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Livingston M, Hashmi SF, Ramachandran S, Laing I, Heald A. Macroprolactin over time: Is there any point in rechecking it in people with a persistently elevated serum prolactin? Clin Endocrinol (Oxf) 2024; 100:450-458. [PMID: 38534014 DOI: 10.1111/cen.15051] [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: 10/09/2023] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE AND DESIGN Macroprolactinemia may influence the interpretation of serum prolactin levels-a recognised phenomenon since 1981. The degree of macroprolactinaemia over time is less well described. We determined how macroprolactin status (based on polyethylene glycol (PEG) precipitation) varied by analysing serial measurements in hyperprolactinaemic individuals over a period of 9 years. PATIENTS AND MEASUREMENTS Results from 1810 individuals were included. All serum total prolactin results (measured using Roche Cobas 8000 analyser) were extracted from the laboratory information system for the period 1 January 2012 to 1 April 2021, along with relevant patient demographic/test data. Samples with a macroprolactin screening test performed (on samples with prolactin > 700 miu/L) were included in the main analysis. RESULTS During the study period, 2782 macroprolactin checks were performed (12.5% of all prolactin tests) in 1810 individuals (599 males/2183 females, median-age: 35, interquartile range: 25-47, range: 16-93 years). Multiple macroprolactin checks were carried out on 465 patients (1437 measurements) with 94 patients (141 measurements) screening positive (<60% recovery). Only 19 patients (18 female) had at least one result above and one below the 60% screening cut-off, with 10 of these patients having results close to the 60% cut-off; in 9 patients, results were clearly different between repeat samples. In seven cases, the adjusted monomeric prolactin showed a potentially clinically significant difference. CONCLUSIONS In this study, only 19/465 patients appeared to change macroprolactin status based on a 60% PEG recovery cut-off. The majority of these 19 patients were on antipsychotic/antidepressant medication(s) or had a prolactinoma; in only 7 did monomeric prolactin change significantly. This suggests that once macroprolactin status has been determined, clinical decision making is rarely affected by repeating it.
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Affiliation(s)
- Mark Livingston
- Department of Clinical Biochemistry, Black Country Pathology Services , Walsall Manor Hospital, Walsall, UK
- Faculty of Science and Engineering, School of Medicine and Clinical Practice, The University of Wolverhampton, Wolverhampton, UK
| | - Syeda F Hashmi
- Department of Clinical Biochemistry, Black Country Pathology Services , Walsall Manor Hospital, Walsall, UK
| | - Sudarshan Ramachandran
- Department of Clinical Biochemistry, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, UK
- Institute of Science and Technology, Keele University, Keele, UK
- Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, UK
- Department of Mechanical and Aerospace Engineering, Brunel University, London, UK
| | - Ian Laing
- Department of Clinical Biochemistry, Royal Preston Hospital, Preston, UK
| | - Adrian Heald
- Department of Endocrinology and Diabetes, Salford Royal Hospital, Salford, UK
- The School of Medicine and Manchester Academic Health Sciences Centre, Manchester University, Manchester, UK
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Li JB, Guo SS, Tang LQ, Guo L, Mo HY, Chen QY, Mai HQ. Longitudinal Trend of Health-Related Quality of Life During Concurrent Chemoradiotherapy and Survival in Patients With Stage II-IVb Nasopharyngeal Carcinoma. Front Oncol 2020; 10:579292. [PMID: 33134176 PMCID: PMC7578369 DOI: 10.3389/fonc.2020.579292] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/08/2020] [Indexed: 12/24/2022] Open
Abstract
Background and Aims: To investigate the longitudinal trend of health-related quality of life (HRQOL) from the start to the end of concurrent chemoradiotherapy and survival in patients with advanced nasopharyngeal carcinoma (NPC). Methods: A total of 145 patients with stage II-IVb NPC, who were a subsample of a randomized phase III clinical trial, were recruited in this study. HRQOL was measured weekly for a total of 6 weeks during concurrent chemoradiotherapy by the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30. Longitudinal trends of HRQOL domains over time were analyzed using mixed models. Survival rates were estimated using Kaplan-Meier method. Results: During a median follow-up of 45 months, the 3-year progression-free survival rate, overall survival rate, and distant metastasis-free survival rate were highly at 86.8% (95% CI: 80.1%, 91.4%), 95.1% (95% CI: 90.1%, 97.6%), and 91.0% (95% CI: 84.9%, 94.6%), respectively. The average weekly declines of five functioning domains were 1.83-3.52 points during the treatment period, with role functioning having the largest decline rate (-2.52 points per week, 95% CI: -4.50, -2.55; p < 0.001). Loss of appetite is the most affected symptom, with severe appetite loss ranging from 35.9 to 61.1%. The average increases of symptoms were 0.63-5.16 points per week during treatment period (all p-values for time <0.001, except for financial difficulties), with pain symptoms having the largest increase (5.16 points, 95%CI: 4.25, 6.08; p < 0.001), followed by fatigue (3.62 points, 95%CI: 2.90, 4.35; p < 0.001). Conclusion: The HRQOL of patients with advanced NPC is poor and substantially deteriorated during the concurrent chemoradiotherapy (CCRT) period. Psychological care and support is necessary for patients with advanced NPC during the treatment period.
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Affiliation(s)
- Ji-Bin Li
- Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Shan-Shan Guo
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Lin-Quan Tang
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling Guo
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Hao-Yuan Mo
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qiu-Yan Chen
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Hai-Qiang Mai
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
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Abstract
This study examines the world’s Top 100 age class performance times by Master athletes in marathon running. The predominant paradigm for this type of research assumes that the outcomes represent a “virtual” cross-sectional study with important implications about aging. This article critiques this perspective and presents alternative models that include temporal dimensions that relate to cohort differences, age changes and historical transitions. One purpose of this study is to compare these models with respect to goodness of fit to the data. A second purpose is to evaluate the generalizability of findings from the fastest divisional age class quartile to the slower quartiles. Archival listings by the Association of Road Racing Statisticians include a maximum of 100 fastest age class performances in marathon running performances by men and women. This database includes 937 performances by 387 men performances and 856 performances by 301 women. The mean ages are 62.05 years for men and 60.5 years for women. The mean numbers of performances per runner are 6.64 for men and 6.4 for women. Analysis by mixed linear modeling (MLM) indicates best goodness of fit for logarithms of performance time by a model that includes linear and quadratic expressions of age at entry into the database (termed “entry cohort”) and subsequent age changes (termed “elapsed age”) as variables. Findings with this model show higher performance times in women than men. Rates of increase in performance time are higher at older cohort ages and elapsed ages. Performance time increases with interactions between cohort age and elapsed age, cohort age and gender, and elapsed age and gender (i.e., with greater increases in women than men). Finally, increases in performance time with cohort age and elapsed age are higher in slower than faster performance quartiles, with athletes in the faster quartiles more likely to have multiple data entries and athletes in the slower quartiles single data entries. Implications of these findings are discussed.
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Khan A, Choudhury N, Uddin S, Hossain L, Baur LA. Longitudinal trends in global obesity research and collaboration: a review using bibliometric metadata. Obes Rev 2016; 17:377-85. [PMID: 26864566 DOI: 10.1111/obr.12372] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 11/09/2015] [Revised: 12/13/2015] [Accepted: 12/14/2015] [Indexed: 11/28/2022]
Abstract
The goal of this study was to understand research trends and collaboration patterns together with scholarly impact within the domain of global obesity research. We developed and analysed bibliographic affiliation data collected from 117,340 research articles indexed in Scopus database on the topic of obesity and published from 1993-2012. We found steady growth and an exponential increase of publication numbers. Research output in global obesity research roughly doubled each 5 years, with almost 80% of the publications and authors from the second decade (2003-2012). The highest publication output was from the USA - 42% of publications had at least one author from the USA. Many US institutions also ranked highly in terms of research output and collaboration. Fifteen of the top-20 institutions in terms of publication output were from the USA; however, several European and Japanese research institutions ranked more highly in terms of average citations per paper. The majority of obesity research and collaboration has been confined to developed countries although developing countries have showed higher growth in recent times, e.g. the publication ratio between 2003-2012 and 1993-2002 for developing regions was much higher than that of developed regions (9:1 vs. 4:1). We also identified around 42 broad disciplines from authors' affiliation data, and these showed strong collaboration between them. Overall, this study provides one of the most comprehensive longitudinal bibliometric analyses of obesity research. This should help in understanding research trends, spatial density, collaboration patterns and the complex multi-disciplinary nature of research in the obesity domain.
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Affiliation(s)
- A Khan
- Centre for Complex Systems, Faculty of Engineering & IT, The University of Sydney, Sydney, NSW, Australia
| | - N Choudhury
- Centre for Complex Systems, Faculty of Engineering & IT, The University of Sydney, Sydney, NSW, Australia
| | - S Uddin
- Centre for Complex Systems, Faculty of Engineering & IT, The University of Sydney, Sydney, NSW, Australia
| | - L Hossain
- Division of Information and Technology Studies, Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong
| | - L A Baur
- Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, NSW, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, NSW, Australia
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Alsabbagh MW, Mansell K, Lix LM, Teare G, Shevchuk Y, Lu X, Champagne A, Blackburn DF. Trends in prevalence, incidence and pharmacologic management of diabetes mellitus among seniors newly admitted to long-term care facilities in Saskatchewan between 2003 and 2011. Can J Diabetes 2015; 39:138-45. [PMID: 25599902 DOI: 10.1016/j.jcjd.2014.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 08/06/2014] [Revised: 09/29/2014] [Accepted: 10/02/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to describe trends in the prevalence and incidence of diabetes mellitus and also report the overall use of diabetes medications among patients newly admitted to a long-term care facility (LTCF). METHODS A retrospective cohort study was done using health administrative databases in Saskatchewan. Eligible patients were newly admitted to LTCF in Saskatchewan between 2003 and 2011 and maintained LTCF residency for at least 6 months. Prevalence of diabetes was defined with physician or hospital claims in the 2 years preceding admission. Antihyperglycemic medication use was estimated from prescription claims data during the first 6 months after LTCF admission. All data were descriptively analyzed. RESULTS The validated case definition for diabetes (≥2 diagnostic claims) in the 2 years before or 6 months after admission was met by 16.9% of patients (2471 of 14,624). An additional 965 patients (6.6%) had a single diabetes diagnostic claim or antihyperglycemic prescriptions only. Among patients receiving antihyperglycemic therapies, 64.9% (1518 of 2338) were exclusively managed with oral medications, and metformin was the most commonly used medication. Glyburide was commonly withdrawn after LTCF admission. Insulin use was observed in 23.9% of diabetes patients, with a mean daily average consumption of 54.7 units per day. CONCLUSIONS Use of diabetes medications appear to generally align with Canadian practice recommendations as evidenced by declining use of glyburide and frequent use of metformin. Future studies should examine clinical benefits and safety of hypoglycemic agent use in LTCFs.
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Affiliation(s)
- Mhd Wasem Alsabbagh
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kerry Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gary Teare
- Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada
| | - Yvonne Shevchuk
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Xinya Lu
- Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada
| | - Anne Champagne
- Drug Plan and Extended Benefits Branch, Ministry of Health, Government of Saskatchewan, Regina, Saskatchewan, Canada
| | - David F Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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