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Yu HH, Tan CC, Huang SJ, Zhang XH, Tan L, Xu W. Predicting the reversion from mild cognitive impairment to normal cognition based on magnetic resonance imaging, clinical, and neuropsychological examinations. J Affect Disord 2024; 353:90-98. [PMID: 38452935 DOI: 10.1016/j.jad.2024.03.009] [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: 06/13/2023] [Revised: 02/22/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Reversion from mild cognitive impairment (MCI) to normal cognition (NC) is not uncommon and indicates a better cognitive trajectory. This study aims to identify predictors of MCI reversion and develop a predicting model. METHOD A total of 391 MCI subjects (mean age = 74.3 years, female = 61 %) who had baseline data of magnetic resonance imaging, clinical, and neuropsychological measurements were followed for two years. Multivariate logistic analyses were used to identify the predictors of MCI reversion after adjusting for age and sex. A stepwise backward logistic regression model was used to construct a predictive nomogram for MCI reversion. The nomogram was validated by internal bootstrapping and in an independent cohort. RESULT In the training cohort, the 2-year reversion rate was 19.95 %. Predictors associated with reversion to NC were higher education level (p = 0.004), absence of APOE4 allele (p = 0.001), larger brain volume (p < 0.005), better neuropsychological measurements performance (p < 0.001), higher glomerular filtration rate (p = 0.035), and lower mean arterial pressure (p = 0.060). The nomogram incorporating five predictors (education, hippocampus volume, the Alzheimer's Disease Assessment Scale-Cognitive score, the Rey Auditory Verbal Learning Test-immediate score, and mean arterial pressure) achieved good C-indexes of 0.892 (95 % confidence interval [CI], 0.859-0.926) and 0.806 (95 % CI, 0.709-0.902) for the training and validation cohort. LIMITATION Observational duration is relatively short; The predicting model warrant further validation in larger samples. CONCLUSION This prediction model could facilitate risk stratification and early management for the MCI population.
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Affiliation(s)
- Hai-Hong Yu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China; Medical College, Qingdao University, Qingdao, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Shu-Juan Huang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xin-Hao Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
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Akar B, Ceylan Y, Kahraman A, Köle E, Çalışkan E. Centile charts of cervical length in singleton and twin pregnancies between 16 and 24 weeks of gestation. J Turk Ger Gynecol Assoc 2023; 24:114-119. [PMID: 36999666 PMCID: PMC10258568 DOI: 10.4274/jtgga.galenos.2023.2022-7-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 03/31/2023] [Indexed: 04/01/2023] Open
Abstract
Objective The aim of this study was to determine the standard mid-trimester cervical lengths of singleton and twin pregnancies. Material and Methods This study was conducted by retrospective analysis of mid-trimester transvaginal cervical measurements of women with singleton and twin pregnancies that were examined by a single perinatologist in a single center. Results A total of 4621 consecutive asymptomatic pregnant women admitting for advanced obstetric ultrasound screening were evaluated. Of these 4340 (93.9%) were second trimester singleton pregnancies and 281 (6.1%) were twin pregnancies and were included. Mean cervical length measurements of singleton and twin pregnancies were 38.2±6.5 mm and 37.6±7.2 mm respectively (p=0.17). Overall, the 5th percentile of cervical length measurement after analysing singleton and twin pregnancies together was 29.4 mm at 16 weeks, 30 mm at 17 weeks, 30 mm at 18 weeks, 30 mm at 19 weeks, 30 mm at 20 weeks, 30 mm at 21 weeks, 30 mm at 22 weeks, 31 mm at 23 weeks, 29 mm at 24 weeks. Conclusion In our population the 5th precentile value of cervical length which is 30 mm in singletons and 10th percentile cervical length which is 31 mm in twins can be used to follow-up and treat pregnant women at risk for preterm delivers.
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Affiliation(s)
- Bertan Akar
- Department of Obstetrics and Gynecology, İstinye University Faculty of Medicine, Private Kocaeli Hospital, Kocaeli, Turkey
| | - Yasin Ceylan
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Alper Kahraman
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Emre Köle
- Department of Obstetrics and Gynecology, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, Turkey
| | - Eray Çalışkan
- Department of Obstetrics and Gynecology, Okan University Faculty of Medicine, İstanbul, Turkey
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Segev M, Djurabayev B, Katorza E, Yaniv G, Hoffmann C, Shrot S. 3.0 Tesla normative diffusivity in 3rd trimester fetal brain. Neuroradiology 2021; 64:1249-1254. [PMID: 34820712 DOI: 10.1007/s00234-021-02863-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Apparent diffusion coefficient (ADC) values in the developing fetus provide valuable information on the diagnosis and prognosis of prenatal brain pathologies. Normative ADC data has been previously established in 1.5 T MR scanners but lacking in 3.0 T scanners. Our objective was to measure ADC values in various brain areas in a cohort of normal singleton fetuses scanned in a 3.0 T MR scanner. METHODS DWI (diffusion-weighted imaging) was performed in 47 singleton fetuses with normal or questionably abnormal results on sonography followed by normal structural MR imaging. ADC values were measured in cerebral lobes (frontal, parietal, temporal lobes), basal ganglia, and pons. Regression analysis was used to examine gestational age-related changes in regional ADC. RESULTS Median gestational age was 30.1 weeks (range, 26-34 weeks). There was a significant effect of region on ADC values, whereby ADC values were highest in cerebral lobes (parietal > frontal > temporal lobes), compared with basal ganglia. The lowest values were found in the pons. On regression analysis, there was a decrease in ADC values in basal ganglia and pons with increasing gestational age. ADC values in frontal, parietal, and temporal lobes were stable in our cohort. CONCLUSION Regional brain ADC values in 3.0 T scanners are comparable with previously reported values in 1.5 T scanners, with similar changes over gestational age. Using 3.0 T scanners is increasing worldwide. For fetal imaging, establishing normal ADC values is critical as DWI enables a sensitive and quantitative technique to evaluate normal and abnormal brain development.
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Affiliation(s)
- Maria Segev
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel. .,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Bella Djurabayev
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel
| | - Eldad Katorza
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Antenatal Diagnostic Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Gal Yaniv
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Chen Hoffmann
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shai Shrot
- Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Rd, Ramat-Gan 52621, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Yang L, Liang T, Du Y, Guo C, Shang J, Pokharel S, Wang R, Niu G. Nomogram model to predict pneumothorax after computed tomography-guided coaxial core needle lung biopsy. Eur J Radiol 2021; 140:109749. [PMID: 34000599 DOI: 10.1016/j.ejrad.2021.109749] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/25/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To develop a predictive model to determine risk factors of pneumothorax in patients undergoing the computed tomography (CT)1-guided coaxial core needle lung biopsy (CCNB). METHODS A total of 489 patients who underwent CCNBs with an 18-gauge coaxial core needle were retrospectively included. Patient characteristics, primary pulmonary disease, target lesion image characteristics and biopsy-related variables were evaluated as potential risk factors of pneumothorax which was determined on the chest X-ray and CT scans. Univariate and multivariate logistic regressions were used to identify the independent risk factors of pneumothorax and establish the predictive model, which was presented in the form of a nomogram. The discrimination and calibration of the model were evaluated as well. RESULTS The incidence of pneumothorax was 32.91 % and 31.42 % in the development and validation groups, respectively. Age, emphysema, pleural thickening, lesion location, lobulation sign, and size grade were identified independent risk factors of pneumothorax at the multivariate logistic regression model. The forming model produced an area under the curve of 0.718 (95 % CI = 0.660-0.776) and 0.722 (95 % CI = 0.638-0.805) in development and validation group, respectively. The calibration curve showed good agreement between predicted and actual probability. CONCLUSIONS The predictive model for pneumothorax after CCNBs had good discrimination and calibration, which could help in clinical practice.
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Affiliation(s)
- Linyun Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Ting Liang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Yonghao Du
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Chenguang Guo
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Jin Shang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Saugat Pokharel
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - Rong Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China.
| | - Gang Niu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China.
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Abstract
BACKGROUND The weight of the delivered placenta gives a useful representation of placental function in utero. In the absence of Irish data, many pathologists rely on data from other populations, many of which are now 15 to 30 years old. The development of a population-specific nomogram would aid in the examination of placentas after delivery, allowing pathologists and medical scientists to more easily distinguish between placental physiological changes and pathology. AIMS To record placental weights among women having a singleton delivery in Dublin and to establish median placental weights for each gestational age after 37 weeks. METHODS Prospective cohort study in a Tertiary level University Hospital. All singleton pregnancies were included; stillbirths, multiple gestations, and cases with obstetric complications involving the placenta were excluded. The placentas were weighed both untrimmed and trimmed with standard scales. Demographic features including birth weight and maternal parity were also recorded. RESULTS Four hundred thirty placentas were weighed over a 6-week period. A median term placental weight based on gestational age was established, with a range from the tenth to ninetieth centiles. CONCLUSION The weight of the placenta is one of several measurements that are easy to acquire, and when recorded in a systematic fashion, provide information not just on an individual, but also on a population basis. Birth weights have increased over the last century, and this study provides national data helping distinction between placental physiology and pathology.
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Affiliation(s)
- Orlagh O'Brien
- UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Republic of Ireland
| | - Mary F Higgins
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, 65-66 Lower Mount Street, Dublin 2, Republic of Ireland.
| | - Eoghan E Mooney
- Department of Pathology & Laboratory Medicine, National Maternity Hospital, Dublin 2, Republic of Ireland
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Abstract
There have been hundreds of H. pylori eradication trials and yet doubt remains regarding the best regimen for any situation. With most regimens, treatment failure is the result of resistance to one component (e.g., clarithromycin). Thus, if one knows the treatment success with two groups (all with susceptible and with all with resistant infections), one can construct a normogram that provides a reliable estimate of the outcome at any prevalence of resistance. The same data can be used to estimate the prevalence of resistance in any clinical trial, the effects duration of therapy, and effects of any procedures to improve outcome (e.g., increasing the proton-pump inhibitor dose, the duration of therapy, etc.). Because the Hp-normo-graham can reliably predict the outcome of clinical trials, it can also obviate the need for many clinical trials in populations where resistance is common. Here, we illustrate the construction of Hp-normo-graham and its use to describe the effects of resistance, duration of therapy, attempts to improve results, and the prevalence of resistance and to obviate the need for many clinical trials.
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Affiliation(s)
- David Y Graham
- Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine Houston, Houston, TX, USA
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