMID: 32776014 DOI: 10.1097/FM9.0000000000000037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Indexed: 12/20/2022]
Abstract
Objective This study investigated the prospective associations of circulating levels of sex hormone-binding globulin (SHBG) levels with cardiometabolic biomarkers and risk of gestational diabetes (GDM) during pregnancy. It also examines the longitudinal trajectory of SHBG in women with and without GDM. Methods We conducted a nested case-control study of 107 incident GDM cases and 214 matched controls within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort. The cohort enrolled non-obese and obese women aged 18-40 years with a singleton pregnancy between 8 and 13 weeks of gestation from 2009 to 2013. GDM was ascertained via medical records review. Blood samples were drawn four times at gestational weeks 10-14, 15-26, 23-31, and 33-39. The prospective associations between SHBG levels and cardiometabolic biomarkers were examined using the Spearman partial correlation among the controls. The longitudinal trajectories of SHBG levels were examined among the cases and the controls. Meta-analysis of prospective studies were performed to examine the association between SHBG levels and GDM risk. Results SHBG levels at gestational weeks 10-14 were significantly inversely associated with fasting insulin (r = -0.17, P = 0.01) and insulin resistance as measured by HOMA-IR (r = -0.17, P = 0.01) at gestational week 15-26. SHBG at gestational weeks 10-14 and 15-26 was lower in cases than controls (mean ± standard deviation: (204.0 ± 97.6) vs. (220.9 ± 102.5) nmol/L, P = 0.16 and (305.6 ± 124.3) vs. (322.7 ± 105.1) nmol/L, P = 0.14, respectively), yet the differences were not significant. In the meta-analysis, SHBG was 41.5 nmol/L (95% confidence interval: 23.9, 59.1, P < 0.01) significantly lower among women with GDM than without, and each 50 nmol/L increase in SHBG was significantly associated with an odds ratio of 0.85 (95% confidence interval: 0.76-0.95, P = 0.01) for GDM. Conclusion Lower SHBG levels in early pregnancy were prospectively associated with higher high insulin levels and insulin resistance in mid-pregnancy and subsequent risk of GDM, independent of adiposity. SHBG may serve as a marker for the identification of high-risk pregnancies during early pregnancy.
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Sawatzky R, Russell L, Friberg F, Carlsson EK, Pettersson M, Öhlén J. Longitudinal person-centered measurement: A psychometric evaluation of the Preparedness for Colorectal Cancer Surgery Questionnaire (PCSQ). Patient Educ Couns 2017; 100:827-835. [PMID: 27955903 DOI: 10.1016/j.pec.2016.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/28/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The Preparedness for Colorectal Cancer Surgery Questionnaire (PCSQ) was previously developed in Swedish to assess patients' knowledge seeking and sense making capabilities. Aiming to measure preparedness at different phases during the pre-surgery and recovery period, the objectives were to (a) evaluate psychometric properties of the longitudinal PCSQ, (b) establish measurement invariance over time, and (c) describe change in preparedness. METHODS Elective colorectal cancer surgery patients completed a questionnaire at five time points from pre-surgery until 6 months post-surgery (n=250). The longitudinal PCSQ consists of 23 items measuring four domains: Searching for and making use of information, Understanding and involvement in care, Making sense of recovery, Support and access to care. Psychometric analyses, including confirmatory factor analysis, were applied to evaluate internal consistency reliability and ascertain invariance over time of the measurement structure and parameters. RESULTS The psychometric analyses revealed good fit of the measurement models, high internal consistency reliability (≥.94), and support for configural, metric and scalar measurement invariance of the four PCSQ domains. Patients reported lower levels of preparedness after surgery than pre-surgery. CONCLUSION The adapted version of the PCSQ can be used for longitudinal analyses. PRACTICE IMPLICATIONS The measurement of preparedness is important for evaluating person-centred outcomes before and during recovery from colorectal cancer surgery.
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Affiliation(s)
- Richard Sawatzky
- School of Nursing, Trinity Western University, 7600 Glover Road, Langley, BC, V2Y 1Y1, Canada; Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, 588-1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada.
| | - Lara Russell
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, 588-1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada; School of Nursing, University of Victoria, P.O. Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada.
| | - Febe Friberg
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, 4036 Stavanger, Norway.
| | - Eva K Carlsson
- University of Gothenburg Centre for Person-Centred Care, P.O. Box 457, SE-40539 Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, P.O. Box 457, SES-49539 Gothenburg, Sweden; Department of Colorectal Surgery, Sahlgrenska University Hospital/East, SE_41685 Gothenburg, Sweden.
| | - Monica Pettersson
- University of Gothenburg Centre for Person-Centred Care, P.O. Box 457, SE-40539 Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, P.O. Box 457, SES-49539 Gothenburg, Sweden; Department of Vascular Surgery, Sahlgrenska University Hospital, SE-41345 Gothenburg, Sweden.
| | - Joakim Öhlén
- University of Gothenburg Centre for Person-Centred Care, P.O. Box 457, SE-40539 Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, P.O. Box 457, SES-49539 Gothenburg, Sweden.
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Tyagi P, Killinger K, McLennan G, Jayabalan N, Chancellor M, Peters KM. Urine chemokine levels correlate with treatment response to phosphodiesterase 4 inhibitor in prostatitis. World J Clin Urol 2017; 6:18-26. [DOI: 10.5410/wjcu.v6.i1.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 10/12/2016] [Accepted: 12/14/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the association of urinary chemokines with the treatment response in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) patients.
METHODS Between 2007-2011, 18 out of 21 male CP/CPPS patients met the exclusion/inclusion criteria of the 16 wk longitudinal study on twice daily oral treatment with Phosphodiesterase 4 inhibitor called Apremilast for 12 wk. Symptom scores and urine specimen were collected at baseline and every visit at 4 wk interval from CP/CPPS patients who completed at least 8 wk of drug treatment. Urine collected at each visit was frozen and then analyzed together after thawing for chemokines and growth factors using MILLIPLEX™ MAP immunoassay. Cross sectional association of Chronic Prostatitis Symptom Index (CPSI) and visual analog scale (VAS) with chemokine levels in urine collected at baseline was assessed in 18 CP/CPPS patients relative to 10 asymptomatic male subjects. Longitudinal association between urine chemokine levels and symptom scores was assessed in 8 treatment-adherent CP/CPPS patients at baseline and at 4, 8, 12 and 16 wk.
RESULTS Urine chemokines levels of CXCL-1 (GRO-a), CXCL-8 (IL-8), CXCL-10 (IP-10) and CCL5 (RANTES) in CP/CPPS patients at baseline were significantly elevated relative to asymptomatic subjects, whereas levels of sIL-1RA in CP/CPPS were significantly lower compared to controls (P < 0.05). Quantitatively, urine levels of CXCL-10 were higher than other chemokines in CP/CPPS, but its 5 fold change relative to controls was lower than the 20 fold change noted for CXCL-8. The mean age of enrolled patients who completed at least 8 wk of treatment (n = 8) was 46.5 ± 9.4 years and analysis found that elevation of CXCL-8 and CCL5 increased the odds for higher score of CPSI by 54% and 25%, respectively (F test, P = 0.00007). Urine levels of CCL2 (MCP-1) and CXCL-10 together explained approximately 85% of variance in longitudinal data on multivariate analysis. Bivariate analysis of 5 patients who fully complied and completed the assigned dose regimen, showed strong linear correlation of reduced urine levels of CXCL-10, CXCL-8, CCL5, CCL2 and PDGF with improvement in clinical activity as measured by pain VAS and CPSI (Pearson r = 0.83-0.97; P < 0.05).
CONCLUSION Urine levels of CXCL-10, CCL2 and PDGF can be sensitive, objective and non-invasive markers of response to new therapeutic intervention in CP/CPPS patients.
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